“ MEASLES.—Measles is a contagious disease, characterized by a preliminary stage of fever and catarrh of the eyes, nose, and throat, and followed by a general eruption on the skin. One attack practically protects a person from another, yet, on the other hand, second attacks occur with extreme rarity. It is more contagious than scarlet fever, and isolation of a patient in a house is of less service in preventing communication to other inmates, whereas in scarlet fever half the number of susceptible children may escape the disease through this precaution. ”

“ Fractures are partial or complete, the former when the bone is broken only part way through; simple, when the fracture is a mere break of the bone, and compound, when the end of one or both fragments push through the skin, allowing the air with its germs to come in contact with the wound, thus greatly increasing the danger. To be sure that a bone is broken we must consider several points. The patient has usually fallen or has received a severe blow upon the part. This is not necessarily true, for old people often break the thigh bone at the hip joint by simply making a false step. ”

“ For the layman the following points are offered: intermittency of chills and fever, or of fever alone, should suggest malaria, particularly in a patient living in or coming from a malarial region, or in a previous sufferer from the disease. In such a case treatment with quinine will solve the doubt in most cases, and will do no harm even if the disease be not malaria. Malaria is one of the few diseases which can be cured with certainty by a drug; failure to stop the symptoms by proper amounts of quinine means, in the vast majority of cases, that they are not due to malaria. ”

“ Now they not only know that malaria is caused by an animal parasite living and breeding in the blood and that quinine destroys the foe, but they know about the parasite's habits and mode of development and when it most readily succumbs to the drug. Thus a great discovery taught them to give quinine understandingly, at the right time, and in the right doses.
An educated physician has at his command all knowledge, past and present, pertaining to medicine. He is free to employ any means to better his patient. ”

“ The coughing fits increase and the child gets red in the face, has difficulty in getting its breath during them, and sometimes vomits when the attack is over. After a variable period, from a few days to two weeks from the beginning of the cough, the peculiar feature of the disease appears. The child gives fifteen or twenty short coughs without drawing breath, the face swells and grows blue, the eyeballs protrude, the veins stand out, and the patient appears to be suffocating, when at last he draws in a long breath with a crowing or whooping sound, which gives rise to the name of the disease. ”

“ WOUNDS.—A wound is a condition produced by a forcible cutting, contusing, or tearing of the tissues of the body, and includes, in its larger sense, bruises, sprains, dislocations, and breaks or fractures of bones. As ordinarily used, a wound is an injury produced by forcible separation of the skin or mucous membrane, with more or less injury to the underlying parts. ”

“ The patient seems to have a bad cold, with cough, running at the nose, and sore eyes. German measles is mild, and while the rash may look something like that of scarlet fever, the patient does not seem generally ill, is hardly affected at all, though rarely troubled with slight catarrh of the nose. In no sickness are the services of a physician more necessary than in scarlet fever; first, to determine the existence of the disease, and then to prevent or combat the complications which often approach insidiously. ”

“ Consider first the average American household, where the family physician cannot call every day. Not a day finds this household without the need of information in medicine or hygiene or sanitation. More efforts of the profession are thwarted by ignorance than by epidemic. Not to supplant the doctor, but to supplement him, carefully prepared information should be at hand on the hygiene of health—sanitation, diet, exercise, clothing, baths, etc.; on the hygiene of disease—nursing and sick-room conduct, control of the nervous and insane, emergency resources, domestic remedies ”

“ A dog can be killed by a current of ten volts pressure when contacts are made to the head and hind legs, because the current then flows through the heart, while a current of eighty volts is required to kill a dog, under the same conditions, if contacts are made to head and fore leg. In a general way alternating currents of low frequency are the most injurious to the body, and any current pressure higher than two hundred volts is dangerous to life. On the other hand, a current of ninety-five volts has proved fatal to a human being. ”

“ Those to whom the doctor cannot come every day have been repeatedly warned of the follies of self-treatment, and reminded that to-day it is the patient that is treated—not the disease. Those to whom the doctor cannot come in time are likewise warned that the "First-aid Rules" of this Library are for temporary treatment only, in all situations where it is possible to get a physician. ”

“ In accordance with this definition malaria is not a contagious disease in the sense that it is acquired by contact with the sick, which is not the case, but it is derived from contact with certain kinds of mosquitoes, and can be contracted in no other way, despite the many popular notions to the contrary. Mosquitoes, in their turn, acquire the malarial parasite by biting human beings suffering from malaria. It thus becomes possible for one malarial patient, coming to a region hitherto free from the disease, to infect the whole [Pg 248] district with malaria through the medium of mosquitoes. ”

“ In fracture of the leg between the knee and ankle we have pain, angular deformity or an apparent false joint in the leg, swelling and tenderness over the seat of fracture, together with inability to use the injured leg. Two bones form the framework of the leg; the inner, or shinbone, the sharp edge of which can be felt in front throughout most of its course, being much the larger and stronger bone. When both bones are broken, the displacement of the fragments, abnormal motion and consequent deformity, are commonly apparent, and a grating sound may be heard, but should not be sought for. ”

“ Again, the physician cannot come on time to save life, limb, or looks to the victim of many a serious accident. And yet some bystander could usually understand and apply plain rules for inducing respiration, applying a splint, giving an emetic, soothing a burn or the like, so as to safeguard the sufferer till the doctor's arrival—if only these plain rules were in such compact form that no office, store, or home in the land need be without them. ”

“ Fracture of the collar bone is one of the commonest accidents. The bone is usually broken in the middle third. A swelling often appears at this point, and there is pain there, especially on lifting the arm up and away from the body. It will be noticed that the shoulder, on the side of the injury, seems narrower and also lower than its fellow. The head is often bent toward the injured side, and the arm of the same side is grasped below the elbow by the other hand of the patient and supported as in a sling. ”

“ The normal amount of urine passed in twenty-four hours in health is over three pints, and while not more than two-thirds of this amount could be expected to be passed by a fever patient, yet in yellow fever the passage of urine may be almost or wholly suppressed. The course of the disease varies greatly. In children—especially of the Creoles—it is frequently so mild as to pass unnoticed. In adults the fever may only last a few hours, or two or three days, with gradual recovery from the various symptoms, and yellowness of the skin lasting for some time. ”

“ In the absence of a physician, vaccination may be properly done by any intelligent person when the circumstances demand it. Vaccination is usually performed upon the outside of the arm, a few inches below the shoulder, in the depression situated in that region. If done on the leg, the vaccination is apt to be much more troublesome and may confine the patient to bed. The arm should be thoroughly washed in soap and warm water, from shoulder to elbow, and then in alcohol diluted one-third with water. ”

“ If, however, in any circumstances one should have the misfortune to have the care of a typhoid patient remote from medical aid, it is a consolation to know that the outlook is not greatly altered by medicine or special treatment of any sort. ”

“ The muscles are usually relaxed, but sometimes there are twitchings, or even convulsions. Death often occurs within twenty-four or thirty-six hours, preceded by failing pulse, deep unconsciousness, and rapid breathing, often labored or gasping, alternating with long intermissions. Sometimes delirium and unconsciousness last for days. Diminution of fever and returning consciousness herald recovery, but it is a very fatal disorder, statistics showing a death rate of from thirty to fifty per cent. Even when the patient lives, bad after effects are common. ”

“ The fever is best overcome by cold sponging, which at the same time diminishes the nervous symptoms, such as restlessness and delirium. The body is sponged—part at a time—with water at the temperature of about 70° F., after placing a single thickness of old cotton or linen wet with ice or cold water (better an ice cap) over the forehead. The part is thoroughly dried as soon as sponged, and the process is repeated whenever the temperature is over 103° F. There need be no fear that the patient may catch cold if only a portion of the body is exposed at any one time. ”

“ The female lives in the sand and attacks man, on whom she lives, boring into the skin about the toe nail, usually, and laying her eggs under the skin, which gives rise to itching at first and then violent pain. The insect sucks blood and grows as it gorges itself, producing a white swelling of the skin in the center of which is seen a black spot, the front part of the flea. The flea after expelling its eggs drops off and dies. People with habitually sweaty feet are exempt from attacks of the pest. ”

“ Yellow fever is not at all contagious in the sense that a healthy person can contract the disease by contact with a yellow-fever patient, or with his discharges from the stomach, bowels, or elsewhere, and is probably only communicated to man by the bite of a particular kind of mosquito harboring the yellow-fever organism in its body. ”

“ FLIES.—The common housefly does not bite, but is constantly inimical to human health by conveying disease germs of typhoid fever, cholera, and other disorders from bowel discharges of patients suffering from these diseases to articles of food on which the insects light. Flies have been a fruitful source of sickness in military camps, as evidenced in the recent Spanish-American and Anglo-African campaigns. The bites of the sandfly, gadfly, and horsefly may be both relieved and prevented by the same means recommended in the case of mosquitoes for these purposes. ”

“ When the loss of blood has been considerable, so that the patient is pale, faint, and generally relaxed, with cold skin, and perhaps nausea and vomiting, he should be stripped of all clothing and immediately wrapped in a blanket wrung out of hot water, and then covered with dry blankets. Heat should also be applied to the feet by means of hot-water bags or bottles, with great care not to burn a semiconscious patient's skin. ”

“ Cooking the food, preventing contact of flies with the patients, and keeping flies out of human habitations becomes imperative. Milk is a source of contagion through contaminated water used to wash cans, or to adulterate it, or through handling of it by patients or those who have come in contact with patients. Oysters growing in the mouths of rivers and near the outlets of drains and sewers are carriers of typhoid germs, and, if eaten raw, sometimes communicate typhoid fever. Dust is an occasional medium of communication of the germ. ”

“ Detection.—It is impossible for the layman to determine the existence of typhoid fever in any given patient absolutely, but when the symptoms follow the general course indicated above, a probability becomes established. Unusual types are among the most difficult and puzzling cases which a physician has to diagnose, and he can rarely be absolutely sure of the nature of any case before the end of the first week or ten days, when examination of the blood offers an exact method of determining the presence of typhoid fever. ”

“ Tincture of iodine painted all over the end of the finger is also useful, and the hand should be carried in a sling by day, and slung above the head to the headboard of the bed by night. If after twenty-four hours the pain increases, it is best to apply hot poultices to the finger, changing them as often as they cool. If the felon has not begun to abate by the end of forty-eight hours, the end of the finger must be cut lengthwise right down to the bone by a surgeon to prevent death of the bone or extension of the inflammation. ”