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.