A good hot bath (104° F.) is very beneficial, and it may be advantageous to make it alkaline, by adding about 6 oz. carbonate of soda (washing soda) to the bath before entering it; this will be specially efficacious in stiffness of the joints or muscles. Of the many drugs which have the effect of inducing free perspiration, solution of acetate of ammonia may most safely be used in tablespoonful (adults) doses freely diluted with water. The bowels may be opened by a mild aperient, preferably saline, taken largely diluted in hot water, and early in the morning. The action of the kidneys ought to be kept up by diuretics, the simplest being water, say a tumblerful drunk slowly in the morning, while dressing, or it may be rendered more energetic by the addition of 1 teaspoonful cream of tartar.
Diet ought to be restricted to light forms of solid food, e.g., fish, soups, chicken, puddings, vegetables, fruit, milk. Beer and wines should be avoided; ærated waters may be taken freely; smoking is prejudicial. Finally, persons who suffer from rheumatism ought always to wear flannel next the skin, and encourage perspiration. Most alkalies are useful in relieving rheumatism. Potash, or soda bicarbonate may be freely used in doses of ½ teaspoonful, in ½ tumbler of ærated water, twice daily, for 3-4 weeks at a time.
Sea-sickness.—Many people, as soon as sea-sickness commences, have recourse to oranges, lemons, &c. Oranges are very much to be avoided, on account of their bilious tendency, and even the juice of a lemon should only be allowed in cases of extreme nausea. Champagne, too, is a very common remedy, and, without doubt, in many cases does good; but this appears to be chiefly due to its exhilarating effects, as, if it be discontinued, the result is bad, and a great amount of prostration follows. Creosote is an old, but still good, remedy, and, in cases accompanied by great prostration, is very useful; but if given in the early stages of sea-sickness, it is often followed by very bad results, and even increases the nausea. Bicarbonate of soda is useful in slight cases, as it relieves nausea, and checks the frequent eructations which often follow attacks of sea-sickness; but in severe cases it is absolutely useless, and, in fact, it very often prolongs the retching. A very good remedy in the earlier stages of sea-sickness is a teaspoonful of Worcester sauce; it relieves the symptoms, and renders the patient easier. Its action is probably of a stimulant nature. Hydrocyanic acid is of very little service, and most acid mixtures are to be avoided, except that perhaps for drinking purposes, when it is best to acidulate the water with a small quantity of hydrochloric acid. Of all drugs the most effectual is sodium bromide. When sodium bromide is given in doses of 10 gr., 3 times a day, the attacks entirely subside, the appetite improves, and the patient is able to walk about with comfort. In sea-sickness it is very desirable that the patient should take sufficient food, so that at all times the stomach may be comfortably full, for by this means over-straining during fits of retching is prevented, and the amount of nausea is diminished. The practice of taking small pieces of dry biscuit is not of much use, as although the biscuit is retained by the stomach, yet the amount taken is never sufficient to comfortably fill the stomach. Soups, milk-puddings, and sweets are to be avoided, as they increase the desire to be sick, and are followed by sickening eructations. Fat bacon is easily borne, and does much good, if only the patient can conquer his aversion to it. When taken in moderate quantity it acts as a charm, and is followed by very good results. Of all food, curry is the most useful in sea-sickness, and is retained by the stomach when all other food has been rejected. Next to curry come small sandwiches of cold beef, as they look nice on the plate, and are usually retained by the stomach. Brandy should be used very sparingly, as, in many cases, it induces sea-sickness; and its chief use is confined to those cases where the prostration is very great, and even then champagne is more effectual. (Dr. Kendall, Brit. Med. Jour.)
Skin complaints.—Many of these are of a character to demand the early attention of the doctor, but there are others which can readily be combated by home treatment.
Pimple (Acne).—These are a frequent trouble in young people and may be very disfiguring. They arise from inefficient action in the fat (sebaceous) glands of the skin. Generally they can be dislodged by squeezing with the thumb nails. To promote healthy action of the glands and prevent formation of the pimples, Dr. Liveing recommends the following plan.
(a) Steam the face every night by holding it over a basin of hot water for a few minutes. (b) Rub the skin for 5-10 minutes with soap (preferably terebene) and flannel, or with a soft nailbrush; then sponge off the soap with warm water. (c) When the face has been dried, a lotion should be thoroughly applied, composed as follows: ½ oz. precipitated sulphur, 2 dr. glycerine, 1 oz. spirits of wine, with 3 oz. each rose-water and lime-water. This is allowed to dry on the skin and to remain on all night. In the morning the face is cleansed with warm oatmeal and water or weak gruel. If, for any reason, an ointment seems preferable to a lotion, a combination of precipitated sulphur and vaseline is very useful. The treatment must be modified or suspended for 2 or 3 nights if the skin becomes sensitive and somewhat tender. If this plan be unsuccessful, try application of potash soap in the form of a lotion. The lotion is composed of 1 oz. each soft soap and rectified spirits of wine, and 7 oz. rose (or distilled) water. This should be rubbed in vigorously with a piece of flannel for a short time, taking care not to make the skin sore. According to Dr. Liveing, the worst cases of acne will yield to the soft soap treatment if practised with necessary caution.
Something is often required to be done during the daytime to pacify the heat and throbbing, which are part of the usual history of acne. An excellent lotion is made by combining oxide of zinc, calamine, prepared chalk, lead lotion, and lime-water, to which may be added a small quantity of glycerine. Let the bottle containing this be gently waved about so as to diffuse the materials, which are only held in suspension; then pour a little into a saucer, and with a sponge (reserved for the purpose) sprinkle the face from time to time. Wipe off, when necessary, with a bit of fine muslin the powder which remains on the skin after the evaporation of the fluid, and the face may be washed occasionally with a little starch gruel. The cases are not a few in which it is better not to use any kind of soap as part of the evening ceremonial. After the face has been steamed, put on a medicated jelly composed of zinc oxide, gelatine, and glycerine. It must be liquefied by putting the vessel that holds it into hot water, and then applied with a brush. Some sensitive skins are intolerant of sulphur in any guise. When this is so, try combinations of lead, chalk and zinc, blended as a quasi-ointment with the finest vaseline. Dr. McCall Anderson’s formula of bismuth oleate with vaseline and white wax has been aptly described as “one of the most healing of salves.” Sometimes nothing agrees better than the old-fashioned but capital substance called Kirkland’s “neutral cerate,” which is composed essentially of lead plaster and olive oil.
Nettlerash.—A form of nettlerash seen in little children, showing itself as slightly raised red blotches, worst in the night, is referred to “teething,” and that is thought sufficient reason for neglecting it. The best treatment is strict attention to cleanliness and diet. The child should get a tepid bath night and morning. Take care that no part of the dress irritates the skin, flannel not being allowed to touch it; and let the patient enjoy fresh air and sunshine. If itching continues, instead of a simple tepid or warm bath at night, an alkaline bath should be given in this bath: in 8-10 gal. water as warm as the hand; dissolve 1-2 oz. soda bicarbonate. Bathe the child for a few minutes, do not be too exact in drying, and put to bed immediately. Nettlerash in adults requires medical treatment.
Eczema.—Of this skin disease there are many forms, all arising more or less from a disordered state of the blood, and demanding medical advice. As a general rule, the patient should avoid soap in washing, using oatmeal instead. Starchy food, such as potatoes, are deemed unsuitable, while plenty of green vegetables and fruit should be taken. Clean linen is essential, and the patient’s towel should not be used by any one but himself.