2578. "Time," according to the old proverb, "is money;" and it may also,
in many cases, and with equal truthfulness, be said to be life; for a
few moments, in great emergencies, often turn the balance between
recovery and death. This applies more especially to all kinds of
poisoning, fits, submersion in water, or exposure to noxious gases; and
many accidents. If people knew how to act during the interval that must
necessarily elapse from the moment that a medical man is sent for until
he arrives, many lives might be saved, which now, unhappily, are lost.
Generally speaking, however, nothing is done--all is confusion and
fright; and the surgeon, on his arrival, finds that death has already
seized its victim, who, had his friends but known a few rough rules for
their guidance, might have been rescued. We shall, therefore, in a
series of papers, give such information as to the means to be employed
in event of accidents, injuries, &c., as, by the aid of a gentleman of
large professional experience, we are warranted in recommending.
List of Drugs, &c., necessary to carry out all Instructions.
2579. We append at once A LIST OF DRUGS, &c., and a few PRESCRIPTIONS
necessary to carry out all the instructions given in this series of
articles. It will be seen that they are few--they are not expensive; and
by laying in a little stock of them, our instructions will be of instant
value in all cases of accident, &c.--The drugs are--Antimonial Wine.
Antimonial Powder. Blister Compound. Blue Pill. Calomel. Carbonate of
Potash. Compound Iron Pills. Compound Extract of Colocynth. Compound
Tincture of Camphor. Epsom Salts. Goulard's Extract. Jalap in Powder.
Linseed Oil. Myrrh and Aloes Pills. Nitre. Oil of Turpentine. Opium,
powdered, and Laudanum. Sal Ammoniac. Senna Leaves. Soap Liniment,
Opodeldoc. Sweet Spirits of Nitre. Turner's Cerate.--To which should be
added: Common Adhesive Plaster. Isinglass Plaster. Lint. A pair of small
Scales with Weights. An ounce and a drachm Measure-glass. A Lancet. A
Probe. A pair of Forceps, and some curved Needles.
2580. The following PRESCRIPTIONS may be made up for a few shillings;
and, by keeping them properly labelled, and by referring to the remarks
on the treatment of any particular case, much suffering, and, perhaps,
some lives, may be saved.
2581. _Draught_.--Twenty grains of sulphate of zinc in an ounce and a
half of water. This draught is to be repeated in a quarter of an hour if
vomiting does not take place.
2582. _Clyster_.--Two tablespoonfuls of oil of turpentine in a pint of
warm gruel.
2583. _Liniments_.--1. Equal parts of lime-water and linseed-oil well
mixed together. [Lime-water is made thus: Pour 6 pints of boiling water
upon 1/4 lb. of lime; mix well together, and when cool, strain the
liquid from off the lime which has fallen to the bottom, taking care to
get it as clear as possible.] 2. Compound camphor liniment.
2584. _Lotions_.--1. Mix a dessert-spoonful of Goulard's extract and 2
tablespoonfuls of vinegar in a pint of water.--2. Mix 1/2 oz. of
sal-ammoniac, 2 tablespoonfuls of vinegar, and the same quantity of gin
or whisky, in half a pint of water.
2585. _Goulard Lotion_.--1 drachm of sugar of lead, 2 pints of
rain-water, 2 teaspoonfuls of spirits of wine. For inflammation of the
eyes or elsewhere:--The better way of making Goulard Lotion, if for the
eyes, is to add to 6 oz. of distilled water, or water that has been well
boiled, 1 drachm of the extract of lead.
2586. _Opodeldoc_.--This lotion being a valuable application for
sprains, lumbago, weakness of joints, &c., and it being difficult to
procure either pure or freshly made, we give a recipe for its
preparation. Dissolve 1 oz. of camphor in a pint of rectified spirits of
wine; then dissolve 4 oz. of hard white Spanish soap, scraped thin, in 4
oz. of oil of rosemary, and mix them together.
2587. _The Common Black Draught_.--Infusion of senna 10 drachms; Epsom
salts 10 drachms; tincture of senna, compound tincture of cardamums,
compound spirit of lavender, of each 1 drachm. Families who make black
draught in quantity, and wish to preserve it for some time without
spoiling, should add about 2 drachms of spirits of hartshorn to each
pint of the strained mixture, the use of this drug being to prevent its
becoming mouldy or decomposed. A simpler and equally efficacious form of
black draught is made by infusing 1/2 oz. of Alexandrian senna, 3 oz. of
Epsom salts, and 2 drachms of bruised ginger and coriander-seeds, for
several hours in a pint of boiling water, straining the liquor, and
adding either 2 drachms of sal-volatile or spirits of hartshorn to the
whole, and giving 3 tablespoonfuls for a dose to an adult.
2588. _Mixtures_--1. _Aperient_.--Dissolve an ounce of Epsom salts in
half a pint of senna tea: take a quarter of the mixture as a dose, and
repeat it in three or four hours if necessary.
2589. 2. _Fever Mixture_.--Mix a drachm of powdered nitre, 2 drachms of
carbonate of potash, 2 teaspoonfuls of antimonial wine, and a
tablespoonful of sweet spirits of nitre, in half a pint of water.
2590. 3. _Myrrh and Aloes Pills_.--Ten grains made into two pills are
the dose for a full-grown person.
2591. 4. _Compound Iron Pills_.--Dose for a full-grown person: 10 grains
made into two pills.
2592. _Pills_.--1. Mix 5 grains of calomel and the same quantity of
antimonial powder with a little bread-crumb, and make into two pills.
Dose for a full-grown person: two pills.--2. Mix 5 grains of blue pill
and the same quantity of compound extract of colocynth together, and
make into two pills, the dose for a full-grown person.
2593. _Powders_.--Mix a grain of calomel and 4 grains of powdered jalap
together.
2594. In all cases, the dose of medicines given is to be regulated by
the age of the patient.
2595. _Abernethy's Plan for making a Bread-and-Water Poultice_.--First
scald out a basin; then having put in some boiling water, throw in
coarsely-crumbled bread, and cover it with a plate. When the bread has
soaked up as much water as it will imbibe, drain off the remaining
water, and there will be left a light pulp. Spread it a third of an inch
thick on folded linen, and apply it when of the temperature of a warm
bath. To preserve it moist, occasionally drop warm water on it.
2596. _Linseed-Meal Poultice_.--"Scald your basin, by pouring a little
hot water into it; then put a small quantity of finely-ground
linseed-meal into the basin, pour a little hot water on it, and stir it
round briskly until you have well incorporated them; add a little more
meal and a little more water; then stir it again. Do not let any lumps
remain in the basin, but stir the poultice well, and do not be sparing
of your trouble. What you do next, is to take as much of it out of the
basin as you may require, lay it on a piece of soft linen, and let it be
about a quarter of an inch thick."--_Abernethy_.
2597. _Mustard Poultice_.--Mix equal parts of dry mustard and
linseed-meal in warm vinegar. When the poultice is wanted weak, warm
water may be used for the vinegar; and when it is required very strong,
mustard alone, without any linseed-meal, is to be mixed with warm
vinegar.
2598. _An ordinary Blister_.--Spread a little blister compound on a
piece of common adhesive plaster with the right thumb. It should be put
on just thickly enough to conceal the appearance of the plaster beneath.
The part from which a blister has been taken should be covered till it
heals over with soft linen rags smeared with lard.
Baths and Fomentations.
2599. All fluid applications to the body are exhibited either in a hot
or cold form; and the object for which they are administered is to
produce a stimulating effect over the entire, or a part, of the system;
for the effect, though differently obtained, and varying in degree, is
the same in principle, whether procured by hot or cold water.
2600. _Heat_.--There are three forms in which heat is universally
applied to the body,--that of the tepid, warm, and vapour bath; but as
the first is too inert to be worth notice, and the last dangerous and
inapplicable, except in public institutions, we shall confine our
remarks to the really efficacious and always attainable one--the
2601. _Warm and Hot Bath_.--These baths are used whenever there is
congestion, or accumulation of blood in the internal organs, causing
pain, difficulty of breathing, or stupor, and are employed, by their
stimulating property, to cause a rush of blood to the surface, and, by
unloading the great organs, produce a temporary inflammation in the
skin, and so equalize the circulation. The effect of the hot bath is to
increase the fulness of the pulse, accelerate respiration, and excite
perspiration. In all inflammations of the stomach and bowels, the hot
bath is of the utmost consequence; the temperature of the warm bath
varies from 92° to 100°, and may be obtained by those who have no
thermometer to test the exact heat, by mixing one measure of boiling
with two of cold water.
2602. _Fomentations_ are generally used to effect, in a part, the
benefit produced on the whole body by the bath; to which a sedative
action is occasionally given by the use of roots, herbs, or other
ingredients; the object being to relieve the internal organ, as the
throat, or muscles round a joint, by exciting a greater flow of blood to
the skin _over_ the affected part. As the real agent of relief is heat,
the fomentation should always be as hot as it can comfortably be borne,
and, to insure effect, should be repeated every half-hour. Warm fluids
are applied in order to render the swelling which accompanies
inflammation less painful, by the greater readiness with which the skin
yields, than when it is harsh and dry. They are of various kinds; but
the most simple, and oftentimes the most useful, that can be employed,
is "Warm Water." Another kind of fomentation is composed of dried
poppyheads, 4 oz. Break them to pieces, empty out the seeds, put them
into 4 pints of water, boil for a quarter of an hour, then strain
through a cloth or sieve, and keep the water for use. Or, chamomile
flowers, hemlock, and many other plants, may be boiled, and the part
fomented with the hot liquor, by means of flannels wetted with the
decoction.
2603. _Cold_, when applied in excess to the body, drives the blood from
the surface to the centre, reduces the pulse, makes the breathing hard
and difficult, produces coma, and, if long continued, death. But when
medicinally used, it excites a reaction on the surface equivalent to a
stimulating effect; as in some cases of fever, when the body has been
sponged with cold water, it excites, by reaction, increased circulation
on the skin. Cold is sometimes used to keep up a repellent action, as,
when local inflammation takes place, a remedy is applied, which, by its
benumbing and astringent effect, causes the blood, or the excess of it
in the part, to recede, and, by contracting the vessels, prevents the
return of any undue quantity, till the affected part recovers its tone.
Such remedies are called _Lotions_, and should, when used, be applied
with the same persistency as the fomentation; for, as the latter should
be renewed as often as the heat passes off, so the former should be
applied as often as the heat from the skin deprives the application of
its cold.
2604. _Poultices_ are only another form of fomentation, though chiefly
used for abscesses. The ingredient best suited for a poultice is that
which retains heat the longest; of these ingredients, the best are
linseed--meal, bran, and bread. Bran sewed into a bag, as it can be
reheated, will be found the cleanest and most useful; especially for
sore throats.
How to Bleed.
2605. In cases of great emergency, such as the strong kind of apoplexy,
and when a surgeon cannot possibly be obtained for some considerable
time, the life of the patient depends almost entirely upon the fact of
his being bled or not. We therefore give instructions how the operation
of bleeding is to be performed, but caution the reader only to attempt
it in cases of the greatest emergency. Place a handkerchief or piece of
tape rather but not too tightly round the arm, about three or four
inches above the elbow. This will cause the veins below to swell and
become very evident. If this is not sufficient, the hand should be
constantly and quickly opened and shut for the same purpose. There will
now be seen, passing up the middle of the fore-arm, a vein which, just
below the bend of the elbow, sends a branch inwards and outwards, each
branch shortly joining another large vein. It is from the _outer_
branch--that the person is to be bled. The right arm is the one mostly
operated on. The operator should take the lancet in his right hand,
between the thumb and first finger, place the thumb of his left hand on
the vein below the part where he is going to bleed from, and then gently
thrust the tip of the lancet into the vein, and, taking care not to push
it too deeply, cut in a gently curved direction, thus and bring it
out, point upwards, at about half an inch from the part of the vein into
which he had thrust it. The vein must be cut lengthways, and not across.
When sufficient blood has been taken away, remove the bandage from above
the elbow, and place the thumb of the left hand firmly over the cut,
until all the bleeding ceases. A small pad of lint is then to be put
over the cut, with a larger pad over it, and the two kept in their
places by means of a handkerchief or linen roller bound pretty tightly
over them and round the arm.
2606. When a person is bled, he should always be in the standing, or at
any rate in the sitting, position; for if, as is often the case, he
should happen to faint, he can, in, most eases at least, easily be
brought to again by the operator placing him flat on his back, and
stopping the bleeding. _This is of the greatest importance._ It has been
recommended, for what supposed advantages we don't know, to bleed people
when they are lying down. Should a person, under these circumstances,
faint, what could be done to bring him to again? The great treatment of
lowering the body of the patient to the flat position cannot be followed
here. It is in that position already, and cannot be placed lower than it
at present is--except, as is most likely to be the case, under the
ground.
2607. BLEEDING FROM THE NOSE.--Many children, especially those of a
sanguineous temperament, are subject to sudden discharges of blood from
some part of the body; and as all such fluxes are in general the result
of an effort of nature to relieve the system from some overload or
pressure, such discharges, unless in excess, and when likely to produce
debility, should not be rashly or too abruptly checked. In general,
these discharges are confined to the summer or spring months of the
year, and follow pains in the head, a sense of drowsiness, languor, or
oppression; and, as such symptoms are relieved by the loss of blood, the
hemorrhage should, to a certain extent, be encouraged. When, however,
the bleeding is excessive, or returns too frequently, it becomes
necessary to apply means to subdue or mitigate the amount. For this
purpose the sudden and unexpected application of cold is itself
sufficient, in most cases, to arrest the most active hemorrhage. A wet
towel laid suddenly on the back, between the shoulders, and placing the
child in a recumbent posture, is often sufficient to effect the object;
where, however, the effusion resists such simple means, napkins wrung
out of cold water must be laid across the forehead and nose, the hands
dipped in cold water, and a bottle of hot water applied to the feet. If,
in spite of these means, the bleeding continues, a little fine wool or a
few folds of lint, tied together by a piece of thread, must be pushed up
the nostril from which the blood flows, to act as a plug and pressure on
the bleeding vessel. When the discharge has entirely ceased, the plug is
to be pulled out by means of the thread. To prevent a repetition of the
hemorrhage, the body should be sponged every morning with cold water,
and the child put under a course of steel wine, have open-air exercise,
and, if possible, salt-water bathing. For children, a key suddenly
dropped down the back between the skin and clothes, will often
immediately arrest a copious bleeding.
2608. SPITTING OF BLOOD, or hemorrhage from the lungs, is generally
known from blood from the stomach by its being of a brighter colour, and
in less quantities than that, which is always grumous and mixed with the
half-digested food. In either case, rest should be immediately enjoined,
total abstinence from stimulants, and a low, poor diet, accompanied with
the horizontal position, and bottles of boiling water to the feet. At
the same time the patient should suck through a quill, every hour, half
a wine-glass of water in which 10 or 15 drops of the elixir of vitriol
has been mixed, and, till further advice has been procured, keep a towel
wrung out of cold water on the chest or stomach, according to the seat
of the hemorrhage.
Bites and Stings.
2609. BITES AND STINGS may be divided into three kinds:--1. Those of
Insects. 2. Those of Snakes. 3. Those of Dogs and other Animals.
2610. 1. _The Bites or Stings of Insects_, such as gnats, bees, wasps,
&c., need cause very little alarm, and are, generally speaking, easily
cured. They are very serious, however, when they take place on some
delicate part of the body, such as near the eye, or in the throat. _The
treatment_ is very simple in most cases; and consists in taking out the
sting, if it is left behind, with a needle, and applying to the part a
liniment made of finely-scraped chalk and olive-oil, mixed together to
about the thickness of cream.
2611. Bathing the part bitten with warm turpentine or warm vinegar is
also of great use. If the person feels faint, he should lie quietly on
his back, and take a little brandy-and-water, or sal-volatile and water.
When the inside of the throat is the part stung, there is great danger
of violent inflammation taking place. In this case, from eight to twelve
leeches should be immediately put to the outside of the throat, and when
they drop off, the part to which they had been applied should be well
fomented with warm water. The inside of the throat is to be constantly
gargled with salt and water. Bits of ice are to be sucked. Rubbing the
face and hands well over with plain olive-oil, before going to bed, will
often keep gnats and musquitoes from biting during the night. Strong
scent, such as eau-de-Cologne, will have the same effect.
2612. 2. _Bites of Snakes_.--These are much more dangerous than the
preceding, and require more powerful remedies. The bites of the
different kinds of snakes do not all act alike, but affect people in
different ways.--_Treatment of the part bitten_. The great thing is to
prevent the poison getting into the blood; and, if possible, to remove
the whole of it at once from the body. A pocket-handkerchief, a piece of
tape or cord, or, in fact, of anything that is at hand, should be tied
tightly round the part of the body bitten; if it be the leg or arm,
immediately _above_ the bite, and between it and the heart. The bite
should then be sucked several times by any one who is near. There is no
danger in this, provided the person who does it has not got the skin
taken off any part of his mouth. What has been sucked into the mouth
should be immediately spit out again. But if those who are near have
sufficient nerve for the operation, and a suitable instrument, they
should cut out the central part bitten, and then bathe the wound for
some time with warm water, to make it bleed freely. The wound should
afterwards be rubbed with a stick of lunar caustic, or, what is better,
a solution of this--60 grains of lunar caustic dissolved in an ounce of
water--should be dropped into it. The band should be kept on the part
during the whole of the time that these means are being adopted. The
wound should afterwards be covered with lint dipped in cold water. The
best plan, however, to be adopted, if it can be managed, is the
following:--take a common wine-glass, and, holding it upside down, put a
lighted candle or a spirit-lamp into it for a minute or two. This will
take out the air. Then clap the glass suddenly over the bitten part, and
it will become attached, and hold on to the flesh. The glass being
nearly empty, the blood containing the poison will, in consequence, flow
into it from the wound of its own accord. This process should be
repeated three or four times, and the wound sucked, or washed with warm
water, before each application of the glass. As a matter of course, when
the glass is removed, all the blood should be washed out of it before it
is applied again.--_Constitutional Treatment_. There is mostly at first
great depression of strength in these cases, and it is therefore
requisite to give some stimulant; a glass of hot brandy-and-water, or
twenty drops of sal-volatile, is the best that can be given. When the
strength has returned, and if the patient has not already been sick, a
little mustard in hot water should be given, to make him so. If, on the
other hand, as is often the case, the vomiting is excessive, a large
mustard poultice should be placed over the stomach, and a grain of solid
opium swallowed in the form of a pill, for the purpose of stopping it.
Only one of these pills should be given by a non-professional person. In
all cases of bites from snakes, send for a surgeon as quickly as
possible, and act according to the above directions until he arrives. If
he is within any reasonable distance, content yourself by putting on the
band, sucking the wound, applying the glass, and, if necessary, giving a
little brandy-and-water.
2613. 3. _Bites of Dogs_.--For obvious reasons, these kinds of bites are
more frequently met with than those of snakes. _The treatment_ is the
same as that for snake-bites, more especially that of the bitten part.
The majority of writers on the subject are in favour of keeping the
wound open as long as possible. This may be done by putting a few beans
on it, and then by applying a large linseed-meal poultice over them.
Injuries and Accidents to Bones.
2614. _Dislocation of Bones_.--When the end of a bone is pushed out of
its natural position, it is said to be dislocated. This may be caused by
violence, disease, or natural weakness of the parts about a
joint.--_Symptoms_. Deformity about the joint, with unnatural prominence
at one part, and depression at another. The limb may be shorter or
longer than usual, and is stiff and unable to be moved, differing in
these last two respects from a broken limb, which is mostly shorter,
never longer, than usual, and which is always more movable.--_Treatment_.
So much practical science and tact are requisite in order to bring a
dislocated bone into its proper position again, that we strongly advise
the reader never to interfere in these cases; unless, indeed, it is
altogether impossible to obtain the services of a surgeon. But because
any one of us may very possibly be placed in that emergency, we give a
few rough rules for the reader's guidance. In the first place make the
joint, from which the bone has been displaced, perfectly steady, either
by fixing it to some firm object or else by holding it with the hands;
then pull the dislocated bone in a direction towards the place from
which it has been thrust, so that, if it moves at all from its unnatural
position, it may have the best chance of returning to its proper place.
Do not, however, pull or press against the parts too violently, as you
may, perhaps, by doing so, rupture blood-vessels, and produce most
serious consequences. When you _do_ attempt to reduce a dislocated bone,
do it as quickly as possible after the accident has taken place, every
hour making the operation more difficult. When the patient is very
strong, he may be put into a warm bath until he feels faint, or have
sixty drops of antimonial wine given him every ten minutes until he
feels sickish. These two means are of great use in relaxing the muscles.
If the bone has been brought back again to its proper place, keep it
there by means of bandages; and if there is much pain about the joint,
apply a cold lotion to it, and keep it perfectly at rest. The lotion
should be, a dessert-spoonful of Goulard's extract, and two tablespoonfuls
of vinegar, mixed in a pint of water. Leeches are sometimes necessary.
Unless the local pain, or general feverish symptoms, are great, the
patient's diet should be the same as usual. Dislocations may be reduced
a week, or even a fortnight, after they have taken place. As, therefore,
although the sooner a bone is reduced the better, there is no very great
emergency, and as the most serious consequences may follow improper or
too violent treatment, it is always better for people in these cases to
do too little than too much; inasmuch as the good which has not yet may
still be done, whereas the evil that _has_ been done cannot so easily be
undone.
2615. FRACTURES OF BONES.--_Symptoms_. 1. Deformity of the part. 2.
Unnatural looseness. 3. A grating sound when the two ends of the broken
bone are rubbed together. 4. Loss of natural motion and power. In some
cases there is also shortening of the limb.--Fracture takes place from
several causes, as a fall, a blow, a squeeze, and sometimes from the
violent action of muscles.--_Treatment_. In cases where a surgeon cannot
be procured immediately after the accident, the following general rules
are offered for the reader's guidance:--The broken limb should be placed
and kept as nearly as possible in its natural position. This is to be
done by first pulling the two portions of the bone in opposite
directions, until the limb becomes as long as the opposite one, and then
by applying a splint, and binding it to the part by means of a roller.
When there is no deformity, the pulling is of course unnecessary. If
there is much swelling about the broken part, a cold lotion is to be
applied. This lotion (_which we will call Lotion No. 1_) may be thus
made:--Mix a dessert-spoonful of Goulard's extract and two
tablespoonfuls of vinegar in a pint of water. When the leg or arm is
broken, always, if possible, get it to the same length and form as the
opposite limb. The broken part should be kept perfectly quiet. When a
broken limb is deformed, and a particular muscle is on the stretch,
place the limb in such a position as will relax it. This will in most
cases cure the deformity. Brandy-and-water, or sal-volatile and water,
are to be given when the patient is faint. Surgical aid should, of
course, be procured as soon as possible.
2616. JOINTS, INJURIES TO.--All kinds of injuries to joints, of whatever
description, require particular attention, in consequence of the violent
inflammations which are so liable to take place in these parts of the
body, and which do so much mischief in a little time. The joint injured
should always be kept perfectly at rest; and when it is very painful,
and the skin about it red, swollen, hot, and shining, at the same time
that the patient has general feverish symptoms, such as great thirst and
headache--leeches, and when they drop off, warm poppy fomentations, are
to be applied; the No. 1 pills above-mentioned are to be given (two are
a dose for a grown person) with a black draught three hours afterwards.
Give also two tablespoonfuls of the fever-mixture every four hours, and
keep the patient on low diet. When the injury and swelling are not very
great, warm applications, with rest, low diet, and a dose of aperient
medicine, will be sufficient. When a joint has received a penetrating
wound, it will require the most powerful treatment, and can only be
properly attended to by a surgeon. The patient's friends will have to
use their own judgment to a great extent in these and in many other
cases, as to when leeches, fever-mixture, &c., are necessary. A
universal rule, however, without a single exception, _is always to rest
a joint well_ after it has been injured in any way whatever, to purge
the patient, and to keep him on low diet, without beer, unless he has
been a very great drinker indeed, in which case he may still be allowed
to take a little; for if the stimulant that a person has been accustomed
to in excess be all taken away at once, he is very likely to have an
attack of delirium tremens. The quantity given should not, however, be
much--say a pint, or, at the most, a pint and a half a day. Rubbing the
joint with opodeldoc, or the application of a blister to it, is of great
service in taking away the thickenings, which often remain after all
heat, pain, and redness have left an injured joint. Great care should be
observed in not using a joint too quickly after it has been injured.
When the shoulder-joint is the one injured, the arm should be bound
tightly to the body by means of a linen or flannel roller, and the elbow
raised; when the elbow, it should be kept raised in the straight
position, on a pillow; when the wrist, it should be raised on the chest,
and suspended in a sling; when the knee, it should be kept in the
straight position; and, lastly, when the ankle, it should be a little
raised on a pillow.
2617. BRUISES, LACERATIONS, AND CUTS.--Wherever the bruise may be, or
however swollen or discoloured the skin may become, two or three
applications of the _extract of lead_, kept to the part by means of
lint, will, in an hour or little more, remove all pain, swelling, and
tenderness. Simple or clean cuts only require the edges of the wound to
be placed in their exact situation, drawn close together, and secured
there by one or two slips of adhesive plaster. When the wound, however,
is jagged, or the flesh or cuticle lacerated, the parts are to be laid
as smooth and regular as possible, and a piece of lint, wetted in the
_extract of lead_, laid upon the wound, and a piece of greased lint
placed above it to prevent the dressing sticking; the whole covered over
to protect from injury, and the part dressed in the same manner once a
day till the cure is effected.
2618. BRUISES AND THEIR TREATMENT.--The best application for a bruise,
be it large or small, is moist warmth; therefore, a warm bread-and-water
poultice in hot moist flannels should be put on, as they supple the
skin. If the bruise be very severe, and in the neighbourhood of a joint,
it will be well to apply ten or a dozen leeches over the whole bruised
part, and afterwards a poultice. But leeches should not be put on young
children. If the bruised part be the knee or the ankle, walking should
not be attempted till it can be performed without pain. Inattention to
this point often lays the foundation for serious mischief in these
joints, especially in the case of scrofulous persons. In all conditions
of bruises occurring in children, whether swellings or abrasions, no
remedy is so quick or certain of effecting a cure as the pure extract of
lead applied to the part.
Burns and Scalds.
2619. BURNS AND SCALDS being essentially the same in all particulars,
and differing only in the manner of their production, may be spoken of
together. As a general rule, scalds are less severe than burns, because
the heat of water, by which scalds are mostly produced, is not, even
when it is boiling, so intense as that of flame; oil, however, and other
liquids, whose boiling-point is high, produce scalds of a very severe
nature. Burns and scalds have been divided into three classes. The first
class comprises those where the burn is altogether superficial, and
merely reddens the skin; the second, where the injury is greater, and we
get little bladders containing a fluid (called serum) dotted over the
affected part; in the third class we get, in the case of burns, a
charring, and in that of scalds, a softening or pulpiness, perhaps a
complete and immediate separation of the part. This may occur at once,
or in the course of a little time. The pain from the second kind of
burns is much more severe than that in the other two, although the
danger, as a general rule, is less than it is in the third class. These
injuries are much more dangerous when they take place on the trunk than
when they happen on the arms or legs. The danger arises more from the
extent of surface that is burnt than from the depth to which the burn
goes. This rule, of course, has certain exceptions; because a small burn
on the chest or belly penetrating deeply is more dangerous than a more
extensive but superficial one on the arm or leg. When a person's clothes
are in flames, the best way of extinguishing them is to wind a rug, or
some thick material, tightly round the whole of the body.
2620. _Treatment of the First Class of Burns and Scalds_.--_Of the part
affected_.--Cover it immediately with a good coating of common flour, or
cotton-wool with flour dredged well into it. The great thing is to keep
the affected surface of the skin from the contact of the air. The part
will shortly get well, and the skin may or may not peel
off.--_Constitutional Treatment_. If the burn or scald is not extensive,
and there is no prostration of strength, this is very simple, and
consists in simply giving a little aperient medicine--pills (No. 2), as
follows:--Mix 5 grains of blue pill and the same quantity of compound
extract of colocynth, and make into two pills--the dose for a full-grown
person. Three hours after the pills give a black draught. If there are
general symptoms of fever, such as hot skin, thirst, headache, &c. &c.,
two tablespoonfuls of fever-mixture are to be given every four hours.
The fever-mixture, we remind our readers, is made thus:-Mix a drachm of
powdered nitro, 2 drachms of carbonate of potash, 2 teaspoonfuls of
antimonial wine, and a tablespoonful of sweet spirits of nitro, in half
a pint of water.
2621. _Second Class. Local Treatment_.--As the symptoms of these kinds
of burns are more severe than those of the first class, so the remedies
appropriate to them are more powerful. Having, as carefully as possible,
removed the clothes from the burnt surface, and taking care not to break
the bladders, spread the following liniment (No. 1) on a piece of linen
or lint--not the _fluffy_ side--and apply it to the part: the liniment
should be equal parts of lime-water and linseed-oil, well mixed. If the
burn is on the trunk of the body, it is better to use a warm
linseed-meal poultice. After a few days dress the wound with Turner's
cerate. If the burn is at the bend of the elbow, place the arm in the
_straight_ position; for if it is _bent_, the skin, when healed, will be
contracted, and the arm, in all probability, always remain in the same
un natural position. This, indeed, applies to all parts of the body;
therefore, always place the part affected in the most _stretched_
position possible.--_Constitutional Treatment_. The same kind of
treatment is to be used as for the first class, only it must be more
powerful. Stimulants are move often necessary, but must be given with
great caution. If, as is often the case, there is great irritability and
restlessness, a dose of opium (paregoric, in doses of from sixty to a
hundred drops, according to age, is best) is of great service. The
feverish symptoms will require aperient medicines and the fever mixture.
A drink made of about a tablespoonful of cream of tartar and a little
lemon-juice, in a quart of warm water, allowed to cool, is a very nice
one in these cases. The diet throughout should not be too low,
especially if there is much discharge from the wound. After a few days
it is often necessary to give wine, ammonia, and strong beef-tea. These
should be had recourse to when the tongue gets dry and dark, and the
pulse weak and frequent. If there should be, after the lapse of a week
or two, pain over one particular part of the belly, a blister should be
put on it, and a powder of mercury and chalk-grey powder, and Dover's
powder (two grains of the former and five of the latter) given three
times a day. Affections of the head and chest also frequently occur as a
consequence of these kinds of burns, but no one who is not a medical man
can treat them.
2622. _Third Class_.--These are so severe as to make it impossible for a
non-professional person to be of much service in attending to them. When
they occur, a surgeon should always be sent for. Until he arrives,
however, the following treatment should be adopted:--Place the patient
full-length on his back, and keep him warm. Apply fomentations of
flannels wrung out of boiling water and sprinkled with spirits of
turpentine to the part, and give wine and sal-volatile in such
quantities as the prostration of strength requires; always bearing in
mind the great fact that you have to steer between two quicksands--death
from present prostration and death from future excitement, which will
always be increased in proportion to the amount of stimulants given.
Give, therefore, only just as much as is absolutely necessary to keep
life in the body.
2623. CONCUSSION OF BRAIN--STUNNING.--This may be caused by a blow or a
fall.--_Symptoms_. Cold skin; weak pulse; almost total insensibility;
slow, weak breathing; pupil of eye sometimes bigger, sometimes smaller,
than natural; inability to move; unwillingness to answer when spoken to.
These symptoms come on directly after the accident.--_Treatment_. Place
the patient quietly on a warm bed, send for a surgeon, _and do nothing
else for the first four or six hours_. After this time the skin will
become hot, the pulse full, and the patient feverish altogether. If the
surgeon has not arrived by the time these symptoms have set in, shave
the patient's head, and apply the following lotion (No. 2): Mix half an
ounce of sal-ammoniac, two tablespoonfuls of vinegar, and the same
quantity of gin or whisky, in half a pint of water. Then give this pill
(No. 1); Mix five grains of calomel and the same quantity of antimonial
powder with a little bread-crumb, and make into two pills. Give a black
draught three hours after the pill, and two tablespoonfuls of the
above-mentioned fever-mixture every four hours. Keep on low diet.
Leeches are sometimes to be applied to the head. These cases are often
followed by violent inflammation of the brain. They can, therefore, only
be attended to properly throughout by a surgeon. The great thing for
people to do in these cases is--nothing; contenting themselves with
putting the patient to bed, and waiting the arrival of a surgeon.
2624. THE CHOLERA AND AUTUMNAL COMPLAINTS.--To oppose cholera, there
seems no surer or better means than cleanliness, sobriety, and judicious
ventilation. Where there is dirt, that is the place for cholera; where
windows and doors are kept most jealously shut, there cholera will find
easiest entrance; and people who indulge in intemperate diet during the
hot days of autumn are actually courting death. To repeat it,
cleanliness, sobriety, and free ventilation almost always defy the
pestilence; but, in case of attack, immediate recourse should be had to
a physician. The faculty say that a large number of lives have been
lost, in many seasons, solely from delay in seeking medical assistance.
They even assert that, taken early, the cholera is by no means a fatal
disorder. The copious use of salt is recommended on very excellent
authority. Other autumnal complaints there are, of which diarrhoea is
the worst example. They come on with pain, flatulence, sickness, with or
without vomiting, followed by loss of appetite, general lassitude, and
weakness. If attended to at the first appearance, they may soon be
conquered; for which purpose it is necessary to assist nature in
throwing off the contents of the bowels, which may be one by means of
the following prescription:--Take of calomel 3 grains, rhubarb 8 grains;
mix and take it in a little honey or jelly, and repeat the dose three
times, at the intervals of four or five hours. The next purpose to be
answered is the defence of the lining membrane of the intestines from
their acrid contents, which will be best effected by drinking copiously
of linseed tea, or of a drink made by pouring boiling water on
quince-seeds, which are of a very mucilaginous nature; or, what is still
better, full draughts of whey. If the complaint continue after these
means have been employed, some astringent or binding medicine will be
required, as the subjoined:--Take of prepared chalk 2 drachms,
cinnamon-water 7 oz., syrup of poppies 1 oz.; mix, and take 3
tablespoonfuls every four hours. Should this fail to complete the cure,
1/2 oz. of tincture of catechu, or of kino, may be added to it, and then
it will seldom fail; or a teaspoonful of the tincture of kino alone,
with a little water, every three hours, till the diarrhoea is checked.
While any symptoms of derangement are present, particular attention must
be paid to the diet, which should be of a soothing, lubricating, and
light nature, as instanced in veal or chicken broth, which should
contain but little salt. Rice, batter, and bread puddings will be
generally relished, and be eaten with advantage; but the stomach is too
much impaired to digest food of a more solid nature. Indeed, we should
give that organ, together with the bowels, as little trouble as
possible, while they are so incapable of acting in their accustomed
manner. Much mischief is frequently produced by the absurd practice of
taking tincture of rhubarb, which is almost certain of aggravating that
species of disorder of which we have now treated; for it is a spirit as
strong as brandy, and cannot fail of producing harm upon a surface which
is rendered tender by the formation and contact of vitiated bile. But
our last advice is, upon the first appearance of such symptoms as are
above detailed, have _immediate_ recourse to a doctor, where possible.
2625. TO CURE A COLD.--Put a large teacupful of linseed, with 1/4 lb. of
sun raisins and 2 oz. of stick liquorice, into 2 quarts of soft water,
and let it simmer over a slow fire till reduced to one quart; add to it
1/4 lb. of pounded sugar-candy, a tablespoonful of old rum, and a
tablespoonful of the best white-wine vinegar, or lemon-juice. The rum
and vinegar should be added as the decoction is taken; for, if they are
put in at first, the whole soon becomes flat and less efficacious. The
dose is half a pint, made warm, on going to bed; and a little may be
taken whenever the cough is troublesome. The worst cold is generally
cured by this remedy in two or three days; and, if taken in time, is
considered infallible.
2626. COLD ON THE CHEST.--A flannel dipped in boiling water, and
sprinkled with turpentine, laid on the chest as quickly as possible,
will relieve the most severe cold or hoarseness.
2627. SUBSTANCES IN THE EYE.--To remove fine particles of gravel, lime,
&c., the eye should be syringed with lukewarm water till free from them.
Be particular not to worry the eye, under the impression that the
substance is still there, which the enlargement of some of the minute
vessels makes the patient believe is actually the case.
2628. SORE EYES.--Incorporate thoroughly, in a glass mortar or vessel,
one part of strong citron ointment with three parts of spermaceti
ointment. Use the mixture night and morning, by placing a piece of the
size of a pea in the corner of the eye affected, only to be used in
cases of chronic or long-standing inflammation of the organ, or its
lids.
2629. LIME IN THE EYE.--Bathe the eye with a little weak
vinegar-and-water, and carefully remove any little piece of lime which
may be seen, with a feather. If any lime has got entangled in the
eyelashes, carefully clear it away with a bit of soft linen soaked in
vinegar-and-water. Violent inflammation is sure to follow; a smart purge
must be therefore administered, and in all probability a blister must be
applied on the temple, behind the ear, or nape of the neck.
2630. STYE IN THE EYE.--Styes are little abscesses which form between
the roots of the eyelashes, and are rarely larger than a small pea. The
best way to manage them is to bathe them frequently with warm water, or
in warm poppy-water, if very painful. When they have burst, use an
ointment composed of one part of citron ointment and four of spermaceti,
well rubbed together, and smear along the edge of the eyelid. Give a
grain or two of calomel with 5 or 8 grains of rhubarb, according to the
age of the child, twice a week. The old-fashioned and apparently absurd
practice of rubbing the stye with a ring, is as good and speedy a cure
as that by any process of medicinal application; though the number of
times it is rubbed, or the quality of the ring and direction of the
strokes, has nothing to do with its success. The pressure and the
friction excite the vessels of the part, and cause an absorption of the
effused matter under the eyelash. The edge of the nail will answer as
well as a ring.
2631. INFLAMMATION OF THE EYELIDS.--The following ointment has been
found very beneficial in inflammations of the eyeball and edges of the
eyelids:--Take of prepared calomel, 1 scruple; spermaceti ointment, 1/2
oz. Mix them well together in a glass mortar; apply a small quantity to
each corner of the eye every night and morning, and also to the edges of
the lids, if they are affected. If this should not eventually remove the
inflammation, elder-flower water may be applied three or four times a
day, by means of an eye-cup. The bowels should be kept in a laxative
state, by taking occasionally a quarter of an ounce of the Cheltenham or
Epsom salts.
2632. FASTING.--It is said by many able physicians that fasting is a
means of removing incipient disease, and of restoring the body to its
customary healthy sensations. Howard, the celebrated philanthropist
(says a writer), used to fast one day in every week. Napoleon, when he
felt his system unstrung, suspended his wonted repast, and took his
exercise on horseback.
Fits.
2633. Fits come on so suddenly, often without even the slightest
warning, and may prove fatal so quickly, that all people should be
acquainted at least with their leading symptoms and treatment, as a few
moments, more or less, will often decide the question between life and
death. The treatment, in very many cases at least, to be of the
slightest use, should be _immediate_, as a person in a fit (of apoplexy
for instance) may die while a surgeon is being fetched from only the
next street. We shall give, as far as the fact of our editing a work for
non-professional readers will permit, the peculiar and distinctive
symptoms of all kind of fits, and the immediate treatment to be adopted
in each case.
2634. APOPLEXY.--These fits may be divided into two kinds--the _strong_
and the _weak_.
2635. 1. _The strong kind_.--These cases mostly occur in stout, strong,
short-necked, bloated-faced people, who are in the habit of living
well.--_Symptoms_. The patient may or may not have had headache, sparks
before his eyes, with confusion of ideas and giddiness, for a day or two
before the attack. When it takes place, he falls down insensible; the
body becomes paralyzed, generally more so on one side than the other;
the face and head are hot, and the blood-vessels about them swollen; the
pupils of the eyes are larger than natural, and the eyes themselves are
fixed; the mouth is mostly drawn down at one corner; the breathing is
like loud snoring; the pulse full and hard.--_Treatment_. Place the
patient immediately in bed, with his head well raised; take off
everything that he has round his neck, and bleed freely and at once from
the arm. If you have not got a lancet, use a penknife or anything
suitable that may be at hand. Apply warm mustard poultices to the soles
of the feet and the insides of the thighs and legs; put two drops of
castor oil, mixed up with eight grains of calomel, on the top of the
tongue, as far back as possible; a most important part of the treatment
being to open the bowels as quickly and freely as possible. The patient
cannot swallow; but these medicines, especially the oil, will be
absorbed into the stomach altogether independent of any voluntary
action. If possible, throw up a warm turpentine clyster (two
tablespoonfuls of oil of turpentine in a pint of warm gruel), or, if
this cannot be obtained, one composed of about a quart of warm
salt-and-water and soap. Cut off the hair, and apply rags dipped in weak
vinegar-and-water, or weak gin-and-water, or even simple cold water, to
the head. If the blood-vessels about the head and neck are much swollen,
put from eight to ten leeches on the temple opposite to the paralyzed
side of the body. Always send for a surgeon immediately, and act
according to the above rules, doing more or less, according to the means
at hand, and the length of time that must necessarily elapse until he
arrives. A pint, or even a quart of blood in a very strong person, may
be taken away. When the patient is able to swallow, give him the No. 1
pills, and the No. 1 mixture directly. [The No. 1 pills are made as
follows:--Mix 5 grains of calomel and the same quantity of antimonial
powder with a little bread-crumb: make into two pills, the dose for a
full-grown person. For the No. 1 mixture, dissolve on ounce of Epsom
salts in half a pint of senna tea: take a quarter of the mixture as a
dose] Repeat these remedies if the bowels are not well opened. Keep the
patient's head well raised, and cool as above. Give very low diet
indeed: gruel, arrowroot, and the like. When a person is recovering, he
should have blisters applied to the nape of the neck, his bowels should
be kept well open, light diet given, and fatigue, worry, and excess of
all kinds avoided.
2636. 2. _The weak kind_.--_Symptoms_. These attacks are more frequently
preceded by warning symptoms than the first kind. The face is pale, the
pulse weak, and the body, especially the hands and legs, cold. After a
little while, these symptoms sometimes alter to those of the first class
in a mild degree.--_Treatment._ At first, if the pulse is _very feeble
indeed_, a little brandy-and-water or sal-volatile must be given.
Mustard poultices are to be put, as before, to the soles of the foot and
the insides of the thighs and legs. Warm bricks, or bottles filled with
warm water, are also to be placed under the armpits. When the strength
has returned, the body become warmer, and the pulse fuller and harder,
the head should be shaved, and wet rags applied to it, as before
described. Leeches should be put, as before, to the temple opposite the
side paralyzed; and the bowels should be opened as freely and as quickly
as possible. Bleeding from the arm is often necessary in these cases,
but a non-professional person should never have recourse to it. Blisters
may be applied to the nape of the neck at once. The diet in those cases
should not be so low as in the former--indeed, it is often necessary, in
a day or so after one of these attacks, to give wine, strong beef-tea,
&c., according to the condition of the patient's strength.
2637. _Distinctions between Apoplexy and Epilepsy_.--1. Apoplexy mostly
happens in people over _thirty_, whereas epilepsy generally occurs under
that ago; at any rate for the first time. A person who has epileptic
fits over thirty, has generally suffered from them for some years. 2.
Again, _in apoplexy_, the body is paralyzed; and, therefore, has not
_the convulsions which take place in epilepsy_. 3. The peculiar
_snoring_ will also distinguish apoplexy from epilepsy.
2638. _Distinctions between Apoplexy and Drunkeness_.--1. The known
habits of the person. 2. The fact of a person who was perfectly sober
and sensible a little time before, being found in a state of
insensibility. 3. The absence, in apoplexy, of the _smell of drink_ on
applying the nose to the mouth. 4. A person in a fit of apoplexy cannot
be roused at all; in drunkenness he mostly can, to a certain extent.
2639. _Distinction between Apoplexy and Hysteria_.--Hysterics mostly
happen in young, nervous, unmarried women; and are attended with
convulsions, sobbing, laughter, throwing about of the body, &c. &c.
2640. _Distinction between Apoplexy and Poisoning by Opium_.--It is
exceedingly difficult to distinguish between these two cases. In
poisoning by opium, however, we find the particular smell of the drug in
the patient's breath. We should also, in forming our opinion, take into
consideration the person's previous conduct--whether he has been low and
desponding for some time before, or has ever talked about committing
suicide.
2641. EPILEPSY.--_Falling Sickness_.--Those fits mostly happen, at any
rate for the first time, to young people, and are more common in boys
than girls. They are produced by numerous causes.--_Symptoms_. The fit
may be preceded by pains in the head, palpitations, &c. &c.; but it
mostly happens that the person falls down insensible suddenly, and
without any warning whatever. The eyes are distorted, so that only their
whites can be seen; there is mostly foaming from the mouth; the fingers
are clinched; and the body, especially on one side, is much agitated;
the tongue is often thrust out of the mouth. When the fit goes off, the
patient feels drowsy and faint, and often sleeps soundly for some
time.--_Treatment_. During the fit, keep the patient flat on his back,
with his head slightly raised, and prevent him from doing any harm to
himself; dash cold water into his face, and apply smelling-salts to his
nose; loosen his shirt collar, &c.; hold a piece of wood about as thick
as a finger--the handle of a tooth-brush or knife will do as
well--between the two rows of teeth, at the back part of the mouth. This
will prevent the tongue from being injured. A teaspoonful of common salt
thrust into the patient's mouth, during the fit, is of much service. The
after-treatment of these fits is various, and depends entirely upon
their causes. A good general rule, however, is always to keep the bowels
well open, and the patient quiet, and free from fatigue, worry, and
excess of all kinds.
2642. _Fainting Fits_ are sometimes very dangerous, and at others
perfectly harmless; the question of danger depending altogether upon the
causes which have produced them, and which are exceedingly various. For
instance, fainting produced by disease of the heart is a very serious
symptom indeed; whereas, that arising from some slight cause, such as
the sight of blood, &c., need cause no alarm whatever. The symptoms of
simple fainting are so well known that it would be quite superfluous to
enumerate them here. The _treatment_ consists in laying the patient at
full length upon his back, with his head upon a level with the rest of
his body, loosening everything about the neck, dashing cold water into
the face, and sprinkling vinegar and water about the mouth; applying
smelling-salts to the nose; and, when the patient is able to swallow, in
giving a little warm brandy-and-water, or about 20 drops of sal-volatile
in water.
2643. _Hysterics_.--These fits take place, for the most part, in young,
nervous, unmarried women. They happen much less often in married women;
and even (in some rare cases indeed) in men. Young women, who are
subject to these fits, are apt to think that they are suffering from
"all the ills that flesh is heir to;" and the false symptoms of disease
which they show are so like the true ones, that it is often exceedingly
difficult to detect the difference. The fits themselves are mostly
preceded by great depression of spirits, shedding of tears, sickness,
palpitation of the heart, &c. A pain, as if a nail were being driven in,
is also often felt at one particular part of the head. In almost all
cases, when a fit is coming on, pain is felt on the left side. This pain
rises gradually until it reaches the throat, and then gives the patient
a sensation as if she had a pellet there, which prevents her from
breathing properly, and, in fact, seems to threaten actual suffocation.
The patient now generally becomes insensible, and faints; the body is
thrown about in all directions, froth issues from the mouth, incoherent
expressions are uttered, and fits of laughter, crying, or screaming,
take place. When the fit is going off, the patient mostly cries
bitterly, sometimes knowing all, and at others nothing, of what has
taken place, and feeling general soreness all over the body. _Treatment
during the fit_. Place the body in the same position as for simple
fainting, and treat, in other respects, as directed in the article on
Epilepsy. _Always well loosen the patient's stays_; and, when she is
recovering, and able to swallow, give 20 drops of sal volatile in a
little water. The _after-treatment_ of these cases is very various. If
the patient is of a strong constitution, she should live on plain diet,
take plenty of exercise, and take occasional doses of castor oil, or an
aperient mixture, such as that described as "No. 1," in previous
numbers. If, as is mostly the case, the patient is weak and delicate,
she will require a different mode of treatment altogether. Good
nourishing diet, gentle exercise, cold baths, occasionally a dose of No.
3 myrrh and aloes pills at night, and a dose of compound iron pills
twice a day. [As to the myrrh and aloes pills (No. 3), 10 grains made
into two pills are a dose for a full-grown person. Of the compound iron
pills (No. 4), the dose for a full grown person is also 10 grains, made
into two pills.] In every case, amusing the mind, and avoiding all
causes of over-excitement, are of great service in bringing about a
permanent cure.
2644. LIVER COMPLAINT AND SPASMS.--A very obliging correspondent
recommends the following, from personal experience:--Take 4 oz. of dried
dandelion root, 1 oz. of the best ginger, 1/4 oz. of Columba root;
braise and boil all together in 3 pints of water till it is reduced to a
quart: strain, and take a wine-glassful every four hours. Our
correspondent says it is a "safe and simple medicine for both liver
complaint and spasms."
2645. LUMBAGO.--A "new and successful mode" of treating lumbago,
advocated by Dr. Day, is a form of counter-irritation, said to have been
introduced into this country by the late Sir Anthony Carlisle, and which
consists in the instantaneous application of a flat iron button, gently
heated in a spirit-lamp, to the skin. Dr. Corrigan published, about
three years ago, an account of some cases very successfully treated by
nearly similar means. Dr. Corrigan's plan was, however, to touch the
surface of the part affected, at intervals of half an inch, as lightly
and rapidly as possible. Dr. Day has found greater advantages to result
from drawing the flat surface of the heated button lightly over the
affected part, so as to act on a greater extent of surface. The doctor
speaks so enthusiastically of the benefit to be derived from this
practice, that it is evidently highly deserving attention.
2646. PALPITATION OF THE HEART.--Where palpitation occurs as symptomatic
of indigestion, the treatment must be directed to remedy that disorder;
when it is consequent on a plethoric state, purgatives will be
effectual. In this case the patient should abstain from every kind of
diet likely to produce a plethoric condition of body. Animal food and
fermented liquor must be particularly avoided. Too much indulgence in
sleep will also prove injurious. When the attacks arise from nervous
irritability, the excitement must be allayed by change of air and a
tonic diet. Should the palpitation originate from organic derangement,
it must be, of course, beyond domestic management. Luxurious living,
indolence, and tight-lacing often produce this affection: such cases are
to be conquered with a little resolution.
2647. Poisons shall be the next subject for remark; and we anticipate
more detailed instructions for the treatment of persons poisoned, by
giving a simple LIST OF THE PRINCIPAL POISONS, with their ANTIDOTES OR
REMEDIES.
Oil of Vitriol ...............\
Aquafortis ................... Magnesia, Chalk, Soap-and-Water.
Spirit of Salt .............../
Emetic Tartar................. Oily Drinks, Solution of Oak-bark.
Salt of Lemons, or............ Chalk, Whiting, Lime or Magnesia and
Acid of Sugar................. Water. Sometimes an Emetic
Draught.
Pump on back, Smelling-Salts to nose,
Prussic Acid................... Artificial Breathing,
Chloride of Lime to nose.
Pearlash ......................\
Soap-Lees...................... \
Smelling-Salts................. \
Nitre.......................... Lemon-Juice and Vinegar-and-Water
Hartshorn...................... /
Sal-Volatile.................../
Arsenic........................\
Fly-Powder, or................. Emetics, Lime-Water, Soap-and-Water,
White Arsenic.................. Sugar and Water, Oily Drinks.
Kings Yellow, or............... /
Yellow Arsenic................./
Mercury........................\
Corrosive Sublimate............ Whites of Eggs, Soap-and-Water.
Calomel......................../
Opium.......................... Emetic Draught, Vinegar-and-Water,
Laudanum....................... dashing Cold Water on
chest and
face, walking up and down two or
three hours.
Lead...........................\
White Lead..................... Epsom Salts, Castor Oil, Emetics.
Sugar of Lead................../
Goulard's Extract............./
Copper
Blue-stone .................... Whites of Eggs, Sugar-and-Water,
Verdigris...................... Castor Oil, Gruel.
Zinc .......................... Lime-Water, Chalk-and-Water,
Soap-and-Water.
Iron .......................... Magnesia, Warm Water.
Henbane........................\
Hemlock........................ Emetics and Castor Oil;
Nightshade..................... Brandy-and-Water, if necessary.
Foxglove......................./
Poisonous Food................. Emetics and Castor Oil.
2648. The symptoms of poisoning may be known for the most part from
those of some diseases, which they are very like, from the fact of their
coming on _immediately_ after eating or drinking something; whereas
those of disease come on, in most cases at least, by degrees, and with
warnings. In most cases where poison is known, or suspected, to have
been taken, the first thing to be done is to empty the stomach, well and
immediately, by means of mustard mixed in warm water, or plain warm
salt-and-water, or, better, this draught, which we call No. 1:--Twenty
grains of sulphate of zinc in an ounce and a half of water. This draught
to be repeated in a quarter of an hour if vomiting does not ensue. The
back part of the throat should be well tickled with a feather, or two of
the fingers thrust down it, to induce vomiting. The cases where vomiting
must not be used are those where the skin has been taken off, and the
parts touched irritated and inflamed by the poison taken, and where the
action of vomiting would increase the evil. Full instructions are given
in the article on each particular poison as to where emetics are or are
not to be given. The best and safest way of emptying the stomach is by
means of the stomach-pump, as in certain cases the action of vomiting is
likely to increase the danger arising from the swollen and congested
condition of the blood-vessels of the head, which often takes place. In
the hands, however, of any one else than a surgeon, it would be not only
useless, but harmful, as a great deal of dexterity, caution, and
experience are required to use it properly. After having made these
brief introductory remarks, we shall now proceed to particulars.
2649. _Sulphuric Acid, or Oil of Vitriol_ (a clear, colourless liquid,
of an oily appearance).--_Symptoms in those who have swallowed it_. When
much is taken, these come on immediately. There is great burning pain,
extending from the mouth to the stomach; vomiting of a liquid of a dark
coffee-colour, often mixed with shreds of flesh and streaks of blood;
the skin inside the mouth is taken off; and the exposed surface is at
first white, and after a time becomes brownish. There are sometimes
spots of a brown colour round the lips and on the neck, caused by drops
of the acid falling on these parts. There is great difficulty of
breathing, owing to the swelling at the back part of the mouth. After a
time there is much depression of strength, with a quick, weak pulse, and
cold, clammy skin. The face is pale, and has a very anxious look. When
the acid swallowed has been greatly diluted in water, the same kind of
symptoms occur, only in a milder degree.--_Treatment_. Give a mixture of
magnesia in milk-and-water, or, if this cannot be obtained, of finely
powdered chalk, or whiting, or even of the plaster torn down from the
walls or ceiling, in milk-and-water. The mixture should be nearly as
thick as cream, and plenty of it given. As well as this, simple gruel,
milk, or thick flour-and-water, are very useful, and should be given in
large quantities. Violent inflammation of the parts touched by the acid
is most likely to take place in the coarse of a little time, and can
only be properly attended to by a surgeon; but if one cannot be
obtained, leeches, the fever-mixtures (the recipe for which appears
repeatedly in previous paragraphs), thick drinks, such as barley-water,
gruel, arrowroot, &c., must be had recourse to, according to the
symptoms of each particular case and the means at hand. The inflamed
condition of the back part of the mouth requires particular attention.
When the breathing is very laboured and difficult in consequence, from
fifteen to twenty leeches are to be immediately applied to the outside
of the throat, and when they drop off, warm poppy fomentations
constantly kept to the part. When the pain over the stomach is very
great, the same local treatment is necessary; but if it is only slight,
a good mustard poultice will be sufficient without the leeches. In all
these cases, two tablespoonfuls of the fever-mixture should be given
every four hours, and only gruel or arrowroot allowed to be eaten for
some days.
2650. _Nitric Acid_, commonly known as _Aqua Fortis_, or _Red Spirit of
Nitre_ (a straw-coloured fluid, of the consistence of water, and which
gives off dense white fumes on exposure to the air).--_Symptoms produced
in those who have swallowed it._ Much the same as in the case of
sulphuric acid. In this case, however, the surface touched by the acid
becomes _yellowish_. The tongue is mostly much swollen.--_Treatment_.
The same as for sulphuric acid.
2651. _Muriatic Acid, Spirit of Salt_ (a thin yellow fluid, emitting
dense white fumes on exposure to the air).--This is not often taken as a
poison. The _symptoms_ and _treatment_ are much the same as those of
_nitric acid_.
N.B.--_In no case of poisoning by these three acids should emetics ever
be given_.
2652. _Oxalic Acid_, commonly called _Salt of Lemons_.--This poison may
be taken by mistake for Epsom salts, which it is a good deal like. It
may be distinguished from them by its very acid taste and its shape,
which is that of needle-formed crystals, each of which, if put into a
drop of ink, will turn it to a reddish brown, whereas Epsom salts will
not change its colour at all. When a large dose of this poison has been
taken, death takes place very quickly indeed.--_Symptoms produced in
those who have swallowed it_. A hot, burning, acid taste is felt in the
act of swallowing, and vomiting of a _greenish-brown_ fluid is produced,
sooner or later, according to the quantity and strength of the poison
taken. There is great tenderness felt over the stomach, followed by
clammy perspirations and convulsions; the legs are often drawn up, and
there is generally stupor, from which the patient, however, can easily
be roused, and always great prostration of strength. The pulse is small
and weak, and the breathing faint.--_Treatment_. Chalk or magnesia, made
into a cream with water, should be given in large quantities, and
afterwards the emetic draught above prescribed, or some
mustard-and-water, if the draught cannot be got. The back part of the
throat to be tickled with a feather, to induce vomiting. Arrowroot,
gruel, and the like drinks, are to be taken. When the prostration of
strength is very great and the body cold, warmth is to be applied to it,
and a little brandy-and-water, or sal-volatile and water, given.
2653. _Prussic Acid_ (a thin, transparent, and colourless liquid, with a
peculiar smell, which greatly resembles that of bitter almonds).--_Symptoms
produced in those who have swallowed it_. These come on _immediately_
after the poison has been taken, and may be produced by merely _smelling_
it. The patient becomes perfectly insensible, and falls down in
convulsions--his eyes are fixed and staring, the pupils being bigger
than natural, the skin is cold and clammy, the pulse scarcely perceptible,
and the breathing slow and gasping.--_Treatment_. Very little can be done
in these cases, as death takes place so quickly after the poison has
been swallowed, when it takes place at all. The best treatment--which
should always be adopted in all cases, even though the patient appears
quite dead-is to dash quantities of cold water on the back, from the top
of the neck downwards. Placing the patient under a pump, and pumping on
him, is the best way of doing this. Smelling-salts are also to be applied
to the nose, and the chest well rubbed with a camphor liniment.
2654. ALKALIS: _Potash, Soda_, and _Ammonia_, or common
_Smelling-Salts_, with their principal preparations--_Pearlash, Soap
Lees, Liquor Potassae, Nitre, Sal Prunella, Hartshorn_, and
_Sal--Volatile._--Alkalis are seldom taken or given with the view of
destroying life. They may, however, be swallowed by mistake.--_Symptoms
produced in those who have swallowed them_. There is at first a burning,
acrid taste in, and a sensation of tightness round, the throat, like
that of strangling; the skin touched is destroyed; retching mostly
followed by actual vomiting, then sets in; the vomited matters often
containing blood of a dark brown colour, with little shreds of flesh
here and there, and always changing vegetable blue colours green. There
is now great tenderness over the whole of the belly. After a little
while, great weakness, with cold, clammy sweats, a quick weak pulse, and
purging of bloody matters, takes place. The brain, too, mostly becomes
affected.--_Treatment_. Give two tablespoonfuls of vinegar or
lemon-juice in a glassful of water every few minutes until the burning
sensation is relieved. Any kind of oil or milk may also be given, and
will form soap when mixed with the poison in the stomach. Barley-water,
gruel, arrowroot, linseed-tea, &c., are also very useful, and should be
taken constantly, and in large quantities. If inflammation should take
place, it is to be treated by applying leeches and warm poppy
fomentations to the part where the pain is most felt, and giving two
tablespoonfuls of the fever mixture every four hours. The diet in all
these cases should only consist of arrowroot or gruel for the first few
days, and then of weak broth or beef-tea for some time after.
2655. When very strong fumes of smelling-salts have in any way been
inhaled, there is great difficulty of breathing, and alarming pain in
the mouth and nostrils. In this case let the patient inhale the steam of
warm vinegar, and treat the feverish symptoms as before.
2656. _Arsenic_.--Mostly seen under the form of white arsenic, or
fly-powder, and yellow arsenic, or king's yellow.--_Symptoms produced in
those who have swallowed it_. These vary very much, according to the
form and dose in which the poison has been taken. There is faintness,
depression, and sickness, with an intense burning pain in the region of
the stomach, which gets worse and worse, and is increased by pressure.
There is also vomiting of dark brown matter, sometimes mixed with blood;
and mostly great thirst, with a feeling of tightness round, and of
burning in, the throat. Purging also takes place, the matters brought
away being mixed with blood. The pulse is small and irregular, and the
skin sometimes cold and clammy, and at others hot. The breathing is
painful. Convulsions and spasms often occur.--_Treatment_. Give a couple
of teaspoonfuls of mustard in a glass of water, to bring on or assist
vomiting, and also use the other means elsewhere recommended for the
purpose. A solution, half of lime-water and half of linseed-oil, well
mixed, may be given, as well as plenty of arrowroot, gruel, or
linseed-tea. Simple milk is also useful. A little castor-oil should be
given, to cleanse the intestines of all the poison, and the
after-symptoms treated on general principles.
2657. _Corrosive Sublimate_.--Mostly seen in the form of little heavy
crystalline masses, which melt in water, and have a metallic taste. It
is sometimes seen in powder. This is a most powerful poison.--_Symptoms_.
These mostly come on immediately after the poison has been taken. There
is a coppery taste experienced in the act of swallowing, with a burning
heat, extending from the top of the throat down to the stomach; and also
a feeling of great tightness round the throat. In a few minutes great
pain is felt over the region of the stomach, and frequent vomiting of
long, stringy white masses, mixed with blood, takes place. There is
also mostly great purging. The countenance is generally pale and
anxious; the pulse always small and frequent; the skin cold and clammy,
and the breathing difficult. Convulsions and insensibility often occur,
and are very bad symptoms indeed. The inside of the mouth is more or
less swollen.--_Treatment_. Mix the whites of a dozen eggs in two pints
of cold water, and give a glassful of the mixture every three or four
minutes, until the stomach can contain no more. If vomiting does not now
come on naturally, and supposing the mouth is not very sore or much
swollen, an emetic draught, No. 1, may be given, and vomiting induced.
(The No. 1 draught, we remind our readers, is thus made:--Twenty grains
of sulphate of zinc in an ounce and a half of water; the draught to be
repeated if vomiting does not take place in a quarter of an hour.) After
the stomach has been well cleaned out, milk, flour-and-water, linseed-tea,
or barley-water, should be taken in large quantities. If eggs cannot be
obtained, milk, or flour-and-water, should be given as a substitute for
them at once. When the depression of strength is very great indeed, a
little warm brandy-and-water must be given. In the course of an hour or
two the patient should take two tablespoonfuls of castor-oil, and if
inflammation comes on, it is to be treated as directed in the article on
acids and alkalis. The diet should also be the same. If the patient
recovers, great soreness of the gums is almost certain to take place. The
simplest, and at the same time one of the best modes of treatment, is to
wash them well three or four times a day with brandy-and-water.
2658. _Calomel_.--A heavy white powder, without taste, and insoluble in
water. It has been occasionally known to destroy life.--_Symptoms_. Much
the same as in the case of corrosive sublimate.--_Treatment_. The same
as for corrosive sublimate. If the gums are sore, wash them, as
recommended in the case of corrosive sublimate, with brandy-and-water
three or four times a day, and keep the patient on _fluids_, such as
arrowroot, gruel, broth, or beef-tea, according to the other symptoms.
Eating hard substances would make the gums more sore and tender.
2659. _Copper_.--The preparations of this metal which are most likely to
be the ones producing poisonous symptoms, are _blue-stone_ and
_verdigris_. People are often taken ill after eating food that has been
cooked in copper saucepans. When anything has been cooked in one of
these vessels, _it should never be allowed to cool in it_.--_Symptoms_.
Headache, pain in the stomach, and purging; vomiting of green or blue
matters, convulsions, and spasms.--_Treatment_. Give whites of eggs,
sugar-and-water, castor-oil, and drinks, such as arrowroot and gruel.
2660. _Emetic Tartar_.--Seen in the form of a white powder, or crystals,
with a slightly metallic taste. It has not often been known to destroy
life.--_Symptoms_. A strong metallic taste in the act of swallowing,
followed by a burning pain in the region of the stomach, vomiting, and
great purging. The pulse is small and rapid, the skin cold and clammy,
the breathing difficult and painful, and the limbs often much cramped.
There is also great prostration of strength.--_Treatment_. Promote the
vomiting by giving plenty of warm water, or warm arrowroot and water.
Strong tea, in large quantities, should be drunk; or, if it can be
obtained, a decoction of oak bark. The after-treatment is the same as
that for acids and alkalis; the principal object in all these cases
being to keep down the inflammation of the parts touched by the poison
by means of leeches, warm poppy fomentations, fever-mixtures, and very
low diet.
2661. _Lead_, and its preparations, _Sugar of Lead, Goulard's Extract,
White Lead._--Lead is by no means an active poison, although it is
popularly considered to be so. It mostly affects people by being taken
into the system slowly, as in the case of painters and glaziers. A
newly-painted house, too, often affects those living in it.--_Symptoms
produced when taken in a large dose_. There is at first a burning,
pricking sensation in the throat, to which thirst, giddiness, and
vomiting follow. The belly is tight, swollen, and painful; _the pain
being relieved by pressure_. The bowels are mostly bound. There is great
depression of strength, and a cold skin.--Treatment. Give an emetic
draught (No. 1, see above) at once, and shortly afterwards a solution of
Epsom salts in large quantities. A little brandy-and-water must be taken
if the depression of strength is very great indeed. Milk, whites of
eggs, and arrowroot are also useful. After two or three hours, cleanse
the stomach and intestines well out with two tablespoonfuls of
castor-oil, and treat the symptoms which follow according to the rules
laid down in other parts of these articles.--_Symptoms when it is taken
into the body slowly_. Headache, pain about the navel, loss of appetite
and flesh, offensive breath, a blueness of the edges of the gums; the
belly is tight, hard, and knotty, and the pulse slow and languid. There
is also sometimes a difficulty in swallowing.--_Treatment_. Give five
grains of calomel and half a grain of opium directly, in the form of a
pill, and half an ounce of Epsom salts in two hours, and repeat this
treatment until the bowels are well opened. Put the patient into a warm
bath, and throw up a clyster of warmish water when he is in it.
Fomentations of warm oil of turpentine, if they can be obtained, should
be put over the whole of the belly. The great object is to open the
bowels as freely and as quickly as possible. When this has been done, a
grain of pure opium may be given. Arrowroot or gruel should be taken in
good large quantities. The after-treatment must depend altogether upon
the symptoms of each particular case.
2662. _Opium_, and its preparations, _Laudanum, &c_.--Solid opium is
mostly seen in the form of rich brown flattish cakes, with little pieces
of leaves sticking on them here and there, and a bitter and slightly
warm taste. The most common form in which it is taken as a poison, is
that of laudanum.--_Symptoms_. These consist at first in giddiness and
stupor, followed by insensibility, the patient, however, being roused to
consciousness by a great noise, so as to be able to answer a question,
but becoming insensible again almost immediately. The pulse is now quick
and small, the breathing hurried, and the skin warm and covered with
perspiration. After a little time, these symptoms change; the person
becomes _perfectly insensible_, the breathing slow and _snoring_, as in
apoplexy, the skin cold, and the pulse slow and full. The pupil of the
eye is mostly smaller than natural. On applying his nose to the patient's
mouth, a person may smell the poison very distinctly.--_Treatment_.
Give an emetic draught (No. 1, see above) directly, with large quantities
of warm mustard-and-water, warm salt-and-water, or simple warm water.
Tickle the top of the throat with a feather, or put two fingers down it
to bring on vomiting, which rarely takes place of itself. Dash cold water
on the head, chest, and spine, and flap these parts well with the ends of
wet towels. Give strong coffee or tea. Walk the patient up and down in
the open air for two or three hours; the great thing being to keep him
from sleeping. Electricity is of much service. When the patient is
recovering, mustard poultices should be applied to the soles of the feet
and the insides of the thighs and legs. The head should be kept cool and
raised.
2663. The following preparations, which are constantly given to children
by their nurses and mothers, for the purpose of making them sleep, often
prove fatal:--_Syrup of Poppies_, and _Godfrey's Cordial_. The author
would most earnestly urge all people caring for their children's lives,
never to allow any of these preparations to be given, unless ordered by
a surgeon.
2664. The treatment in the case of poisoning by _Henbane_, _Hemlock_,
_Nightshade_, and _Foxglove_, is much the same as that for opium.
Vomiting should be brought on in all of them.
2665. _Poisonous Food_.--It sometimes happens that things which are in
daily use, and mostly perfectly harmless, give rise, under certain
unknown circumstances, and in certain individuals, to the symptoms of
poisoning. The most common articles of food of this description are
_Mussels_, _Salmon_, and certain kinds of _Cheese_ and _Bacon_. The
general symptoms are thirst, weight about the stomach, difficulty of
breathing, vomiting, purging, spasms, prostration of strength, and, in
the case of mussels more particularly, an eruption on the body, like
that of nettle-rash.--_Treatment_. Empty the stomach well with No. 1
draught and warm water, and give two tablespoonfuls of castor-oil
immediately after. Let the patient take plenty of arrowroot, gruel, and
the like drinks, and if there is much depression of strength, give a
little warm brandy-and-water. Should symptoms of fever or inflammation
follow, they must be treated as directed in the articles on other kinds
of poisoning.
2666. _Mushrooms_, and similar kinds of vegetables, often produce
poisonous effects. The symptoms are various, sometimes giddiness and
stupor, and at others pain in and swelling of the belly, with vomiting
and purging, being the leading ones. When the symptoms come on quickly
after taking the poison, it is generally the head that is affected.--The
treatment consists in bringing on vomiting in the usual manner, as
quickly and as freely as possible. The other symptoms are to be treated
on general principles; if they are those of depression, by
brandy-and-water or sal-volatile; if those of inflammation, by leeches,
fomentations, fever-mixtures, &c. &c.
2667. FOR CURE OF RINGWORM.--Take of subcarbonate of soda 1 drachm,
which dissolve in 1/2 pint of vinegar. Wash the head every morning with
soft soap, and apply the lotion night and morning. One teaspoonful of
sulphur and treacle should also be given occasionally night and morning.
The hair should be cut close, and round the spot it should be shaved
off, and the part, night and morning, bathed with a lotion made by
dissolving a drachm of white vitriol in 8 oz. of water. A small piece of
either of the two subjoined ointments rubbed into the part when the
lotion has dried in. No, 1.--Take of citron ointment 1 drachm; sulphur
and tar ointment, of each 1/2 oz.: mix thoroughly, and apply twice a
day. No. 2.--Take of simple cerate 1 oz.; creosote 1 drachm; calomel 30
grains: mix and use in the same manner as the first. Concurrent with
these external remedies, the child should take an alterative powder
every morning, or, if they act too much on the bowels, only every second
day. The following will be found to answer all the intentions desired.
2668. Alterative Powders for Ringworm.--Take of
Sulphuret of antimony, precipitated . 24 grains.
Grey powder . . . . . 12 grains.
Calomel . . . . . . 6 grains.
Jalap powder . . . . . 36 grains.
Mix carefully, and divide into 12 powders for a child from 1 to 2 years
old; into 9 powders for a child from 2 to 4 years; and into 6 powders
for a child from 4 to 6 years. Where the patient is older, the strength
may be increased by enlarging the quantities of the drugs ordered, or by
giving one and a half or two powders for one dose. The ointment is to be
well washed off every morning with soap-and-water, and the part bathed
with the lotion before re-applying the ointment. An imperative fact must
be remembered by mother or nurse,--never to use the same comb employed
for the child with ringworm, for the healthy children, or let the
affected little one sleep with those free from the disease; and, for
fear of any contact by hands or otherwise, to keep the child's head
enveloped in a nightcap, till this eruption is completely cured.
2669. SCRATCHES.--Trifling as scratches often seem, they ought never to
be neglected, but should be covered and protected, and kept clean and
dry until they have completely healed. If there is the least appearance
of inflammation, no time should be lost in applying a large
bread-and-water poultice, or hot flannels repeatedly applied, or even
leeches in good numbers may be put on at some distance from each other.
2670. FOR SHORTNESS OF BREATH, OR DIFFICULT BREATHING.--Vitriolated
spirits of ether 1 oz., camphor 12 grains: make a solution, of which
take a teaspoonful during the paroxysm. This is found to afford
instantaneous relief in difficulty of breathing, depending on internal
diseases and other causes, where the patient, from a very quick and
laborious breathing, is obliged to be in an erect posture.
2671. SPRAINS.--A sprain is a stretching of the leaders or ligaments of
a part through some violence, such as slipping, falling on the hands,
pulling a limb, &c. &c. The most common are those of the ankle and
wrist. These accidents are more serious than people generally suppose,
and often more difficult to cure than a broken log or arm. The first
thing to be done is to place the sprained part in the straight position,
and to raise it a little as well. Some recommend the application of cold
lotions at first. The editress, however, is quite convinced that warm
applications are, in most cases, the best for for the first three or
four days. These fomentations are to be applied in the following
manner:--Dip a good-sized piece of flannel into a pail or basin full of
hot water or hot poppy fomentation,--six poppy heads boiled in one quart
of water for about a quarter of an hour; wring it almost dry, and apply
it, as hot as the patient can bear, right round the sprained part. Then
place another piece of flannel, quite dry, over it, in order that the
steam and warmth may not escape. This process should be repeated as
often as the patient feels that the flannel next to his skin is getting
cold--the oftener the better. The bowels should be opened with a black
draught, and the patient kept on low diet. If he has been a great
drinker, he may be allowed to take a little beer; but it is better not
to do so. A little of the cream of tartar drink, ordered in the case of
burns, may be taken occasionally if there is much thirst. When the
swelling and tenderness about the joint are very great, from eight to
twelve leeches may be applied. When the knee is the joint affected, the
greatest pain is felt at the inside, and therefore the greater quantity
of the leeches should be applied to that part. When the shoulder is
sprained, the arm should be kept close to the body by means of a linen
roller, which is to be taken four or five times round the whole of the
chest. It should also be brought two or three times underneath the
elbow, in order to raise the shoulder. This is the best treatment for
these accidents during the first three or four days. After that time,
supposing that no unfavourable symptoms have taken place, a cold lotion,
composed of a tablespoonful of sal-ammoniac to a quart of water, or
vinegar-and-water, should be constantly applied. This lotion will
strengthen the part, and also help in taking away any thickening that
may have formed about the joint. In the course of two or three weeks,
according to circumstances, the joint is to be rubbed twice a day with
flannel dipped in opodeldoc, a flannel bandage rolled tightly round the
joint, the pressure being greatest at the lowest part, and the patient
allowed to walk about with the assistance of a crutch or stick. He
should also occasionally, when sitting or lying down, quietly bend the
joint backwards and forwards, to cause its natural motion to return, and
to prevent stiffness from taking place. When the swelling is very great
immediately after the accident has occurred, from the breaking of the
blood-vessels, it is best to apply cold applications at first. If it can
be procured, oil-silk may be put over the warm-fomentation flannel,
instead of the dry piece of flannel. Old flannel is better than new.
2672. CURE FOR STAMMERING.--Where there is no malformation of the organs
of articulation, stammering may be remedied by reading aloud with the
teeth closed. This should be practised for two hours a day, for three or
four months. The advocate of this simple remedy says, "I can speak with
certainty of its utility."
2673. STAMMERING.--At a recent meeting of the Boston Society of Natural
History, Dr. Warren stated, "A simple, easy, and effectual cure of
stammering." It is, simply, at every syllable pronounced, to tap at the
same time with the finger; by so doing, "the most inveterate stammerer
will be surprised to find that he can pronounce quite fluently, and, by
long and constant practice, he will pronounce perfectly well."
2674. SUFFOCATION, APPARENT.--Suffocation may arise from many different
causes. Anything which prevents the air getting into the lungs will
produce it. We shall give the principal causes, and the treatment to be
followed in each case.
2675. 1. _Carbonic Acid Gas. Choke-Damp of Mines_.--This poisonous gas
is met with in rooms where charcoal is burnt, and where there is not
sufficient draught to allow it to escape; in coalpits, near limekilns,
in breweries, and in rooms and houses where a great many people live
huddled together in wretchedness and filth, and where the air in
consequence becomes poisoned. This gas gives out no smell, so that we
cannot know of its presence. A candle will not burn in a room which
contains much of it.--_Effects_. At first there is giddiness, and a
great wish to sleep; after a little time, or where there is much of it
present, a person feels great weight in the head, and stupid; gets by
degrees quite unable to move, and snores as if in a deep sleep. The
limbs may or may not be stiff. The heat of the body remains much the
same at first.--_Treatment_. Remove the person affected into the open
air, and, even though it is cold weather, take off his clothes. Then lay
him on his back, with his head slightly raised. Having done this, dash
vinegar-and-water over the whole of the body, and rub it hard,
especially the face and chest, with towels dipped in the same mixture.
The hands and feet also should be rubbed with a hard brush. Apply
smelling-salts to the nose, which may be tickled with a feather. Dashing
cold water down the middle of the back is of great service. If the
person can swallow, give him a little lemon-water, or vinegar-and-water
to drink. The principal means, however, to be employed in this, as, in
fact, in most cases of apparent suffocation, is what is called
_artificial breathing_. This operation should be performed by three
persons, and in the following manner:--The first person should put the
nozzle of a common pair of bellows into one of the patient's nostrils;
the second should push down, and then thrust back, that part of the
throat called "Adam's apple;" and the third should first raise and then
depress the chest, one hand being placed over each side of the ribs.
These three actions should be performed in the following order:--First
of all, the throat should be drawn down and thrust back; then the chest
should be raised, and the bellows gently blown into the nostril.
Directly this is done, the chest should be depressed, so as to imitate
common breathing. This process should be repeated about eighteen times a
minute. The mouth and the other nostril should be closed while the
bellows are being blown. Persevere, if necessary, with this treatment
for seven or eight hours--in fact, till absolute signs of death are
visible. Many lives are lost by giving it up too quickly. When the
patient becomes roused, he is to be put into a warm bed, and a little
brandy-and-water, or twenty drops of sal-volatile, given cautiously now
and then. This treatment is to be adopted in all cases where people are
affected from breathing bad air, smells, &c. &c.
2676. 2. _Drowning_.--This is one of the most frequent causes of death
by suffocation.--Treatment. Many methods have been adopted, and as some
of them are not only useless, but hurtful, we will mention them here,
merely in order that they may be avoided. In the first place, then,
never hang a person up by his heels, as it is an error to suppose that
water gets into the lungs. Hanging a person up by his heels would be
quite as bad as hanging him up by his neck. It is also a mistake to
suppose that rubbing the body with salt and water is of
service.--_Proper Treatment_. Directly a person has been taken out of
the water, he should be wiped dry and wrapped in blankets; but if these
cannot be obtained, the clothes of the bystanders must be used for the
purpose. His head being slightly raised, and any water, weeds, or froth
that may happen to be in his mouth, having been removed, he should be
carried as quickly as possible to the nearest house. He should now be
put into a warm bath, about as hot as the hand can pleasantly bear, and
kept there for about ten minutes, artificial breathing being had
recourse to while he is in it. Having been taken out of the bath, he
should be placed flat on his back, with his head slightly raised, upon a
warm bed in a warm room, wiped perfectly dry, and then rubbed constantly
all over the body with warm flannels. At the same time, mustard
poultices should be put to the soles of the feet, the palms of the
hands, and the inner surface of the thighs and legs. Warm bricks, or
bottles filled with warm water, should be placed under the armpits. The
nose should be tickled with a feather, and smelling-salts applied to it.
This treatment should be adopted while the bath is being got ready, as
well as when the body has been taken out of it. The bath is not
absolutely necessary; constantly rubbing the body with flannels in a
warm room having been found sufficient for resuscitation. Sir B. Brodie
says that warm air is quite as good as warm water. When symptoms of
returning consciousness begin to show themselves, give a little wine,
brandy, or twenty drops of sal-volatile and water. In some cases it is
necessary, in about twelve or twenty-four hours after the patient has
revived, to bleed him, for peculiar head-symptoms which now and then
occur. Bleeding, however, even in the hands of professional men
themselves, should be very cautiously used--non-professional ones should
never think of it. The best thing to do in these cases is to keep the
head well raised, and cool with a lotion such as that recommended above
for sprains; to administer an aperient draught, and to abstain from
giving anything that stimulates, such as wine, brandy, sal-volatile, &c.
&c. As a general rule, a person dies in three minutes and a half after
he has been under water. It is difficult, however, to tell how long he
has actually been _under_ it, although we may know well exactly how long
he has been _in_ it. This being the case, always persevere in your
attempts at resuscitation until actual signs of death have shown
themselves, even for six, eight, or ten hours. Dr. Douglas, of Glasgow,
resuscitated a person who had been under water for fourteen minutes, by
simply rubbing the whole of his body with warm flannels, in a warm room,
for eight hours and a half, at the end of which time the person began to
show the _first_ symptoms of returning animation. Should the accident
occur at a great distance from any house, this treatment should be
adopted as closely as the circumstances will permit of. Breathing
through any tube, such as a piece of card or paper rolled into the form
of a pipe, will do as a substitute for the bellows. To recapitulate: Rub
the body dry; take matters out of mouth; cover with blankets or clothes;
slightly raise the head, and place the body in a warm bath, or on a bed
in a warm room; apply smelling-salts to nose; employ artificial
breathing; rub well with warm flannels; put mustard poultices to feet,
hands, and insides of thighs and legs, with warm bricks or bottles to
armpits. _Don't bleed_. Give wine, brandy, or sal-volatile when
recovering, and _persevere till actual signs of death are seen._
2677. Briefly to conclude what we have to say of suffocation, let us
treat of _Lightning_. When a person has been struck by lightning, there
is a general paleness of the whole body, with the exception of the part
struck, which is often blackened, or even scorched.--_Treatment_. Same
as for drowning. It is not, however, of much use; for when death takes
place at all, it is generally instantaneous.
2678. CURE FOR THE TOOTHACHE.--Take a piece of sheet zinc, about the
size of a sixpence, and a piece of silver, say a shilling; place them
together, and hold the defective tooth between them or contiguous to
them; in a few minutes the pain will be gone, as if by magic. The zinc
and silver, acting as a galvanic battery, will produce on the nerves of
the tooth sufficient electricity to establish a current, and
consequently to relieve the pain. Or smoke a pipe of tobacco and
caraway-seeds. Again--
2679. A small piece of the pellitory root will, by the flow of saliva it
causes, afford relief. Creosote, or a few drops of tincture of myrrh, or
friar's balsam, on cotton, put on the tooth, will often subdue the pain.
A small piece of camphor, however, retained in the mouth, is the most
reliable and likely means of conquering the paroxysms of this dreaded
enemy.
2680. WARTS.--Eisenberg says, in his "Advice on the Hand," that the
hydrochlorate of lime is the most certain means of destroying warts; the
process, however, is very slow, and demands perseverance, for, if
discontinued before the proper time, no advantage is gained. The
following is a simple cure:--On breaking the stalk of the crowfoot plant
in two, a drop of milky juice will be observed to hang on the upper part
of the stem; if this be allowed to drop on a wart, so that it be well
saturated with the juice, in about three or four dressings the warts
will die, and may be taken off with the fingers. They may be removed by
the above means from the teats of cows, where they are sometimes very
troublesome, and prevent them standing quiet to be milked. The wart
touched lightly every second day with lunar caustic, or rubbed every
night with blue-stone, for a few weeks, will destroy the largest wart,
wherever situated.
2681. To CURE A WHITLOW.--As soon as the whitlow has risen distinctly, a
pretty large piece should be snipped out, so that the watery matter may
readily escape, and continue to flow out as fast as produced. A
bread-and-water poultice should be put on for a few days, when the wound
should be bound up lightly with some mild ointment, when a cure will be
speedily completed. Constant poulticing both before and after the
opening of the whitlow, is the only practice needed; but as the matter
lies deep, when it is necessary to open the abscess, the incision must
be made _deep_ to reach the suppuration.
2682. WOUNDS.--There are several kinds of wounds, which are called by
different names, according to their appearance, or the manner in which
they are produced. As, however, it would be useless, and even hurtful,
to bother the reader's head with too many nice professional
distinctions, we shall content ourselves with dividing wounds into three
classes.
2683. 1. _Incised wounds or cuts_--those produced by a knife, or some
sharp instrument.
2684. 2. _Lacerated, or torn wounds_--those produced by the claws of an
animal, the bite of a dog, running quickly against some projecting blunt
object, such as a nail, &c.
2685. 3. _Punctured or penetrating wounds_--those produced by anything
running deeply into the flesh; such as a sword, a sharp nail, a spike,
the point of a bayonet, &c.
2686. Class 1. _Incised wounds or cuts_.--The danger arising from these
accidents is owing more to their position than to their extent. Thus, a
cut of half an inch long, which goes through an artery, is more serious
than a cut of two inches long, which is not near one. Again, a small cut
on the head is more often followed by dangerous symptoms than a much
larger one on the legs.--_Treatment_. If the cut is not a very large
one, and no artery or vein is wounded, this is very simple. If there are
any foreign substances left in the wound, they must be taken out, and
the bleeding must be quite stopped before the wound is strapped up. If
the bleeding is not very great, it may easily be stopped by raising the
cut part, and applying rags dipped in cold water to it. All clots of
blood must be carefully removed; for, if they are left behind, they
prevent the wound from healing. When the bleeding has been stopped, and
the wound perfectly cleaned, its two edges are to be brought closely
together by thin straps of common adhesive plaster, which should remain
on, if there is not great pain or heat about the part, for two or three
days, without being removed. The cut part should be kept raised and
cool. When the strips of plaster are to be taken off, they should first
be well bathed with lukewarm water. This will cause them to come away
easily, and without opening the lips of the wound; which accident is
very likely to take place, if they are pulled off without having been
first moistened with the warm water. If the wound is not healed when the
strips of plaster are taken off, fresh ones must be applied. Great care
is required in treating cuts of the head, as they are often followed by
erysipelas taking place round them. They should be strapped with
isinglass plaster, which is much less irritating than the ordinary
adhesive plaster. Only use as many strips as are actually requisite to
keep the two edges of the wound together; keep the patient quite quiet,
on low diet, for a week or so, according to his symptoms. Purge him well
with the No. 2 pills (five grains of blue pill mixed with the same
quantity of compound extract of colocynth; make into two pills, the dose
for an adult). If the patient is feverish, give him two tablespoonfuls
of the fever-mixture three times a day. (The fever-mixture, we remind
our readers, is thus made: Mix a drachm of powdered nitre, 2 drachms of
carbonate of potash, 2 teaspoonfuls of antimonial wine, and a
tablespoonful of sweet spirits of nitre in half a pint of water.) A
person should be very careful of himself for a month or two after having
had a bad cut on the head. His bowels should be kept constantly open,
and all excitement and excess avoided. When a vein or artery is wounded,
the danger is, of course, much greater. Those accidents, therefore,
should always be attended to by a surgeon, if he can possibly be
procured. Before he arrives, however, or in case his assistance cannot
be obtained at all, the following treatment should be adopted:--Raise
the cut part, and press rags dipped in cold water firmly against it.
This will often be sufficient to stop the bleeding, if the divided
artery or vein is not dangerous. When an artery is divided, the blood is
of a bright red colour, and comes away in jets. In this case, and
supposing the leg or arm to be the cut part, a handkerchief is to be
tied tightly round the limb _above_ the cut; and, if possible, the two
bleeding ends of the artery should each be tied with a piece of silk. If
the bleeding is from a vein, the blood is much darker, and does not come
away in jets. In this case, the handkerchief is to be tied _below_ the
cut, and a pad of lint or linen pressed firmly against the divided ends
of the vein. Let every bad cut, especially where there is much bleeding,
and even although it may to all appearance have been stopped, be
attended to by a surgeon, if one can by any means be obtained.
2687. Class 2. _Lacerated or torn wounds_.--There is not so much
bleeding in these cases as in clean cuts, because the blood-vessels are
torn across in a zigzag manner, and not divided straight across. In
other respects, however, they are more serious than ordinary cuts, being
often followed by inflammation, mortification, fever, and in some cases
by locked-jaw. Foreign substances are also more likely to remain in
them.--_Treatment_. Stop the bleeding, if there is any, in the manner
directed for cuts; remove all substances that may be in the wound; keep
the patient quite quiet, and on low diet--gruel, arrowroot, and the
like; purge with the No. 1 pills and the No. 1 mixture. (The No. 1 pill:
Mix 5 grains of calomel and the same quantity of antimonial powder, with
a little bread-crumb, and make into two pills, which is the dose for an
adult. The No. 1 mixture: Dissolve an ounce of Epsom salts in half a
pint of senna tea. A quarter of the mixture is a dose.) If there are
feverish symptoms, give two tablespoonfuls of fever-mixture (see above)
every four hours. If possible, bring the two edges of the wound
together, _but do not strain the parts to do this_. If they cannot be
brought together, on account of a piece of flesh being taken clean out,
or the raggedness of their edges, put lint dipped in cold water over the
wound, and cover it with oiled silk. It will then fill up from the
bottom. If the wound, after being well washed, should still contain any
sand, or grit of any kind, or if it should get red and hot from
inflammation, a large warm bread poultice will be the best thing to
apply until it becomes quite clean, or the inflammation goes down. When
the wound is a very large one, the application of warm poppy
fomentations is better than that of the lint dipped in cold water. If
the redness and pain about the part, and the general feverish symptoms,
are great, from eight to twelve leeches are to be applied round the
wound, and a warm poppy fomentation or warm bread poultice applied after
they drop off.
2688. Class 3. _Punctured or penetrating wounds_.--These, for many
reasons, are the most serious of all kinds of wounds.--_Treatment_. The
same as that for lacerated wounds. Pus (matter) often forms at the
bottom of these wounds, which should, therefore, be kept open at the
top, by separating their edges every morning with a bodkin, and applying
a warm bread poultice immediately afterwards. They will then, in all
probability, heal up from the bottom, and any matter which may form will
find its own way out into the poultice. Sometimes, however, in spite of
all precautions, collections of matter (abscesses) will form at the
bottom or sides of the wound. Those are to be opened with a lancet, and
the matter thus let out. When matter is forming, the patient has cold
shiverings, throbbing pain in the part, and flushes on the face, which
come and go. A swelling of the part is also often seen. The matter in
the abscesses may be felt to move backwards and forwards, when pressure
is made from one side of the swelling to the other with the first and
second fingers (the middle and that next the thumb) of each hand.
MEDICAL MEMORANDA.
2689. ADVANTAGES OF CLEANLINESS.--Health and strength cannot be long
continued unless the skin--_all_ the skin--is washed frequently with a
sponge or other means. Every morning is best; after which the skin
should be rubbed very well with a rough cloth. This is the most certain
way of preventing cold, and a little substitute for exercise, as it
brings blood to the surface, and causes it to circulate well through the
fine capillary vessels. Labour produces this circulation naturally. The
insensible perspiration cannot escape well if the skin is not clean, as
the pores get choked up. It is said that in health about half the
aliment we take passes out through the skin.
2690. THE TOMATO MEDICINAL.--To many persons there is something
unpleasant, not to say offensive, in the flavour of this excellent
fruit. It has, however, long been used for culinary purposes in various
countries of Europe. Dr. Bennett, a professor of some celebrity,
considers it an invaluable article of diet, and ascribes to it very
important medicinal properties. He declares:--1. That the tomato is one
of the most powerful deobstruents of the _materia medica_; and that, in
all those affections of the liver and other organs where calomel is
indicated, it is probably the most effective and least harmful remedial
agent known in the profession. 2. That a chemical extract can be
obtained from it, which will altogether supersede the use of calomel in
the cure of diseases. 3. That he has successfully treated diarrhoea with
this article alone. 4. That when used as an article of diet, it is
almost a sovereign remedy for dyspepsia and indigestion.
2691. WARM WATER.--Warm water is preferable to cold water, as a drink,
to persons who are subject to dyspeptic and bilious complaints, and it
may be taken more freely than cold water, and consequently answers
better as a diluent for carrying off bile, and removing obstructions in
the urinary secretion, in cases of stone and gravel. When water of a
temperature equal to that of the human body is used for drink, it proves
considerably stimulant, and is particularly suited to dyspeptic,
bilious, gouty, and chlorotic subjects.
2692. CAUTIONS IN VISITING SICK-ROOMS.--Never venture into a sick-room
if you are in a violent perspiration (if circumstances require your
continuance there), for the moment your body becomes cold, it is in a
state likely to absorb the infection, and give you the disease. Nor
visit a sick person (especially if the complaint be of a contagious
nature) with _an empty stomach_; as this disposes the system more
readily to receive the contagion. In attending a sick person, place
yourself where the air passes from the door or window to the bed of the
diseased, not betwixt the diseased person and any fire that is in the
room, as the heat of the fire will draw the infectious vapour in that
direction, and you would run much danger from breathing it.
2693. NECESSITY OF GOOD VENTILATION IN ROOMS LIGHTED WITH GAS.--In
dwelling-houses lighted by gas, the frequent renewal of the air is of
great importance. A single gas-burner will consume more oxygen, and
produce more carbonic acid to deteriorate the atmosphere of a room, than
six or eight candles. If, therefore, when several burners are used, no
provision is made for the escape of the corrupted air and for the
introduction of pure air from without, the health will necessarily
suffer.
LEGAL MEMORANDA.