TALKING ABOUT HEALTH .sx OUR FAMILY DOCTOR .sx SPRAINED ANKLE .sx She was not quite thirty and was obviously having trouble putting her left foot to the ground .sx Her husband had to help her into my consulting room .sx She told me what had happened .sx " I was coming downstairs with an armful of things and I tripped on the last step but one .sx The carpet's loose there and my heel got caught .sx I fell with my foot underneath me .sx " Obediently she slipped off her right shoe and stocking .sx I helped her out of the slipper she was wearing on her left foot .sx " I took my stocking off to bathe my foot in cold water , " she said apologetically .sx I made her lie on the examination couch , and compared the two ankles .sx There was nothing much to see except that the left one was badly swollen .sx I persuaded her to try all the different movements of the ankles and toes .sx Her right foot moved normally of course .sx Her left foot would move a little in most directions but all her movements were limited and painful .sx It hurt most when she tried to twist the foot outwards .sx Clearly there was no damage to her foot or to her freely wiggling toes .sx The damage and the worst pain was in the area just below the left ankle bone on the outer side .sx I felt each ankle in turn carefully , and although the left one hurt her it was fairly certain that no bones were broken .sx " You've been lucky , " I told her .sx " I don't think there's a fracture .sx Just a bad sprain with bruising and swelling .sx " But we'd better have an X-ray to be quite sure about it .sx " Armed with my note , her husband took her in their car to the casualty department .sx They were back in just over an hour .sx There was no fracture and all that had been needed was the simplest treatment .sx What they had done was to take a three-inch elastic adhesive bandage and apply it carefully but firmly from below upwards , so that it supported the torn outer ligament of her ankle .sx I encouraged her to try walking on it now that it was safely strapped up .sx She was unsteady but she could manage a few steps .sx " That's a lot more comfortable , " she agreed .sx I instructed her to walk on it a little each day , increasing the time daily , but being careful for a week and not overdoing it .sx At the end of a fortnight I was able to take off the bandage .sx For now the cure was complete .sx But to be on the safe side I advised her to take it easy for another fortnight .sx She was very good about it .sx And her husband has made sure that there are now no loose stair-carpets , mats , or rugs anywhere in the household .sx Dr. MERIDITH .sx facts about eczema .sx JOAN WILLIAMS S.R.N. , S.C.M. advises on the best ways to relieve discomfort .sx IN the ordinary way , a baby's skin and the skin of a young child is perfect and quite flawless .sx But in some circumstances , a rash may develop of one kind or another .sx And of these , eczema calls for the greatest amount of skilful management and patience .sx Sufferers from eczema can be divided into three groups .sx Firstly , babies who develop it at about four months of age , and in whom the trouble clears up spontaneously by the second birthday ; secondly , babies in whom the rash persists after this point has been reached ; and thirdly , children who have no sign of eczema in babyhood , but who develop it when they are around two or three years of age , or even later .sx Of these three groups , the first is by far the most common .sx Eczema usually begins on the cheeks , which become first bright red , then very shiny .sx Next the skin begins to crack .sx Then follows the " weeping " stage .sx The rash tends to spread from the child's cheeks to his head , neck , body and limbs .sx It's an uncomfortable condition because of the irritation , and unless he is checked , the child will inevitably scratch .sx But this is precisely what he mustn't do , because scratching can lead to bad infection .sx And , quite apart from anything else , skin infections can be passed on to other people , although eczema itself is never contagious .sx How can this scratching and subsequent infection be prevented ?sx By making impossible direct contact between the baby's hands and the affected skin .sx This entails completely covering the latter by means of dry sterile gauze and bandages , and/or a washable cotton garment .sx And , unless he is at an age when he can take them off , by putting his hands in cotton mitts .sx cure unknown .sx There is no known way of curing eczema .sx If it's going to clear up , as is usually the case , it will do so of its own accord , generally when the child is between eighteen months and two years of age .sx If it doesn't go spontaneously by this time , it's likely to last for several years , as is the case when the older child develops it .sx Fortunately , in these circumstances , the eczema is generally the " dry " type , and only slight , restricted to neck , elbows , and behind the knees .sx But even though there is no specific treatment which will cure eczema , there are ways by which discomfort can be greatly eased .sx First on the list of relief measures is a simple lotion , cream or ointment , which is applied direct to the affected skin in order to relieve the irritation .sx Usually , the doctor will prescribe calamine for " weeping " eczema , and zinc cream or coal tar ointment for the " dry " type .sx sedative .sx Almost certainly , he will prescribe a suitable sedative , too .sx Probably , one which is also an anti-histamine ( which means it is able to offset to some extent at least , the irritating effect of the chemical substance called histamine spilling out from body cells into the tissues) .sx Something else the doctor is likely to prescribe is a special emulsifying ointment .sx This is used instead of ordinary soap .sx For the latter may well increase the irritation and probably aggravate the rash .sx Since wool is also irritating to the child with eczema , it's advisable for his mother to make him removable linings or little undergarments of butter muslin or cotton .sx But it's not necessary to put him on a special diet .sx Some babies seem to improve when fed on a reliable brand of evaporated milk or soya bean flour instead of fresh or dried milk .sx But then the well-known child specialist with whom I discussed the subject of eczema is convinced that these children would improve anyway , and that it has nothing to do with the milk .sx One last word .sx Just as there is no specific cure for eczema , so there is no one specific cause .sx Nevertheless , it is regarded as an allergic reaction , although it's only in rare cases that a particular substance can be detected to which the child is allergic .sx Some believe that eczema is caused by emotional factors , even in the youngest baby .sx But while most experienced doctors will agree that the condition is aggravated by tension , they do not agree that this is the basic cause .sx Except , possibly , in the older child .sx Certainly in such a child , eczema is made worse by parental tension , and by repeated attempts to find someone who will cure him .sx Fortunately , it's equally true that the condition begins to improve once the family doctor can induce the parents to accept philosophically the fact that their child has eczema , that there is no specific cure , but that , in time , it's almost certain to disappear .sx This spontaneous disappearance of the rash is even more likely when , in addition to carrying out the proper treatment , the parents are able to provide tranquillity and happiness within the home itself , and in their day-to-day dealings with their child .sx TALKING ABOUT HEALTH .sx OUR FAMILY DOCTOR .sx CRAMP .sx She was a tall , slim , athletic looking nineteen-year-old .sx " I'm going on holiday with friends next month , " she said , " and want to swim a lot .sx I'm apt to get cramp and wondered how to prevent it ?sx " " When do you get cramp ?sx " " Mostly at night , but I'm worried about getting it while I'm swimming .sx Usually it starts just as I'm going to sleep , " she added .sx " Always in my right leg .sx Here , " touching her calf muscles .sx " But if I get up and stamp around the bedroom it soon goes .sx " " Does it happen any special night in the week ?sx " I asked .sx She said slowly :sx " Well , I've noticed it on Tuesdays and Thursdays .sx " " What do you do on those days that you don't on others ?sx " The answer was that she went to keep-fit sessions at a local gymnasium .sx " Do you perspire a lot ?sx " " We all do , but we drink lots of lemonade and that sort of thing .sx " I explained to her that cramp is often caused by having lost salt through sweating .sx " You get thirsty and drink a lot .sx " All the body fluids are salty , and the salt and water is carefully balanced .sx Lose water and salt by sweating profusely and they stay in balance .sx Replace only the water and the balance of salt gets upset and that shows up very commonly as a muscular cramp later on .sx " You must try what people do in hot countries .sx Drop a salt tablet into the water or lemonade and you replace both salt and water .sx Then you won't get cramp .sx " On holiday , I told her , she was more likely to get cramp if she swam soon after a meal .sx " Wait at least an hour after eating , and never swim when you are cold .sx Warm up your muscles by running about and doing a few exercises before you go into the water .sx " If ever you do get cramp in the water , don't panic .sx Float on your back and use your hands and arms to scull yourself back to the beach .sx " Then pull the cramped leg right up to your chest and massage the affected calf muscles .sx If you can get some heat into them- say from a handkerchief soaked in a thermos of hot tea- so much the better .sx " And if you should get cramp again in bed at night pull your leg up to your chest .sx Then try to pull your toes up towards your chin .sx That lengthens and stretches the contracted muscles and the cramp will soon go .sx " I learnt later that she had a really wonderful holiday with never a hint of cramp .sx DR. MERIDITH .sx hoping for a baby .sx Discussing delayed pregnancy , JOAN WILLIAMS S.R.N. , S.C.M. emphasizes that , with rare exceptions , every young couple may become parents .sx IT is a known fact that within the framework of marriages where there is a complete and natural sex relationship , pregnancy will begin within a year for about eighty out of a hundred couples .sx And with only a further ten per cent will it occur during the second year .sx Obviously then , a couple who have tried unsuccessfully for a whole year to have a baby are justified in thinking that something may be wrong .sx And they are equally justified in seeking medical advice .sx Indeed , they would be wise to do so :sx particularly if the wife is in her late twenties or older .sx They may well find that the delay has a very simple explanation which is quickly revealed through a quiet talk with their doctor .sx For often the root of the trouble is their lack of true understanding in regard to marital relationship , and/or the fertile phase in the menstrual cycle .sx adjustment .sx In this case , the putting into practice of necessary adjustments will probably lead to the desired pregnancy within a few months .sx Or maybe even sooner .sx And if the doctor cannot find any obvious cause for the delay in conception ?sx If he advises specialist investigation ?sx There is still no cause for despondency or apprehension .sx For true sterility is rare , and there is every chance that the cause or causes of delay will be found through tests- none of which is in the least alarming .sx ( A brief description of what is likely to be involved is given in my free newsheet [SIC] entitled " Routine Fertility Tests .sx "