Neurasthenia (continued). - It is most important to attend to any digestive disturbance, since dyspepsia, if neglected, will produce neurasthenia. The earlier these patients are under the doctor for treatment, the better chance they have of quick and complete recovery. It is no use at all for neurasthenics to dose themselves, and imagine they will get better if they swallow a certain number of drugs. The first thing necessary is that they should be thoroughly examined in order that the doctor may discover any condition sapping the vitality or poisoning the patient. Bad teeth, chronic constipation, or any stomach derangement, for example, must be put right. The nutrition has to be built up by good food and hygienic surroundings. A rest probably will be necessary in the first instance, especially if the condition has originated in a severe mental or physical or nervous shock.
Neurasthenia after a railway accident, for instance, is very common, although it may not manifest itself for some time. Diet will have to be simple, light, nourishing, and easily digested. Alcohol, tobacco, strong tea, and coffee should be given up, for a time at least. Warm baths are useful with a cold sponge in the morning, and regular outdoor exercise, carefully graduated so as to avoid excessive fatigue in the first instance, will very much improve the general health. Nerve tonics will be necessary, but they must be ordered by the doctor in charge of the case. It is important for the patient to make a determined effort to overcome depressing thoughts, and to cultivate will power. Healthy self-suggestion will be necessary on the lines of the articles dealing with " Nerves " in earlier numbers of the Encyclopaedia (Pages 1697, 1817, and 1940, Vol. 3).
Neuritis is an inflammation of the nerves. In neuralgia there is pain, but the nerves are not necessarily inflamed. Neuritis may be situated in a single nerve, and often arises as the result of cold affecting the nerves of the face. It may also be caused by blows, or pressure, or tearing of the nerve, such as follows a dislocation or fracture. Neuritis may occur, again, in several nerves, as from the effect of some poison, perhaps the poisons of infectious disease such as diphtheria, typhoid, or scarlet fever. Alcohol acts as a poison in the same way, also lead, arsenic, etc., whilst it may occur in anaemia or consumptive disease due to general enfeeblement of vitality. The chief sjanptom of neuritis is a somewhat boring pain which varies in character. There is generally numbness, and the skin may be slightly irritated or glossy. In some instances, the temperature of the part seems to be raised. Neuritis is fairly common in the forearm, and seems in such cases to follow exposure to cold and over-fatigue. When it is accompanied by chill and pain in the back and limbs the attack resembles acute rheumatism.
In connection with the infectious diseases, the commonest form of neuritis follows diphtheria, and the condition often follows upon long-continued habits of alcoholism, in which cases the muscles become affected, and paralysis may set in. Treatment of these cases is favourable if the cause can be removed, and the system gradually braced up again.
In all cases of neuritis, rest is the most important item of treatment, whether the neuritis is in the leg (sciatica), arm, or other situation. Heat, especially if applied in the early stages, is exceedingly useful. Bathing with hot water, hot fomentations, poultices, will all help to allay pain. Mustard-plasters and blisters will more or less check an attack in the beginning. Those who are subject to neuritis must guard against cold and over-fatigue. As it is a fairly common affection with gouty people, attention to diet should always be given. Food should be nourishing and yet easily digested. Butter, cream, fat, and milk are more suitable foods than butcher's meat and rich pastries, for example.
The application of electricity will sometimes cure the pain at once, and at the same time it improves the nutrition of the muscles. It is most important to build up the general health in every possible way, as neuritis, like neuralgia, is an evidence that the health is below par. Blood and nerve tonics will probably be necessary, but these must be ordered by the doctor in charge. In anaemia, a course of iron with outdoor exercise and plenty of fresh air will generally cure the neuritis, and deal with the anaemic condition at the same time. Treatment will have to be kept up for two or three weeks after the pain has disappeared, so as to get the system into a healthy condition. Otherwise, relapses are liable to occur.
Night blindness sometimes attacks people whose general health is low and who have been using their eyes a great deal in artificial light, or perhaps been exposed to the strong glare of the sun. In this condition vision in poor light is very defective, but when the eyes are rested and the general health improves, the condition passes off. In other cases, night blindness is associated with some disease of the eye, whilst it sometimes exists from birth apart altogether from other defect in the eye.
Night sweats occur commonly in cases of phthisis, when the temperature falls in the early morning hours. They may be present even when the disease is quite in an early stage. On the other hand, some patients may not suffer from night sweats at all. Certain medicines will very much diminish this tendency, but they require to be ordered by a doctor. It is important for the patient to wear light woollen nightdresses, because they are porous and have not the cold damp feeling of cotton. The patient should only have nightdresses after they have been thoroughly aired, so as to avoid the clanger of further chill.
Night terrors are fairly common in the nursery, but in most cases they indicate either bad management or some nervous condition which can be put right. The first thing is to inquire as to the child's diet, as digestive disturbance is one of the commonest causes. If a child is being too frequently fed, for example, and especially it he is given a heavy meal just at bed-time, disturbed rest and sleeplessness and night terrors can hardly be avoided. The child starts in his sleep, wakens up crying, or is subject to dreaming. So that the first thing should be a re-arrangement of nursery diet on the lines advised in the "Hygiene in the Nursery " (see pages 1590 and 1703, Vol. 3).