MEDICAL.
Florence.—The glands under your arm have inflamed and broken down, and you ask us to tell you what has caused this. There are many possible causes, but we will confine our remarks to the commonest, and therefore most likely causes. The use of these glands is to filter off from the lymph any impurities it may contain. Let us briefly glance at physiological considerations to enable us to understand why these glands are so extremely commonly inflamed. Your right arm is affected. Very well. The blood reaches your right arm and hand by the arteries. Part of the blood returns to the heart by the veins, part of it exudes through the walls of the smallest arteries. This part is not red but colourless, and is called lymph. This lymph bathes and nourishes the tissues, giving them food, and taking away with it their impurities. This lymph flows back through colourless vessels called lymph-channels, which end in the veins of the neck; but we said that the lymph takes up impurities in its passage. These impurities are partly physiological and partly unhealthy; the latter consist of germs. If these germs were sent into the blood-stream there would be disastrous consequences, and to prevent this the lymph-glands are placed in the course of the lymph-channels just before these enter the blood-stream. All the lymph is forced through these glands as through a filter, and any germs it may contain remain in the glands, and are quickly destroyed by the elements of the glands, which are there for this purpose. But suppose you have an abscess on your hand; that abscess is swarming with germs, and the lymph in its passage will carry away a vast number of these injurious microbes, and will take them to the glands of the armpit. The germs remain in the glands and give the glands extra work to do. The glands will enlarge and become inflamed. If the infection of the glands is very virulent, the glands may, as it were, die at their post and become abscesses. Now we can proceed. The commonest cause of inflamed glands in the axilla is inflammation and suppuration about the hand or arm. An abscess, a small dirty wound, or anything of a septic character on the arm or hand will produce inflammation of the glands under the arm. In these cases, as soon as the primary condition is remedied the glands regain their normal condition. But suppose that the primary wound was a stab in the hand from a hat-pin, which in some way had become infected with the germs of tubercle; then the glands will also become infected with tubercle, and this brings us to the second commonest form of inflammation of lymphatic glands, the so-called strumous or scrofulous glands. This is an exceedingly common affection, especially in children. Good diet and cod-liver oil will help to enable the body to withstand this disease. Sea air, and especially the air of Margate, Folkestone, or Cromer will do more than anything else to cure this affection in its early stages. Sometimes, in the later stages, or in cases where the malady has been neglected, operation is necessary to prevent excessive scarring or exhaustion from continued discharge. It is imperative when glands have broken down, and are discharging, that they should be kept extremely clean and free from external infections by the use of local antiseptic washes and applications. The arm must also be kept at rest.
A Girton Girl.—Should persons with organic disease of the heart marry? is a question which is very much easier to ask than it is to answer. In this case we have not to consider the dangers of heredity, for though heart-disease, and still more so, the commonest cause of heart-disease, rheumatism, is undoubtedly sometimes hereditary, it is not sufficiently so to forbid marriage on this score. Our personal experience is that heart-disease is not hereditary. Nor is heart-disease an infectious disease like consumption, which you could communicate to your children or husband. Valvular disease is so varied in its nature and degree that it is impossible to lay down laws which are applicable to every case.
Glasbury.—Influenza is a terrible disease, and it often leaves much suffering in its train. Indeed, we know of no disease which leaves so much ill-health behind it. You, it has left with dyspepsia and nervous weakness—perhaps its commonest legacy. You must be exceedingly careful of your diet. The wind in your stomach you can relieve by bicarbonate of soda or by two or three drops of essence of ginger in a wineglassful of water. At the present time you should feed as well as your dyspepsia will admit; and, really, to treat indigestion properly does not entail many privations. Meat and malt wine, or cod-liver oil and maltine would do you good if you can digest it; or you might derive great benefit from a course of iron with quinine or other bitter tonic. But you cannot take the last until your indigestion is relieved.
Evelyn.—If you go to a dental hospital, they will tell you where you can get artificial teeth cheaply. It is against our rules to give the name or address of any person.
Molly.—Before attempting to cure any ailment, it is necessary to discuss two questions. The first is—What is the nature of the trouble? The second is—What has caused it? It is only in certain cases that one can answer both these questions definitely; but the more clearly he answers these, the more rational and efficacious will be the treatment of the malady. And in the treatment itself, the first thing to do is to remove the cause, if possible. Now what causes your hands to get “hot and clammy?” There is a possibility that it may be a purely natural condition, for the palms of the hands perspire more freely than any other part of the body, and persons vary extremely in the quantity of fluid which exudes through their skin. Or your trouble may be due to some unhealthy cause. Persons who are suffering from many forms of illness perspire profusely. One of the commonest causes is indigestion, which acts in this way. The stomach lies just below the heart, and when the stomach is in difficulty it worries the heart, and so interferes with the circulation. This is the cause of the flutterings, palpitations, flushes and excessive perspirations, so common in indigestion. You must therefore see to your digestion; also wash your hands frequently in warm water with a good soap, and occasionally rinse your hands in diluted toilet vinegar. Do not wear kid gloves, but if you require any gloves at all wear thin silk ones. Healthy exercise is necessary in this as in every other condition.
Elsa.—This correspondent asks us the following question. “My father and mother died of consumption, and one of my sisters is in the last stages of the same disease; am I going to get consumption?” We are going to answer this question at length because it gives us an opportunity for demonstrating what is meant by hereditary influence in disease; and also because here is a poor girl worrying herself over a calamity which may never occur. We say that consumption is an hereditary disease, but this is not accurate. The disease is not hereditary, but the tendency to it is. Consumption is a chronic infectious disease caused by the presence of the tubercle organism in the body. It may and does strike down anybody; but those who are sprung from a family with a tubercular history are more liable to be attacked than others. We have a great deal of evidence to show that nearly one-tenth of the human race becomes infected with tuberculosis, but only a very small proportion of those infected succumb, or indeed ever show symptoms of the disease. Now it is presumable that those who do show symptoms have some extra factor which prevents their throwing off the disease. For instance, persons who suffer from chronic bronchitis, or who are barrel-chested, or who are run down in health, etc., are less likely to successfully combat the disease than are others. It is therefore one of these extra factors which is hereditary; it may be a peculiarly-shaped chest, for instance. Nobody is born with the tubercle germ inside her. So if every relative of yours died of consumption, you can prevent yourself from contracting the disease by running away from the tubercle germ and living in a spot where this worst of all human pests does not exist. Unfortunately this germ is almost ubiquitous. It swarms in every city and town, and lurks by rivers and in sandy wastes. It does not inhabit the ocean or the high latitudes or the tops of mountains. The sea-coast is much less impregnated with this germ than are the inland parts. The germ apparently dislikes the north wind, and is therefore comparatively uncommon on our East coasts. Therefore, if you have a special dread of consumption, live in a land where the tubercle bacillus does not thrive.
Athena.—Occasionally it is possible to restore the original form to a nose which has been broken. Where there is great lateral deformity, the question of correcting the displacement is well worth considering. In the minor grades of distortion of the nose, due to old injuries, it is scarcely worth while to have an operation done. In recent injury the nose should always be “set” at once, for in this case deformity can be almost always prevented. But remember that, if you have had your nose “set” after a recent injury, and still deformity does occur, you must not lay the blame on the surgeon. All operations on the nose or any other part of the face should be done by a specialist, if possible.
Olga Bertha.—The probable cause of your trouble is anæmia and nervous exhaustion. We cannot enter at length into the treatment of this condition as we have done so many times already. You had better give up bicycling for a time till you feel stronger again. Drinking large quantities of water does dilute the blood, but only for a second or two, for if more water than is necessary is drunk, though it is absorbed into the blood it is thrown out again immediately by the skin, the kidneys and the lungs. Drinking large quantities of fluid with meals is a potent cause of dyspepsia, for the gastric juice cannot digest anything when it is too much diluted. Perhaps you would derive benefit from meat and malt wine, or maltine.
Natator.—There have been many explanations of the cause of cramp while bathing, and it is not yet definitely settled which, if any, of these is correct. The most probable theory is that cramp is due to over-distention and paralysis of the heart. According to this hypothesis, the contact of the skin with the cold water causes all the blood-vessels of the skin to contract and so force the blood which was contained in them into the internal vessels. As more blood than usual will be thus thrown into those vessels which are deeply situated, the blood pressure will rise greatly. The heart has to overcome this pressure before it can drive the blood through the body. But if the pressure is exceedingly high, the heart may be unable to overcome it—a condition which means instantaneous death. But there are two conditions in which cramp occurs whilst bathing. In the first way, the instant the bather enters the water she is struck down by cramp, and if help is not instantly forthcoming she dies in a few seconds. In the second case, the bather is all right till she has been in the water perhaps half an hour; she is then gradually seized with cramp. Let us see if we can reconcile both these conditions to our heart theory? The first is obvious from the above. In the second case we must presume that although the blood pressure is raised, still the heart, being healthy and strong, can overcome it. But after half an hour’s violent exercise the heart begins to tire, and is now no longer capable of working against the great resistance. This form of cramp is therefore more gradual than the first; but both forms are necessarily fatal unless timely help is at hand. Most of the other theories of cramp refer the condition to temporary derangements of the nervous system, but Broadbent, the greatest authority on the heart, is much in favour of the theory we have just enunciated.
Terror.—A bunion is an inflammation of the joint of the great toe. It is almost always due to the pressure of an ill-fitting boot. In the normal foot the great toe stands away from the other toes, and so, if boots were made to resemble the foot, the inner border would be either perfectly straight or slightly curved towards the middle line of the body. But cobblers have improved on Nature, and they make boots in which the inner border meets the outer border in a point. In consequence of this absurdity, the great toe is forced towards the other toes; its chief joint is partially dislocated and the ball of the toe forms a projection on the inner side. This ball is part of the joint, and so the side of the boot actually presses upon the joint itself. This the joint is unable to stand. A “bursa”—that is, a sort of water-cushion—is developed above the ball of the toe, and so protects the joint from pressure. This is Nature’s method of preserving the human foot from the ignorance and stupidity of its owner. But although Nature is very cute in her way, she is unable to cope with the owner of the foot, whose stupidity gets the better of the struggle, though her foot comes off very badly indeed. Nature has provided the above-mentioned water-cushion, but the boots are still tight and misshapen. The “water-cushion” now becomes inflamed, its edges get thickened, the joint underneath the water-cushion shares in the inflammation and becomes destroyed. This is a bunion. So, after all, Nature does get the better of it. She says she will not have joints distorted and pressed upon, and she has got her way, only she has had to destroy the joint altogether. The treatment of a bunion depends upon the stage of the disease. In the early stages merely wearing properly-shaped boots will undo the mischief. At a later date, a special boot with a special compartment for the great toe must be worn. In the last stages, nothing but a surgical operation—no less than cutting away the joint—will give relief. We cannot too strongly impress upon you the necessity of wearing rightly-shaped boots which do not distort the great toe. For a bunion is really a serious disease, and, moreover, if its cause is not removed, it is a progressive disease, and will leave you in the end either a cripple for life or with the necessity of having to submit to a surgical operation of moderate severity.
Curious.—Pepsin is obtained by scraping the stomach of a pig or calf. It is the chief digestive agent secreted by the gastric juice. Papain is a vegetable production, having much the same action as pepsin, but is not so likely to do harm when taken for indigestion. Peptone is the name given to the product of albumin (proteid) when completely digested. You will find an account of the digestion in any book on physiology.
“One of the Old Girls.”—We fear that we cannot answer your questions, for we never have given and never will give the address of any chemist, physician or herbalist, or of any professional or tradesmen whatsoever, in this column. As we know of no depilatory which is useful without being injurious, we could not answer your question under any circumstances. As a well-known physician once tersely put it, “There is no depilator which is not a delapidator.”