MEDICAL NOTES.

New Zealand Herald, Volume LVI, Issue 17234, 9 August 1919, Page 4 (Supplement)

MEDICAL NOTES.

Ktrasrw© ohsojtio Bmmamms.

The cough, "which, i?,oßn§Jly, ■worse, m the -winter,' is "characterised .by ■ . being rough and ringing to the ears;"the'patientcontinues coughing till .eventually he finds, relief in expectoration. The : expectoration is, as a rule," profuse, -muco-purulent and frothy in character. For this reason a thoughtful, nurse, will always have two. expectoration mugs beside her patient ready for use, otherwise she may have to keep him waiting while she emptied, scalds, and places disinfectant in the ning; in the meantime he may he coughing violently, spluttering and trying to restrain the sputum, the getting rid of which is the only hope of relief; a handkerchief or rag should also always be ready at his hand. This may seem very small and obvious matters, but it is forethought and attention to detail in a nurse which means so much to the comfort of the patient. Also, when making the patient's bed or giving a blanket bath the nurse should be careful to guard against flicking the bedclothes or replacing them hurriedly or letting him feel in any way fussed or flurried. Often an attack of distressed coughing is brought on owing to the thoughtlessness of the nurse in this respect. Inhalations of eucalyptus and benzoin are very soothing and help to soften the bronchial secretions. In preparing an inhalation, if a regulation inhaler is not at hand, a bowl or large jng can be used. The vessel should be warmed and filled to three-quarters of its capacity with boiling water. To this should be added either a few drops of the eucalyptus to the pint of water, or a dram to the pint of tincture of benzoin. The patient is instructed to inhale tho steam ; it is advisable, when possible, to prop him up in a sitting position, with pillows, and make him as comfortable as possible. The inhaler , should be placed in front of him, and *■ bath-towel or small light blanket placed over' his head, including the inhaler; the bedclothes should be protected. The patient should not be left, as in moving the boiling water may be tipped, causing painful scalds.

AILMENTS OF OLD AGE. It is interesting to note that different diseases attack us at different periods of our lives. And even those that do attack us at different ages do so in different ways. Many ailments are definitely spoken of as " children's ailments," so rarely do they attack the grown man or woman. Others are common in young adult life and rare, at other, ages. Others again are almost peculiar to people past the prime of life. Measles, whooping cough, chicken pox, are hardly ever seen except in children ; but the interest is increased by the. fact that they are occasionally seen in men, and women. Enteric fever, again, and rheumatic fever, which axe commonest in young manhood and young womanhood, and less common in young children, are very rare, diseases indeed among old people. Some of the most, terrible afflictions of mankind, however, ire reserved for the aged. Nearly all those conditions which we speak of as malignant are altogether commoner among the old people, and nearly all diseases take a less acute and more gradual course with them than with the young. A large number of the morbid affections of old age are traceable directly or indirectly to degenerating changes in the walls of the arteries, which thicken and lose their elasticity. To this fact is due rupturing of blood vessels in old people, and the "old-age " disease of apoplexy " stroke." The degeneration of the blood vessels is a natural result of age, but premature degeneration can be produced by unhealthy habits and excesses. When young or middle-aged men are attacked by apoplexy, the cause can often be traced to an, " intemperate life, though a constant and undue strain on the blood vessels, by disease or overexertion, may have a similar effect. Actual rupturing of arteries is' not the only evil resulting from the changes which " take place in their Walls. Their -functions are performed less efficiently;" the blood supply to the various organs is reduced, and a want of vitality, both mental and physical, follows. As a natural consequence, there is much greater susceptibility to cold and exposure. In cold weather old people fall victims to bronchitis, which occasionally develops into a low form of pneumonia. This pneumonia of old age differs from the acute pneumonia of childhood and youth, the symptoms being less marked and obvious. But it is no less dangerous. Whilst it is necessary for people who advance in years to adopt increasing prudence and precaution, they should ■* fall into the common error of over-protec tion and undue timidity. A conaiderab'e degree of physical and mental exercise and a moderate degree of pleasurable ex citement is absolutely essential to true health, and complete "uniformity and automatism are altogether destructive of elasticity and resilience. DOCTORS AND PATIENTS.

It is a question whether more barm or rood results to the community from the Wind faith which the public in general i\p.a in the power of doctors, tempered though this often is, with suspicion equally blind- It is, of course, the other side of the medal on which is stamped the l.i-fonnded dogmatism of the doctors. On t\e one side it may be argued that the whole business of doctoring is a highly technical one, calling for highly specialised knowledge; and the less the layman meddles with it the better; and seeing that faith and confidence in one's doctor is often a decisive factor in cure, the more completely the treatment of disease is handed over to a mysterious medical priesthood the better. On the other hand, a very large number of arguments may be advanced, which demand serious consideration. For ore thing, mecPical knowledge is itself in an extremely primitive state, and is about as incomplete a* the theoretical basis of any practical art could well be. When we cull in a good carpenter to make a table we know that we can quite safely leave the entire carrying out of our wishes to him. He has, at "the back of his crait an entirely adequate knowledge ofl n aterials and means, and we can be practically sure that his efforts will end in a rcai table, more or less corresponding to rmr wishes. But when we have pneumonia ah*, call in a doctor the whole position is a very different one on both sides. And this holds good of nearly all divergations from a state of real health.

I Again, to look at the matter from a ; slightly different point of view, it is notorii ous that the wearing of corsets or other ! appliances for the support or resting of | '>; n part of the body, while probably ! yielding temporary relief* tends in the long i ran to weaken our own muscles, so that I they no longer are able to do the work I from which they have been relieved. A • similar atrophy is apt to take place in our ] judgment when we lean too much on other peopie. And this point is especially releI yant in matters of health and disease. For I it is becoming more and more obvious that ! for the most part, even specific diseases j Ret a hold upon us, only in so far as bv I foolish habits of life or'bad environment, 1 our bodies have got into such a state that i they form a suitable soil for disease. It : would be far better all round if candour and self-reliance-replaced the bombast and credulity which mow hold the field. It , would be better both for the doctors and i the public if the former openly professed i no more knowledge and skill than they possess, and the latter stupefied itself with no more superstition than the facts justified. A few neurasthenics now kept going : by daily dopes of humbug might appear Ito suffer; but the greater intellectual vigour and strengthening of will, to say ; thing of increase of knowledge, • which j would certainly occur generally, would al- | together outweigh this doubtful loss I As Dr. Oliver Wendell Holmes, the I author «of "Autocrat at the Breakfast j .table, said, many years ago : "The disgrace of medicine has been that colossal system of self-deception, in obedience of which mines have been emptied of their cantankerous minerals, the entrails of animals uken for their impurities, the poison bags drained of their venom, and all the inconceivable absurdities thus obtained tnrust down the throats of human beings si.ffenng from some want of .organisation nourishment, or vital stimulation."