bottle, good, fresh, unboiled cow’s milk to such a height that
after the addition of 1 oz. granulated or powdered sugar, and after
corking, there would still be left at least 1 in. of empty space
below the cork. Before corking, add a piece of fresh compressed
yeast, about the size of 2 peas, then cork and tie the cork firmly
down. In place of compressed yeast, 1 teaspoonful good beer yeast may
be taken. The contents of the bottle are well shaken, repeatedly,
then the bottles are placed in the cellar, where they are turned up
and down a few times during the day. From and after the fifth day the
mixture is ready and may be drunk to about the twentieth day. It is
best to prepare about 6 bottles full at a time, refilling each after
it has been emptied and cleaned, so that the treatment, after being
begun, may not be interrupted. On opening the bottles, the contents
are very apt to foam over, hence the bottle should be opened while
being held over a plate. It should never be opened where there may be
any furniture or dresses about, which might be soiled by spattering.
A good milk-wine or kumys should have a homogeneous appearance of the
consistence of thin cream, should be effervescent when poured out,
of an acidulous, agreeably vinous odour and taste, and should not be
full of lumps, or taste like butter-milk. On first using kumys it
produces loose bowels, but this effect soon passes off.
(_b_) 200 parts condensed milk, 2000 parts water, 2 parts lactic
acid, 1 part citric acid, and 30 parts brandy are mixed and
carbonated. Cork well and let it stand for 2 days in a warm room till
it froths.
=Administering Physic.=--Never allow a bottle of lotion for external
use to stand beside a bottle of medicine to be taken internally. Keep
them entirely separate, and _keep all medicines in a place where
children cannot by any possibility reach them_. One further piece of
advice, which is unfortunately but seldom attended to, is deserving
of attention, namely, after an illness has terminated either in
recovery or death, _empty out all the medicine bottles_, and on no
account retain any of them for future use. Spoons differ very much
in size, and it is not wise to trust to them in measuring medicines.
It is best to get a medicine glass or spoon, either of which can be
got at a chemist’s for a few pence. In giving sick people medicine
there are 3 points which ought carefully to be remembered--namely,
regularity, punctuality, and exactitude. Those intrusted with the
administration of medicine to sick persons should _always_ read the
label of the bottle before administering the medicine. By doing so
they will probably save themselves a lifelong reproach. An inhaler
for taking medicated vapours in bronchial and catarrhal affections
may be extemporised out of a pickle bottle fitted with a perforated
cork and a bit of tube. A special apparatus (Dr. Felton’s) is sold at
7_s._ 6_d._ by Savory and Moore.
To mask the taste of cod-liver oil:--(_a_) Use Allan and Hanbury’s
“perfected” oil. (_b_) Put a little salt in the mouth before taking
the oil. (_c_) Add 30 drops sulphuric ether to the dose and take it
quite cold. (_d_) Add a little iodoform and essence of anise; say 96
grm. oil, 20 c. grm. iodoform, 4 drops essence.
Quinine may be enclosed in gelatine capsules when otherwise refused.
If in powder it is best mixed with a little milk.
Keep a separate measure and separate glass for administering such
drugs as castor-oil, cod-liver oil, asafœtida, valerian, &c.
Pills should be placed well towards the gullet and washed down with
a drink. Or they may be hidden in jam, or wrapped in rice paper, and
then washed down. Powders may be mixed in jam, treacle, honey, milk,
or water.
To remove the taste of nauseous medicines from the mouth chew a small
piece of bread and spit it out.
The best times for administering medicines, according to the
frequency with which they are ordered, are as follows:--
“Daily.”--At 9 A.M. or at bedtime.
“Night and morning.”--9 A.M. and bedtime.
“Twice-a-day.”--10 A.M. and 6 P.M.
“Three times a day.”--10 A.M., 2 P.M., 6 P.M.
“Every 4 hours.”--10 A.M., 2 P.M., 6 P.M., 10 P.M., 2 A.M., 6 A.M.
Never wake a patient to administer medicine or food unless ordered to
do so.
To apportion doses according to age, reckon 21 years and upwards as
adults requiring full dose; then 17 will take ¾, 14 will take ½, 7
will take ⅓, 4 will take ¼, 3 will take ⅙, and 2 years or under will
take ⅛ of the full dose.
Medicines are classified according to their general properties, the
following being the chief:--
_Anæsthetics_--produce insensibility to pain.
_Anodynes_--procure relief from pain.
_Antiseptics_--prevent putrefaction.
_Antispasmodics_--check spasms and cramps.
_Caustics_--destroy animal tissues by a kind of burning.
_Collyrium_--an eyewash.
_Diaphoretics_--induce perspiration.
_Diuretics_--increase the flow of urine.
_Emetics_--cause sickness (vomiting).
_Expectorants_--favour spitting.
_Liniments_--for rubbing in.
_Narcotics_--induce sleep.
_Purgatives_--cause very loose bowels.
_Refrigerants_--cooling.
_Sedatives_--calm the nerves.
_Soporifics_--induce sleep.
_Styptics_--arrest bleeding.
_Tonics_--increase the appetite and give a stimulus to the system.
The principal domestic remedies, with their doses (m. means minims,
gr. grains, table. tablespoonful, tea. teaspoonful, dr. drams, oz.
ounces, dess. dessertspoonful) and properties, are as follows:--
Aloes (compound decoction): 1-3 tablespoonfuls; pleasant purgative,
useful in habitual constipation, and will often relieve headache.
Alum: 10-20 gr. in whooping cough and internal bleeding; 1 tea. (in
treacle) as an emetic; 15 gr. in 10 oz. water as a collyrium; 60 gr.
in 10 oz. water for gargles and injections; astringent (coddling the
mouth) and styptic.
Ammonio-citrate of iron: 5-10 gr. in water; tonic.
Antimonial wine: 5-15 m. 3 times a day in bronchitis and fever,
diaphoretic; 1 table. (for adults), emetic.
Aromatic chalk: 20 gr. in water checks diarrhœa.
Belladonna liniment (compound): externally applied on rag covered
with waterproof for 12 hours as local remedy for rheumatism and
lumbago; anodyne.
Bicarbonate of potash: 15-20 gr.; antacid; taken with lemon juice or
citric acid as a cooling drink.
Bicarbonate of soda: 10-20 gr.; antacid; checks heartburn and stops
diarrhœa.
Blue pill: 3-5 gr.; alterative; cures bilious attacks.
Borax: 1 in 24 parts water as a gargle for sore throat.
Calomel: 1-3 gr.; powerful purgative and alterative; taken for
biliousness.
Camphor liniment (compound): stimulant liniment.
Carbonate magnesia: 5-30 gr. in milk; antacid, gentle aperient;
useful for children.
Castor oil: ½ tea. (infants), 2 table. (adults), on milk, wine, or
orange juice, or blended with glycerine or egg-yolk; most reliable
aperient.
Chlorate potash: 10-20 gr., stimulant; 1 dr. with 4 dr. honey and 8
oz. water, gargle for sore throat; lozenges, overcomes effect of high
altitudes on the respiratory system.
Chloric ether: 20-30 m. in water, cordial and antispasmodic; relieves
cramp, violent cough, spasms, &c.
Chloroform: not to be inhaled or taken except in a doctor’s presence;
sedative; applied to rheumatism, stings, and toothache as an anodyne.
Citrate of iron and quinine: 3-5 gr. in water; tonic and binding.
Citrate of magnesia (granular effervescent): 1 dess. in tumbler cold
water; cooling aperient.
Cream of tartar: 20-60 gr., diuretic and cooling; ½ oz. in 1 qt. of
water, fever drink.
Dover’s power: unfit for children; 5 gr. in wineglassful water,
diaphoretic, checks diarrhœa and cures fresh colds; 3 gr. after meals
prevents chest-ache.
Epsom salts: 1-4 dr. in water; purgative.
Essence of camphor: 30 m. in wineglassful water; exhilarating.
Essence of ginger: ½ tea. in wineglassful water; cordial stimulant,
useful in chest-ache.
Essence of peppermint: 10-15 m. on sugar; exhilarating, warming and
antispasmodic.
Extract of bark: 10-30 m. in wineglassful water; valuable tonic in
neuralgia and fever.
Friar’s balsam: ½-1 dr. with sugar and egg-yolk, stimulating
expectorant; applied on cuts.
Glycerine: may replace sugar for sweetening drinks and medicines;
much used for softening the skin.
Goulard’s extract: 5 m. in wineglassful water as an eyewash; 1 in 40
of water, astringent, applied to bruises and sprains as a wash.
Gregory’s powder: 1 tea. in wineglassful water, cooling mild aperient.
Grey powder: 3-5 gr. (adult); aperient, acting on the liver.
Ipecacuanha powder: 15 gr. emetic.
Ditto wine: 10-20 m., expectorant for coughs; 1 table. (adults),
repeated at 10 minutes intervals, emetic.
Jalapine: 2-6 gr., aperient for children.
Laudanum: 10-20 m., anodyne and soporific; with equal quantity
opodeldoc, applied as an anodyne.
Lime-water: antacid; checks infantile diarrhœa; mixed with sweet oil
affords great relief when applied to burns.
Liquorice powder (compound): 1 tea., mild aperient, best for piles.
Milk of sulphur: 1 tea. rubbed up with milk, gentle aperient and
cooling, useful in rheumatism and piles.
Morphia bimeconate: 5 m. increasing every 3 hours; most valuable
sedative and soporific; applied as an anodyne after the part has been
reddened by compound camphor liniment.
Muriate (chloride) of ammonia: 10 gr. in wineglassful water, good
expectorant in bronchitis; 1 oz. with 1 oz. alcohol and 10 oz. water;
stimulant lotion for sprains.
Nitrate of silver: 2-4 gr. in 1 oz. water, lotion for sore nipples;
20 gr. in 1 oz. water, throat wash in diphtheria.
Nitre (saltpetre): 5 gr. in saline draught, cooling and diuretic for
fever; ¼ oz. in ½ pint barley water, gargle for inflamed sore throat.
Nitric acid (dilute): 10 m. with 5 m. tincture of chiretta, 15 m.
tincture of orange and 10 m. syrup in 1 wineglassful water, excellent
between meal-times for convalescents.
Opodeldoc (soap liniment): excellent applied to bruises, stops
swelling and discoloration.
Paregoric: 30-60 m., checks coughing.
Prepared chalk: 15-30 gr. repeated, with cinnamon and tincture of
catechu, antacid and astringent for diarrhœa and cholera; made into a
cream with water, cooling shield for burns.
Rhubarb: 1-5 gr., tonic to bowels; 10-20 gr., aperient followed by
astringent.
Sal volatile: 30-60 m. in wineglassful camphor julep; antacid,
antispasmodic, and exhilarating.
Santonine: 2-3 gr. on 3 alternate nights, followed by castor oil in
the morning, expels threadworms from children.
Spirit of minderus: 15-20 m. in gruel at bedtime, excellent
diaphoretic and cure for coryza (cold in the head); 20 m. in
wineglassful water, eyewash; 1 table. in tumbler water, cooling
lotion.
Spirit of nitre: 20-30 drops in wineglassful water, or 1 tea. in hot
gruel at bedtime, diuretic and diaphoretic, for colds.
Sulphate of copper: 10-15 gr. in wineglassful water, rapid emetic in
poisoning.
Sulphate of potash: 10-20 gr. with 10 gr. rhubarb and 15 gr. sugar in
peppermint-water, mild aperient.
Sulphate of quinine: 1-5 gr. 2 or 3 times a day, tonic, useful in
neuralgia, dyspepsia, weakness and fever.
Sulphate of zinc: 20 gr. in wineglassful water, emetic; 1 gr. in 1
oz. water, eyewash, astringent.
Sulphuric ether: ½-1 tea. in camphor julep, exhilarant.
Syrup of senna: 1 tea. (adults), mild aperient.
Tincture of arnica: with 4 times its bulk in hot water for fomenting
bruises.
Tincture of chiretta: 10-30 m., tonic, useful in dyspepsia.
Tincture of colchicum: 10-20 m. at night after a light meal,
diaphoretic, valuable in gout, rheumatism, and dropsy.
Tincture of henbane: 15-60 m., narcotic and anodyne.
Tincture of lavender (compound): 1 tea. with ½ tea. sal volatile in
water, stimulant, antispasmodic, and exhilarant.
Tincture of quinine: 1-2 tea. in wineglassful water 2 or 3 times a
day, tonic.
Tincture of rhubarb: 2-4 tea., cordial and purgative.
Tincture of squills: 1 tea. with wineglassful water, expectorant;
take 1 dess. at short intervals to check coughing.
Tincture of steel: 5-15 m. in wineglassful water, tonic, astringent,
and diuretic, good in weakness and dyspepsia.
Tincture of valerian: 1 tea. in camphor water, antispasmodic and
stimulant, valuable in nervous headache.
_Common Complaints._--Without making the least pretence to give
such information as will enable the sick man to dispense with the
services of the physician or surgeon, whose aid should be promptly
sought, there are many matters which by careful study may enable
the threatened attack to be warded off, and there are a variety of
ailments and troubles which are not generally deemed of sufficient
importance to be worth troubling a doctor about. It is these subjects
which claim treatment here, and with which the following paragraphs
will deal, leaving all special and serious diseases in hands which
have been trained to the work.
=Accidents and Emergencies.=--The first piece of advice to every
one is to attend a series of lectures given every winter by the
St. John’s Ambulance Association at very numerous centres all over
the kingdom. This will convey an amount of knowledge and practical
experience such as can never be attained by reading alone. Even
Volunteers, who have gone through a course for the Army Hospital
Corps, will do well to supplement it for every-day life with a course
of St. John’s Ambulance lectures.
When you have not witnessed the occurrence of an accident, make some
inquiry of the bystanders or patient as to its cause before taking
any other steps, as this will often indicate what kind of injury is
to be looked for. Never proceed to lift or remove a patient with
broken limbs or bleeding wounds till the necessary bandaging and
staunching have been done: let traffic be interrupted, if need be,
rather than risk converting a simple hurt into a fatal one.
The ordinary accidents and emergencies of every-day life will now be
dealt with in alphabetic order.
_Bites and Stings._--These may be divided into two classes--those of
insects and those of poisonous or rabid animals.
Of Insects.--First remove the sting (of a bee or wasp) by pressing a
small key on the spot, whereby the sting is forced into the hollow
barrel; then apply any of the following lotions:--(_a_) Rub the bite
of mosquitoes with a solution of borax in ammonia. (_b_) When bitten
by midges, the best applications are oil of camphor and laudanum,
equal parts, applied on lint; or (_c_) 6 oz. Goulard water, ½ oz.
laudanum, applied on lint. (_d_) ½ dr. extract of belladonna; ½ oz.
glycerine; 3½ oz. water; to be well mixed, and made into a lotion.
The parts to be washed with a small quantity--about a teaspoonful or
two at a time. (_e_) Goulard water mixed with a little Eau de Cologne
makes an excellent wash for the skin in case of gnat bites. (_f_)
Keep an onion always at hand, and instantly when bitten squeeze or
cut it, so that the juice should flow into the puncture, rubbing it
gently over the place; its effects are equally efficacious in the
sting of a wasp or bee, always provided the sting does not remain in
the wound. (_g_) Ipecacuanha powder is very effective in allaying the
pain caused by the sting of scorpion, hornet, and wasp, also mosquito
and midge bites. For scorpion stings, &c., make a paste of the powder
with a little water, and apply it to the wound in a patch about the
size and thickness of a shilling. (_h_) In bee sting, first remove
the sting as quickly as possible with a forceps or by scratching
with a finger, but never with the thumb and forefinger, because this
squeezes more of the poison into the wound. Next squeeze the wound
until a drop of blood comes out, and rub the place as large as a
florin with an aqueous or dilute alcoholic solution of salicylic
acid. The effect is still better by injecting the salicylic acid into
the wound with the hypodermic syringe. After this the spot is painted
with collodion, to keep out the air. (_i_) Gnat bites, stings of
wasps, bees, &c., may be cured by applying a tincture of minderus,
laudanum, and Goulard water in equal parts. (_j_) Sweet oil, or
camphorated spirit of wine, is a good thing to apply to bite of the
mosquito. (_k_) One raw egg well beaten, ½ pint vinegar, ½ oz. spirit
of turpentine, ¼ oz. spirit wine, ¼ oz. camphor; these ingredients
to be well beaten together, then put in a bottle and shaken for 10
minutes, after which to be corked down tightly to exclude the air.
In ½ hour it is fit for use. To be well rubbed in 2, 3, or 4 times
a day. (_l_) The leaves of the common dock, bruised and well rubbed
on the part affected, alleviate the pain. (_m_) For bee stings:
after pulling out the stings, break some lettuce leaves close to
the stalk, and apply the milk afterward. (_n_) Anything “strong,”
in a popular sense, will generally suffice to decompose and destroy
an organic poison if instantly applied. This is why the juice of an
onion answers the purpose. Anything equally pungent would do as well.
(_Lancet._)
Poisonous bites.--There is great similarity in the immediate
treatment desirable in the bite of snakes and mad dogs, the object
being to prevent, as far as possible, the absorption of the poison
by the blood. In the same category come any poisonous wound, as from
arrows, &c. (_a_) Buckland recommends the following outlines:--(1)
Suck the wound, if possible, most vigorously, taking care that there
be _no sores on the lips or in the mouth_. In all cases before
sucking fill the mouth with oil or salt and water if possible. (2)
Apply, if you can, a cupping glass, or cut off the tip of a cow-horn,
cut the bottom level, apply it over the wound, and exhaust the air
by the mouth; when exhausted fill up the hole by means of a bit of
wax or other material placed into the mouth before the operation of
sucking is commenced. This is the mode adopted by the Kaffirs. (3)
Wash the parts with hartshorn (ammonia). (4) Tie a ligature tightly
above the wounded part. (5) Give doses of hartshorn and water as
strong and as frequently repeated as the patient can bear them. (6)
Send for the doctor as quickly as you can.
(_b_) Favourable results have followed using chloride of lime, a
filtered solution of which was injected into the same place where
the fatal virus (snakes’) had previously been introduced. In 17
trials made in succession, the poisoned animal survived without the
slightest disturbance of its healthy condition.
(_c_) First tie a ligature above the part bitten. Then slightly
cauterise with a lucifer match. Next swallow tumbler of raw brandy,
to be repeated whenever the feeling of sinking comes on, till the
liquor (which goes down like water) is tasted, and begins to affect
the head. Meanwhile the patient is to be walked about by two men by
force if he cannot do so alone or wants to lie down, which would be
fatal. (Sir R. Burton.)
(_d_) Permanganate of potash may be added to the list of antidotes,
as it is said to counteract very effectively the poison of serpents,
when an equal quantity of filtered (1 per cent.) solution of
permanganate of potash is injected 1-2 minutes after the poison.
(_e_) Probably a vapour bath immediately after being bitten by a
venomous reptile or rabid dog will be found to prove one of the best
remedies, the intense perspiration induced carrying off the poison.
Excessive exercise following a poisonous bite generally effects a
cure for this reason.
_Bleeding._--Bleeding may result from a wound or from the bursting of
a blood vessel, and may occur outwardly or inwardly. Bleeding from
a wound may be arterial (coming from the arteries which carry the
blood from the heart to the body and limbs), venous (coming from the
veins which take the blood back to the heart), or capillary (coming
from the capillaries which convey the blood to the extremities and
surface of the body). In arterial bleeding, the blood is bright
scarlet, and escapes in jerks, as if from a pump; this is highly
dangerous. In venous bleeding, the blood is dark coloured, and flows
away in an uninterrupted stream. In capillary bleeding, the blood
leaks or oozes out. In some wounds all three kinds of bleeding will
occur simultaneously. The foremost method of arresting external
bleeding is by pressure, either on the wound itself or on the blood
vessels feeding it, and in the case of a limb, it should be elevated
above the body to retard the flow of blood towards the part. As the
pressure is to be made on the vessels leading to the wound, it is
obvious that in arterial bleeding the pressure must be between the
heart and the wound, while in venous bleeding it must be beyond the
wound.
[Illustration: 110. Head bleeding. 111. Arm bleeding.]
The simplest and readiest way to apply pressure is by the fingers.
But first of all some knowledge of anatomy and physiology is
necessary to guide the operator where to press. Bleeding from the
head and upper neck requires pressure to be exerted on the large
artery which passes up beside the windpipe and just above the
collar-bone, as in Fig. 110. The artery supplying the arm and hand
runs down the inside of the upper arm almost in line with the coat
seam, and should be pressed, as shown in Fig. 111. The artery feeding
the leg and foot can be felt in the crease of the groin, just where
the flesh of the thigh seems to meet the flesh of the abdomen, and
this is the best spot to select in the case of a male patient; but in
the case of a female, unless the injury were very high up the thigh,
it would be more judicious perhaps to apply increased pressure around
the leg about half-way between the hip and the knee. Pressure with
the hands will not suffice to restrain severe bleeding for any length
of time, and recourse must be had to a ligature.
The simplest and most available form of ligature is a
pocket-handkerchief or neck-wrap, or any other article of attire long
and strong enough to bind the limb. Fold the article necktie fashion,
then place a smooth stone or anything serving as a firm pad on the
artery, tie the handkerchief loosely, insert any available stick in
the loop, and proceed to twist it as if wringing a towel until tight
enough to stop the flow of blood, as in Fig. 111.
In the case of bleeding from an external wound or sore on the body,
employ direct pressure over the bleeding point. If the bleeding is
from the interior of the nose or other cavity, apply cold water
or ice over the bleeding part or near it, and keep the patient
perfectly quiet on the back, or let the patient stand erect with head
well thrown back. Injection of hot water into the nostrils is very
effective. When the bleeding is from a diseased surface or ulcer,
and direct pressure does not stay it, a compress should be soaked
in a strong solution of alum, or in steel-drops, and again applied
over the point which is bleeding. Should the wound from which the
blood is coming be large and gaping, you may stuff firmly into it a
compress of some soft material large enough to fill the cavity; but
this should always be avoided if possible, as it prevents the natural
junction of the sides of the wound, and is very likely to introduce
the germs of poison. In any case of bleeding the patient may become
weak or may faint, but unless the blood is flowing actively, this
is not necessarily a serious sign, and the quiet condition of the
circulation during the faint often assists nature in staying the
bleeding, by allowing the blood to clot, and so block up any wound
in a blood-vessel. Unless the faint is prolonged, or the patient is
losing much blood, it is better not to hasten to relieve the faint
condition.
When blood is being coughed or vomited up in considerable quantities,
ice or iced water or milk should be given, and the patient be
allowed to breathe cool fresh air freely. If the blood is coming
from the lungs, inhaling steam of turpentine and hot water mixed (2
tablespoonfuls turpentine to 1 qt. hot water) will often reduce the
evil; apply cold wet cloths to the chest.
_Broken bones._--Never move a patient with a broken bone till it
has been suitably bandaged. Broken bones (fractured) are of three
kinds--(_a_) simple fracture, when the bone is simply broken in one
place; (_b_) compound fracture, when there is a wound in the flesh
communicating with the broken ends of the bone; (_c_) comminuted
fracture, when the bone is broken into pieces. The occurrence of
a fracture may almost always be learned from the history of the
accident, the patient having generally felt or heard the bone snap;
other indications are deformity of the limb, such as shortening or
bending, and on taking hold of the limb, you will find there is
increased movability, and will hear and feel a peculiar grating
caused by the broken ends of the bone rubbing against each other,
called “crepitus”; also pain and loss of power in the limbs.