HYGIENE OF THE CIRCULATORY ORGANS
367. If any part of the system is deprived of blood, its vitality will
cease; but, if the blood is lessened in quantity to a limited extent,
only the vigor and health of the part will be impaired. The following
conditions, if observed, will favor the free and regular supply of
blood to all portions of the system.
368. _The clothing should be loosely worn._ Compression of any kind
impedes the passage of blood through the vessels of the compressed
portion. Hence, no article of apparel should be worn so as to prevent
a free flow of blood through every organ of the body.
369. The blood which passes to and from the brain, flows through the
vessels of the neck. If the dressing of this part of the body is
close, the circulation will be impeded, and the functions of the brain
will be impaired. This remark is particularly important to scholars,
public speakers, and individuals predisposed to apoplexy, and other
diseases of the brain.
370. As many of the large veins lie immediately beneath the skin,
through which the blood is returned from the lower extremities, if the
ligatures used to retain the hose, or any other article of apparel, in
proper position, be tight and inelastic, the passage of blood through
these vessels will be obstructed, producing, by their distention, the
varicose, or enlarged veins. Hence elastic bands should always be used
for these purposes.
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367-386. _Give the hygiene of the circulatory organs._ 367. What
effect will be produced on the body if it is deprived of blood? If the
blood is only lessened in quantity? 368. Why should the clothing be
worn loose? 369. What is said of dressing the neck? To what persons is
this remark applicable? 370. How are enlarged veins frequently
produced?
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371. _An equal temperature of all parts of the system promotes
health._ A chill on one portion of the body diminishes the size of
its circulating vessels, and the blood which should distend and
stimulate the chilled part, will accumulate in other organs. The
deficiency of blood in the chilled portion induces weakness, while the
superabundance of sanguineous fluid may cause disease in another
part of the system.
372. _The skin should be kept not only of an equal, but at its natural
temperature._ If the skin is not kept warm by adequate clothing, so
that chills shall not produce a contraction of the blood-vessels and a
consequent paleness, the blood will recede from the surface of the
body, and accumulate in the internal organs. Cleanliness of the skin
is likewise necessary, for the reason, that this condition favors the
free action of the cutaneous vessels.
_Observation._ When intending to ride in a cold day, wash the face,
hands, and feet, in cold water, and rub them smartly with a coarse
towel. This is far better to keep the extremities warm, than to take
spirits into the stomach.
373. _Exercise promotes the circulation of the blood._ As the action
of the muscles is one of the important agents which propel the blood
through the arteries and veins, daily and regular exercise of the
muscular system is required to sustain a vigorous circulation in the
extremities and skin, and also to maintain a healthy condition of the
system. The best stimulants to improve the sluggish circulation of an
indolent patient, whose skin is pale and whose extremities are cold,
are the union of vigorous muscular exercise with agreeable mental
action, and the systematic application to the skin of cold water,
attended with friction.
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371. Why should the temperature of the body be equal? 372. Why should
the skin be kept at its natural, as well as at an equal temperature?
What practical observation when intending to ride in a cold day? 373.
Why does exercise promote health? What are good stimulants for
sluggish circulation in the indolent?
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_Illustration._ The coach-driver and teamster throw their arms around
their bodies to warm them when cold. The muscles that are called into
action in swinging the arms, force a greater quantity of blood into
the chilled parts, and consequently, more heat is produced.
374. When a number of muscles are called into energetic action, a
greater quantity of blood will be propelled to the lungs and heart in
a given time, than when the muscles are in a state of comparative
inaction. It is no uncommon occurrence, that before there is a proper
expansion of the respiratory organs to correspond with the frequency
and energy of the movements of the muscles, there is an accumulation
of blood in the lungs, attended by a painful sensation of fulness and
oppression in the chest, with violent and irregular action of the
heart. This condition of the organs of the chest, called _congestion_,
may be followed by cough, inflammation of the lungs, asthma, and a
structural disease of the heart.
375. To avoid these sensations and results, when we feel necessitated
to walk or run a considerable distance in a short time, commence the
movements in a moderate manner increasing the speed as the respiratory
movements become more frequent and their expansion more extensive, so
that a sufficient amount of air may be received into the lungs to
purify the increased quantity of blood forced into them. The same
principles should be observed when commencing labor, and in driving
horses and other animals.
_Observation._ When a large number of muscles are called into action
after repose, as when we rise from a recumbent or sitting posture,
the blood is impelled to the heart with a very strong impetus. If that
organ should be diseased, it may arrive there in larger quantities
than can be disposed of, and death may be the result. Hence the
necessity of avoiding all sudden and violent movements, on the part of
those who have either a functional or structural disease of the
heart.
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Mention the illustration. 374. What is the effect when a number of
muscles are called into energetic action? What effect has this
accumulation of blood in the lungs? 375. How can such disagreeable
sensations be avoided? Mention a practical observation.
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376. _The mind exercises no inconsiderable influence upon the
circulatory organs._ When an individual is stimulated by hope, or
excited by anger, the heart beats more forcibly, and the arteries act
more energetically, than when a person is influenced by fear, despair,
or sorrow. Consequently, the system is more fully nourished, and
capable of greater exertion, when the former condition obtains, than
when the latter exists.
377. _The quality and quantity of the blood modify the action of the
heart and blood-vessels._ If this fluid is abundant and pure, the
circulatory vessels act with more energy than when it is deficient in
quantity or defective in quality.
_Illustrations._ 1st. In an athletic man, whose heart beats forcibly,
and whose pulse is strong, if a considerable quantity of blood is
drawn from a vein, as in bleeding, the heart will beat feebly, and the
pulse will become weak.
2d. When the blood is made impure by inhaling vitiated air, the action
of the heart and arteries is diminished, which produces an effect
similar to that which takes place when blood is drawn from a vein.
378. _Hemorrhage from divided arteries should be immediately
arrested._ When large blood-vessels are wounded or cut, the flow of
blood must be immediately stopped, or the person soon faints, and the
heart ceases its action. If it is a large artery that is wounded, the
blood will be thrown out in jets, or jerks, every time the pulse
beats. The flow of blood can be stopped until a surgeon arrives,
either by compressing the vessel between the wound and the heart, or
by compressing the end of the divided artery in the wound.
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376. State some of the effects that the mind has on circulation. 377.
What effect have the quantity and quality of blood upon the
circulatory organs? Give illustration 1st. Illustration 2d. 378. What
is necessary when large blood-vessels are wounded or cut?
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[Illustration: Fig. 76. The track of the large artery of the arm. 1, The
collar-bone. 9, The axillary artery. 10, The brachial artery.]
[Illustration: Fig. 77. B, The manner of compressing the artery near the
collar-bone. A, The manner of compressing the large artery of the arm,
with the fingers. C, The manner of compressing the divided extremity of
an artery in the wound, with a finger.]
379. After making compression with the fingers, as described and
illustrated, take a piece of cloth or handkerchief, twist it
cornerwise, and tie a hard knot midway between the two ends. This
knot should be placed over the artery, between the wound and the
heart, and the ends carried around the limb and loosely tied. A stick,
five or six inches long, should be placed under the handkerchief,
which should be twisted until the knot has made sufficient compression
on the artery to allow the removal of the fingers without a return of
bleeding. Continue the compression until a surgeon can be called.
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What is shown by fig. 76? By fig. 77? 379. What is to be done after
compressing the wound, as before described?
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[Illustration: Fig. 78. A, B, The track of the large artery of the arm.
The figure exhibits the method of applying the knotted handkerchief to
make compression on this artery.]
[Illustration: Fig. 79. A, C, The track of the large artery of the thigh.
B, The method of applying the knotted handkerchief to compress this
artery. In practice, the twisting stick B should be placed opposite the
knot over the artery A, C.]
380. When an artery of the arm is cut, elevating the wounded limb
above the head will tend to arrest the flow of blood. In a wound of a
lower limb, raise the foot, so that it shall be higher than the hip,
until the bleeding ceases.
_Illustration._ On one occasion, the distinguished Dr. Nathan Smith
was called to a person who had divided one of the large arteries
below the knee. After trying in vain to find the bleeding vessel, so
as to secure it, he caused the foot to be elevated higher than the
hip. At the first instant the blood was forced from the wound about
twelve inches; in a minute, it was diminished to three or four; and,
in a short time, the bleeding ceased. This Dr. S. called his "_great_"
operation; and it was truly great in _simplicity_ and _science_.
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What is shown by fig. 78 and 79? 380. What suggestion relative to the
position of a limb when bleeding? Relate a simple operation by Dr.
Nathan Smith.
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381. The practical utility of every person knowing the proper means of
arresting hemorrhage from severed arteries, is illustrated by the
following incidents. In 1848, in the town of N., Mass., a mechanic
divided the femoral artery; although several adult persons were
present, he died in a few minutes from loss of blood, because those
persons were ignorant of the method of compressing severed arteries
until a surgeon could be obtained.
382. In 1846, a similar accident occurred in the suburbs of
Philadelphia. While the blood was flowing copiously, a lad, who had
received instruction on the treatment of such accidents at the
Philadelphia High School, rushed through the crowd that surrounded the
apparently dying man, placed his finger upon the divided vessel, and
continued the compression until the bleeding artery was secured by a
surgeon.
383. In "flesh wounds," when no large blood-vessel is divided, wash
the part with cold water, and, when bleeding has ceased, draw the
incision together, and retain it with narrow strips of adhesive
plaster. These should be put on smoothly, and a sufficient number
applied to cover the wound. In most instances of domestic practice,
the strips of adhesive plaster are too wide. They should not exceed in
width one fourth of an inch. Then apply a loose bandage, and avoid
all "healing salves," ointments, and washes. In removing the dressing
from a wound, both ends of the strips of plaster should be raised and
drawn toward the incision. The liability of the wound re-opening is
thus diminished.
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381. Relate the first incident showing the utility of every person
knowing the proper method of arresting the flow of blood from divided
arteries. 382. The second incident. 383. How should "flesh wounds" be
dressed?
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_Observation._ The union of the divided parts is effected by the
action of the divided blood-vessels, and not by salves and ointments.
The only object of the dressing is to keep the parts together, and
protect the wound from air and impurities. _Nature_, in all cases of
injuries, performs her own cure. Such simple wounds do not generally
require a second dressing and should not be opened until the incisions
are healed.
[Illustration: Fig. 80. The manner in which strips of adhesive plaster
are applied to wounds.]
384. In wounds made by pointed instruments, as a nail, or in lacerated
wounds, as those made by forcing a blunt instrument, as a hook, into
the soft parts, there will be no direct and immediate union. In these
cases, apply a soothing poultice, as one made of linseed meal, and
also keep the limb still. It is judicious to consult a physician
immediately, in punctured or lacerated wounds, because they often
induce the most dangerous diseases.
385. Wounds caused by the bite of rabid animals or venomous serpents,
should be immediately cleansed with pure water. In many instances,
the application of suction, either with "cupping glasses," or the
mouth, will prevent the introduction of the poisonous matter into the
system by absorption. When this is effected, cover the wound with a
soothing poultice, as one made of slippery elm bark.
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What should be avoided? How should the strips of plaster be removed
from a wound? How is the union of the divided parts effected? 384. How
should punctured and lacerated wounds be dressed? 385. What is the
treatment of wounds caused by the bite of rabid animals?
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_Observation._ Although animal poisons, when introduced into the
circulating fluid through the broken surface of the skin, frequently
cause death, yet they can be taken into the mouth and stomach with
impunity, if the mucous membrane which lines these parts is not
broken.
[Illustration: Fig. 81. _a_, _a_, Representation of wounds on the back
part of the arm and fore-arm _b_, _b_, Wounds on the anterior part of the
arm and fore-arm. By bending the elbow and wrist, the incisions at _a_,
_a_, are opened, while those at _b_, _b_, are closed. Were the arm
extended at the elbow and wrist, the wounds at _a_, _a_, would be closed,
and those at _b_, _b_, would be opened.]
386. The proper position of the limbs favors the union of wounds. If
the incision be upon the anterior part of the leg, between the knee
and ankle, extending the knee and bending the ankle will aid its
closing. If it be upon the back part of the leg, by extending the foot
and bending the knee, the gaping of the incision will be diminished.
When wounds occur upon the trunk or upper extremities, let the
position of the person be regarded.
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386 Does the proper position of the limbs favor the union of wounds?
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