There is no doubt that mental and physical fatigue, or any digestive disturbance, are conditions liable to bring on an attack. In some cases the headache appears on a certain day of the week, or perhaps once a fortnight, or once a month. The real cause of the disease is not known. It is well known that in a family where migraine is common there is generally an evidence of nervous inheritance. Anyone who suffers from this affection must avoid all excitement, and try to live a regular, simple, and healthy life. Diet is very important, and sometimes the mere fact of stopping butcher's meat is extremely beneficial. Any impairment of health must be attended to. Anaemia, for example, must be treated by hygienic measures and iron tonics. Any error of refraction must be corrected. The digestion requires special care. Rush and worry after meals will certainly increase the frequency of the attacks. Although permanent cure cannot be anticipated in every case, a great deal can be done by regulating the daily life to lessen the severity and frequency of sick headaches. A few simple rules might be laid down.
1. Take three meals a day. Give up afternoon tea and snacks of all sorts between meals.
3. Be careful to attend to any constipation.
During an attack the patient must be absolutely quiet in a dark room. A hot mustard foot-bath and hot fomentations to the back of the neck relieve the congestion. Cold whisky, applied to the head and the forehead, also helps to relieve the condition, and if there is any sickness, heat should be applied over the stomach in the form of a poultice or hot-water bag. Phenacetin and antipyrin are sometimes recommended, but they have a depressing action on the heart, although they kill the pain for the time being. It is best not to take drugs without a doctor's advice. Only milk diet should be taken during an attack, and a purgative at the beginning is a good measure.
Heartburn is an acid or burning sensation passing up from the stomach to the mouth, with sometimes the presence of a mouthful of acid water fluid or " water-brash." The cause is an acid condition of the stomach contents due to some failure of the digestive process. An acid fermentation is set up a few hours after taking food which produces the sensation of heartburn. In other cases the acid condition is due to the formation of too much acid in the digestive juice. In such cases the pain comes on generally before food, and may be better after eating for some time. In this condition the proper treatment consists in correcting the digestive disorder by attention to diet and general health. The condition is relieved by sipping a tumblerful of hot water, to which half a teaspoonful of bicarbonate of soda has been added. But this is only a temporary measure. Permanent improvement will follow regulation of diet and other hygienic measures, especially thorough mastication.
Heart Disease. The heart is a hollow organ, with walls made of muscular tissue which contract with each "beat," thus forcing blood through the body. It is divided into four chambers, which communicate with each other by openings guarded by valves. These valves, and also the whole interior of the heart, are covered by a thin, transparent membrane, which is very liable to inflame. Certain irritant poisons in the blood, due to gout, rheumatism, scarlet fever, or even measles, will set up inflammation in this membrane. The result is that the valves do not move smoothly. They are liable to stick together, and thus their function of opening and closing with each beat of the heart is interfered with. Unless absolute rest is provided, with the patient lying down, so as to give the heart as little work as possible to do when it is inflamed, permanent damage, and the condition known as heart disease remain for life. Poisons likely to injure the heart are strong tea and coffee and alcohol, which increase the work of the heart and produce strain from palpitation. The walls of the heart may be dilated after certain acute fevers-for example, influenza. The heart muscles, like all the other muscles in fever, are flabby and lacking in tone, but under proper treatment, nourishing diet, fresh air, and tonics the constitution rapidly improves, and the heart recovers. Excessive muscular exercise will cause enlargement of the heart, just as it will cause increase in size of the muscles of the arm. The " athletic heart " can hardly be put in the same category with heart disease, but it is certainly a condition requiring care, if permanent heart mischief is to be escaped. Palpitation and breathlessness may be evidences of heart disease, but sometimes they are caused by simple anaemia, and a great deal of unnecessary worry is suffered by " nervy " women, who imagine that they have heart disease. Now, although it would be a grave mistake to make light of heart disease, many people are unnecessarily despondent because they suffer from a weak heart. With commonsense care and a regular mode of life, there is no reason why people with heart disease should not live to a good old age, and do useful work in the world. The daily habits and temperament of anyone suffering from heart disease influence very much the course of the affection. A temperate, regular, simple life is a great aid. Idleness is not a good thing, neither is overwork or strain. The best advice is to remember the golden rule not to overstrain a diseased organ. Work in moderation. Rest judiciously. Do not worry. Live a moderate and quiet life, and do not go in for violent physical exercise or rushing about. Diet is very important. Animal food should be reduced very much and taken in the form of scraped meat or chicken. Starchy foods, such as potatoes, are best avoided, and any food of the indigestible type, such as pastry and pickles, must be given up. Stimulants must not be taken. The meals should be light and easily digested. Avoid going long without food, because it produces exhaustion and fatigue. A restful habit should be cultivated. The capacity to work quietly without worry is a wonderful aid to health. A daily tepid bath is a good thing. Hot baths are to be avoided. If such symptoms as pain and palpitation appear a doctor should always be consulted, as heart tonics ought to be taken, but these can never be self-prescribed. Anyone suffering from heart disease must be careful to avoid chill, especially if there is any rheumatic tendency, as an attack of rheumatism will further cripple the heart.
Heat Stroke or Heat Apoplexy is the term applied to that condition caused by exposure to excessive heat. It is to be distinguished from sunstroke, which is due to the direct action of the sun's rays. The symptoms, however, in both cases are practically the same. After prolonged exposure to high temperature, especially if associated with physical exertion, a condition of restlessness, collapse, and prostration supervenes. It may come on during the day out of doors, and the high temperature which we sometimes experience in this country is quite sufficient to account for a good many cases in summer. Heat stroke, however, sometimes attacks people who are working in close, stuffy rooms in hot weather. Sickness, faintness, giddiness are the first symptoms, and these may be followed by difficulty in breathing, palpitation, and unconsciousness. In tropical countries death may be almost instantaneous. In this country attacks are less severe. The chief danger is from collapse and heart failure.
Treatment consists in moving the patient to a cool, shady place and undoing the clothing. Lay him flat, with the head and shoulders resting on a pillow. The great thing is to get a free circulation of air. The patient should be placed in as draughty a place as possible. Cold water must be poured on the neck, head, and body, and, if available, ice-bags to the head and spine will do a great deal of good. The temperature is usually very high, and a doctor will probably give the patient a wet pack; consisting of a sheet wrung out of cold water laid all over him. Give nothing by the mouth so long as the patient is unconscious. After consciousness returns, stimulants are best given under the direction of a doctor. A little cold water to drink may be allowed. Anyone who " feels " the heat should be careful to guard against severe exertion and unnecessary exposure during the hottest part of the day. A shady hat and folded handkerchief on the nape of the neck protect the upper part of the spine from the sun, and dark glasses also should be worn. Heat exhaustion is more liable to come on when one is fatigued or in a weak state of health. A great deal depends on prompt treatment, and neglect to apply remedies at once may have fatal results.
Hemiplegia is paralysis of one side of the body due to injury in the brain. In elderly people it generally comes on after an attack of apoplexy, from rupture of a blood-vessel in the brain. The patient is unconscious for a time, the limbs of one side are affected, and one side of the face and tongue may also be paralysed, so that speech is impaired. The condition generally occurs in elderly people, but it may appear at any period of life. Injuries to one side of the head, for example, may produce paralysis of the opposite side of the body (see page 619, Part 5). The paralysis may be only slight or may be very severe. In favourable cases the limbs gradually recover power.
The treatment depends upon the cause of the paralysis. A good deal can be done by electrical treatment for the paralysed limbs to improve the nutrition and activity of the muscles. When unconscious the patient must be kept absolutely quiet. Nothing should be given by the mouth, and a doctor should be summoned. To be continued.