Sensitiveness.—When the nervous system is in a certain state, all impressions on it are exaggerated, and the patient suffers from light sounds, and various irritations, far more than is usual or healthy. This state makes treatment difficult, because either cold towel or hot flannel distresses the sufferer, and by this does more harm than good. Narcotics only do harm, without any good, and leave the patient worse.

The nervous system may in such cases be soothed by soaping the back with soap lather (see Lather; Soap). The lather is to be blood heat, and very soft and creamy. Spread it all over a soft cloth as large as the back (having first warmed the cloth), and then place it gently on the back, lather side next the skin. Let this be done at bedtime. Fasten the cloth on the back with a bodice that will fasten closely, and let the patient sleep on it. Wash off in the morning with warm vinegar and water half-and-half. Rub with oil and dry off. Let the patient take twice a-day, for eight days, a teaspoonful of well-boiled liquorice and a tablespoonful of hot water. This treatment will usually abate the sensitiveness in a week or so, and bring the patient within reach of other remedies. For example, it will, after a week or so, even in very trying cases, be possible to foment the feet and legs once a day, and rub them with warm olive oil. It will even be possible and well to foment with a hot blanket across the haunches, and in this way to bring on comparatively strong health. Change of air and scene will then be desirable: it is highly refreshing to one who is in the way of recovering, though only harassing to one who is feeling despondent and increasingly ill. We generally, when asked if a "change" would not be good in such cases, reply, "Yes, if once you have got health enough to enjoy it." When that has been fairly secured, stronger measures may be used with advantage. We feel much sympathy with those who suffer from sensitiveness, as so many do, and earnestly pray that these remarks may be blessed to such sufferers.

Shampooing.—See Head, Soaping.

Shingles.—Though not often fatal, this illness gives serious trouble. Its outstanding feature is a rash which comes out as a more or less regular belt round the body, or over one shoulder. The rash forms, if allowed to go on, into blackish scabs, and is accompanied in some instances by severe pains shooting through the body. It arises from a failure of the digestive system, therefore the stomach must be as little taxed as possible. Let hot water be sipped in teaspoonfuls for half-an-hour at a time, several times a day. For external treatment, wring a small sheet out of cold water and vinegar, and pack the whole trunk of the patient in this for half-an-hour. Do not use olive oil. The vinegar packing may be renewed in an hour, and as often as the patient feels it agreeable. The mixture of vinegar and water must be weak enough not to be painful on the skin. If the pains in the body persist, then cold cloths may be applied, not very large at first, to the spine, while the patient is warm in bed. Should the feet be cold, this cooling of the spine must not be done until they are wrapped in a hot fomentation up to the knees. If the scabby eruption is very obstinate, the SOAPY BLANKET (see) applied daily for two or three days should clear it away. Wheaten porridge, gruel, and milk diet is best. A drink may be made of hot water and lemon juice, with five or six drops of tincture of cayenne added to a tumblerful, and sweetened to taste. See Drinks.

Shivering.—This is often a trivial matter, but sometimes it is a symptom of a serious chill. It may be only the effect of a thought, or of some mental shock, but in any case it is a nervous disturbance, and failure of energy, causing us to lose control of the nerves which produce the shivering movements.

For ordinary shivering, the result of cold, treat as in Cold, Taking. For cases where the vital action has evidently become very low, foment the patient as directed in Angina Pectoris.

If pain in some part, as in a nursing breast or tender lung, indicates inflammatory action there, cold towels may be applied to that part while this fomentation is on. Renew the cold cloth as often as the patient feels it agreeable, keeping up the heat of the fomentation all the time. Increase the size of the cold cloth if the patient finds this pleasant; stop if it becomes unpleasant. Many serious troubles are checked in the first stage by treatment on these simple lines.

Sick Headache.—See Headache.

Sitting (or Sitz) Bath.—This bath, in whatever form administered, is essentially a sitting in cold water with the feet out. The feet, in fact, are better to be warmly covered up while the patient sits in the bath. The most important thing to be considered in all such baths is the degree of vitality possessed by the patient. If he has much vitality, then the bath may be deep and longer continued—as long as even forty minutes. If the vitality be low, the bath must be brief and very shallow—it may be even necessary to make it as short as one minute, or even less. In some cases, as a beginning, a mere dip is all that is required. This leaves a large discretion to the nurse, and is a matter which common sense should be able to decide. To try a short bath first, and repeat it several times, rather than to give one long one, is the safest plan. It will soon be found out how much the patient can bear. If the vitality be so low as to make the simple sitz-bath a danger, the feet may be immersed, for the one or two minutes of the bath, in a small bath of hot water, and the patient well wrapped up all over in warm blankets.

In some cases it is necessary to pour cold water on relaxed organs, which, especially with females, will sometimes not be braced up by mere immersion. But such pouring must be done with caution. Half-a-minute of it is a long time; one quarter-of-a-minute or less will usually be enough, even in important cases. If longer applications have only done harm, then let our friends try the one-minute bath, or the quarter-minute stream of water. In many cases we have known this make all right. Such short baths may be taken twice or thrice a day.

Skin, Care of.—Among the vast majority of people air and water far too seldom touch the skin. Want of water makes it unclean, and want of water and air make it slow in reaction. Now, a healthy skin is of the utmost value when one is attacked by disease. It can regulate the temperature of the various organs, and the application of heat or cold to it will cause a reaction at once. Much of our treatment as given in this book is directed towards stimulating the action of the skin. It is obvious that in health as in disease the skin can and does so act on the internal organs.

It should be the aim of everyone that this most important part of the body should receive careful attention by a strict watch on the diet, by cleanliness, tonic water baths (cold, tepid, shower, as may be found to suit), and by tonic air baths. Light clothing and porous underwear will also be found of use. We have already drawn attention to the value of Kneipp linen as the most suitable form of underwear (see).



Skin, A Wintry.—Something like an epidemic of skin trouble is often experienced in cold, wintry weather. First, the skin becomes dry and hard. A moist and sticky exudation replaces the ordinary sweat, and great irritation is felt when the skin is exposed to the air. If the sticky exudation be completely rubbed off, this irritation ceases. In this, and in the absence of inflammation, "wintry skin" differs entirely from eczema. The remedy is to rub all over every night for three or four nights with the CAYENNE LOTION (see). If this does not effectually cure, lather all over with soap and olive oil (see Lather; Soap), before rubbing with the cayenne lotion. If the treatment of the whole skin at once is felt to be too severe, it may be cured by taking it in parts.

Skin, Creeping.—A sensation sometimes very much annoys patients, which they describe as like thousands of small creatures creeping over the skin. It most commonly arises from defective working of the pores. A kindred trouble may be noticed along with this creeping. It is as if a stream of cold water were passing down the back. That causes great discomfort in many cases.

The cure is sponging frequently with weak ACETIC ACID (see) or even good buttermilk. The skin being in such cases very sensitive, it is well to treat it bit by bit, a small part at a time. Take one limb, then another, then part of the back, and then another part. Besides this sponging with acid, and before it is done, the skin should be gently covered with lather (see Lather; Soap). If this treatment is not successful, a little olive oil, with cayenne lotion, may be mixed with the soapy lather, and will make its effect more powerful. This creepy feeling is sometimes the result of cold, and some extra clothing may remove it. See Underwear.

Sleep.—No greater mistake could be made than to curtail the hours of sleep. Eight hours should be taken as a minimum, and any weak person should take ten hours. More and better work can be done by a person who takes fully eight hours' sleep than by one who tries to do with less.

Sometimes strong tea or coffee is taken to drive away sleep, and so the nervous system is injured and sleep will not come when it is desired. Tea or coffee should never be taken except very weak, and the person who accustoms himself to this will very soon come greatly to prefer it.

Sleeplessness.—In search of sleep men do many things both dangerous and foolish—sometimes even fatal. Sleeplessness arises in so many ways and from so many causes, that it is often hard for the patient to find a cure, and he will try anything in desperation. A little thought should prevent this state of mind. For instance, we have a man who tries to get sleep by fatiguing himself by long walks in the open air or hard physical work of some kind, but he only grows worse. Now, a little thought will show that sleep requires a certain amount of brain energy. If the supply be below this amount, the brain is too tired to sleep. Violent exercise of any kind will only make matters worse. So "keeping people awake" all day is tried, to make them sleep at night. It fails from the same reason—that it reduces brain power. All narcotics in the end fail similarly. There comes a time when they have so reduced brain power, that even an enormous dose fails to give sleep, and the patient comes dangerously near poisoning himself—sometimes, indeed, does so outright. In all these cases, that which has worn down the brain must be given up as a first condition of cure. Whether brain work, over-excitement and dissipation, alcohol or tobacco, the cause must be removed, and rest taken in the open air, or in well ventilated rooms.

This done, we come to treatment. Soaping the head (see Head, Soaping), or even the application of towels wrung out of cold water, will often, when the cause has been removed, do all that is needed to give sleep. These remedies, especially the first, should be at once applied, if the sleeplessness is accompanied, as is usual, with heat in the head. Even where the fevered head is connected with indigestion, the stomach will be powerfully helped by a good soaping of the head at bedtime. If, on the contrary, the head is cold, then warm fomentations to it will be the proper treatment. Perhaps the very best guide will be to aim at what will make both head and feet perfectly comfortable, and both of natural heat. If cold, the feet must be bathed or fomented, and the legs also up to the knees. Sometimes the pouring of warm water in a douche over the head will act perfectly, instead of the fomentation; but pouring cold water must be avoided, or only very cautiously resorted to (see Sitz-Bath and Restlessness).

Sometimes sleeplessness proceeds from the use of bad drinking water, through its effect on the stomach and bowels. In this case, of course, the first thing is to see that no bad water is drunk. People cannot be too careful about a water supply. Usually boiling for half-an-hour renders water safe enough, but this is not always the case. Care must then be taken to see that water from any corrupted source is not used. When it is given up, treatment as above may be applied.

If the sleeplessness be caused by a nasty tickling cough, put a BRAN POULTICE (see), or similar FOMENTATION (see) on the back behind where the cough catches. Then change cold towels in front over the same place. Soap the head, and sleep will probably soon come.

Where palpitation of the heart causes sleeplessness, change cold towels over the heart, fomenting the feet if necessary, and the palpitation will usually soon yield. See Brain; Children's Sleep; Exercise; Head; Rest.

Smallpox.—If an epidemic prevails in the neighbourhood, or a case occurs in the house, after due and carefully performed vaccination of the family, the important matter to regard is cleanliness. Frequent and thorough washing and changing of all the clothes worn next the skin will do much to prevent possible infection. If the clothes are often changed, then, and well washed, and the skin gets a daily washing with soap and is sponged with hot vinegar, there is little danger of infection during an epidemic of smallpox, or even when nursing the disease. Acetic acid, or white wine vinegar, is even a more powerful cleansing agent than carbolic acid, and has the advantage of being non-poisonous.

It is important in treatment to attack the disease early. We have known an attack completely defeated, and the patient cured, by a wet-sheet pack administered at the right time. The early symptoms are a great weariness and chilliness. In this cold stage, half-a-teaspoonful of cream of tartar, in two tablespoonfuls of hot water, should be given every half-hour. Also (and this is important) wrap the feet and legs up over the knees in a large hot FOMENTATION (see). The head also may be packed in hot cloths. If the fever does not rise, the applications may continue. If the fever does come on, cold cloths must be persistently changed on the head. This we have known reduces the bodily temperature two degrees in half-an-hour, when if left alone it would probably have risen two degrees. The whole body may be packed in a damp sheet, covered with dry blanket, and this continued cooling of the head still proceeded with.

When the eruption has appeared, and the violent itching set in, the eruption must be persistently soaked with weak ACETIC ACID (see), or good white wine vinegar and water. In this soaking, avoid giving the patient pain by too strong acid. The necessary healing power will be found in such a mixture as will only cause the eruption slightly to smart.

It is not necessary to treat a patient all over at once. You will do better if you take one or two pimples at a time. You can then pass from part to part slowly, getting over the whole. You can use a little olive oil after this soaking with vinegar, and so keep off all danger of chill such as might occur if too much of the surface were treated at once.

If these simple means are well applied from the first, it must be a very bad case indeed which will not be cured, and most likely without any marks being left on the skin.

Snake Bites.—A snake bite is only one of a large class of injuries which may be considered under one title. From an insect sting upwards to the most fatal snake bite, we need to note, first, the blow or shock of the bite, and then the fever symptoms which show poison spreading in the system. The blow or shock paralyses or kills a larger or smaller part of the nervous system. The nerve of the heart may be almost instantly so paralysed, with fatal effect. The snake poison especially affects the organic nervous system, and thus attacks the very source of vitality. In smaller stings, rubbing vinegar or weak ACETIC ACID (see) into the wound is sufficient almost instantly to cure. The same substance will cure greater evils. In the case of snake bite, first suck the wound thoroughly, watching that the lips and gums of the person who sucks are free from wound or scratch, or use what is called "dry cupping." Much may be done thus in a few seconds. But it must not be continued longer, and hinder the next step. This is to inject weak acetic acid into the bite. Where snakes are abundant, a small syringe, such as is used to inject morphia, with a rather blunt point, should be always carried, and acetic acid of the right strength. The injection must be thorough, and of course pain must be borne to avoid greater evil. Foment cautiously but persistently over the stomach and along the spine. Pay special attention to the lower back if bitten in the foot or leg, and to the upper part if in the hand or arm. During recovery, give careful diet, and rest. Of course this treatment will fail in some cases, as any treatment may. But if immediately applied, it will save a very large number of lives.

Soaping the Head.—See Head, Soaping.

Soap, M'Clinton's.—Those of our readers who have followed out in practice the suggestions which we have given in these papers, will have seen some reason to believe in the importance of soap. Probably some of them have laughed at patients whose chief need evidently was a good washing of the skin! But there is more in soap applications than mere cleansing. These are found to be of immense value in cases in which there has been no want of perfect cleanliness—in cases even in which the skin has been habitually clean. For instance, in patients with nerves so sensitive that almost no application of any kind can be used, a covering of the back with a fine lather, and over this a soft cloth, has soothed the system so effectively that a great step has been secured by this alone in the direction of cure.

When in search of really good soap we soon find that certain soaps are very harmful. Soaps made from "soda ash," as nearly all hard soaps are, tend to dry and harden the skin, and if used often produce bad effects.

Soda soap does well enough for many purposes, and if it is not used often, and the skin is strong, no great harm may be done; but when it has to be used frequently, or is applied to a tender sensitive skin or to parts from which the outer skin has been removed, it will not do at all.

For years we had been seeking for somebody who could make us hard soap without any mixture of soda. Once, when in Belfast, we spoke of this to a friend. He took us to a soapmaker, to whom we mentioned our desire. This gentleman at once saw what we wanted, and told us frankly that he could not make the soap that would suit us, and that he knew only one firm in the trade who could do so. But he assured us that that firm made a pure hard soap which we should find exactly suitable to our purpose. Thus we were introduced to the manufacturers of M'Clinton's soap. This firm, we found, made the very soap we had been so long in search of.

It is made (by a process which is, we believe, a secret in possession of this firm alone) from the ash of plants, and so it may truly be said that it is Nature's soap.

There is something in the composition of this soap which makes it astonishingly curative and most agreeable on the skin. Lather made from it, instead of drying and so far burning the skin of those using it, has the most soothing and delightful effect.

As yet we do not feel able to explain this, not being sufficiently chemical for the work, but we have tried the matter, and feel assured that this soap is by a long way the best for cleansing and curative purposes. Even soap which possesses the same chemical composition lacks the properties of that made from plants, a fact not without parallel, as chemists know. The substances of the plant ash differ in some unknown way from even those chemically the same, which have been artificially produced.

We trust that our noticing the thing in this way will have the effect of calling attention to the whole question of soap-making and using. It is one of those questions on which great ignorance prevails. Many people judge toilet soaps by the perfume and price. If the former is pleasant, and the latter high, they consider they must be getting something specially suitable, and yet the soap itself may be very injurious. Before we had some cases of bad diseases of the skin arising from the use of certain soaps, it did not occur to us to think much of the difference between one sort and another. Hence we just said, "use lather from good soap." Now we see need for care as to the kind of soap used, and especially to warn against all soaps, however fine-looking, that burn the tender skin when lather made from them is much applied.

Very especially is it important to distinguish between the qualities of soaps used on the sensitive skins of infants and invalids. If you ever wash an infant in strongly caustic soap, you may look for a state of discomfort in the child which will make it restless and miserable without your being able to tell how it is so. You may ascribe to unhappy "temper" what is due to the bad soap which you have put on the skin. So with sensitive invalids, when they have to be washed or soaped, so as to keep off or heal the bedsores which are apt to appear on them, it is easy to see how much difference there must be between the effect of a caustic soap and one really and delightfully soothing.

M'Clinton's soap is the very best and most lasting of the soaps we know for washing purposes, so that in recommending it we are not promoting the use of a merely medical thing, but of one for ordinary purposes of a genuine and excellent character. Every grocer ought to have it in stock, and if it is sought after with some vigour it will be soon brought in general trade within reach of all. It is not one of those things that flame on railway stations and on the covers of magazines. The makers are most quiet, unpretending men, and one would think almost afraid to take their light from under a bushel. But they are in possession of a most valuable secret in knowing how to make this soap.

Several soap-makers claim to be makers of this soap, insisting that theirs is as good as M'Clinton's. It is far cheaper. Well, we put it to the test of use. It is not the same thing at all. It won't do, nor will it nearly do: the soda is there beyond all doubt. We are compelled to recommend our readers to make sure that they get M'Clinton's soap, with this name stamped upon it.

There is a strong temptation to deception, because M'Clinton's soap requires eight days at least to make, while the fiery stuff is made in one day, or two at most. It is of great importance that the true soap should be secured. The matter is so important that precious life and health depend on so humble a thing as this.

Take care you are not cheated by a wrong substance. Do not say you have tried our remedy and found it fail. If you have applied irritating soap instead of soothing, the so-called remedy could not but fail. Make sure you have the right substance, and you will have the right effect.[A]

[Footnote A: To prevent an inferior article being substituted if it is asked for as barilla soap simply, it is in this edition called M'Clinton's soap. It is now made solely by D. Brown & Son, Ltd., Donaghmore, Tyrone, Ireland, who have purchased the business and trade secrets of the old firm, and manufacture the soap in the same way. If not stocked by the local chemist or grocer, small samples can be had from the manufacturers free on receipt of 2d. to cover postage, or a large assorted box will be sent on receipt of 2s. 6d.]

Fortunately the makers of M'Clinton's soap are sternly honest men, and their soap can be relied on: that we have found out, we think, beyond mistake. We are happy to be able to say that they have not sent us even a bar of soap for our "Papers" on their behalf, but only assured us that they will "reward" our kindness by "making a genuine article." If there is "puffing," there is at least to be no payment for it, and that is a safe way of keeping the "puffer" to the truth!

The curative effects of M'Clinton's soap will be found dealt with in the directions for treatment of various troubles throughout this volume. See the articles on Abscess; Asthma; Blood, Purifying; Boils; Cancer; Child-Bearing; Dwining; Fever; Hands; Hives; Pimples on Face; Rheumatism; Skin; Sleeplessness; Soapy Blanket; Stomach Trouble; Vaccination Trouble.

Soapy Blanket, The.—It seems necessary, in getting people to use the best means for the recovery of health, carefully to consider, not the diseases to which they are subject only, but especially the processes of cure. We require to go into the very nature of things, so to speak, and to make it all palpable to the inquirer. For example, you prescribe a little olive oil on the skin, and the nurse is horrified at its being suggested that she should "block up the pores." Her idea is that these pores are only little holes in the skin, so that, if you fill them up with oil, the insensible perspiration will not get through. Now let us observe that a pore is a complete organ in itself, and has at least three things that characterise it. (See page 285). First of all, it is a living thing. It is so as really as a finger is a living organ, or an eye, or an ear. When it dies, it is as much an opening as ever, but it ceases to secrete the perspiration which is constantly separated from the current of the blood when it was healthily alive. When it is sickly, though still living in a weak degree, it secretes, but so sluggishly that the substance which it separates from the blood does not pass off easily—it gets, so to speak, thick and sticky, and remains in the pores.

In the second place, the substance which a pore secretes will not combine with certain things, and it will chemically combine readily with other things. When the pore is sickly, it may be aided, first, by the introduction of heat, which becomes vital action, and secondly, by the use of such substances as will readily combine with its secretion. The heat makes it secrete more perfectly, and the chemical combination makes the removal of the secretion easy. It is possible to block the pores up, but it is not very easy to do so. A healthy pore will send its secretions out through very close stuff. It is only by something like very strong varnish that it can be prevented.

There is wonderfully little danger in ordinary life of any such "block" as this. But there is very great danger of the pore being deprived of its secretive power, and of its power to open its mouth when that is so much wanted. Warm olive oil sets millions of pores to full work sometimes in a few seconds.

Now let us look at the application of the soapy blanket in the light of these remarks. Here is a poor patient, sitting in an armchair by the fireside, labouring to get breath. It makes one feel burdened to see him. What is wrong? Are the pores blocked up? No; but they are more than half dead, and what they do secrete is not such an ethereal thing as it should be. Nearly all the work of getting rid of the waste of the body has been thrown for months upon the poor lungs. The kidneys, too, have got far more than their share, just because the pores are sickly.

The remedy is the soapy blanket. This most valuable means of stimulating the healthy action of the skin (as prescribed in many articles in this volume) is prepared and applied as follows:—Have a good blanket, and plenty of M'Clinton's soap (see Lather and Soap). Shear down a tablet or two into boiling water—as much water as the blanket will absorb. The blanket may be prepared as directed in article Fomentation, using these boiling suds instead of water. Have the patient's bed ready, and spread on it a double dry sheet. Soak in the suds a piece of thick flannel large enough to go round the body under the armpits. Wring this out and put it on the patient. Wrap the blanket tightly round the patient from the neck downwards. Tie something round the waist to confine it close to the body. Put the patient into bed, and wrap the feet well up in the blanket. If it is not sufficient to cover them, an extra piece of soapy flannel must be used. Then wrap the sheets over the patient above the moist blanket, and cover all nicely up. In removing the blanket, which may remain on half-an-hour, it is well to proceed gradually, uncovering the body bit by bit, sponging each part with hot water and vinegar or weak acetic acid (see Acetic Acid), and rubbing hot oil on after drying. Dry this oil off, and cover each dried part of the body either with clothing or blankets before uncovering a fresh part.

There is a modification of this treatment which suits more weakly persons, and suits also those who must do all, or almost all, for themselves. A long flannel or flannelette nightdress is used in this, instead of the blanket. This is covered on the whole of the inner side with well-made soap lather. When so covered it is put on at bedtime, and a dry nightdress put on over it. Both are then fastened as closely as possible to the skin, and the patient goes to sleep thus clothed. If the night is cold, the greatest care must be taken to be well covered, and brought to as good a heat as possible. In the morning a very great change will have come from this treatment. When the whole body is washed down with warm water, dried, and nicely rubbed with fresh oil, the skin is found very considerably changed, and in case of asthma the breathing relieved.

If cold is taken when this process is fairly gone through, it would be very astonishing indeed; but if it is badly done, a person might get chilled instead of comforted. Therefore every care must be taken to keep the patient thoroughly warm. The result of one effectual pack is usually sufficient to convince the poor sufferer that he is being treated in the right way. The effect of the second is greater, and so on to the fourth or fifth, beyond which he need not go as a rule. He will do well once a day to wash with hot vinegar and rub after with the oil. These should not be required more than a fortnight at most. If chilliness continues, it is well to put on cotton stockings on going to bed, and even to bathe the feet and oil them before doing so. This bathing may be continued every night for a fortnight.

Sores.—These will be found dealt with under many headings throughout this book (see Abscess; Bone, Diseased; Blood; Boils; Breast; Cancer; Carbuncle; Cauliflower Growth; Eruptions; Erysipelas, etc.), therefore we here only treat generally of two kinds of common sores. The first is the surface sore, which eats inwards; the second, the deep-seated sore, which eats outwards. The first usually begins as a small pimple like a pin's head, and, if neglected, breaks, and gradually increases in size. Its origin is something which has caused the minute vessels of the skin at the spot to give way, so that they remain congested with bad blood, which soon becomes practically poisonous, and so the sore enlarges and eats into the surrounding tissue. If such a sore appears on the leg, it is often due to over-pressure through too much standing. Rest, with the leg kept horizontal or inclined slightly upwards to the foot, will often be enough to cure. When complete rest cannot be had, a thigh bandage (see Veins, Swollen) should be worn.

To treat the sore, it should be washed twice a day with BUTTERMILK (see), and afterwards thoroughly soaked with weak ACETIC ACID (see), and dressed with antiseptic lint, or, if that cannot be had, with buttermilk cloths. A buttermilk poultice (see Potato Poultice) may be used. But if no rest can be had, the sore will be extremely difficult, if not impossible, to heal.

The second kind of sore, arising from an abscess under the part, or diseased bone or membrane far down beneath the skin, is to be treated on the same principles, using weak acetic acid for the syringing, and buttermilk only for the surface. The method of treatment is such as will secure the contact of the weak acid with every part, even the deepest, of the wound. Procure a small pointed glass syringe, which must be kept thoroughly clean. The point of this may be inserted into the sore, and care taken that the weak acid penetrates into the very bottom, and thoroughly soaks all the diseased parts. This syringing should be repeated until the wound is thoroughly clean in every part. If pain is set up, the acid is too strong. Syringing with lukewarm water will at once relieve this, and then weaker acid may be used. This treatment may be given twice a day, and the wound properly dressed after it. Attention must be paid in all treatment of sores or wounds to the proper cleansing and boiling of all materials and instruments used. Wash the hands in hot water and M'Clinton's soap, using a nail-brush, before touching or dressing a sore.

Boil some soft clean rags for five minutes, and wash the sore with these, using water that has been boiled and allowed to cool to blood-heat, to which a few drops of acetic acid have been added, but not so much as to be painful on the sore.

If a syringe is used, boil it before using, and only use boiled or distilled water in all operations. This secures the destruction of the germs (or Bacteria), which are now known as the cause of the inflammation and suppuration of wounds and sores of all kinds.

Spinal Congestion.—In some cases of this trouble the symptoms are very alarming, consisting in violent convulsive movements, which seem altogether beyond the possibility of relief. It is something to know that these terrible kickings and strugglings arise from simply an accumulation of blood in the vessels of the spinal cord, irritating it violently, as an electric current might do. Sedatives and narcotics will be useless. Leeches applied to the spine will sometimes cure by withdrawing the blood from it, though such treatment leaves no bracing and strengthening effect, but the very opposite. Use the cold towel, wrung out and placed along the spine, together with a hot blanket FOMENTATION (see) to the feet and legs, up over the knees. The patient must be gently held still, as far as possible, so that the treatment may be applied. The applications will not be at once successful, but after an hour's work something like permanent relief should come. Above all, the nurse must keep cool and calm in mind and manner. There is no need for hysterics, and any excitable person should be kept out of the sick-room. If the skin of the back has been broken by blistering or any such treatment, a fine lather (see Lather; Soap) should be spread over all the back, and on this a soft cloth. Above this the cold towels may be safely and comfortably applied. It will do no harm if the treatment be continued for even two or three hours.

Spine, Misshapen.—Often in the case of delicate infants or children, the bones of the spine fail to have the necessary hardness to bear the strain which comes upon them, and the spine gets more or less out of its proper shape. If this softness of bone continues, no amount of mechanical support, or lying down, will cure the misshapen spine. Therefore means should be taken by proper diet and nourishment to help the production of good bone substance in the child's body. The best bone-making food we know is good oatmeal, as well-boiled porridge (boiled for two or three hours), or as oatmeal jelly and gruel. Good air and water are also essential, and such treatment as is described in article on Children's Healthy Growth. Especially should attention be paid to constant supply of fresh air to the child's lungs. Windows should be wide open in all weathers, and if the child cannot walk far, it should be wheeled out for as long as possible every day the weather permits. Such supply of fresh air is of vital importance, and the want of it is frequently the sole cause of disease.

In other cases it is not the bones which are soft, but the muscles and ligaments which hold the spine in a proper position are defective. Where the bone is felt to be good-sized and hard, and the surrounding substance too soft, it is a case of this kind. To proper nourishment, in this case, must be added proper exercise of the muscles concerned. Immovable plaster jackets are bad, because they forbid this. This exercise may best be given by rubbing (see Exercise and Massage). Gentle rubbing and pressure over the back, with hot OLIVE OIL (see), will work wonders in such a case. During the rubbing the patient should lie down at full length. It must also be done so as to be pleasant, or it is of no use.

See that the patient has plenty of rest, and only as much walking exercise as is evidently enjoyed. There may be complications with other troubles—for example, a quick pulse and some fever heat, if the temperature is tested. That will require to be itself treated with repeated rubbings of finely wrought lather over the stomach and bowels. Until you have in some measure subdued this fever, you will not do much in the way of improving the muscles of the back. In many cases you will be able to bring the fever down completely, and then you will be free to exercise the muscles, and so to strengthen them that they will bring the spine to something like its proper shape. (See Assimilation; Diet; Digestion; Nerves; Nourishment; Paralysis; Massage.)

Spine, Weakness of the.—See Children's Healthy Growth.

Sprains or Racks.—A sprain is usually the result of some involuntary stress coming upon the part. If the injury be to the muscular substance only, it is easily healed; hot fomentations should be given to the sprained parts, with perfect rest and every possible ease and comfort by position, etc., and nature will soon effect a cure. If the injury be really to the nerves which control the muscles, as is generally the case, the matter is more difficult. The muscle swells, but this is primarily due to the overstrain of the nerves in the sudden effort they make to bear a crushing load on the muscle. The pain is from pressure in the swelling, and also from inflammatory action.

The cure, then, must be applied to the motor nerves controlling the muscles, and is best applied at their roots in the spinal cord. If the arm, hand, or wrist be sprained, rub gently the upper spinal region with warm olive oil, continuing the rubbing gently down the arm to the injured part (see Rubbing) until the whole shoulder and arm glow with comfortable warmth. But all rubbing such as causes pain must be avoided. If such rubbing cannot be managed, then a hot BRAN POULTICE (see) must be placed between the shoulders, and a warm fomentation given to the shoulder and arm. The treatment should be given once a day, and ere many days the sprain should be cured. For ankle and knee sprains, the lower back and leg must be treated on similar principles.

Where the chest muscles that cover the ribs are sprained, rubbing and moist heat should be applied over the back and round the side where the sprain is, paying especial attention to the spine opposite the sprain, and using hot olive oil before fomentation and after, as well as to rub with.

If the belly be sprained, similar treatment should be given lower down the back.

If the back muscles are sprained, then the same treatment should be applied, taking special care to stimulate with moist heat and rubbing the part of the spine on a level with the injury, where the roots of the nerves lie which supply the sprained muscles. Care must ever be taken to avoid giving pain—to give pain is to increase the injury. To produce a glow of heat all through the parts is to cure it. (See Muscular Pains.)

For a sprained heel, when there is some degree of inflammation about it, we should pack the whole foot in fine soap lather. Let it be in this all night, and also during the day when resting. Wash the foot with a little weak acetic acid, after being packed in the lather, to keep it quite clean. Now rub the whole limb from the ankle upwards in such a way as to press the blood onwards in the veins. Use a little oil, so that the skin may not suffer till a fine heat is raised in the whole limb. This may be done for a quarter-of-an-hour twice or thrice a day. It relieves the heel of all congestion, and lets good arterial blood flow to it, as it would not otherwise. An elastic bandage, not very tight, put on above the knee will help the cure. Sprained joints and muscles should have perfect rest for a fortnight, and be used very cautiously for some time longer.

Spring Trouble.—Many persons are distressed by some form of eruption or inflammation in the skin in spring. The change of atmosphere and temperature at this time greatly increases the demands made upon the skin as an organ of perspiration, and this strain it is in many cases unable to stand—hence the trouble referred to. To prevent this, the skin must be brought into a better state of health and fitness for any extra work, so that it can bear without injury even very great changes of air and temperature. This may be done by regular application of soap lather (see Lather and Soap) to the entire skin each evening for three or four days, and then twice a week through all the season. Good olive oil may be rubbed on before and after the lather, or even mixed with it in rubbing on; if the cooling effect is found too great, two or three thick coats of lather should be put on, and then gently wiped off, and the oil applied. This, continued during the later winter and spring, should entirely prevent eruptions. But if these do appear, or have already come on, the irritation is apt to be so great that only very fine and carefully made lather can be used. It is better then to use buttermilk instead of lather. But the BUTTERMILK (see) must be new, and if necessary weakened by addition of sweet milk; if old and strongly acid buttermilk be used, harm may be done. Do not rub the milk on: soak it into the parts by gentle dabbing with a pad of soft cloth. This done frequently, even twice or three times a day, will almost always effect a cure.

It should be remembered that no amount of washing or bathing will do in this state of the skin. Water somehow, especially hard water, fails to produce this fine state of the surface. When spring trouble has set in, we would keep water entirely from the skin. Nothing does so well as good buttermilk. In some forms of spring eruption, a strong mixture of salt and water may be freely applied with great advantage. If this irritates, it should at once be discontinued, but in many cases the eruption will disappear under a few applications. The salt solution should be gently rubbed on, and left to dry on the skin (see Skin, Care of; Underwear).

With the increasing warm weather the body ceases to require as much food as in the cold days. Heavy stimulating food in warm weather will certainly cause an unhealthy skin.

Squeezing.—See Rubbing.

Stammering.—This trouble is simply a loss of command of the vocal organs, and is distinctly nervous in its cause. Especially must we look to the roots of the nerves controlling the vocal organs, if we are to see the real difficulty. There is evidently a state of irritability and undue sensitiveness in these nerves which must be soothed down, if a cure is to be obtained. The roots of such nerves lie in the back of the head and neck, and they are best soothed by application of soap lather (see Lather; Soap). This must be well wrought, and applied warm to the back of the head and neck in three or four coats. Then mix some hot OLIVE OIL (see) with the lather, and apply with the brush gently to the parts. Altogether, in applying the various latherings, and the final oil-and-lathering, an hour should be spent, so as to continue the soothing effect during that time. The head may be soaped one night (see Head, Soaping the), and this treatment given the alternate night. Where the case is of long standing, it may take long to cure it, or a cure may be impossible, but some mitigation will result from this treatment. The Sabbath should in all cases be a day of rest from treatment, and generally common sense will indicate that it be not continued too long. The patient may do a great deal for himself by the strictest watch on his enunciation, speaking slowly and deliberately, and breathing deeply. This will be difficult to maintain at first, but practice will make the habit unconscious. An instrument called a metronome may be had from a music shop (used for keeping time in practising), if a book be read aloud by the stammerer, pronouncing one syllable only to each beat, he will soon gain complete control of his voice.

Stiffness, General.—This is often an adjunct of old age, and sometimes occurs in the young and middle-aged as the result of chills. In neither case is it incurable, but for a cure rest is a first necessity. If there be standing and working for twelve or fourteen hours a day, we should not expect a cure at all. Rest must be had, at least twelve hours out of the twenty-four, and it is well if sixteen or even eighteen hours' rest can be taken (see Rest). Then there must be heating the spine with moist heat (see Fomentation). This is done to revive the organs which supply oil to the joints, by giving fresh vitality to the roots of the nerves which control these organs. But the heating requisite to do this must be gently and persistently applied. An hour's gradual heating is worth far more than half-an-hour's half-burning. Then, after the spine fomentation, which must be applied in bed, rub (see Massage) the back with hot olive oil for a considerable time—say half-an-hour, if the patient can bear it (see Exercise). Then the joints may be similarly fomented and rubbed at another time, back and joints being treated, say, every other day. If there be costiveness, treat as in Constipation, and give easily digested food (see Assimilation; Digestion; Nourishment). Such treatment daily should remove stiffness, even in very bad cases.

Stimulants.—See Alcohol; Narcotics.

Stomach Trouble.—If you would cure thoroughly, you must first make sure that the skin is doing its part well. Very often indigestion arises from irritation of the stomach, caused by the impurities in the blood which arise from defective skin action.

With strong people, exercise causing perspiration will often suffice to cure, in other cases where exercise cannot be had the Soapy Blanket (see) is effective. After the blanket, give a warm, gentle rubbing with hot vinegar or diluted acetic acid; and, finally, a similar rubbing with warm olive oil. This rubbing may be given by itself, where the patient is too weak to endure the blanket, or where the lather cannot be well applied. Even the rubbing with oil alone will do much to cure.

The problem in this case is to remove from the blood the irritating waste which is inflaming the stomach, and this is better done by cleansing and stimulating the skin than by means of drastic drugs. A lazy man will swallow a peck of pills rather than go through an ordeal of cleansing like this, but in that case he need not be surprised if his poor stomach become only poorer still, while his purse will not get any heavier. Besides this cleansing, take sips of hot water as recommended under Indigestion. A very plain and sparing diet should be taken, and great attention given to chewing all food till reduced to a liquid. For it must be remembered that the majority of stomach troubles have their origin in abuse of this organ, through overloading with food, or other dietetic errors. See Diet; Assimilation; Biscuits and Water; Constipation; Cramp in Stomach; Diarrhoea; Digestion; Flatulence; Indigestion; Weariness.

Stomach Ulcers.—Generally the tongue will tell whether the stomach is ulcerated or not. If the tongue is fiery-looking, and small ulcers show themselves on it, while food produces pain in the stomach, there is little doubt of the presence of ulcers there. The tongue may at once, in such a case, be brushed with weak acid (see Acetic Acid) or vinegar, so as to cleanse the surface and produce a gentle smarting. This brushing will quickly produce a healing change in the tongue, which guides us to the cure of the stomach. This will be attained by swallowing teaspoonfuls of the same weak acid. Two or three of these should be taken at intervals half-an-hour before food. If the case is severe, the skin over the stomach must be carefully soaped, as directed in article on HEAD SOAPING (see also Lather; Soap). The four-ply flannel BANDAGE (see) should also be worn. Do not use drugs, such as iron, arsenic, or soda, and avoid all narcotics. Persevere with the weak acid, and a cure will come unless in very obstinate cases indeed. Care must be taken to avoid irritating food. Milk, or milk and boiling water is the best diet. A general symptom is severe pain after eating, relieved by vomiting.

No fluid should be taken hotter than the finger can be held in it. This is indeed a good rule always in matters of food and drink, which are often taken too hot, to the injury of the stomach.

Stone.—See Gravel.

Stoutness.—See Breath, and the Heart.

Strangulation or Hanging.—Often accidentally caused in children or intoxicated persons. Waste no time in going for or shouting for assistance. At once cut the rope, necktie, or whatever else causes the tightening. Pull out the tongue and secure it, commence artificial respiration at once (see Drowning), open the windows, make any crowd stand back.

St. Vitus' Dance.—This proceeds from a simple irritation of the spinal nerves, and is to be cured by soothing the spine with persistent cooling. In mild cases this cooling is easily applied with towels wrung out of cold water, and folded so as to lie at least four-ply thick along the whole spine. If narcotic drugs have been largely used, and the nervous system spoiled thereby, a severer form of the trouble comes on, and requires a good deal of care and persistence in cooling. In all cases the cooling of the spine must only be done when the patient is warm in bed.

It will be of great importance, in carrying out this process, to use olive oil in such a way, all over the body, as to help in maintaining the general normal heat. In addition to these suggestions, it may be well to remark that the appearances in such cases are, as a rule, worse than the reality. For instance, the motion of the eyes and of the tongue makes one imagine that the sufferer has lost all reason, and even consciousness of normal character. But this is not so; the brain may not be affected at all, and the worst feeling is that of weariness. We have seen a patient smiling through the most distressing contortions—that is, most distressing to the ordinary observer. It is of great importance that any one who treats such cases should be cool and kind.

It will sometimes be impossible for one person to keep the patient in bed and covered with the clothes so as to keep warm. If so, two must do it. It is, however, to be remembered constantly, that the patient feels it much more agreeable to be held within even close limits than to be allowed to throw arms and legs, and head and body about in all directions. This is a most invaluable truth in such cases. It will not do to hold as with an iron grasp, so that no degree of movement is allowed; but you may hold softly, so that no motion, such as will even disturb the bedclothes, shall take place. This must be done so that all the body shall be comfortably warm when the cold towel is laid along the spine and pressed gently to the centre of the back. In comparatively mild cases, we give an hour of this cooling process every morning only, and the warm washing and anointing with olive oil at bedtime; but in such cases as we sometimes meet with, where drugs have done their mischievous work, it is necessary to cool much more frequently. For instance, when the morning cooling has laid the irritation, and the patient is quiet for an hour, or, perhaps, only half-an-hour, the movement returns. The persons applying the cure are afraid to repeat it till another morning has come. But they need not be so. Or, they apply it for five minutes, and are afraid to continue it longer. They may quite safely apply it as long as they can keep the rest of the body comfortably warm. If they can keep nice, soft blankets well round the patient, as a rule it will not be difficult to keep up all general heat. Let us suppose that, when warm in bed and asleep, the patient wakes up, and the diseased movement begins; it will be well then to ply the back with the cold towel. If the movement is perfectly still in half-an-hour, a rest may be given. If the movement soon returns, the cold can be applied till perfect quiet is had again. This will, perhaps, be secured in twenty minutes or so. A rest and comfortable warming may be given again. If the movement still returns, it may be met by the same cooling process again. If only the heat is kept up all right, the cold towel may be used till the spinal irritation is finally gone.

This simple mode of treatment we have found to be perfectly successful, not only in removing every symptom of nervous irritation, but in giving most vigorous health to patients who, to begin with, were truly miserable-looking subjects. This may be looked for, as well as the mere removal of the malady.

It should be noted that one outstanding feature of St. Vitus' Dance is that the movement ceases during sleep. If this is not the case, other treatment is called for. See Paralysis, and articles under Nerves; Spine, etc.

Sunshine.—Is a most valuable aid to health, acting as a physical and mental tonic. The sunbath, for either portions of the body at a time, or for the whole body, will be found very beneficial to nervous sufferers, and also to those having a tendency to certain skin diseases. Its tonic effect is very noticeable on the hair, giving it better growth and richer colour. Sunlight should be admitted freely into bedrooms and sitting-rooms, for it is hostile to the growth of many of those microbes which cause disease.

Tapeworm.—The only sure sign of the presence of this parasite in the intestine is the passing from the bowels of some of its joints or ova. Its presence in the body is a serious matter, always giving rise to more or less inconvenience and disturbance to health. We mention it here because we know of a very good and harmless remedy which will completely expel the worm. This may be obtained from D. Napier & Sons, herbalists, 17, Bristo Place, Edinburgh, postage paid, for 2s. One dose will be sufficient.

We dislike secret preparations, yet when we come across a remedy which never fails, we confess to putting aside our dislikes and getting it.

The best thing is, however, to prevent the worm obtaining access to the body. All food, especially beef and pork, should be thoroughly cooked, and all cooking processes, and all places where meat is kept should be thoroughly clean. Where this is the case, tapeworm will never occur.

Tea.—Tea should not be infused longer than three or four minutes, and cream should be used with it. The albuminous matter in milk tends to throw down some of the tannic acid in an insoluble form. It should not be taken too hot, and if taken at a meat meal (which is undesirable), not till quite the conclusion of the meal. Much tea-drinking produces nervousness and indigestion. If taken very weak it forms a pleasing addition to the morning and evening meal, but taken as it usually is, and especially between meals, such as at afternoon tea, it is a serious cause of ill-health.

Teeth.—In order to prevent decay, the teeth should be carefully brushed at least once a day, preferably at night, but better still after each meal. There is no better dentifrice than pure soap, and M'Clinton's tooth soap, being specially prepared from the ash of plants and a pure vegetable oil, does not leave the objectionable soapy taste in the mouth which all soda soaps do.

The prevalence of bad teeth is believed by many to be due to processes of milling, which remove the bone and enamel making properties of the grain. So much of the natural salts of the grain are removed to make bread white that it ceases to be the staff of life. A contributory cause is the consumption of large quantities of sweets or candies, especially between meals. White bread lodging in the teeth and thereby producing acid fermentation, is believed to have a bad effect on them, also too hot or ice-cold liquids. Remember also that the teeth cannot be healthy if they are not exercised. The Scotch peasant when he ate hard oat-cake had splendid teeth, as the Swedish peasants who eat hard rye-bread still have. Sloppy foods hastily bolted will ruin the digestion and thereby the teeth, besides depriving them of the work essential to their good condition. If teeth do decay they should be seen to by a dentist at once, as their presence in the mouth is injurious to the general health.

Teething.—At the outset, it must ever be remembered that this is not a disease. It is a natural growth, and often is accomplished without any trouble at all. It is, however, a comparatively quick growth, accomplishing much in a little time, as a plant in flowering. This rush of growth in one place draws upon the vitality available for general purposes in the child's body, and if this vitality is not very large, trouble ensues. Diarrhoea, cold feet, and lack of spirit and appetite thus arise. If at this stage the lower limbs and body be carefully fomented (see Fomentation), all trouble may cease at once; at least a very great deal will be done to relieve it. Give three teaspoonfuls of warm water, slightly sweetened with pure CANE SYRUP (see), three times a day. A little of the confection of senna will do instead of this if desired. The fomentation must never be so hot or so long at a time as to cause discomfort. Irritation is bad for a teething infant, and all must be done soothingly if success is to be gained. Also it will not do to foment and rub with oil a feverish child. Such cases must be treated differently, as we shall see, and it is easy to distinguish them from cases without fever. Meantime we would say that in many cases where vital force is low without fever, the treatment by fomentation as described is of great value.

In regard to the artificial "cutting" of the gum by surgical instruments, we would say that such should only be resorted to when the tooth is very near the surface indeed, and by a careful surgeon who knows what he is about. The irritation in the gums which makes it thought of at all can be usually allayed by simple means. Let the mother dip her finger in good vinegar and water, just strong enough to slightly smart the lips, and rub it on the irritated gum. This can of course be done often, and is most powerfully soothing. It may indeed do all that is required. But if more general symptoms appear, such as sleeplessness and heat in the head, cooling of the head is required. Have two little caps made of thick cotton cloth, one slightly larger, so as to fit on above the other on the child's head. Wring the smaller out of cold (but not ice-cold) water, and put it on. Press it gently on the head, and if the heat and restlessness continue, cool it again, perhaps twice or three times. When the restlessness is relieved, leave the damp cap on the head, and place the dry one on over it. If the heat returns, repeat the process. This treatment, though a mere cooling of the brain, has saved ere now both reason and life, and should never be lightly thought of or despised.

Often the stomach is seriously disordered during teething, both vomiting and purging resulting. In small degree these are not dangerous, but they are better avoided. If severe, they are the beginning of often fatal trouble.

To quiet the excited bowels, nothing is better than enemas of cool water. It need not be too cold, but just a little under blood heat, with a little vinegar added. One tablespoonful of vinegar to a pint of water. Also a "baby's bottle," prepared with water at blood heat (98 deg.), without any milk or sugar, will greatly assist the stomach if given to be sucked. In such cases infants usually suck this water greedily. It is most soothing to the stomach. Half a teacupful at a time is enough. In the evening wash the child with warm water and SOAP (see) rub all over with warm olive or almond oil, especially the back up and down. Then place a BRAN POULTICE (see) over all the back, taking care to have it just comfortably warm. When this is fastened on, an ordinary pocket-handkerchief wrung out of cold water is folded and laid over the bowels. This is changed for a fresh one as soon as heated, and gently pressed all over. The milk, if the child is brought up on the bottle, may be given now, reduced in strength for a time. This treatment will often cure without enemas, which may then be dispensed with. Great improvement in health may be expected after a few days of such treatment. A cool handkerchief, similar to that on the bowels, may also be applied to the head, if that is heated.

Some form of head eruption often comes on after a long time of heated head. A little sour buttermilk, vinegar, or weak acetic acid, not stronger than to cause a slight smarting tried in the nurse's nostrils, will relieve almost instantly the itching which accompanies this. If strong acid be used, matters are made worse, and great pain caused. The acid, weak as we have described, at once neutralises the irritating substance exuded from the eruption. It also prepares the way for a cure. If astringent lotions are employed, drying the sore, and driving it in on the brain, serious injury may be caused. But if healing takes place under soaking with weak acid, no such result need be feared, for this simply removes the unhealthy state of the part. Water, especially hard water, must be absolutely kept away from such a head. No more must be used than is necessary to dilute the acid; and, if it can be got, the acid of buttermilk is decidedly preferable. The whole body, when feverish, may be cooled in a tepid bath, several times a day if necessary, having the water just at blood heat.

Besides these outside effects, teething often causes brain disorders. (See various articles on Children.) The infant should be watched carefully, and if the eye be dull, and the head heavy with feverish symptoms, the head should be cooled at once as above directed, and if the feverish symptoms are not marked, and the feet cold, the feet, legs, and lower body should be wrapped in a good warm fomentation. Where the trouble has gone so far that insensibility comes on, the treatment is the same, only the cloths had better be wrung out of iced water if available. It is important to not only lay the cloths on the head, but to press them. Take the little head in your two hands, and so bring the cool cloth close to every part of it, while you lift up a prayer for help from the Great Healer. Keep at this till your feeling tells you it is time to change the cloth. Take off the hot one and put on the cool one. Go on with the gentle pressure again. It does require work, but it is well worth work to save a precious life. You must so work that you will cause the least disturbance possible to the little sufferer. It may be you may require to keep this up for many hours, but you will probably find that some signs of sense appear ere you have gone on very long, and you may see that natural sleep has succeeded the drowse that lay in the worn-out brain. If so, you will allow the head to lie still in the cold cloth, and change only when it gets very warm. If natural heat has been fully restored to the legs and feet, you will let these rest also.

We know of a case where the brain seemed gone, and the medical man abandoned hope; but the head was cooled with ice cloths, while the feet and legs were kept in a hot fomentation, for a whole night, and all danger was passed by the morning. So that, even in very bad cases, this should be perseveringly tried.

For diet, in teething, the child must get easily digested food, and all "rich" foods—brandy, beef-tea, etc.—must be avoided.

Involuntary starting, and the manifestation of great fear on waking out of sleep, frequently arise from irritation of the spine during teething. The cold compress applied along the spine when the child is warm in bed will relieve this. It may be applied (see Towels, Cold) twice or thrice a day. If the feet are cold, these may be fomented at the same time. If the head is cold, it may be fomented also. If it is hot, cool it. This treatment relieves the irritation of the mouth, as well as removes the starting. If both head and feet are hot, then you need only cool the spine.

In all cases, common sense must be used, but we think we have given sufficient indication of principles to enable a thoughtful nurse or mother to treat successfully almost any case. Where very cold cloths on application cause shivering and crying, either use tepid cloths, slightly cooler than the skin, or warm the surface of the cold folded cloth by holding for a short time to a fire, and then apply to the patient. The warm surface thus first touches the skin, and afterwards the cold in the body of the cloth penetrates gradually.

Temperature (see Heat, Internal).

Tempering Treatment.—Much, if not all, of the success in any case of treatment depends on its being properly tempered to the strength of the patient. In putting on LATHER (see), for instance, a delicate and nervous child will be greatly annoyed if soaped all over at once. But if one arm be done and finished, then the other, then the breast, and so on to the abdomen, the back, and the legs, bit by bit, the effect will be soothing in the extreme. So with MASSAGE (see); so also with applying a cold towel. If it chills and terrifies the patient when suddenly "clapped on," common sense would suggest holding it to the fire till the surface is warm. This warm surface will give no shock when applied to the skin, and the cold in the body of the towel will gradually penetrate and do its work. Also, as we have frequently repeated, the strength of ACETIC ACID (see) must be carefully looked to, when it is used. It must ever be remembered that some of the finest and noblest spirits are inhabitants of frail bodies, which, with right treatment, are strong enough, but suffer terribly in rough hands.

Thirst.—This forms a severe feature in many cases of illness, and has to be treated variously according to its kind. It may be due first to dryness in the membranes of the throat and stomach; secondly it may be due to a concentrated or deranged state of the juices of the body; thirdly, it may be the result of a burning heat in the body. It will not be difficult for a careful person to say in any case which of them is the cause. The nature of the disease will indicate it. A little cold water may be given first. If this fails, a cold cloth over the stomach (see Changing Treatment) may be tried. If these are not successful, a few tablespoonfuls of hot water may be given. The first of these meets the simple dryness, the second cures the burning heat, the third meets the case of concentrated and deranged juices in the body. A few drops of vinegar, lemon juice, or other fruit acid (see Drinks), will often greatly assist the hot water in its duty. All alcoholic drinks are worse than useless in real thirst. Any power they possess is either due to the effect they have on the artificial thirst they create or to the water they contain. And the danger of rousing or creating the dreadful desire of the drunkard is so great, that they ought never to be given to relieve a patient's thirst.

If the cold water is known, from any cause, to be dangerous to the patient, then hot water will do equally well. If the thirst arises from some drug which has been taken, then hot water should always be given.

Again, the locality of the dryness causing thirst indicates the best method of quenching it. If only the mouth and tongue be dry, then it will be sufficient to wash out the mouth with the water, or acid drink, not swallowing, so as to avoid unnecessary loading of the stomach. If throat and mouth are cool, and only the stomach burns, then the cold towel above that is the best treatment.

There is no need, except in very special cases, for iced water. Tap water is generally cool enough, unless stored in heated cisterns. In this case a little ice may be used to bring it down to a temperature of 45 deg. or so, but not below 40 deg.

Throat Hoarseness.—This is best treated by a good large BRAN POULTICE (see) on the back of the head and neck. While the patient lies on this, cold towels must be changed on the front above the "apple" of the throat. Do this for an hour twice a day. Or, if the feet be cold, give treatment as in Teething. There must also be rest from talking. Procure a good camel's-hair throat-brush from the druggist, and brush the back of the throat well with weak ACETIC ACID (see) several times a day, or simply gargle if there is difficulty with the brushing. The brush must be carefully cleansed, and dipped in the strong acid after use.

Especially is it necessary to give up, in such cases, the use of tobacco. Where the trouble has lasted for years, it may be slow to heal, and the poulticing may be done only once a week. In ordinary cases, a day or two's treatment should cure.

Many times we have seen a good fomentation of feet and legs alone give very sensible relief. Never be satisfied with putting a hot bottle or brick to the feet. This is a lazy way of dealing with a serious case. Have the feet and legs up to the knees rubbed with vinegar and olive oil, and wrapped in a large blanket fomentation. It is not the mere dry skin of the soles of the feet that needs warming: the whole legs, especially the muscles, require the moist heat of a thorough fomentation. Circulation is at once accelerated just where it is wanted, so as to lessen the pressure where the vital stream is pressing too heavily and lodging in a dangerous congestion. It is good even if the feet are not very cold, but only cool, to ply this part of the remedy well. Where the patient is strong enough to sit out of bed, a good hot foot-bath will do instead of this fomentation.

Throat, Sore.—The first question in any case of sore throat, is, What is the temperature of the patient? (see Heat, Internal). If this cannot be ascertained, at least we can say whether the patient is feverish or not.

Let us first take the case where there is no fever. Get the patient warmly to bed. Foment (see Fomentation) carefully all round the neck, first rubbing on a little olive oil. Renew the fomentation every five minutes for three-quarters-of-an-hour at least. Allow rest for an hour. Then foment thoroughly the feet and legs up over the knees. When this is done, and the heat kept up, cool the throat with constant fresh cold towels. Let this go on for an hour. Finally sponge the whole body with warm vinegar. Rub lightly over with olive oil, dry, and allow to rest. Probably the throat will be cured. If not, repeat the treatment the following day.

Where there is fever with the sore throat, first make sure whether the feet are hot or cold. If cold, put on fomentations as above. Even if the feet are only cool this should be done. While the feet and legs are thus fomented thoroughly, change cold towels on the throat every three minutes for an hour. Sponge all over as above directed, and allow to rest. If the feet are hot, cold towels alone are applied to the throat; but if the feet get at all chilled while such cooling is going on, they must be fomented.

If there is vomiting and sickness along with the sore throat, the other symptoms of scarlet fever should be looked for, and medical aid obtained if possible.

But here is a case where the most experienced eye, aided by the best possible instrument, sees nothing wrong in the throat itself, but the cough and difficulty of breathing point to the throat. The trouble is not there, but in the roots of the nerves by which vital energy is supplied to the windpipe and other vocal organs. You must go to the back of the neck, and to the back between the upper parts of the shoulders, and there affect the roots that are really in a state of distressing over-action. If you are skilful enough in applying cold, and your patient has plenty of general warmth, you need nothing more than a cold towel, changed pretty often, and nicely pressed over the proper parts. If this fails, have recourse to a cloth with mustard spread like thin butter on it, say about six inches broad and a foot long. Lay this gently on the spine at the back of the neck, and down as far as it goes. Apply your cold compresses now over this as well as you can, and the violent spasmodic symptoms will be mitigated. If one trial is not sufficient, sprinkle the cold cloth with cayenne. If the result can be reached by the cold cloth alone, it will be best. If mustard or cayenne must be applied, observe very carefully that they should never distress the patient. As much as can be borne quite easily, and no more, should be employed. Whenever a remedy becomes seriously distressing, we may be pretty sure it has ceased to be remedial, for the time at least.

Throat, Sore (Clergyman's).—Those who are in the habit of using their voice much should be very careful to produce it in the proper way. It is noticeable that actors (who learn to produce their voice properly) do not suffer from what is known as clergyman's sore throat.

The voice in speaking should be pitched, as a rule, considerably lower than is usually done, especially if speaking in public. Any tightening of the throat muscles should be avoided, and the voice sent out from a full chest well expanded.

Those who are musical should take a note on the piano enunciating the vowels in their natural order (ā, ay, ee, o, oo) on this note. Then proceed to the next note; the whole of the octave may thus be gone over. Choose an octave most consonant with the range of the voice.

Then add the consonants: bā, bay, bee, cā, cay, etc., etc. Thus a perfect command over all the possible combinations of vowels and consonants may be attained.

There is absolutely no reason why any musical person should have an unmusical voice, especially since this bad production of the voice often strains the muscles and inflames the mucous membrane of the throat. In connection with this question of music, it should be remembered that almost irretrievable injury to the voice may be done by allowing a boy to continue singing after his voice has begun to "break."

It is not a good plan to be constantly "clearing" the throat whilst speaking. One gets to imagine after a while that it needs clearing when it really does not.

Alcohol and tobacco are both undoubtedly injurious to the voice. A little honey and lemon juice will be found the best gargle if a gargle is required.

Deep breathing is of great assistance in endeavouring to produce the lower note, in fact it is not possible to produce a full note except from a full chest. In this connection it may be said that it has been observed that deep-chested, deep-breathing, slow-speaking people are frequently possessed of certain estimable points of character, such as prudence, firmness, self-reliance, calmness. If one is going to be angry, ten deep breaths might save a world of trouble. (See Breathing, Correct method of).

Thumb, Bruised and Broken.—Frequently a tradesman will strike the thumb or finger a serious blow with a hammer, in missing a stroke. If not treated properly, the whole hand may be destroyed, but if promptly plunged into warm clean water and kept there, even the broken bones can be handled quite comfortably, and all pain and uneasiness pass away ere very long. Plenty of bathing in clean warm water, and proper setting and dressing, are all such an injury requires.

Toothache.—This trouble appears in two opposite characters. In the one it is cured by rightly applied heat, and in the other by cold. If it is merely the soft substance in the tooth which is affected, local cooling applications will cure, if persisted in. If it be the nerve terminating in the tooth which is irritated, then even the extraction of the tooth may fail to give relief. Both cold and hot applications to the tooth or cheek will then probably prove useless.

In such a case, apply COLD TOWELS (see) gently pressed over the head and back of the neck. If the case be a bad one, the feet may be put in a hot bath, or fomented. Persevered in for an hour, this treatment is almost certain to cure. It may take away all pain in a few minutes. After the pain is cured, dry well, and keep the head moderately warm.

But if the toothache is caused by a severe chill to the head, and that be still cold, it should be packed in a hot fomentation. This gives almost instant relief. Rub on a little oil when the fomentation comes off, and keep the head warm.

It should not be difficult to distinguish the cases requiring heat from those requiring cold. In any case, if the first application of either increases the pain, try the other.

Towels, Cold Wet.—A towel of the ordinary kind, and full size, is soaked in a basin of cold water and carefully wrung out until it is merely damp. Prejudice against this treatment is often aroused by putting on the cloths wet, and in a slack, blundering way, so as to make the patient most uncomfortable. It is then folded and applied to the skin, as directed. While applying the first, a second towel may be in the water. It is then wrung out and applied, while the first is placed to soak afresh. In prolonged cooling, care must be taken that the water in the basin does not get too warm. It should be frequently changed. The nurse should gently press the towels on the part, frequently changing the position of her hands. They should not merely be laid on, but gently pressed, unless this causes pain. The towels will need to be changed when hot, and will take from two to five minutes to lose their cooling effect, according to circumstances. Where cold increases the patient's distress, it is almost always safe to substitute heat. See Cooling in Heating; Fomentation.

Tumours.—A large, soft, fleshy tumour is usually simply an accumulation of waste material, which should have been excreted from the body if all the organs were in healthy working order. Where such a swelling exists, the first consideration is diet. For this, Barley (see) as chief food will do very well. Lemon and orange juice (see Drinks) should be the drinks. The barley must not be cooked with milk, and the drinks must be made with pure water. This plain diet will help very much towards the removal of the tumour.

Then the back should be rubbed (see Massage) with hot olive oil twice a day. This treatment alone has often removed the disagreeable swellings on the neck so often afflicting women.

Also, fine soap lather (see Lather; Soap) should be gently rubbed repeatedly over the tumour itself. This alone we have known remove tumours, so it is important.

The three forms of treatment, all applied carefully, will cure all but very obstinate cases. See also Armpit Swelling; Hydrocele.

Where fibrous tumours exist, the treatment is to douche cold water on the part affected, while the rest of the body is kept warm. In case of such a growth in the abdomen, the patient sits in cold water, while the feet are placed in hot water, and the whole body warmly wrapped in blankets. Cold water is then thrown against the spot where the tumour lies. If the tumour is discovered early, its growth may be entirely stopped by this means. Such treatment for several minutes twice a day has in our own experience cured cases pronounced incurable. See Sitz Bath.

Turnip Poultice.—Part of a raw turnip is grated down to a pulp. As much of this is prepared as will cover the inflamed part. It is put on next the skin, and covered with a soft cloth. All is then tied nicely up in another cloth. In violent inflammation of the knee joint, this is a most valuable soothing application. Placed on discoloured and shrivelled skin, it is marvellously curative. When applied, the patient must be thoroughly warm. This warmth must be maintained while the poultice is on, as it has a powerful cooling effect.

Typhoid Fever.—See Fever, Typhoid.

Ulcers.—An ulcer is an "eating sore": that is, a sore containing matter which eats away the skin and flesh, thereby extending itself, and increasing in depth as well. To stop this diseased process, the virulent matter in the ulcer must be killed or neutralised, and this can usually best be done by means of vinegar or weak ACETIC ACID (see), which is most powerfully antiseptic. The only difficulty is to avoid irritating the sore by the application of too strong acid. The treatment by weak acid is very effective, but it must be a fairly prolonged and thorough soaking. Apply a little at a time to the sore. Use warm water if pain be caused. Continue the soaking for even an hour at a time, twice or even three times a day. The wound may be dressed with good fresh olive oil after each soaking. Usually, nothing else will be required, but it must be thoroughly done.

In a very severe case, mix in a teacupful of hot water as much saltpetre as the water will dissolve. Add to this a teaspoonful of acetic acid, and use this to soak the sore instead of simple weak acid. Then, if healing does not come, it is probably because rest is not taken, and most likely also because there is deficient vitality in the whole system. Let the treatment with the lotion be given in the morning. Secure rest during the day, and in the evening, for an hour, thoroughly foment the feet and legs up over the knees. Once a week for two weeks give the SOAPY BLANKET (see) instead of this treatment, and in the morning rub all over the body with hot vinegar. This powerfully stimulates the vitality of the whole system. Even a very bad ulcer should give way under a careful course of united acid soaking, rest, and this stimulating treatment.

Unconsciousness.—There are two opposite causes of unconsciousness. One is congestion of the brain, the other sheer nerve exhaustion. Either will produce a prolonged suspension of consciousness very different from a mere passing faint. In the case of congestion, the head will be hot and the feet cold. The cure is therefore at once seen to be to cool the head and foment the feet in a hot blanket up to the knees. This is the treatment usually to be given to young children. When aged people, or those much exhausted from any cause, become unconscious from lack of vitality, there will be rather a general coldness, and no special heat in the head. We have seen such a case of "coma," which had lasted for forty-eight hours, come all right in ten minutes, by simply fomenting the back of the head and neck, and all down the spinal column. Press a thickly-folded piece of flannel wrung out of hot water carefully and gently over these parts, and often in a few minutes the mental power comes back. Care must be taken not to scald the patient. See Fomentation.

Underwear.—There is a common and very popular error, namely, that of putting too much clothing on our bodies, under the mistaken idea that additional weight means additional warmth. The fact that the main object of clothing is to preserve the natural heat of the body is lost sight of, and little attention is paid to the selection of proper garments for wearing next the skin. Every day the skin of an average healthy individual gives off so many pints of moisture, which must not be allowed to settle on the body if health is to be maintained. After long and exhaustive trials, we have come to the conclusion that the best material for wearing next the skin is knitted linen, and the best knitted linen of the kind, and in fact, the only pure linen mesh material which we have seen, is known as Kneipp linen, and can be obtained from all leading retailers and outfitters in this and other countries. The name of the nearest agent may be had by sending a card to the Kneipp Linen Warehouse, 2 Milk St., London, E.C. In winter light woollen underwear can be worn over the linen if desired, thus retaining the hygienic advantages of the linen, as well as the warmth of the wool. As the wool does not touch the skin, it will not require frequent washing, and so will not become felted up.

Linen is the symbol of cleanliness, the priests of old, as we read in Ezekiel, being commanded to wear it, and not wool or any garment causing sweat.

Our reason for specially naming Kneipp linen is that we know it is pure linen, whereas we know that what is sold as linen mesh is frequently half linen and half cotton.

Linen is the most absorbent material for underwear. It soaks up moisture very rapidly, and dries with equal rapidity. Hence linen is always preferred for towels and bandages. Those who use it for underwear will not require to change the clothes after exercise, as they would if wool were worn next the skin. The ordinary woven linen is clean but cold: Kneipp linen is so constructed as to be clean and warm. This material retains air in its meshes, and a layer of dry air next the body is the best method of preserving an even temperature, and thus avoiding colds and chills, which are so prevalent in a climate such as ours. Wool is entirely unsuited for wearing next the skin. It does not absorb the perspiration rapidly nor radiate it freely, and after several washings it becomes felted, and in that condition is absolutely injurious to health. It is the material par excellence for outer clothing, but all inner garments coming in contact with the body should be composed of pure linen. (See Skin, Care of).

Uric Acid.—This acid is found in persons of a gouty tendency, such tendencies being a great deal more common than is imagined.

It is really a waste product formed by the activity of the body cells, and should properly be mainly transformed into urea and so excreted. If it is not so transformed it accumulates in the blood and deposits in stony formations in different parts of the body, as in the joints, kidneys and bladder, causing very serious disease. Pure air and plenty of exercise will assist its transformation.

It is also taken into the body in various foods, particularly meat and tea, which are very rich in it or kindred chemical substances, therefore, anyone having such a tendency should avoid these. The consumption of sugar should also be limited. Avoid alcohol and use plenty of green vegetables and fruits.

The tendency to a "uric acid" constitution is hereditary, and is prevalent among families who live high. Such should be continually on the watch lest their diet should precipitate an attack. Water should be freely drunk, and plenty of bathing with subsequent rubbing of the muscles or massage is advisable.

Drugs are to be avoided as they often result in painful heart affection, and besides do not strike at the real root of the disease.

Soda or lithia water may be taken either with or without milk. Brine baths may be taken when practicable.

Urinary Troubles.—A healthy man usually evacuates about 30-40 ozs. of urine daily, the excretion being greater in the winter than in the summer, owing to the checked perspiration. The urine should be of a pale straw colour and transparent. Where any irregularity in the urine, either in quantity or quality, is suspected, it is wise to use soft boiled or distilled water only, for drinking, and to take frequent sips of it throughout the day, and especially early in the morning. Either pure hot water, hot water and lemon juice, or whey, will help the action of the kidneys when this is sluggish.

Where the bladder is irritated and painfully sensitive, a large hot BRAN POULTICE (see) should be applied to the lower back. While the patient lies on this, cold towels (see Towels, Cold Wet) should be changed over the bladder in front. While giving such treatment once or twice a day, rest must be taken, if a cure is to be obtained. For a patient to say that rest cannot be had, is to say that cure is impossible.

Where there is a tendency to stoppage of the urine, a warm sitz-bath should be taken. The patient first sits in three inches deep of comfortably hot water. More water at the same temperature is poured gradually in at intervals, until it rises well up over the abdomen. This will usually relieve even a bad case.

Treat with bran poultice and cold towels, as above recommended, after the warm bath has given relief. It should be remembered that the cold is the healing power, bracing the bladder and all its muscles and vessels. Hence more than a slight cooling is needed. But the cooling is only possible when good heat is kept up on the base of the back. This treatment also cures the swelling of the bladder which often accompanies restriction of urine.

Where a positive growth interferes with the urinary discharge, this may often be actually melted away by soaking with weak ACETIC ACID (see), when it is at all possible to reach it. The power of cure possessed by acetic acid is incredible, except to those who have seen it exercised, and its persistent use would, we are use, save many lives, if people would only try it.

We would also advise the four-ply flannel bandage, with two plies damp and two dry. This round the body has a wonderfully soothing effect. So has a nicely applied lathering with SOAP (see). As in most other troubles, special care must be taken to keep the feet warm.

Vaccination Trouble.—When a child is suffering after vaccination, we should have him gently rubbed all over—thrice at least with M'Clinton's soap (see Lather). No one who has not seen this well done can believe how blessed are its effects on an irritated skin. It soothes incredibly. When thoroughly covered and covered again with well-made lather of this soap, the child will sleep beautifully. We should soap head and all, and let the little man sleep all night in the soap. He may be sponged in the morning with weak vinegar and water to clean off the remains of the soap, if there are any. Now, there will occur a most important question: Is the child cold or feverish? If cold, then mix some good olive oil in your rubbing with the lather. If hot, use no oil. If cold, rub all over with warm oil before applying the lather. It will make no difference, or next to none, if the disease has broken out as a visible skin disease, only it will be necessary to use the vinegar on the unbroken parts of the skin and not to distress the child by painful smarting. The soap will not need to be so restricted. That cures the most tender sores, and soothes in a delightful way.