A method in use in the N. Y. City Hospital known as the “glue burn
mixture” is composed as follows: “7-1/2 Troy oz. white glue, 16 fluid
oz. water, 1 fluid oz. glycerine, 2 fluid drachms carbolic acid. Soak
the glue in the water until it is soft, then heat on a water bath until
melted; add the glycerine and carbolic acid and continue heating until,
in the intervals of stirring, a glossy strong skin begins to form over
the surface. Pour the mass into small jars, cover with parafine papers
and tin foil before the lid of the jar is put on and afterwards protect
by paper pasted round the edge of the lid. In this manner the mixture
may be preserved indefinitely.
“When wanted for use, heat in a water bath and apply with a flat brush
over the burned part.”
=_Insensibility from Smoke._=—To recover a person from this dash cold
water in the face, or cold and hot water alternately. Should this fail
turn the patient on his face with the arms folded under his forehead;
apply pressure along the back and ribs and turn the body gradually on
the side; then again slowly on the face, repeating the pressure on the
back: continue the alternate rolling movements about sixteen times a
minute until breathing is restored. A warm bath will complete the cure.
=_Heat-stroke or Sun-stroke._=—The worst cases occur where the sun’s
rays never penetrate and are caused by the extreme heat of close and
confined rooms, overheated workshops, boiler-rooms, etc. The symptoms
are: 1, a sudden loss of consciousness; 2, heavy breathing; 3, great
heat of the skin; and 4, a marked absence of sweat.
_Treatment._—The main thing is to lower the temperature. To do this,
strip off the clothing, apply chopped ice wrapped in flannel to the
head; rub ice over the chest, and place pieces under the armpits and
at the side. If no ice can be had use sheets or cloths wet with cold
water, or the body can be stripped and sprinkled with cold water from a
common watering pot.
=_Cuts and Wounds._=—In these the chief points to be attended to are:
1, arrest the bleeding; 2, remove from the wound all foreign bodies as
soon as possible; 3, bring the wounded parts opposite to each other and
keep them so; this is best done by means of strips of adhesive plaster,
first applied to one side of the wound and then secured to the other;
these strips should not be too broad, and space must be left between
the strips to allow any matter to escape. Wounds too extensive to be
held together by plaster must be stitched by a surgeon, who should
always be sent for in all severe cases.
For washing a wound, to every pint of water add 2-1/2 teaspoonfuls
of carbolic acid and 2 tablespoonfuls of glycerine—if these are not
obtainable, add 4 tablespoonsful of borax to the pint of water—wash the
wound, close it, and apply a compress of a folded square of cotton or
linen; wet it in the solution used for washing the wound and bandage
down quickly and firmly. If the bleeding is profuse, a sponge dipped in
very hot water and wrung out in a cloth should be applied as quickly as
possible—if this is not to be had, use ice or cloth wrung out in ice
water.
Wounds heal in two ways. 1, rapidly by primary union, without
suppuration, and leaving only a very fine scar. 2, slowly by
suppuration and the formation of granulations and leaving a large red
scar.
=_Bleeding._=—This is of three kinds: 1, from the arteries which lead
from the heart; 2, that which comes from the veins, which take the
blood back to the heart; 3, that from the small veins which carry the
blood to the surface of the body. In the first, the blood is bright
scarlet and escapes as though it was being pumped. In the second, the
blood is dark red and flows away in an uninterrupted stream. In the
third, the blood oozes out. In some wounds all three kinds of bleeding
occur at the same time.
The simplest and best remedy to stop the bleeding is to apply direct
pressure on the external wound by the fingers. Should the wound be long
and gaping, a compress of some soft material large enough to fill the
cavity may be pressed into it; but this should always be avoided, if
possible, as it prevents the natural closing of the wound.
Pressure with the hands will not suffice to restrain bleeding in
severe cases for a great length of time and recourse must be had to a
ligature; this can best be made with a pocket handkerchief or other
article of apparel, long enough and strong enough to bind the limb.
Fold the article neck-tie fashion, then place a smooth stone, or
anything serving for 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 just tight enough to stop the flow.
Examine the wound from time to time, lessen the compression if it
becomes very cold or purple, or tighten up the handkerchief if it
commences bleeding.
Some knowledge of anatomy is necessary to guide the operator where to
press. Bleeding from the head and upper neck requires pressure to be
placed on the large artery which passes up beside the windpipe and just
above the collar bone. 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. 185. 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
place to apply the ligature. In arterial bleeding the pressure must be
put between the heart and the wound, while in _venous_ bleeding it must
be beyond the wound to stop the flow as it goes towards the heart.
In any case of bleeding, the person may become weak and faint; unless
the blood is flowing actively this is not a serious sign, and the quiet
condition of 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 in this
state anything like excitement should be avoided, external warmth
should be applied, the person covered with blankets, and bottles of hot
water or hot bricks applied to the feet and arm-pits.
=_Frost-bite._=—No warm air, warm water, or fire should be allowed near
the frozen parts until the natural temperature is nearly restored; rub
the affected parts gently with snow or snow water in a cold room; the
circulation should be restored very slowly; and great care must be
taken in the after treatment.
=_Broken Bones._=—The treatment consists of, 1, carefully removing
or cutting away, if more convenient, any of the clothes which are
compressing or hurting the injured parts; 2, very gently replacing the
bones in their natural position and shape, as nearly as possible, and
putting the part in a position which gives most ease to the patient; 3,
applying some temporary splint or appliance, which will keep the broken
bones from moving about and tearing the flesh; for this purpose, pieces
of wood, pasteboard, straw, or firmly folded cloth may be used, taking
care to pad the splints with some soft material and not to apply them
too tightly, while the splints may be tied by loops of rope, string, or
strips of cloth; 4, conveying the patient home or to a hospital.
The bearer then places his arm behind the back of the patient and
grasps his opposite hip, at the same time catching firmly hold of the
hand of the patient resting on his shoulder, with his other hand; then
by putting his hip behind the near hip of the patient, much support is
given, and if necessary, the bearer can lift him off the ground and as
it were, carry him along.
=_Poultices._=—These outward applications are useful to relieve
sudden cramps and pains due to severe injuries, sprains and colds.
The secret of applying a mustard is to apply it hot and keep it so by
frequent changes—if it gets cold and clammy it will do more harm than
good. Poultices to be of any service and hold its heat should be from
one-half to one inch thick. To make it, take flaxseed, oatmeal, rye
meal, bread, or ground slippery elm; stir the meal slowly into a bowl
of boiling water, until a thin and smooth dough is formed. To apply it,
take a piece of old linen of the right size, fold it in the middle;
spread the dough evenly on one half of the cloth and cover it with the
other.
To make a “mustard paste” as it is called, mix one or two
tablespoonfuls of mustard and the same of fine flour, with enough water
to make the mixture an even paste; spread it neatly with a table knife
on a piece of old linen, or even cotton cloth. Cover the face of the
paste with a piece of thin muslin.
=_How to Carry an Injured Person._=—In case of an injury where walking
is impossible, and lying down is not absolutely necessary, the injured
person may be seated in a chair, and carried; or he may sit upon a
board, the ends of which are carried by two men, around whose necks he
should place his arms so as to steady himself.
Where an injured person can walk he will get much help by putting his
arms over the shoulders and round the necks of two others.
A seat may be made with four hands and the person may be thus carried
and steadied by clasping his arms around the necks of his bearers.
If only one person is available and the patient can stand up, let him
place one arm round the neck of the bearer, bringing his hand on and in
front of the opposite shoulder of the bearer.
To get at a broken limb, or rib, the clothing must be removed, and
it is essential that this be done without injury to the patient; the
simplest plan is to rip up the seams of such garments as are in the
way. Boots must be cut off. It is not imperatively necessary to do
anything to a broken limb before the arrival of a doctor except to keep
it perfectly at rest.
To carry an injured person by a stretcher (which can be made of a
door, shutter, or settee—with blankets or shawls or coats for pillows)
three persons are necessary. In lifting the patient on the stretcher
_it should be laid with its foot to his head_, so that both are in the
same straight line; then one or two persons should stand on each side
of him, and raise him from the ground, slip him on the stretcher; this
to avoid the necessity of any one stepping over the stretcher, and the
liability of stumbling. If a limb is crushed or broken, it may be laid
upon a pillow with bandages tied around the whole (_i.e._, pillow and
limb) to keep it from slipping about. In carrying the stretcher the
bearers should “break step” with short paces; hurrying and jolting
should be avoided and the stretcher should be carried so that the
patient may be in plain sight of the bearers.