450 THE TREATMENT OF DISEASES. 



be taken off. Should the plaster cause this irritation of the skin, it may be punched 

 with holes at regular intervals so as to admit of the escape of the retained per- 

 spiration. These porous plasters are often very useful. We can warmly recommend 

 the belladonna plaster in the treatment of palpitation. Its application does not, of 

 course, in any way limit the choice of internal remedies. Mustard poultices applied 

 over the region of the heart often help to regulate its action ; they lessen the feeling 

 of distress, and cannot possibly do any harm, even if they do no good. When 

 there is any suspicion of gout, colchicum must be given. Tincture of musk and 

 caffeine are remedies that occasionally prove useful in palpitation. 



As accessory measures, abstinence from tea and tobacco is very essential. The 

 effect of tobacco is to render the heart's action quicker, its beat feebler, and to 

 promote a liability to palpitation. There is a distinct functional derangement of the 

 heart which is recognised and known as " smoker's heart." In many instances this 

 condition arises from great indulgence in strong tobacco, and frequently the substi- 

 tution of a lighter form of tobacco in moderation is sufficient to afford relief without 

 the abandonment of the favourite habit. We recently met with a man whose 

 palpitation had for years resisted treatment, simply because he consumed three or 

 four cigars regularly every day of his life. Many of the London poor the women 

 especially live almost exclusively on weak tea and bread-and-butter. It is hardly 

 to be wondered at that they suffer from palpitation, and form so large a contingent 

 of our hospital out-patients. The great thing is to get them to substitute milk or cocoa 

 for tea. Soberness in the use of alcoholic stimulants is important. It is really 

 wonderful what a quantity of drink many people consume in the course of the day. 

 Only a week or two ago a patient told us that his usual allowance was four or five 

 pots of beer, with a " go or two " of rum or rum-and-milk, in the morning, to " pull 

 himself together." He added that of course that did not include a glass or two if 

 he met a friend, " which didn't count." He expressed considerable surprise on being 

 advised to reduce the quantity, and said that he always considered himself " a very 

 sober man." He added, by way of explanation, that he was a barman, and was 

 " always in it ; " and that, as it didn't cost him anything, he didn't see how it could 

 do him any harm. This is by no means an exceptional case ; and when a man 

 assures you that he is not taking too much, it is desirable to obtain from him some 

 idea of what he considers to be " too much." The free use of wine and spirits in 

 the intervals of the attacks of palpitation not only renders the patient more subject 

 to them, but deprives him of one of his chief aids during their occurrence. There is 

 no occasion to abstain altogether from the use of alcohol a pint of beer a day, or 

 three glasses of sherry or port, can do no one any harm. Experience alone will 

 teach the sufferer what kind of alcohol may be taken with least discomfort. People 

 subject to palpitation should not hurry themselves. Take a rest going up-stairs, for 

 example ; never get excited, and rather lose a train than hurry to catch it. 



PARALYSIS. 



By paralysis, or palsy, is meant impairment or loss of power or sensation in some 

 part of the body. Sometimes only one side is affected, and then it is technically 



