In heat prostration, as already stated, the surface of the body is cool, the pulse rapid and feeble, and there is a feeling of general weakness. There may be only slight faintness and nausea, and under prompt treatment patient may rapidly recover, or, on the other hand, there may be complete loss of consciousness and a rapid and fatal termination from exhaustion.

Heat cramps.-Painful spasms of the muscles, especially those of the abdomen and limbs, may occur when persons who are exposed to high temperatures are required to perform hard labor. Stokers on steamships are liable to suffer from them. They are extremely painful, making the patient cry out; there is headache, and the bowels are constipated. In some cases the patient is unconscious, and the convulsions resemble those of epilepsy. The attacks may last from 12 to 24 hours, but even after the patient becomes quiet the spasms may be renewed by a slight stimulus, such as a cold draft or a sudden movement. The muscles are sore and the patient weak and listless for several days following the seizure. The cases vary greatly in intensity; there may be simply a slight cramp in the abdomen or in one of the muscles of an extremity.

Prevention. The temperature and humidity of inclosed places like firerooms of ships, weaving rooms, etc., should be regulated so as to prevent the temperature of the air from rising above 86° F. and the moisture 80 per cent. This may be accomplished by the use of fans to keep the air in motion. Cold air may be forced into these places or hot air exhausted by the same means.

Treatment. In heat stroke (fever heat) the temperature of the body should be reduced as rapidly as possible. Place the patient in a cold-water bath, add ice, rub the body with the blocks of ice, apply ice water with ice cap to his head, and keep up the treatment until the temperature, as shown by the thermometer in the rectum, is reduced to 100° F. If the temperature rises again, repeat the treatment. If symptoms of exhaustion follow the reduction of the temperature, stimulants should be given-strychnine sulphate, onefortieth grain.

In heat prostration, with cool skin, weak and rapid pulse, stimulants and friction are required. Give strychnine sulphate, onefortieth grain, rub the surface of the body and the extremities, place hot-water bottles to the feet, and cover the body with blankets. If the head is hot, apply cold water to the forehead. If vomiting occurs, inject hot salt solution (one teaspoonful of salt to a pint of water) into the rectum. Apply a mustard plaster over the region of the stomach. Mustard plasters may also be applied to the feet.

Heat cramps.-Twenty drops of tincture of nux vomica in a glass of water taken three times a day will often prevent these cramps.

Oatmeal water should be used by the firemen to quench their thirst. If a fireman feels faint, a cup of strong tea will frequently revive him. The minor spasms in the muscles of the arms and legs are usually treated by the men themselves by rubbing each other. When the cramps are severe the patient should be placed in a hot bath, the muscles vigorously rubbed, and large quantities of hot water given by the mouth and injected into the bowel. Thirty grains of bromide of potash should be given in half a glass of water. If the patient can not retain this, 60 grains in a pint of water should be administered by the rectum. The next day every effort should be made to get the patient's bowels opened by giving him castor oil or salts or by injection of soapy water.

HEADACHE.

Headache is a symptom of disease of some portion of the body. When it is unilateral, localized, sharp, and paroxysmal it is known as neuralgia. It may be caused by many conditions, among which may be mentioned derangements of the stomach and liver, constipation, neurasthenia, eyestrain, heat exhaustion, exposure to cold and dampness, inflammation of the kidneys or genital organs. It is present in malarial fever, typhoid fever, smallpox, syphilis, diabetes, and influenza. In meningitis or inflammation of the coverings of the brain the pain in the head is excruciating. Many of the diseases of childhood begin with headache.

Treatment. Remove the cause if possible. Open the bowels with a dose of castor oil or salts. Take 10 grains of aspirin and repeat if necessary in three hours. A little hot tea and toast should be given with this medicine to prevent nausea. If the headaches are frequent, a physician should be consulted to ascertain the cause.

CONVULSIONS.

Convulsions are a symptom of many diseases. They commonly occur in children after eating indigestible food and at the beginning of any serious disease. They may be present in disease of the brain and kidneys, rickets, epilepsy, apoplexy, hysteria, after poisoning from many drugs, and in women during pregnancy or after the child is born.

Treatment. During an epileptic fit nothing can be done except to keep the patient from injuring himself. A cork or other similar object should be wrapped in a handkerchief and placed between the patient's teeth to prevent his biting his tongue. Twenty grains of bromide of potash three times a day will sometimes ward off an attack.

If a child has a convlusion, it should be put into a lukewarm bath. Cold compresses may at the same time be applied to its head. A mustard plaster may be applied to the back of the neck, being careful to leave it on only long enough to redden the skin. A solution containing bromide of potash (15 grains in 2 tablespoonfuls of water) may be injected into the child's bowels or 5 grains may be given by the mouth.

In the convulsions of pregnancy little can be done by the layman, except to keep the patient's bowels open, give the patient warm baths, and keep her wrapped in hot blankets, hoping to eliminate the poisonous substances through the skin. If there is electricity in the house, an apparatus described on page 171 may be used to make the patient sweat.

POISON IVY.

Contact of the skin with poison ivy causes in many people a very annoying inflammation of the skin. The vine is of the climbing variety, with three pointed leaves on each stem. A few hours or about a day after the skin is exposed to the poison of this plant a red rash appears, with more or less swelling and itching; small blisters appear, filled with serum, even becoming quite large. When they burst there is considerable weeping from the surface. Later it may go on to a formation of pus. The hands and face, being the most exposed parts of the body, and the feet and ankles of those who go barefooted, are usually first affected. If the inflammation is very severe, there may be some incidental disturbance, such as fever, headache, and general feeling of malaise.

Treatment. One of the best treatments for this disease is bathing with salt water, sea water being the best. Boric acid, 1 teaspoonful in a glass of hot water, is a good application. The large blisters should be punctured and the contents allowed to run out. Every one or two days the affected parts should be bathed with warm water, carefully dried without rubbing, and the boric acid treatment resumed.

BOILS.

A boil is a circumscribed inflammation of the skin and connective tissue. It is often caused by infection following a slight wound or scratch of the skin, but may occur apparently without any cause. It begins as a small red pimple and gradually increases in size and forms a dusky red swelling the size of a silver dollar or less. The central portion of the swelling sloughs or forms a "core," and as soon as the core is separated or cast off the inflammation subsides, the pain lessens, and the ulcer begins to heal.

Treatment.-Compresses made of aseptic gauze or clean white cotton cloth wet with a 1 to 5,000 hot solution of bichloride of mer

cury should be applied every two hours until the central portion of the boil is softened. The bichloride solution should be made in a metal basin or some utensil not employed in cooking or for holding drinking water. The solution should be heated each time it is used, and in the intervals it should be kept upon a high shelf, so that no person or animal may be poisoned by it. The separation of the core of the boil may be aided by an incision. This incision should be made through the thickened tissues of the edge of the boil by a thin sharp blade previously sterilized by boiling. The blade should be wrapped in cotton before boiling, and a little soda added to the water to prevent the edge of the knife from becoming dull. The knife. may also be sterilized by placing it for a half an hour in a 3 per cent compound cresol solution (see p. 104), which does not injure metals. After the core is discharged, the ulcer should be washed daily with the bichloride solution and dressed with dry sterile gauze.

ABSCESS.

An abscess is a circumscribed collection of pus. It may occur in any part of the body. The local symptoms are those of inflammation, redness, heat, pain, and swelling. There may be constitutional symptoms consisting of chills, fever, and sweats. A "cold abscess" is due to bone tuberculosis. It has received this name because it develops slowly and presents but few of the signs of inflammation. The patient may not be aware of its existence until a swelling is noticed.

Treatment.-An abscess should be opened and the contents evacuated. A sharp knife should be disinfected by placing it for half an hour in a 3 per cent compound cresol solution or a 3 per cent carbolic acid solution. (See p. 104.) The hands should be scrubbed and disinfected with the same solution, and the abscess should then be opened by quickly plunging the blade into the abscess cavity and cutting outward. The abscess should then be washed out with a weak bichloride solution (see p. 175) and a small piece of gauze soaked with the solution should be left in the opening to keep it from closing before the abscess heals from the bottom. A gauze compress should then be placed over the abscess, and a bandage should be applied to keep it in place. The dressing should be renewed daily. An abscess should not be opened by a layman if it is possible to secure the services of a physician, as there is danger of doing serious injury to blood vessels and other important structures if care is not exercised. If the abscess is situated near one of the large vessels it is better to first carefully cut through the skin and then open the abscess by separating the tissues with a blunt instrument (the end of a sterilized wooden penholder is suit

able for this purpose). The location of the large blood vessels is shown in figures 138, 139, 140, 141, 142, 143, 144.

A cold abscess should not be opened by a layman. The patient should be kept quiet in bed until the services of a physician can be secured. If the abscess ruptures, a compress composed of absorbent cotton wrapped in gauze should be applied. Care should be taken by the dresser to disinfect his hands before he handles the dressing materials, as they should be kept as clean as possible.

SORE EYES.

Conjunctivitis.-This is an inflammation of the membrane covering the eye. It is caused by foreign bodies, grit, and particles of dirt which lodge upon the eye, exposure to cold, irritating gases and other chemicals, and the action of numerous bacteria. It is a complication of many diseases, such as pneumonia, syphilis, gonorrhea, diphtheria, measles, and influenza.

Symptoms. The eye is painful and feels as though there were grains of sand 'between the eyeball and the lid. This pain is increased by exposing the eyes to light. The eyeball is red and the lids are swollen. There is an increased flow of water from the eye which runs down over the cheeks in tears or is discharged in the nose through the tear duct.

Treatment. The eye should be washed out every two hours with a solution of boric acid (one teaspoonful of boric acid in a glass of hot water). In doing this the eyelids should be held apart, but great care should be taken not to press upon the eyeball, as it may be injured thereby. A few drops of a solution composed of zinc sulphate (grain; water, 1 ounce) should be dropped into the eye every three hours. A 10 per cent solution of argyrol or a 5 per cent solution of silvol may be used for the same purpose.

Iritis. This is an inflammation of the iris, the muscular curtain in the eyeball which separates the anterior from the posterior chamber. It is an affection which accompanies syphilis, acute rheumatism, diabetes, tuberculosis, gonorrhea, etc. It may occur as the result of extension of inflammation from other eye structures.

Symptoms.-There is a red ring just back of the cornea (the clear portion of the eye which forms the front of the eyeball). The pupil or dark spot of the eye, instead of being round, may be oval or irregular in shape. The eye is painful and many of the symptoms of conjunctivitis are present.

Treatment. The eye should be washed out with boric acid solution and a drop of 1 per cent solution of atropin sulphate should be placed in it three times a day. Keep the patient in a dark room.

Preventable blindness.-One-half of the blindness of the world is said to be preventable. One-quarter of the blindness of children is