452 THE TREATMENT OP DISEASES. 



of a tumour or other causes. Sometimes it follows the immersion of the lower part 

 of the body for some time in cold water. In one case the patient had been in the 

 habit of wading for hours together in a river while fly-fishing. Much good may 

 often be done by medicinal treatment in these cases. The remedy to give is extract 

 of physostigma. It is made into little pills, each containing a thirty-second of a 

 grain, and one of these is taken every three hours during the day-time, and also at 

 night if awake. In three or four cases we have seen considerable benefit derived 

 from the adoption of this mode of treatment. The sooner the physostigma is taken, 

 the greater is the likelihood of its doing good. In old-standing cases the treatment 

 may have to be persisted in for some weeks, or even months. These patients require 

 the greatest care and attention, and it is extremely difficult to keep them clean and 

 dry. The great thing is to avoid bed-sores. The parts on which the pressure is 

 greatest should be examined almost daily to make sure that there are no signs of 

 redness. The skin may be hardened by the occasional application of a little alcohol 

 in the form of brandy or eau de Cologne, rubbed in with the palm of the hand. A 

 mixture of oxide of zinc and starch, in equal parts, forms an excellent dusting powder. 

 One of the best preventives of bed-sores is glycerine or glycerine cream. The parts 

 exposed to pressure should be washed morning and evening with tepid water, 

 dabbed quite dry with a soft towel, and then gently rubbed over with a little of the 

 glycerine or glycerine cream. A draw-sheet, made of linen, and sufficiently large to 

 be firmly tucked in at both sides of the bed, will prevent the bedclothes from getting 

 soiled. When people have of necessity to pass the whole of their time in the hori- 

 zontal posture, it is a capital plan to have two beds placed side by side, and to move 

 them occasionally from one to the other. The question of getting a water-bed is in, 

 many cases well worth considering. 



Locomotor ataxy is a disease closely allied to, though not identical with,, 

 paraphlegia. There is loss of control over the movements of the legs, but there is 

 no actual paralysis. When the patient attempts to walk, instead of the leg 

 dragging after him as it does in true paralysis, it is suddenly jerked out in a most 

 peculiar manner, just as if it were trying to dance a "break-down" by itself. The 

 patient can move the limb, but not in the way he wishes. The power of guiding 

 the muscles aright is quite gone. It is not a common disease, but we recently had a 

 case of this description under our care, and succeeded in doing him some good. He 

 was a tall, thin, wiry-looking man, the foreman in a large warehouse in the city. 

 He had always been accustomed to lead an active life, and could, as he said, " walk, 

 run, or jump with anybody." He lived five miles from his work, and " did the 

 journey, twice a day, in and out, under the hour." After a time he noticed a feeling 

 of uncertainty in his walk, and " a little giving way in his knees ; " in fact, to use 

 his own expression, he was " like a horse that had been hamstrung." Soon he felt 

 that he could not run so well, and he gave up his morning and evening walk, taking 

 the omnibus to and from his work. In a little while he felt afraid to jump on the 

 omnibus whilst it was in motion, and took to hailing it so that it might stop for him. 

 As time went on he felt afraid to get on the roof or knifeboard, and went inside. 

 He next noticed that he staggered a little in his walk, and suddenly received notice 

 of dismissal from his employers without any reason being assigned. He was at the 



