Bed-sore.
When a patient is confined to his bed for a long time it is necessary to support the lower part of the back on something soft, such as a pad of wool, or an extra pillow, in order to prevent the formation of a bed-sore; pillows should also be placed under the hips and heels.
To harden the skin it is well to rub it with alcohol or to treat it with oil or white of an egg three parts, and spirits one part; zinc ointment is also useful for this purpose.
Besides pressure, the most frequent cause of bed-sores is constant moisture from the passage of urine and motions and consequent damping of the sheets. Great care must be taken to thoroughly dry the back after any evacuation; the lower part of the back should be dusted with a powder of boric acid and zinc oxide.
If a bed-sore is present the patient should lie on a circular pad with a hole in the middle, to take pressure off the bed-sore. The sore should be thoroughly cleaned twice a day with some antiseptic lotion, such as chinosol or permanganate, and subsequently dressed with zinc ointment or vaseline.
If the bed-sore is on the back, the patient should lie if possible on each side alternately, to relieve the pressure.
Beri-beri.
In most cases this is a disease due to some deficiency in the dietary, which leads to a form of what is called peripheral neuritis. The name is possibly derived from a Cingalese word signifying “I cannot.”
Symptoms.—Weakness of the legs and digestive troubles, abnormal sensations in the legs, frequently associated with swelling. The gait alters, and the arms and fingers may be affected. The condition is one of spreading paralysis, and in bad cases the heart is affected. In so-called wet beri-beri the patient becomes bloated as in dropsy, while in dry beri-beri he wastes away until he is little better than a skeleton. There is a “squatting test” which may enable one to recognize the disease at an early stage. The patient, with his hands on the top of his head, is unable to assume a squatting position and to rise from it unaided. If he is squatting and has to rise he accomplishes the act by climbing, as it were, up his own legs.