Part 23

For treatment, unless distinct running sores are formed, bathe the limb with warm water and M'Clinton's Soap, which will remove all crusts, scabs, &c. Then apply zinc ointment. Do not bathe or poultice after the first time. All secretion can be removed by a piece of cotton wool dipped in warm olive oil. If deep running sores have formed, then we must have a water-tight box of rough deal in which the whole leg up to the knee can be bathed for an hour in hot water. We see no reason why it should cost much over a shilling to get this, and it would be a sore want if it could not be procured. It is so made that the leg and foot can rest easily in it while it is nearly full of hot water. It need not be wider than just to hold the limb easily. Some good-hearted joiner will put five small boards together so as to meet this want. We shall suppose that it is supplied. Now for a few cloths, such as will cover the diseased parts, about three-ply all round. Then for vinegar or acetic acid, so diluted with water that it will just cause a slight smarting when heated and touching the affected skin. It must not be so strong as to cause burning, nor so weak as to give no sense of its presence at all, but between these extremes. It can be tried when too weak, and vinegar or other acetic acid added till a gentle smarting is felt. The cloths are dipped in the diluted and heated vinegar, allowed to drip till no more falls off, and then laid tenderly all round the sore. A strip of dry cloth may then be wound round so as to keep these on, and the leg thus dressed placed in the bath. It should be kept there, with now and again a gentle movement, and the strong comfortable heat of the water kept up for an hour, unless the patient should feel sickness before that time. If this comes on, the water is too hot; but, instead of merely cooling it, the bath may cease for the time, and water not so hot may be tried on a second occasion. Whether the hour has been reached or not, good has been done. The leg is taken out of the hot water and gently dried--not rubbed, but dried without rubbing. Then as much cloth as will go twice round all is dipped in warm olive oil, and this is pressed out a little, so that it may not run. The oiled cloth is wrapped all round the limb. Some dry cloth is also wrapped round, and the first treatment is completed. This should be repeated every night before going to bed, for a week at least. It may be required for a fortnight if the case is bad and no rest at all can be had during the day. We should say the cure may fail for want of this rest, but this is not likely. In the morning as soon as convenient, the diseased skin should be soaked with a warm vinegar cloth, so that it shall smart just a little. It should then be dressed again with the warm olive oil. If at any time during the day or night it gets irritated and troublesome, this morning dressing may be repeated. It will not be very long before the one leg is as good as the other. The general health, too, of the patient will be sensibly improved.

It is scarcely necessary to point out that a similar treatment to this will cure "outstrikings" of the same sort in the arms and other parts of the body, as well as upon the legs. There is required only some such modification of the appliances as may meet the particular case. For example, we have seen the outstriking between the shoulders, so that it could not be reached by bathing, unless by appliances utterly out of the question in the circumstances. But dressing with hot vinegar cloths, allowing these to remain on for twenty minutes or so, and then dressing with warm olive oil, allowing this to remain for two or three hours, is quite possible to any one who is so affected; and this will usually be sufficient for a cure.

You have, perhaps, been cured temporarily more than once with arsenic, and the evil has returned worse and worse. In that case you may require all the more patience and the longer application of the above treatment; but, once cured in this way, you will not, so far as a good long experience enables us to judge, be likely to have any relapse. In very bad cases we have seen poultices of mashed potatoes made with buttermilk cleanse the diseased parts most effectually, and then the acid takes healing effect very speedily. In these cases ordinary medical treatment had utterly and hopelessly failed.

Pain, Severe, in Limbs.--This is often not due to any trouble in the joint itself, but to some disorder in the large nerves which have their roots in the lower part of the back. In the case of severe pains in the back of the leg, ankle, or knee, when a chill to the large limb nerves has been the cause, and has raised inflammation, the patient should be put warm in bed. Take two large towels, thoroughly wrung out of cold water. Fold one six or eight ply thick. Gently press this, avoiding cold shock to the patient, over the lower part of the back. When this towel gets hot, spread it out to cool, and apply the other. Continue this with each towel alternately, and when finished, or after an hour, rub the skin with warm olive oil and cover up with new flannel. Similar cold applications to the _upper_ part of the spine will cure such pains in the wrists. If the cold application intensifies or fails to relieve the pain, it is well to try the ARMCHAIR FOMENTATION (_see_).

Sometimes light pressure in the form of squeezing the muscles of the lower back is very useful. A very gentle pressure on the right parts is most pleasant to the sufferer. At first it simply relieves in some degree the weary feeling of the limbs. When it is at all well done, it soon raises a gentle heat, which slowly passes down the limbs, even to the very toes. This is just life itself communicated to the limb. But we must not confine our treatment to the spinal cord. The squeezing, or gentle pressure, must be carried down the limb; and when new life has been infused so far, it will be well to apply the pressure between the hands to the swollen and painful part. _See_ Massage.

Palpitation.--Ordinarily we are not aware of the beating of the heart, enormous as is the work it does; but in certain cases this beating becomes distressingly violent, especially on lying down flat or in ascending hills or stairs. The latter cases are the more s