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in clean hot water, drained, and when thoroughly dry wrapped in a clean towel or tissue paper. The ordinary fountain syringe hanging for months by a dirty string on a hook in the bath room is an unpleasant and generally an unclean object.
Sprays and Gargles.

—Several other methods of administering medicines are occasionally employed. Some remedies may be applied directly to the throat by gargles, and to the nose and throat by sprays. The throat may be cleansed by gargling with a solution of a teaspoonful of baking soda or common salt in a glass of warm water. Nose sprays should not be used except under medical advice, and it is well to remember that if the mouth washes, gargles, and sprays advertised to be disinfectants were really strong enough to kill germs, they would be too harsh for common or continued use. The nozzles of nose and throat sprays should be boiled immediately after use. A surprising number of families who have progressed far beyond common drinking cups and towels, continue to use a common nose spray without even washing the nozzle. Children while they are well should be taught to gargle the throat; a child with a sore throat and an aching head is in a poor condition to learn anything.

Inhalation  

or breathing in, is another method used to introduce drugs into the membranes of the nose, throat, and lungs. Smelling salts are an example of substances used for inhalation; they are used to stimulate persons who are faint. They should not be placed close to the nostrils, nor used at all when the patient is totally unconscious.

Inhalations of steam are often used in asthma, croup, and bronchitis. Special croup kettles are made for the purpose, but an ordinary pitcher half full of boiling water may be used instead. The patient's head should be held closely over the pitcher, and a towel should be adjusted around the top covering the patient's nose and mouth, but admitting just enough air to make it possible for him to breathe. If a drug is ordered it should be added to the water.

Inunction

, or rubbing a substance into the skin, is sometimes ordered for delicate babies and children. After the skin of the abdomen has been washed with warm soapy water and thoroughly dried, the substance ordered, generally olive oil or cod liver oil, should be applied by means of a circular movement of the palm of the hand. The oil should be warm and the rubbing continued until it is absorbed.

Ointments are also applied by inunction. A small quantity at a time should be rubbed in, using a circular motion. If an ointment is ordered to be applied where the skin is broken, the ointment should be spread upon gauze and applied without friction. Liniments are rubbed in in the same way as ointments. In many cases rubbing accomplishes more than the ointment or liniment itself, so that this part of the treatment must not be slighted.

Household Medicine Cupboard.

—In every household a small cupboard is needed for medical and surgical supplies. Glass shelves are desirable, because they show when dirty and are easily cleaned, but a wooden cupboard can easily be lined with clean paper or white enamel cloth held in place with thumb tacks. Dirty, stained shelves should not be tolerated. The cupboard should be kept locked and the key put well out of the reach of children. In the cupboard should be kept medicines in daily use; they should not be paraded on family dinner tables.

Poisonous drugs should have rough glass bottles and conspicuous labels. All medicine bottles should be kept well corked, since evaporation may take place and the remaining solution, by becoming stronger, may be dangerous to use in the ordinary amount. Pills and tablets sometimes deteriorate by standing, and may become so hard that they pass through the stomach and intestines without dissolving. It is best to buy drugs and surgical supplies in small quantities; when it is cheaper to buy more at a time the druggist should be asked whether they will deteriorate or not.

Almost every family needs to keep on hand some cathartics, some disinfectants, some material for first aid, and a few simple appliances. Most families have certain other needs peculiar to themselves, and for those who live at a distance from drug stores a greater quantity and variety may be required. Elaborate equipment and extensive supplies of medicines are neither economical nor necessary for household use.

Castor oil, Rochelle or other laxative salts, and two grain cascara tablets ordinarily constitute a sufficient supply of cathartics. The dose of castor oil is one or two teaspoonfuls for a baby up to a tablespoonful for an adult. Rochelle salts and seltzer aperient are given dissolved in water; the ordinary dose is from one to four teaspoonfuls. Seidlitz powders come in two packets, one white and one blue. The contents of the packets should first be dissolved in separate glasses each filled about a quarter full of water. One solution should then be poured into the other and the mixture taken while it is effervescing. Cascara tablets are generally given in one to ten grain doses.

A small bottle of tincture of iodine and one of 70% alcohol should be kept for disinfecting. Neither one is for internal use. The iodine is used to disinfect small wounds and abrasions of the skin. It is applied with cotton swabs and several swabs should be made and kept on hand in a box or envelope. Alcohol is used to disinfect thermometers and other instruments that cannot be boiled, for rubbing, and may also be used for disinfecting the skin. A 90% solution is sometimes used for rubbing; it need not be bought until needed. Denatured and wood alcohol are poisons and should be used in households only in spirit lamps; they are not safe for other purposes.

First aid materials may include two gauze bandages two and one-half inches wide and two bandages one inch wide, one American Red Cross First Aid Outfit, a small package of absorbent cotton, a roll of old muslin, a package of adhesive plaster one inch wide, boracic ointment, picric acid gauze or other application for burns, safety pins, and a pair of scissors.

For use in cases of fainting or exhaustion it is well to keep aromatic spirits of ammonia on hand. Its bottle should have a rubber stopper. The dose is one-half to one teaspoonful, in a quarter to half a glass of water. Hot coffee and tea are also good stimulants, but the time necessary to prepare them makes it desirable to have aromatic ammonia on hand. Household or ordinary ammonia must not be used as a substitute.

Olive oil, mustard, and baking soda may be brought from the kitchen when needed. It is assumed that vaseline, cold cream, hand lotion, talcum powder, and other toilet preparations will also be available.

Only a few appliances are necessary. Among them are a medicine glass, a teaspoon, clinical thermometer, hot water bag, fountain syringe, and an alcohol lamp in houses without gas or electric stoves. It is better not to buy other appliances until they are needed, particularly rubber goods since they deteriorate rapidly.

EXERCISES Why is it dangerous for persons without medical training to prescribe medicines? What is the especial danger of dosing oneself? What is meant by a habit-forming drug? Name all you can, and tell why they are peculiarly dangerous. What are the special objections to patent medicines? What precautions should be taken in order to administer medicine accurately? What precautions to avoid giving wrong medicines? How may some disagreeable medicines be made more palatable? Tell how to prepare and give a soapsuds enema. How should a fountain syringe be cared for? a throat spray? Describe methods for giving steam inhalations. Describe the equipment and care of a household medicine cupboard. What drugs is it well for a family to keep on hand? What appliances? What materials for first aid? How many drugs in addition to those prescribed by a physician have you or your family on hand at the present time? How many do you consider really necessary? Are any of these medicines used to remedy troubles that might be cured by sufficient attention to rest, exercise, diet, and fresh air? FOR FURTHER READING Health and Disease—Roger I. Lee, Chapter VI. How to Live—Fisher and Fisk, Supplementary Notes, Sections IV, V. Scientific Features of Modern Medicine—Frederic S. Lee, Chapters III, VIII. The Human Mechanism—Hough and Sedgwick, Chapter XX. The Conquest of Nerves—Courtney. Primitive Psychotherapy and Quackery—Lawrence, Chapters I-V. Nostrums and Quackery—American Medical Association. (See especially "Cancer Cures" and "Consumption Cures.")
Footnotes:

[2] See "Nostrums and Quackery," p. 445.

CHAPTER XI

APPLICATION OF HEAT, COLD, AND COUNTER-IRRITANTS
Inflammation.

—A process called inflammation sometimes occurs in tissues that have been injured or invaded by bacteria. Although painful, it is nevertheless one of the reparative processes of the body, and therefore beneficial. Common examples of inflammation are boils, sore throat, and the swollen, painful condition resulting from sprains and fractures. Characteristic symptoms of inflammation are heat, redness, swelling, and pain.

When a tissue has been invaded by bacteria, nearby blood vessels dilate, thus bringing an increased supply of blood to the affected part. This extra supply serves to wash away the offending substance, and at the same time it brings more white blood corpuscles, one function of which is to destroy bacteria. From the increased supply of blood the affected part becomes red and hot, and so much blood may come that the vessels further on are unable to carry it away fast enough. Some of the fluid part of the blood is then forced out into the tissues, and the part becomes swollen. Distension of the tissues and pressure on the nerve endings cause pain, and the injured part now exhibits the characteristic symptoms of inflammation.

Fig. 21.—"The History of a Boil." This figure represents a cross-section of normal skin. Note the surface layer, or cuticle, and the "true skin," or cutis. In the cutis one sees that the blood capillaries are just wide enough for the blood-cells to pass through "in single file." The skin has just been pricked by a dirty pin. On the point of this pin were several poisonous germs which were deposited at a. (From Emerson's "Essentials of Medicine.")

Fig. 22.—"The History of a Boil" (continued). The poison from these germs diffuses through the cutis. The capillaries dilate. The leucocytes force their way through the walls of the capillaries and travel towards these germs. Note the dumb-bell shape of the leucocytes as they pass through the minute holes in the capillary walls, and their pseudopods as they travel towards their common destination, attracted by the poison from the germs. The skin in this region is now swollen, red, hot, and painful. (From Emerson's "Essentials of Medicine.")

At this point, if the injury begins to heal or the bacterial infection to yield, the extra blood supply is gradually carried off, the blood vessels resume their normal size, and the tissues return to their usual condition. If, however, the infection does not yield so quickly, more and more white blood corpuscles assemble and pass through the walls of the tiny blood vessels into the tissues. Here the struggle continues. Some bacteria and some white blood corpuscles are killed, and substances are formed which liquify these dead cells and also some cells of the surrounding tissues. The resulting fluid is called pus or matter, and in the case of a boil we then say it has come to a head. If the infection occurs near a cavity or near the surface of the body, the pus may escape by

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