Besides pressure, the most frequent cause of bed-sores is constant
moisture from the passage of urine and motions and consequent damping of
the sheets. Great care must be taken to thoroughly dry the back after any
evacuation; the lower part of the back should be dusted with a powder of
boric acid and zinc oxide.
If a bed-sore is present the patient should lie on a circular pad with a
hole in the middle, to take pressure off the bed-sore. The sore should
be thoroughly cleaned twice a day with some antiseptic lotion, such as
chinosol or permanganate, and subsequently dressed with zinc ointment or
vaseline.
If the bed-sore is on the back, the patient should lie if possible on
each side alternately, to relieve the pressure.
_Beri-beri._
In most cases this is a disease due to some deficiency in the dietary,
which leads to a form of what is called peripheral neuritis. The name is
possibly derived from a Cingalese word signifying “I cannot.”
_Symptoms._—Weakness of the legs and digestive troubles, abnormal
sensations in the legs, frequently associated with swelling. The gait
alters, and the arms and fingers may be affected. The condition is one of
spreading paralysis, and in bad cases the heart is affected. In so-called
wet beri-beri the patient becomes bloated as in dropsy, while in dry
beri-beri he wastes away until he is little better than a skeleton. There
is a “squatting test” which may enable one to recognize the disease at
an early stage. The patient, with his hands on the top of his head, is
unable to assume a squatting position and to rise from it unaided. If he
is squatting and has to rise he accomplishes the act by climbing, as it
were, up his own legs.
_Prophylaxis._—Avoid overcrowding, as this seems in some cases to
predispose to the disease. Give the yeast extract known as “Marmite,”
which is supplied in small cubes one-quarter ounce in weight. One
should be taken twice a week, either alone or with bread or biscuit, or
dissolved in warm water in the form of a soup. Lentils, other legumes,
and oatmeal are useful. Eggs and fresh meat, when obtainable, are very
valuable.
_Treatment._—This is chiefly dietetic. Give yeast, two ounces daily,
along with milk and sugar, or marmite in one-cube doses twice a day. Eggs
are specially useful, while fresh milk, legumes, and nourishing soups are
all indicated. Only small quantities of food should be given at a time.
Rest in bed is very important, and the patient must be careful when he
is allowed to get up owing to the danger of heart failure. Tonics are
required during convalescence.
_Blackwater Fever._
Public-domain text, read in full here on John Shaqi.
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