Insomnia.—The next time a sufferer finds himself awake, say 2 or 3 o'clock in the morning, instead of merely trying to banish the painful thought and repeating numbers, according to habit, let him revert at once to the dream which was the cause of his awakening, and try to go on with it. Sleep will come soon. It is stated on good authority that this experiment, oft repeated, has never been known to fail.
A correspondent of the Lancet gives the following method of self-asphyxiation as an effectual remedy for insomnia in his own case: After taking a deep inspiration, he holds his breath till discomfort is felt, then repeats the process a second and third time. As a rule this is enough to procure sleep. A slight degree of asphyxia is thus relied on as a soporific agent.
Leprosy.—An interesting report by the Hawaiian Board of Health is in our hands; incomplete statistics give the number of lepers in the several islands of the Hawaiian group on January 1, 1888, as 400. A statement of the leper population at Leper Settlement at Molokai for the biennial period ending March 31, 1888, is 749.
The report says: "Accurate statistics as to the number of lepers still at large in the various communities of this country cannot be obtained." It is estimated from the best data obtainable, that there were 644 lepers at large on the islands on March 31, 1888.
The report says: "The rations furnished each leper at the Leper Settlement on Molokai are abundant for the support of any adult Hawaiian."
One of the embarrassing questions the board is called upon to decide is, how many of the non-leper friends and relatives of the afflicted ones shall be allowed to go and live with them at the leper settlement as helpers, or kokuas, the number of applicants being in excess of the demand. The great obstacle to be overcome in carrying out the law of segregation consists in the fact that the Hawaiians do not appreciate and refuse to be convinced that leprosy is a communicable disease. It is with them as if devotion to a fatal sentimentality had bid defiance to every instinct of self-preservation. Marriages between leprous and non-leprous individuals are freely contracted, and the intimacies are not prevented by the fact of potent evidences of the disease. "If this race is ever to be rescued from the slough into which it is sinking, the fatal lethargy that stupefies them must be dispelled, the instinct of self-preservation must be awakened, and it must be written upon their hearts, as with the point of a diamond, that to voluntarily contaminate one's self with leprosy is a crime. In spite of a number of claims to the contrary, we believe it safe to say that no one has been able to prove, to the satisfaction of the medical profession, who very rightly demand full proof in such cases, that a single unmistakable case of this disease has been definitely cured." Says the report: "It is necessary always to bear in mind that the symptoms of leprosy, like those of some other diseases, have a way of receding or entirely disappearing for a time, only to show themselves again when least expected."
Government physicians generally attribute the causes which are checking the increase of the Hawaiian population to be leprosy; also the indolent and easy nature of the natives, which causes them to rest content, provided they can obtain the bare necessities of life. They are content to sit idle while their places are being filled with Chinese, and their lands are gradually passing from their possession. This apathy causes them to degenerate, both mentally and physically, and thus leads to the smallness of families and the general extinction of the race.
The following description of how this terrible disease develops and affects the patient is taken from the Hankow (China) Medical Mission report: "Leprosy is common. It chiefly affects men who work in the field; we have met with it in brothers; it is occasionally met with in women. The age varies from ten to fifty years. Often the first symptom complained of is some localized anæsthesia—which is sometimes quite accidentally discovered—in the feet, hands, or face, which are the parts that are most commonly affected. The sensory nerves are first affected, and sensation as a rule absent partially or completely. The anæsthesia is followed by want of free use of affected parts; the circulation is also impaired in those parts; the hair on the eyebrows falls out. A peculiar punched-out-looking ulcer, with a very fetid discharge, is often met in the feet; sometimes, but not so often, in the hands. As the disease advances, which it does very slowly—it often apparently remains stationary for years—the face broadens, becomes square, glazed, irregular and nodular; nodules are also found in the mucous membrane of the lips and in the nerves; perspiration is absent; the natural expression of the face is completely changed; the patient looks old and sad. As the disease further advances, the toes and fingers drop off, and by and by part of the limb. The general health is never affected. Treatment is not very satisfactory; symptoms seem to be controlled for a time, but never cured."
Lockjaw.—Professor Renzi, of Naples, records several cases of tetanus successfully treated by absolute rest. The method advocated is as follows: The patient's ears are closed with wax, after which he is placed in a perfectly dark room, far from any noise. He is made to understand that safety lies in perfect rest. The room is carpeted heavily in order to relieve the noise of stepping about. The nurse enters every quarter of an hour with a well-shaded lantern, using more the sense of touch than sight to find the bed. Liquid food (milk, eggs in beef tea, and water) is carefully given, so that mastication is not necessary. Constipation is not interfered with. Mild doses of belladonna or secale are given to relieve pain. This treatment does not shorten the disease, but under it the paroxysms grow milder, and finally cease. Numerous physicians attest to the value of this treatment.
Marriage.—The Medical Record says the unpopularity of marriage in England continues unabated, and last year was the first in recent times in which, while the price of wheat fell, the marriage rate remained stationary. It is now 14.2 per 1,000. The decline in the popularity of matrimony is greatest with those who have already had some experience of wedded life. Between 1876 and 1888 the marriage rate fell 12 per cent for bachelors and spinsters, 27 per cent for widowers, 31 per cent for widows.