Chapter III: Preface (3)

The headache and dizziness can sometimes be relieved by bromide of sodium or potassium, in doses of 20 to 30 grains for an adult, taken in water and repeated at intervals of four to six hours.

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Snake Bites.

The danger arising from snake bites is owing to the introduction of a poison which so swiftly permeates the whole system, that immediate action is the more imperative as the question of life or death is solved in a few brief moments. Among the chief venomous reptiles may be enumerated the following: the whip-cord, cobra de capello, rattlesnake, viper, and adder. The bites of the two first-named are more fatal and rapid than those of the others.

The teeth of these reptiles lie in the front of the upper jaw and are of a hook-shaped form. The venom is contained in a small sac or duct situated at the base of the fang, which is channelled throughout to allow of the exit of the poison. When the tooth penetrates the tissues, the poisonous sac becomes contracted and the venom is ejected into the wound and immediately caught up by the circulation.

The wounded part quickly swells to an enormous extent, assuming various hues, while the victim experiences a feeling of faintness and depression and quickly passes to a state of delirium and unconsciousness. The bite occasions a sharp and intense pain which extends up the limb, in the direction of the principal nerves. The treatment in this instance should be similar to that of a wound produced by a rabid dog, that is, the part should be well washed, sucked and cauterized. Let some person—the patient, if able to reach the wound—take up the flesh on either side of the bite between the teeth and suck the place, spitting the saliva out at once. (It must be borne in mind that the patient or other person performing the operation should be free from cuts, etc., on the lips or tongue.) Then, if the position of the wound permit, tie a handkerchief or a piece of string firmly round the limb, above, and as near as possible to the wound, and between it and the heart, to prevent the return of the blood to that organ. In the meanwhile a poker or a nail should be made red hot and well pressed over the whole wound, when, if the burning be properly done, the tissues will become white. Stick caustic, moistened in water, will answer the same purpose as a poker. In every instance the patient should be given as much brandy or whiskey as he can drink, together with a liberal application of coal oil to the wound, which should be bandaged with flannel or some material that will absorb and freely retain the oil.

If the above treatment be carried out, all will have been done that a practical physician could do in an emergency of this character.

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Sprains or Strains.

This term is usually given to injuries occurring about the joints due to a forcible straining or wrenching of the surrounding ligaments, so as more or less to lacerate them, or even sometimes to break a tendon, but without entirely displacing a bone. The injured tissues being of low vitality, a considerable time elapses before they again regain their usual form and functions. In severe cases, it is advisable to obtain proper advice, as the consequences are more lasting than in the case of a broken bone, especially where the injury is to the knee, ankle-joint or wrist, the parts most liable to sprains. To be assured that no bones are broken or displaced, as soon as possible, before the swelling takes place, see if the joint looks natural by comparing it with the other one, and noting if any bone is loose or out of place, and if so, consult a surgeon.

CAUSES. Sprains result from over-bending of joints, or from their being bent in a direction not intended by nature, as when making a false step, or falling on the hand, the wrist or foot is twisted much, either forward or backward, causing the ligaments and tendons to be unduly stretched or lacerated. The degree of danger in a sprain depends upon how far the use or disuse of the joint can be suspended with much or little discomfort.

The SYMPTOMS are violent pains at the time of the accident with considerable swelling and discoloration of the injured parts from the blood rushing into the cells under the skin. The joints can at first be readily moved, but as the swelling and inflammation increase, all motion becomes painful and the patient altogether loses for a time the use of the injured limb.

TREATMENT. Raise the injured limb to such a position as will relax the muscles connected with the affected part, and let the sprain have _absolute_ rest, which is most essential and the best way of treating it.

To such sprains as relate to the knee, ankle, elbow, wrist, or finger joints, the necessary rest may be secured by the aid of splints, and these to be thoroughly sufficient, should be such as to adapt themselves to the largest extent of surface. The patient should be kept in a recumbent position, and cold applications, which are the best at first, should be constantly applied to the affected parts by dipping linen rags in the following lotion, which should be kept in a cool place. Goulard water, 4 ounces; gin, 4 ounces; camphor mixture, 1 ounce, and mindererus spirit, 1 ounce. Tincture of arnica, or a poultice of arnica flowers are also valuable applications. This course should be persevered in for one or two days, after which, if the pain or swelling do not abate, apply leeches freely to the injured parts and encourage the bleeding by using a sponge with warm water constantly to the bites. Hot fomentations should afterwards be applied with flannel wrung out of a decoction of chamomile flowers and poppy heads and see that the bowels are kept properly regulated. When the pain lasts for more than two days, it is best to call in a physician, but always when the pain is very severe and the swelling marked. As soon as the parts have recovered their normal healthy condition, care must be taken not to encourage irritation and inflammation in the limb by using it too soon.

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Stings of Insects.

Stings of bees, spiders, wasps, or any insect may become painful and dangerous in case of numerous bites. If the stings of insects have remained in the flesh, they must be extracted the same as a splinter with a pair of forceps or pincers. Then wash the wounds clean and rub the parts with olive oil to prevent smarting. Then apply to the wounds with a rag or sponge salt and vinegar, or a strong solution of ammonia, and afterward cover with cloths moistened with the same substance to remove any swelling that remains.

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Suffocation.

Under this convenient and general designation may be included all those cases, where from special accidental causes the breathing is either impeded or temporarily suspended. The general appearance of the sufferer, the fixed and staring eye, the pallid features, and general look of terror, are characteristic of, and sufficiently evidence to his sufferings.

Only such cases of common incidents and which require immediate attention, are here noticed.

CHOKING. This accident is chiefly due to carelessness. Pieces of meat, bone, especially fish-bones, get into the gullet, or are stopped on their passage to the stomach, producing, according to the size of the substance either suffocation (choking) or a troublesome tickling cough.

TREATMENT. Slap the back smartly with the open hand (but not too heavily) between the shoulders. The sudden compression of air on the chest will generally enable the sufferer to cough out the obstacle; or make him swallow a few crumbs of bread, and then take a draught of water, which will distend the gullet above the obstruction and cause both it and the water to pass with a jerk into the stomach. An emetic of mustard and warm water is often effective when other means have failed.

DROWNING. Suffocation from this cause is fully treated of under that head (see page 62).

NOXIOUS VAPORS. Persons are often overcome by these, either through ignorance of their existence, or imprudence in not taking proper precautions to ascertain it.

FOUL AIR is commonly to be met with in cellars, wells, tanks, and in similar places, and also in mines, where even science has not been able to remove its dangers.

The presence of this noxious gas (carbonic acid) can be readily discovered by the simple expedient of using an open candle or lamp: if the poisonous air be present, the flame which like human beings, requires oxygen for its support, will flicker and die out; in such case no living creature could enter the place without incurring great danger.

CHARCOAL and ILLUMINATING GAS. Charcoal fumes are often purposely inhaled with suicidal intentions, or the ordinary gas is unsuspectedly breathed, especially during sleep, owing to some slight escape, not immediately noticeable, or from carelessness or ignorance in extinguishing it. In either case a person soon loses consciousness and becomes suffocated.

The symptoms of suffocation by gases are analogous to those caused by drowning, and the treatment is alike in both. Place the person in the open air, throw cold water over the head, face and upper part of the body frequently, applying warmth by means of hot plates to the hands, feet and stomach, and friction to the spine, and inflate the lungs if necessary, as directed in the article on DROWNING.

SMOKE from a large fire may often be temporarily be endured and suffocation prevented for a time by throwing a wetted towel or handkerchief over the head, or by holding a moist cloth in the mouth.

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Sunstroke.

As implied by the name, this arises chiefly from undue and prolonged exposure to the heat of the sun, but not necessarily from that alone, as similar effects are produced by exposure to any excessive heat when a person is greatly fatigued and the vital forces are in a state of exhaustion. Sunstroke is not confined to tropical regions, but is of frequent occurrence in northern cities and wherever individuals are exposed to the cause which occasion it.

Those unaccustomed to a high temperature, persons of full habit addicted to free living, and hard workers are more susceptible to sunstroke than those reared in tropical climates; continuous confinement in heated rooms, such as laundries and bake-houses, may produce sunstroke, or rather symptoms identically the same. These symptoms are premonitory, or immediate. In the former, headache, with a burning sensation about the head, together with restlessness and want of sleep at night, are the principal characteristics, the skin becoming hot and dry, the face flushed and the eyes congested. Work continued under the hot sun or in a heated room by a person when laboring under such symptoms, will suddenly cause the sufferer to be seized with vertigo, intense pains in the head, and dimness of sight. The limbs fail to support him, and he falls to the ground in a state of insensibility.

The temperature of the body, as ascertained by a thermometer, varies from 100 degrees to 107 degrees, and in some instances rises as high as 109 degrees. The _immediate_ symptoms are due to exhaustion or syncope, and the stricken person is more likely to die suddenly without any special premonitory symptoms being manifest. In this case the pulse is generally rapid and irregular and the breathing gasping. The pupils may become dilated, but the skin is not extremely hot.

TREATMENT. The patient should at once be removed into the shade or into a cool room, near an open window, and placed in a recumbent position with the head slightly raised. The clothes are then stripped off, and a stream of water as cold as possible poured over him. This should be done from a height of four to five feet to give the sufferer the benefit of the shock. Cold towels dipped in iced water must be _constantly and continuously_ applied to the head and body, which should be also well rubbed with ice. This treatment must be _at once_ resorted to, as it tends to check the bodily temperature from rising, and any neglect to secure this all important end will speedily cause the death of the patient. A doctor should be sent for while the sufferer is undergoing the preliminary treatment above described, which must not be abated until his arrival.

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Things in the Eye.

Sand, broken eye-lashes, cinders, etc., often lodge under the eye-lids, usually the lower lid. When a person complains of some substance in the eye, the inside of the lower eye-lid and lower portion of the ball should first be examined. Pull the lid down and at the same time direct the person to look up and from one side to the other. If nothing be discerned there, the patient is then to be directed to look downward. This will expose to view the upper part of the globe. If the object is under the lower lid, pull the lid down and remove by wiping the little nuisance into the corner of the eye with a camel’s hair brush, or a soft rag, or the end of the finger covered with a silk handkerchief. If the object is under the upper lid, lay a pencil or crochet needle or some round smooth thing, as a bodkin, which will turn the lid wrong side out, and remove in the same way.

Sometimes a small chipping of iron gets fixed on the ball of the eye, and engineers are often very expert in removing them with the point of a pen-knife. But if you can get a good magnet, it will draw away the chip of iron without any risk of injuring the eye.

Broken eye-lashes which have become fixed in the eye, should be extracted with forceps. Persons employed or standing about buildings where quicklime is used, may accidentally get some into the eye. It is instantly removed by bathing the eye well with vinegar and water. One part of vinegar to three parts of water. The vinegar will neutralize the lime and will rob it of its burning properties. The lime will soon burn away the sight, if the proper means are not promptly used.

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Tooth-ache, Pains in the Face and Jaw, Ear-ache.

TOOTH-ACHE is due to the exposure of the nerve in the internal cavity of the tooth, either from fracture or decay of a part of the tooth. The nerve is extremely sensitive, and by coming into contact with air and acrimonious substances, inflammation is excited and tooth-ache is the consequence. Pain in a wholesome tooth may be caused by sympathy with an unsound one, a disordered stomach, or whatever excites painful sympathetic action in the nerves of the face. Relief may be obtained by dropping a little oil of cloves or creosote on a bit of cotton wool and inserting it in the cavity, but when the tooth is too far gone for stopping, extraction is the only remedy.

PAINS IN THE FACE AND JAW, when not caused by rotten teeth, may be allayed by holding a little brandy, or other spirit, or tincture of cayenne, or hot water in the mouth, and _externally_ applying laudanum. The following is an excellent poultice in these cases. Take two large table-spoonfuls of flour, 2 tea-spoonfuls of black pepper, and mix with a little brandy or other spirit; put the poultice on a handkerchief and tie it round the face over the part affected. The poultice which should be of medium consistency, can be kept on for a considerable period without injury to the skin, and will afford great relief.

EAR-ACHE may be caused by an abscess in the passages, or it may be entirely due to neuralgia. It is common with children when teething, and adults at the time that the wisdom teeth appear. Exposure to cold or draughts will often produce it. There are several means of relieving the pain, which is not generally accompanied with any great constitutional derangement. A little laudanum dropped into the ear and plugged with cotton wool or lint, small bags of hot salt, or the heart of a roasted onion on the affected member, are all soothing remedies. Should these prove not effectual, apply a fomentation of hot chamomiles and poppy seeds, and a warm poultice afterwards. When an abscess is the cause, and there is much swelling and pain, hot fomentations and poultices should be applied and the passage syringed with warm water after the abscess has discharged with a solution of eight grains of sulphate of zinc to an ounce of plain or rose-water. The bowels should be kept well attended to.

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Wounds.

The loss of blood consequent upon a wound is, in most cases, the principal and immediate danger, and the first step in the treatment should be directed to checking the hemorrhage. It is the position rather than the extent which constitutes the chief danger in wounds, of which there are several kinds requiring treatment suitable to each. The following are the several classes into which wounds are divided, viz.:

1. INCISED, or clean cut, usually made with sharp instruments or glass without any laceration or tearing about them.

2. LACERATED, when the flesh is torn by machinery, hooks, and other blunt instruments.

3. CONTUSED, when there are divisions of skin and flesh with more or less bruising of the parts, attended by a greater or less amount of loss of substance. They are generally caused by falls or blows from blunt instruments. A _blood blister_ is the simplest form of a contusion and is due to an injury which breaks a blood vessel under the skin, without breaking the skin itself.

4. PUNCTURED WOUNDS or STABS form another class. These are produced by the forcible entry of pointed weapons, as bayonets, lances, daggers, scissors, etc. The danger consists in their penetration into and injury of the blood vessels, nerves, bowels, and other organs.

5. POISONED WOUNDS are those due to the introduction of some poison into the incised or punctured part. Stings and bites of venomous reptiles and insects belong to this class, and also wounds inflicted by poisonous arrows.

Having briefly described the various kinds of wounds, we will proceed to the treatment suitable to each class.

1. INCISED WOUNDS. TREATMENT. Here the flesh is divided by some sharp cutting instrument, the cut parts naturally separating, giving the wound a gaping appearance. All that is to be done is to bring the edges of the wound together and keep them in that position until they join together again. This can be easily managed by means of sticking plaster or collodion, after the wound has been washed with cold water and the skin dried. There need be no hurry to stop the bleeding in ordinary cases, unless it be very profuse. When the blood has a dark bluish appearance, it is from a lacerated or severed _vein_, and as its flow is from the extremities toward the heart, this flow can be checked by pressure on the flesh over the vein, _below_ the wound. If, however, the blood is of a bright red color, it comes from an artery and must be at once stopped by applying a bandage of some strong material, as a handkerchief, tightly round the limb, and _above_ the wound. To perfect the pressure on an artery, insert a stick under the bandage and twist it round several times. This will close the channel and stop the flow of blood until professional aid is obtained. It should be borne in mind that when the blood ceases to come out in _spurts_, the artery is under control.

2. LACERATED WOUNDS. In these, large pieces of flesh are often torn away and the open wound is filled with sand or other extraneous substances, according to the nature of the accident, which must be removed by washing freely with a soft sponge. Wounds caused by laceration are very liable to active inflammation from the great injury done to the parts and from their not bleeding much. If the wounds be considerable, the sufferer must have absolute rest, and the injured parts should be covered with cooling lotions. An attempt should be made to press the parts as nearly as possible into their original position, so far as the wound will allow, and to keep them so by using strips of plaster. The bandages should lie loosely over the injured parts, but firmly applied to the sound. The bowels should be opened by an ordinary black draught.

Should any part of the instrument or other cause of the wound remain deeply in a dangerous region, do not use excessive force in efforts to remove it, but await the arrival of a surgeon. In cases where there is considerable inflammation, take off the adhesive plasters and put on leeches, encouraging the bleeding by the application of hot water and a sponge. Hot fomentations and poultices should take the place of cold lotion; and if there be much fever, restlessness or delirium, then saline purgatives, opium, and a very low diet will be required.

3. CONTUSED WOUNDS require the treatment as those by laceration. That is, cold applications at the first, and if inflammation should afterward set in, then leeches and hot fomentations. These wounds rarely heal without suppuration and sloughing, or mortification of the parts, according to the extent of the injury, but they do not bleed much. Poultices of bread and water, or linseed meal should be applied three or four times a day to encourage these processes, and when the abscess breaks, or the slough is thrown off they should be treated as ordinary ulcers, with basilicon, or other stimulating ointment, for the purpose of effecting a healthy cure.

4. PUNCTURED WOUNDS or STABS, produced by swords, daggers, etc., are more dangerous and difficult of cure than any of those previously described. They cause great swelling and inflammation of the absorbents (vessels running from the wound to the neighboring glands, marked by lines following the course of those vessels), with abscesses of the glands, and other portions of the body, symptomic fever and erysipelas. When the tendons and sinews have been punctured, lockjaw and violent convulsions are generally the result.

In treating wounds of this kind, the puncture should, in the first case, be laid open and superficial dressings of cold lotions or cold water only be used, and a loose bandage. If the pain and swelling increase, leeches may be applied to the parts about the wound and hot fomentations and poultices should replace the cold lotions, putting a small linen rag, spread with spermaceti cerate, over the wound. The limb should rest on an inclined plane to assist the gravitation of the blood towards the body. Saline purgatives and opiates are often required when great pain and inflammation are present. All stimulating drinks should be stopped, the bowels kept freely open, and perfect rest enforced.

5. POISONED WOUNDS. _Bites of Venomous Snakes and Reptiles._ When bitten by a snake or other venomous reptile, at once tie a piece of string tightly round the part _above_ the wound to prevent the return of the blood to the heart. Wash the bite well, and either cut out a piece from the bitten part, or apply a dry cup; if the latter is not ready at hand, take a large quill or small tube and placing one end over the wound suck away at the other. This will create a vacuum and do as a cupping glass. Suction with the mouth, if the spot can be reached, will answer equally well. After doing one of these things, rub the wound well with some lunar caustic, or else take a poker or a steel, and after making it red hot, press it well into the wound. In rattlesnake bites, whiskey or other alcoholic stimulants, taken in large quantities, and immediately after the injury, is the only known remedy.

_For Bites of Mosquitoes, Spiders, and Stings of Bees and Wasps_, the best known applications are a solution of common salt, or sugar of lead, 1 scruple; rose-water, 4 ounces. Mix together and apply externally. If the above are not at hand, cover the bites with wet earth. Tincture of arnica, one-half ounce, and cold water, four ounces, is also an excellent remedy.

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Accidents.—How to avoid them.

It is beyond the power of man to secure absolute immunity from accidents, even when their possibilities have been reduced to a minimum, so far as human foresight is capable of effecting it.

Disregard and neglect of the very precautions enjoined to ensure safety, and the frequent wilful violation of both natural and moral law, are in themselves the too fruitful cases of many disasters which might otherwise have been prevented. Our path through life is daily beset with unknown and unforeseen perils, and familiarity with them begets contempt, and a disregard of what pain and suffering our selfishness and want of care may entail not only to ourselves, but others.

The various inventions that tend to promote man’s wealth or pleasure and comfort, impose responsibilities which, if not rightly understood and carried out may bring disaster on many innocent people. In our home-life, in our journeys whether of pleasure or business, in the workshop or office, in the outdoor enjoyments in which we participate, our freedom from accident depends upon the skill and care of others equally as on our own, and this mutual dependence we must share through our walk in life.

It is impossible to give any rule for the avoidance of accidents beyond the common sense one of a proper regard to our own safety and that of others dependent on the righteous discharge of our duty. By care and presence of mind many accidents may be altogether prevented and the disastrous results of others lessened by knowing what to do and how to do it under certain given circumstances.

The object of this book is to provide in a clear and comprehensive form such rudimentary knowledge of how accidents may be avoided and how we should act in cases of emergency, before skilled advice can be obtained, as can be readily possessed by any intelligent person.

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Presence of Mind. Take Things Quietly.

Knowledge of what should and ought to be done in cases of accident or emergency, is without doubt of primary importance to all of us, for it is impossible to say when its need may not be felt; but to have the _power_ and will to put this knowledge to practical and effective use, is a very different matter and requires qualifications which are either non-existent or not readily found in persons called upon suddenly to exercise them.

The truth of this statement can be verified any day in our very streets. An accident occurs, a crowd naturally collects round the scene, doing on the simple impulse of the moment what at other times they would decry as culpable curiosity, but the observant onlooker will soon notice that one man, by his mere force of character and presence of mind, at once seizes his opportunity and knowing how to act—acts.

It is not given to every one to possess this gift, but with some it is inherent, a part of their very nature, and a sense of danger and the necessity for prompt, decisive and undemonstrative action, seems at once to rouse the latent energy to life. It is this very power of being equal to the occasion which constitutes _presence_ of mind, a quality, however, capable of cultivation and development. A great difficulty is often felt when a person is, for the first time, suddenly brought face to face with a case that demands the exercise of self-possession and the ability of keeping calm and quiet when these are absolutely essential.

There is an instinctive feeling of horror and shrinking from the sight of blood, or any great bodily suffering, which is not unnatural, but the difficulties are only increased and the dangers intensified by senseless screaming and the hindering fussiness so frequently displayed, when silence and prompt recourse to the necessary treatment are imperatively required.

It by no means follows that a person is by nature hard-hearted and unsympathetic, when bravely and determinedly facing a difficulty which requires personal feeling to be put aside, indeed it is very far from being the case, for powers of self-control and self-sacrifice are called for, which are often painful and hard to exercise.

The wards of our hospitals are walked and tended by tender-hearted men and women whose unselfish devotion testifies to their sympathy with, and their desire to alleviate the sufferings of the patients.

Pain and suffering affect persons in different ways, borne by one in silent endurance, whilst another will shout and writhe with the agony. The man whose calling necessitates an active life in the open air, feels more acutely the confinement to a bed, than one whose life has been devoted to study or other sedentary occupation, and a restlessness is exhibited by the former which the latter seldom shows. This is a point worth bearing in mind by those who attend on patients. The sufferers, too, can do much to hasten their own recovery and to lessen the anxiety and trouble of those who administer to their wants and comforts by a cheerful acquiescence in all that is required of them and a manly determination not to give way, but bravely to bear their burden of suffering. As presence of mind and calm self-control are necessary in the nurser, so is a ready compliance to all that is asked of him requisite in the patient.

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Concluding Remarks.

If this book is to be used by the present and rising generation, as I humbly hope and trust that it will, it ought not to be listlessly read merely as a novel or as any other piece of fiction, but it must be thoroughly and carefully studied until its contents in all its bearing be completely mastered and understood.

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Footnote 1:

This appears to be from _Lectures on the Principles and Practice of
Physic_ by Sir Thomas Watson.

Footnote 2:

Dr. John Hunter, 1728-1793.

THE END.

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INDEX.

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A.

Accidents and Emergencies, 7

Accidents on the Water, 11

” How to avoid them, 123

Ache, Tooth, 114

Acids, Poisoning by, 93

Ague Drops, see Arsenic, 94

Alkalies, Poisoning by, 95

Ammonia or Hartshorn, see Alkalies, 95

Ankle and Foot broken, 30

Ankle, Dislocation of, 60

Antidotes for Poisons, 93

Antimony, Poisoning by, 94

Apoplexy, 12

Aquafortis, see Acids, 93

Arm, above the Elbow broken, 22

” below the Elbow broken, 24

Arsenic, Poisoned by, 94

Asiatic Cholera, 15

B.

Bad Fish, Poisoning by, 95

Bilious Colic, 45

Bites of Snakes, 102

Bleeding from the Nose, 31

” ” Cut or Wound, 33

Blue Vitriol, see Copper Compounds, 96

Bones broken, 19

Bowels, Looseness of the, 52

Broken Bones, 19

” Head, 20

” Collar Bone, 20

” Ribs, 21

” Arm above the elbow, 22

” Elbow, 23

” Arm below the elbow, 24

” Hand, 25

” Finger, 26

” Wrist, 26

” Hip Joint, 26

” Thigh, 27

” Knee-pan, 28

” Leg, 29

” Ankle and Foot, 30

Bruises, 30

Bug Poison, Poisoning by, 95

Burns and Scalds, 34

Butter of Antimony, see Antimony, 94