Insanity is a morbid condition of mind, or abnormal state of the emotions and mental condition, which renders a person dangerous to himself and other people. There are various types of insanity. In the minor forms abnormal mental conditions are very common, but any patient suffering from delusions, hallucinations, or any other marked sign of insanity should be under the care of a medical man. People are far too liable to let such cases go on without treatment, and the longer the patient is allowed to drift, the less hopeful the outlook. Rest, mental and physical, dieting, and other hygienic measures are often all that are necessary in the early stages of nervous and mental breakdown; but the more chronic the condition the more difficult it is to restore health and sanity. As a rule, the wisest course is to remove a patient with mental symptoms from his own home and relations, and provide him with change of scene, care, discipline, and medical treatment elsewhere. Such a course will in many cases prevent any need for asylum treatment, a fear of which prevents people taking necessary steps in the first instance.
Insomnia. Under the heading of "Sleep and Sleeplessness," this subject was considered in Part 5 of Every Woman's Encyclopaedia (page 618). It is the result of diverse health conditions, and cannot be cured without attending to the cause which produces it. Briefly, the following are the chief conditions of ill-health with which insomnia is associated:
(1) Disordered digestion, (2) neurasthenia and allied disorders of the nervous system, (3) chronic kidney disorders-insomnia in such cases being characterised by short, fitful sleeps, when the patient drops off for a few minutes at a time, (4) certain heart affections often cause a very painful type of insomnia, (5) insomnia in children may be due to worms, digestive disorders, nasal obstruction-adenoids-and various nervous conditions, such as St. Vitus dance and epilepsy,
The treatment of insomnia must always be directed to the cause, and most of the domestic measures which can be utilised are considered in the article mentioned above.
Intestinal Obstruction. When acute intestinal obstruction occurs a doctor should be summoned immediately to undertake the responsibility of the case. It is associated with sudden stoppage of the bowels, pain, and vomiting, and the patient becomes seriously collapsed. The condition is very serious, and recovery depends almost entirely upon early skilled treatment. No purgative or drug of any sort should ever be given to the patient. The result may be serious. Domestic treatment until the doctor arrives consists in keeping the patient warm, and supplying hot fomentations to the abdomen. If the prompt arrival of the doctor can be expected no food of any sort should be given, but, if necessary, a little milk or small quantities of beef-tea are the safest articles of diet.
Itch, Or Scabies, is an infectious disease of the skin produced by a parasite, the itch mite. It is extremely infectious, and children sometimes contract it even when hygienic measures and ordinary cleanliness are observed. The mite burrows into the skin, generally between the fingers or toes, especially in infants. The itching is intense, and gives rise to scratching, which causes various patches of inflammation. The disease is communicated from one person to another by contact.
Treatment consists in very vigorous scrubbing with soft soap and hot water, followed by liberal applications of sulphur ointment. This ointment has to be renewed several times daily, and, with a hot bath at the end of two or three days, will probably complete the cure. Medicated soaps are useful. It is important to disinfect the clothing of anyone suffering from itch by boiling or fumigation with sulphur.
Itching is not in itself a disease, but it is often the most marked feature of various ailments, and may be so intense as to constitute a grave menace to health. Eczema and urticaria, or nettlerash, are always attended by itching. Rough garments will sometimes produce intolerable itching in sensitive skins, and various parasites-for example, the itch mite-cause itching.
There are also internal causes for the condition. Gout, jaundice, digestive disorders, diabetes, and certain nervous affections may be accompanied by irritation of the skin due to some change in the blood. The eating of various foods, such as shellfish, will cause itching, an evidence of disordered blood. Certain people are "susceptible" to certain foods. For example, they may have an attack of itching, with various digestive symptoms, after eating cheese, or even eggs. Infants are subject to attacks of itching associated with a rash which comes out in crops, due probably to some blood disorder or digestive derangement.
In the treatment of itching it is important to find out if there is any definite cause, such as errors in diet, or the wearing of hard flannel, unbleached cotton, or even tight garments. Calamine lotion is a very useful application, and in the case of a child it should be put into a warm bath to which has been added a dessertspoonful of creoline lotion mixed with a cupful of warm water. In all cases simple diet should be given, and it is best to give up sugar and meat.
Nervous children have generally very sensitive skins, and irritating garments will cause a serious eruption and irritation of the skin. Any tight clothing will have the same effect, and all young children should have soft, loose, comfortable garments next to the skin. Old people are sometimes subject to itching of the skin, which causes them a great deal of discomfort, and may even prevent sleep. In such cases warm baths, with medicated tar soap, should be taken every night, and very soft undergarments worn. Certain drugs have a very marked influence on these conditions, but they must be ordered by a doctor, who will also prescribe some soothing lotion, such as calamine, to be applied to the skin.
Joint Affections. The joints are liable to be attacked by various diseases, acute and chronic. In acute rheumatism, for example (see later) intense pain and swelling of a number of joints is one of the most marked features of the disease. Acute gout usually affects a single joint, the symptoms and treatment of which have already been described (pages 1344 and 1467, Vol. 2, Every Woman's Encyclopaedia). Some of the acute fevers, such as typhoid and pneumonia, may be complicated by inflammation of the joints, whilst in blood poisoning inflammation around the joints is common. Various injuries to joints produce inflammation, swelling, redness, etc. Domestic treatment in all these acute joint inflammations consists in the application of hot fomentations, wrapping the joints in cottonwool, and keeping them at rest until the doctor can be summoned.
What are termed "chronic joint diseases" are those conditions in which there is no sudden or acute swelling or pain. The joint is more or less continually involved and impaired in function. Chronic gout and rheumatism are typical examples, and the condition known as rheumatoid arthritis is very common. This is a sort of chronic rheumatic condition, in which there is great deformity and more or less constant pain and discomfort. It is more fully considered under "Rheumatism" on page 2065.
Tubercular joint disease generally comes on gradually in children, and the hip and knee-joint are the commonest sites. The child probably complains of slight pain in the limbs when walking. Unfortunately, in many cases, the condition is not attended to early enough, and if untreated the formation of an abscess follows. The symptoms may be first noted after an injury, because the microbe of tubercle readily attacks injured tissue. The prospect of a good recovery depends upon the stage in which the case is first treated. A great deal can be done by rest and general health treatment, and the child should always be under the care of a surgeon. It is most important not to leave the matter untreated, in the hope that the child will grow out of it, as destruction of the joint may occur and the disease spread to other parts.
Injuries to Joints. Any injury to a joint should be attended to as soon as possible by a medical man. A great deal of harm can be done by so-called First Aid treatment. No person without medical training can tell whether a joint is strained, sprained, or dislocated in the great majority of cases. In dislocation there is generally some deformity. The swelling, after some severe strain, will simulate deformity, and make it impossible for an unskilled person to tell the difference.
The best domestic measure is gently to put the injured limb into a comfortable position by firmly grasping the limb above and below the injured joint. When it can be easily done without risk of injury, the clothing should be removed from the part. Then towels, or flannel, wrung out of cold water may be applied to the joint, as the cold tends to keep down the swelling. Later, when these cease to relieve the pain and swelling, hot fomentations should be applied. Careful examination and treatment by a surgeon of all joint injuries is most important. . Even a slight injury may be followed by months of pain and discomfort, unless proper treatment is provided. In the case of the knee-joint, for example, displacement of the cartilages is a not uncommon accident, and people often suffer for years because in the first instance they made light of the accident, and did not trouble to call in a doctor at all. The cartilages may have to be stitched, or rather wired, in place in the knee, an operation which could have been prevented by proper treatment at the time. In the case of a strain or sprained ankle, although rest is necessary in the first instance, a doctor's advice as to the period when massage should be commenced is always required.
In some cases, when the ankle has been once severely strained, the accident is likely to occur if the foot is suddenly jerked and slips unexpectedly. Such accidents can be largely prevented by wearing boots with low, flat heels. A high Louis heel is a very common cause of sprains and strains to the ankle. The high heel provides an insecure basis, too far forward in the foot, and tilts the body at an abnormal angle for-forwards. Massage and ankle exercises will strengthen so-called weak ankles which have been subject to strains or sprains. To be continued.