Sleeplessness.
This is common in those broken down by malaria, dysentery or debilitating diseases; it is also induced by the irritation caused by mosquitoes and other pests, such as the itch parasite. It is at times due to errors of diet, prickly heat, mental worry and exhaustion, abuse of tea and coffee, coldness of the feet and indigestion, and as most acute diseases are worse at night, sleeplessness is very common amongst sick people.
Treatment.—As far as possible remove the cause; kneading the feet and legs, or the application of a hot-water bottle to the feet, will often be of service. A cup of hot milk or soup should be taken at bedtime, and again on waking in the night. The bowels must be regulated and alcohol taken very sparingly.
The taking of sedative drugs should be avoided as much as possible. The least harmful of these is sulphonal in doses of from twenty to thirty grains, given several hours before bedtime, or bromide of potassium in twenty or thirty-grain doses given at bedtime. A warm bath at night often acts more satisfactorily than any other remedy. Only very rarely should chloral, chlorodyne, or opium be resorted to.
Regular habits and plenty of work are potent factors in the production of that healthy condition which predisposes to natural refreshing sleep.
The unfortunate man who has no hard work to do, who is without even a hobby to occupy him, and has no interest in life but the torpid condition of his liver, is a constant sufferer from insomnia. He should be purged and put on a light plain diet. Alcohol must be forbidden and plenty of exercise must be taken. A tumblerful of hot water is to be taken the first thing in the morning and the last thing at night.
Small-pox.
Very prevalent in the tropics, hence the importance of revaccination before going abroad.
Incubation period, twelve days. Rash appears third day.