Eczema (continued). The most common situations attacked by eczema are the inner aspects of the joints, such as the bend of the elbow and the back of the knee, behind the ears, and on the scalp and back. It commonly occurs on the scalp in children, and scratching makes the condition worse. With regard to the face, the upper lip and round about the nostrils and ears are the usual sites. Elderly people often suffer from a chronic form of eczema, which appears perhaps on the leg, associated with varicose veins. The real cause in such a condition is probably enfeebled vitality. Elderly people of a gouty type are also liable to eczema.

The treatment differs, according to whether the disease is acute or chronic. In severe acute conditions rest in bed is generally required, with careful dieting. Soothing applications, such as compound calamine lotion or zinc oxide ointment, are necessary. Soap and water should never be used to wash any part of the body suffering from eczema. Creolin lotion, in the strength of half a teaspoonful of creolin to a breakfastcupful of water, is perhaps the best thing to use; or, if preferred, a teaspoonful of boracic powder in a breakfastcupful of water is also excellent. The lotion should be dabbed on with a piece of clean linen soaked in it, and gently dried with soft linen. Ointment containing zinc oxide and lanoline can also be applied. In the eczema which occurs round the nose and ears, a dusting powder containing equal parts of zinc oxide and calamine will keep the skin dry and encourage healing. In chronic eczema, if there are a great many crusts or scales, these should first be removed with olive oil. It may be necessary to apply the oil on strips of lint for some time before the crusts will come off. General health treatment is necessary in eczema. Any digestive disorder must be corrected, and tonics are generally required. Diet should be simple, and yet nourishing, and in acute forms of eczema alcohol must be forbidden. Embolism is that condition in which a bloodvessel is blocked by a clot of blood. It may occur in the blood-vessels of the lungs, producing lung symptoms, or in the brain, as a cerebral embolism followed by apoplexy. Embolism is a complication which may occur in certain heart diseases, in aneurism, and in enfeebled circulation, such as is present with varicose veins. A blood clot forming in a varicose vein may be carried in the circulation and produce an embolism. Surgical skill is required in such cases.

Emphysema is a disease of the lungs, in which the air-vessels become over-distended. The function of the lungs with regard to purifying the blood is interfered with, and breathing rendered more difficult. The disease generally comes on after repeated attacks of bronchitis, and breathlessness is a very marked symptom. The patient finds it increasingly difficult to breathe, and a typical barrel-shaped crest is found on physical examination. The disease generally occurs in elderly people after longstanding bronchitis and asthma. Occupations which throw strain on the lungs, such as glass-blowing, musical instrument blowing, etc., sometimes produce emphysema. The disease is not dangerous, unless it is of a very severe type.

Treatment consists in dealing with any chronic bronchitis and strengthening the heart. Diet is of very great importance, as any overloading or distension of the stomach presses upon the lungs and heart. People who suffer from emphysema should always take their chief meal at one o'clock, followed by a light tea and a very light supper.

Enteric. (See Typhoid.) Enteritis. A catarrhal inflammation of the intestine, with diarrhoea (which see).

Epilepsy is a disease of the nervous system, associated with attacks of unconsciousness, with or without convulsions. In " minor epilepsy," the only symptom is a passing loss of consciousness, occurring in young people, the unconsciousness perhaps lasting half a minute. In "major epilepsy," or epilepsy proper, there is a distinct convulsive attack in addition to unconsciousness. Such an attack is called an epileptic fit. The fits may come only once or twice in a year, every few months, and, in severe cases, there may be only a few days between each attack. As a general rule, the fit is preceded by a warning, or "aura." The patient may feel giddy, see flashes of light, or have a ringing in the ears. Realising that a fit is coming on, he may be able to get himself out of danger before loss of consciousness comes on. The patient falls unconscious suddenly, generally with a loud cry. The body is rigid, and the breathing is suspended, so that the face becomes livid. Then the whole body goes into convulsions, which gradually pass off, and a state of drowsiness succeeds the convulsive attack. It takes some time for the patient to regain the normal state. Hallucinations and mental irresponsibility are often present, but the only evidence that an epileptic fit has occurred may be headache and drowsiness.

As a general rule, epilepsy begins in childhood and adolescence. In most cases a family history of epilepsy or other nervous conditions exists, and heredity is, almost all authorities consider, an important factor in the disease. Fright and head injuries are said to bring on the condition in children of nervous instability. Occasionally, some cause, such as an error of refraction, seems to account for the attacks, as removal of the source of irritation is followed by cure.

In treatment, at any rate, any such likely irritation must be sought for and removed. If an epileptic, for example, suffers from adenoids, an operation must be performed at once. Circumcision in some cases is followed by cessation of the fits. In most cases, however, epilepsy is incurable, but a great deal can be done to check the fits and make them less serious. With proper treatment and care the epileptic child may lead a very useful and happy life. Careful diet is important. As a rule, flesh food should be given up, meals should be very light and given at fixed hours, and over-eating must be guarded against. Plenty of fresh air and a liberal allowance of sleep are necessary. Overstrain at school must be strictly guarded against, as too heavy lessons have a very bad effect upon any child with a tendency to epilepsy. At the same time, regular work is a good thing, and discipline is necessary. Light manual work, which keeps the person happily employed, is often followed by a marked improvement. Drugs must be ordered by a doctor. The regular administration of bromide is necessary, but it must be prescribed by a medical man. During an attack the patient must be protected from injuring hinuelf. To prevent him biting his tongue, a cork wrapped up in a folded handkerchief should be placed between the teeth. Afterwards plenty of rest will be necessary. If any symptoms of mental derangement appear, such as excessive irritability or signs of violence, the doctor's advice must be immediately sought, as medical control is probably necessary.