MEDICAL NOTES.

New Zealand Herald, Volume LI, Issue 15664, 18 July 1914, Page 8 (Supplement)

MEDICAL NOTES.

THE MYSTERIOUS THYROID. The thvroid gland, which is situated about the lower part of the throat, is still a medical mystery. Practically nothing is known as to its uses, and very little about the cause of disease in it. Goitre is a non-malignant enlargement of the thyroid gland. The swelling may be no more than a mere thickening, or it may grow into a mass weighing several pounds. It is common in mountainous districts and where there is magnesian limestone in tho foil and diinking water. Operation may bo necessary, but goitre will usually yield to treatment, and is rarely fatal. Malignant disease of the thyroid gland is often associated with overstrain or sudden shock. Here operation is generally necessary, and is a very serious matter inded. In some mysterious way removal of the thyroid gland affects the mental powers, and the unfortunate person who lias his thyroid removed is in great danger oi losing his wits, more particularly hi* memory. THE BEST EXERCISE. It is extremely easy to over-exercise oneself if unused to physical exertion ; hard exercise suddenly taken by one unlit for it throws an unaccustomed strain on the Jicart, which may permanently weaken its walls or dilate its cavities, thereby injuring the whole organ. By far the best general exercise for the average person is walking—not strolling, but real hard walking. Four or five mile walks at a pace of four miles an hour with a few longer ones ii possible at a slower pace, do wonders for a man's health. When walking for exercise, wear shoes, flannel trousers, a vest, a loose flannel shirt, and a light loose coat; if the weather is cold a warm woollen sweater is a useful extra. In addition to this, exercise with light dumbbells or clubs is useful; do not, however, have these as heavy as those recommended in th usual text books on the subject. They are generally about double the necessary weight. Light gymnasium work is also good and, of course, if possible, outdoor games. THE NATURE OF ACNE. This disease consists in the plugging of the openings of tho little sebaceous tubes which occur thickly in our skin bv a comedo or blackhead. This plug or cork prevents the escape of the secretion of the sebaceous gland, which accordingly accumulates and causes a swelling. By means of pressure tho comedo can bo squeezed out, and a coil of yellow sebaceous matter squeezed out after it. A certain proportion of these swellings and comedones suppurate, and so little abscesses containing pus or matter are formed. The comedo or plug is composed partly of grease, partly of acne germs (bacillus* acne 3), partly of horny matter. It is by a further development of this horny matter that the black colouring at the summit is produced ; as occurs in other horny growths arisinc from the skin. The blackness is definitely not due to dirt. In addition to the presence of the germs peculiar to the disease, the chief other conditions are Kid feding, bad hygienic conditions, anar-mia, greasiness of the skin, and flabby skin. DIARRHOEA. The commonest cause of diarrhoea is local irritation of the lining of the bowels, generally by some offending article of food. In many cases these foods may be in themselves harmless, but by being imperfectly digested, and thus prone to fermentation and decomposition, are capable of acting as irritants to the intestines. Excess of bile may act in the same wav and lack of bile may also lead to diarrhoea through the failure of the diminished quantity to neutralise the acidity of the chyme as it passes out of the stomach. Another common cause of diarrhoea is cold. Then again the trouble may be due to the activity of certain bacilli, as in the case in the green diarrhoea of infants, and the various malarial and dysenteric diseases. As to treatment, the chief thing is to avoid food which leaves any considerable undigested residue. Where it is tolerated, milk ■which has been boiled and diluted with water, soda water, or barley water, is one of the best foods. Arrowroot, cornflour, sago, tapioca, are also suitable. The best food of all consists of the white of an egg beaten up with a teacupful of water, to which a little j»alt and brandy have been added. This may be taken as often as the patient desires. If dieting combined with a dose of laxative medicine does not cure a case if diarrhoea, medical advice should at once be sought.

CONCERNING POULTICES. Poulticing is one of the most usual methods of applying moist heat locally. They eaee pain by softening the tissues and relieving the tension which is the chief cause of pain in cases of inflammation. For checking infiamation large poultices _ should be used as hot as possible, but if matter is formed and the poultice is applied to assist its discharge, it should be very little larger than the affected spot, or jt i 3 apt to have an irritating effect. Poultices can hardly be changed too often, and as soon a they become cool or dry they should be removed. If of proper thickness, from a quarter to half an inch, they will generally keep hot for about two hours. Whatever the material on which the poultice is epread it must be larger than the size required 'for the poultice, and its free edges should be doubled inwards as soon a& the poultice is spread. Cotton-woo! is excellent as a basis; old flannel is also good, and if the poultice is covered with flannel and a layer of oil-silk, it will keep its heat longer than is otherwise possible. Poultices should be put on as bet as the patient can bear them, but care must be taken not to scald the skin. It is best to carry the poultices on the palm of the hand, placing the lower edge aarainst the patient, and so gradually putting it in position. To remove an old one begin at the top, and roll it gentlv down, keeping it pressed against the skin. Do not pull it off; and avoir! leaving pieces of it sticking to the skin. Brend poultices are verv liable to brenk and scntW about the bed. so that special care should bo taken with them.

THE FEEDING OP KICK CHILDREN. There are many points in. the nursing of pick children which, although of importance, are apt to bo overlooked or slurred over. The feeding of infants and young children, a matter for care even when the child is in health, becomes doubly so during illness and convalescence. In the case of infants the utmost care must be taken over matters of cleanliness, proper temperature, and accurate preparation and measurement. No milk must be kept in the sick-room, nor indeed should any other food; milk in particular should be kept in a cool place free from smells, as it quickly take? the taste and odour of any strong smelling tiling near which it may bo placed. Many children have uncontrollable dislikes, either genuine or the result of " fad" or habit, for certain articles of food. These, although children should be broken of them in health should be reepectcd if possible in illness, as they are often strong enough to lead to refusal if the food or even vomiting. Thev may, however, often be avoided by a little diplomacy. Some children, for example, cannot take milk, but may be sriven custard, junket, or chocolate, or milk jelly, flavoured and stiffened with isinglass, and so on. In most cases nourishment, including milk, is not need oftener than every three hours. The patient should not be worried with urging to take fowl at irregular intervals. When tho food is given the mouth should first be cleansed if clammv and drv, and in the case of young children, binders, etc., should be looked to, as a binder which is comfortable before a meal may bo comfortably tight after it. Do not "jig" « young baby nor lay it flat on its back directly after a meal. When drink is given no more than the requisite quantity should be put into the cup or tumbler.'and if the child is weak or has been waked at night to hi fed, ft feeding-bottle or feeding-cup will be found to cause lees disturbance to the patient.