Part 34

This is frequently produced by a fall. Make a clove hitch, by passing two loops of cord over the thumb, placing a piece of rag under the cord to prevent it cutting the thumb; then pull in the same line as the thumb. Afterwards apply a cold lotion.

1324. Cuts and Wounds.

Clean cut wounds, whether deep or superficial, and likely to heal by the first intention, should never be washed or cleaned, but at once evenly and smoothly closed by bringing both edges close together, and securing them in that position by adhesive plaster. Cut thin strips of sticking-plaster, and bring the parts together; or if large and deep, cut two broad pieces, so as to look like the teeth of a comb, and place one on each side of the wound, which must be cleaned previously. These pieces must be arranged so that they shall interlace one another; then, by laying hold of the pieces on the right side with one hand, and those on the other side with the other hand, and pulling them from one another, the edges of the wound are brought together without any difficulty.

1325. Ordinary Cuts.

Ordinary cuts are dressed by thin strips, applied by pressing down the plaster on one side of the wound, and keeping it there and pulling in the opposite direction; then suddenly depressing the hand when the edges of the wound are brought together.

1326. Contusions.

Contusions are best healed by laying a piece of folded lint, well wetted with the extract of lead, on the part, and, if there is much pain, placing a hot bran poultice over the dressing, repeating both, if necessary, every two hours. When the injuries are very severe, lay a cloth over the part, and suspend a basin over it filled with cold lotion. Put a piece of cotton into the basin, so that it shall allow the lotion to drop on the cloth, and thus keep it always wet.

1327. Hæmorrhage.

Hæmorrhage, when caused by an artery being divided or torn, may be known by the blood issuing out of the wound in leaps or jerks, and being of a bright scarlet colour. If a vein is injured, the blood is darker and flows continuously. To arrest the latter, apply pressure by means of a compress and bandage. To arrest arterial bleeding, get a piece of wood (part of a mop handle will do), and tie a piece of tape to one end of it; then tie a piece of tape loosely over the arm, and pass the other end of the wood under it; twist the stick round and round until the tape compresses the arm sufficiently to arrest the bleeding, and then confine the other end by tying the string round the arm. A compress made by enfolding a penny piece in several folds of lint or linen, should, however, be first placed under the tape and over the artery.

If the bleeding is very obstinate, and it occurs in the _arm_, place a cork underneath the string, on the inside of the fleshy part, where the artery may be felt beating by any one; if in the _leg_, place a cork in the direction of a line drawn from the inner part of the knee towards the outer part of the groin. It is an excellent thing to accustom yourself to find out the position of these arteries, or, indeed, any that are superficial, and to explain to every person in your house where they are, and how to stop bleeding.

If a stick cannot be got, take a handkerchief, make a cord bandage of it, and tie a knot in the middle; the knot acts as a compress, and should be placed over the artery, while the two ends are to be tied around the thumb. Observe _always to place the ligature between the wound and the heart_. Putting your finger into a bleeding wound, and making pressure until a surgeon arrives, will generally stop violent bleeding.

1328. Bleeding from the Nose.

Bleeding from the nose, from whatever cause, may generally be stopped by putting a plug of lint into the nostrils, if this does not do, apply a cold lotion to the forehead; raise the head, and place over it both arms, so that it will rest on the hands; dip the lint plug, _slightly moistened_, into some powdered gum arabic, and plug the nostrils again; or dip the plug into equal parts of powdered gum arabic and alum, and plug the nose. Or the plug may be dipped in Friar's balsam, or tincture of kino. Heat should be applied to the feet; and, in obstinate cases, the sudden shock of a cold key, or cold water poured down the spine, will often instantly stop the bleeding. If the bowels are confined, take a purgative.

[MORNING IS WELCOME TO THE INDUSTRIOUS.]

1329. Violent Shocks.

Violent shocks will sometimes stun a person, and he will remain unconscious. Untie strings, collars, &c.; loosen anything that is tight, and interferes with the breathing; raise the head; see if there is bleeding from any part; apply smelling-salts to the nose, and hot bottles to the feet.

1330. Concussion.

In concussion, the surface of the body is cold and pale, and the pulse weak and small, the breathing slow and _gentle_, and the pupil of the eye generally contracted or small. You can get an answer by speaking loud, so as to arouse the patient. Give a little brandy and water, keep the place quiet, apply warmth, and do not raise the head too high. If you tickle the feet, the patient feels it.

1331. Compression of the Brain.

In compression of the brain from any cause, such as apoplexy, or a piece of fractured bone pressing on it, there is loss of sensation. If you tickle the feet of the injured person he does not feel it. You cannot arouse him so as to get an answer. The pulse is slow and laboured; the breathing deep, laboured, and _snorting_; the pupil enlarged. Raise the head, loosen strings or tight things, and send for a surgeon. If one cannot be got at once, apply mustard poultices to the feet and thighs, leeches to the temples and hot water to the feet.

1332. Choking.

When a person has a fish bone in the throat, insert the forefinger, press upon the root of the tongue, so as to induce vomiting; if this does not do, let him swallow a _large piece_ of potato or soft bread; and if these fail, give a mustard emetic.

1333. Fainting, Hysterics, &c.

Loosen the garments, bathe the temples with water or eau-de-Cologne; open the window, admit plenty of fresh air, dash cold water on the face, apply hot bricks to the feet, and avoid bustle and excessive sympathy.

1334. Drowning.

Attend to the following _essential rules_:

i. Lose no time.

ii. Handle the body gently.

iii. Carry the body face downwards, with the head gently raised, and never hold it up by the feet.

iv. Send for medical assistance immediately, and in the meantime act as follows:

v. Strip the body, rub it dry: then wrap it in hot blankets, and place it in a warm bed in a warm room.

vi. Cleanse away the froth and mucus from the nose and mouth.

vii. Apply warm bricks, bottles, bags of sand, &c., to the armpits, between the thighs, and to the soles of the feet.

viii. Rub the surface of the body with the hands enclosed in warm dry worsted socks.

ix. If possible, put the body into a warm bath.

x. To restore breathing, put the pipe of a common bellows into one nostril, carefully closing the other, and the mouth; at the same time drawing downwards, and pushing gently backwards, the upper part of the windpipe, to allow a more free admission of air; blow the bellows gently, in order to inflate the lungs, till the breast be raised a little; then set the mouth and nostrils free, and press gently on the chest: repeat this until signs of life appear. The body should be covered the moment it is placed on the table, except the face, and all the rubbing carried on under the sheet or blanket. When they can be obtained, a number of tiles or bricks should be made tolerably hot in the fire, laid in a row on the table, covered with a blanket, and the body placed in such a manner on them, that their heat may enter the spine. When the patient revives, apply smelling-salts to the nose, give warm wine or brandy and water.

_Cautions_.

i. Never rub the body with salt or spirits.

ii. Never roll the body on casks,

iii. Continue the remedies for twelve hours without ceasing.

[PURE WATER IS BETTER THAN FOUL WINE.]

1335. Hanging.

Loosen the cord, or whatever it may be by which the person has been suspended. Open the temporal artery or jugular vein, or bleed from the arm; employ electricity, if at hand, and proceed as for drowning, taking the additional precaution to apply eight or ten leeches to the temples.

1336. Apparent Death from Drunkenness.

Raise the head, loosen the clothes, maintain warmth of surface, and give a mustard emetic as soon as the person can swallow.

1337. Apoplexy and Fits Generally.

Raise the head; loosen all tight clothes, strings, &c.; apply cold lotions to the head, which should be shaved; apply leeches to the temples, bleed, and send for a surgeon.

1338. Suffocation from Noxious Gases, &c.

Remove to the fresh air; dash cold vinegar and water in the face, neck, and breast; keep up the warmth of the body; if necessary, apply mustard poultices to the soles of the feet and spine, and try artificial respirations as in drowning, with electricity.

1339. Lightning and Sun Stroke.

Treat the same as apoplexy.

1340. Poisons, General Observations.

The abbreviations used are as follows:--

E., effects or symptoms. T., treatment. A., antidotes or counter poisons. D.A., dangerous antidotes.

1341. Poison.

A poison is a _substance_ which is capable of altering or destroying some or all of the functions necessary to life. When a person is in good health, and is suddenly attacked, after having taken some food or drink, with violent pain, cramp in the stomach, feeling of sickness or nausea, vomiting, convulsive twitchings, and a sense of suffocation; or if he be seized, under the same circumstances, with giddiness, delirium, or unusual sleepiness, then it may be supposed that he has been poisoned.

1342. Classes of Poisons.

Poisons have been divided into four classes:

i. Those causing local symptoms. ii. Those producing spasmodic symptoms. iii. Narcotic or sleepy symptoms; and iv. Paralytic symptoms.

Poisons may be mineral, animal, or vegetable.

1343. Procedure.

i. Always send immediately for a Medical Man.

ii. Save all fluids vomited, and articles of food, cups, glasses, &c., used by the patient before being taken ill, and lock them up.

iii. Examine the cups to guide you in your treatment; that is, smell them, and look at them.

1344. Give and Apply.

As a rule give emetics after poisons that cause sleepiness and raving;--chalk, milk, eggs, butter, and warm water, or oil, after poisons that cause vomiting and pain in the stomach and bowels, with purging; and when there is no inflammation about the throat, tickle it with a feather to excite vomiting.

1345. Arsenic.

(_White arsenic; orpiment, or yellow arsenic; realgar, red arsenic; Scheele's green, or arsenite of copper; King's yellow; ague drops_; and _arsenical paste_.)

E. Little or no taste. Within an hour, heat and pain in the stomach, followed by vomiting of green, yellow, and bloody matter, burning, and violent thirst; purging, and twisting about the navel; pulse small, quick, and irregular, breathing laboured, voice hoarse, speaking painful; skin cold and clammy. Sometimes there are cramps and convulsions, followed by death.

T. Give plenty of warm water, _new milk_ in large quantities, lime water, white of egg, mixed with gruel or honey, gruel, linseed tea; apply leeches to the bowels, foment, and give starch or gruel enemas. Scrape the iron rust off anything you can get at, mix it with plenty of water, and give in large draughts frequently, and give an emetic of mustard or ipecacuanha. The chief dependence, however, must be placed on the use of the stomach-pump.

_Caution_.--Never give large draughts of fluid until those given before have been vomited, because the stomach will not contract properly if filled with fluid, and the object is to get rid of the poison as speedily as possible.

1346. Copper.

(_Blue vitriol_, or _bluestone; verdigris; verditer; verdigris crystals_.)

E. An acid, rough, disagreeable taste in the mouth; a dry, parched tongue, with sense of strangling in the throat; coppery eructations; frequent spitting; nausea; frequent desire and effort to vomit, or copious vomiting; severe darting pains in the stomach; griping; frequent purging; belly swollen and painful; skin hot, and violent burning thirst; breathing difficult; intense headache and giddiness, followed by cold sweats, cramps in the legs, convulsions, and death.

A. White of eggs mixed with water (twelve to one pint), to be given in wineglassfuls every two minutes; iron filings mixed with water, or very strong coffee, accompanied by small and repeated doses of castor oil.

D.A. Vinegar, bark, alkalies, gall nuts.

T. If there is much pain in the belly or stomach, apply leeches. Give large draughts of milk and water, to encourage vomiting.

1347. Mercury.

(_Corrosive sublimate; calomel; red precipitate; vermilion; turbeth mineral; prussiate of mercury_.)

E. Acid metallic taste; tightness and burning in the throat; pain in the back part of the mouth, stomach, and bowels; anxiety of countenance; nausea; and vomiting of bloody and bilious fluids; profuse purging, and difficulty of making water; pulse small, hard, and quick; skin clammy, icy coldness of the hands and feet; and death in 24 or 36 hours.

A. White of eggs mixed with water, given as above; milk; flour and water, mixed pretty thick; linseed tea; and barley water.

T. Give large draughts of warm water, if you cannot get anything else; strong emetic of ipecacuanha, the stomach-pump, a dose of castor oil and laudanum. Apply poppy-head fomentations to bowels, and leeches if the belly is very tender.

1348. Antimony.

(_Tartar emetic; butter of; Kermes' mineral_.)

E. A rough metallic taste in the mouth, nausea, copious vomitings, sudden hiccough, purging, pains resembling those caused by colic, frequent and violent cramps, sense of choking, severe heartburn, pain at the pit of the stomach, difficult breathing, wildness of speech, cramp in the legs, and death.

A. Decoction or tincture of galls; strong tea; decoction or powder of Peruvian bark.

D.A. White vitriol, ipecacuanha, as emetics.

T. Give large draughts of water, or sugar and water, to promote vomiting; apply leeches to the throat and stomach if painful; and give one grain of extract of opium dissolved in a wineglassful of sugar and water, as soon as the vomiting ceases, and repeat three times at intervals of a quarter of an hour; and finally, one grain, in a little castor oil emulsion, every six hours.

1349. Tin.

(_Butter of tin; putty powder_.)

E. Colic and purging.

A. Milk.

T. Give warm or cold water to promote vomiting, or tickle the throat with a feather.

1350. Zinc.

(_White vitriol; flowers of; chloride of_.)

E. An astringent taste, sensation of choking, nausea, vomiting, purging, pain and burning in the throat and stomach, difficult breathing, pallor and coldness of the surface, pinched face, cramps of the extremities, but, with the exception of the chloride, seldom death.

A. For the two first give copious draughts of milk, and white of eggs and water, mucilage, and olive oil; for the third, carbonate of soda, and warm water in frequent draughts, with the same as for the other compounds.

T. Relieve urgent symptoms by leeching and fomentations, and after the vomiting give castor oil. For the chloride, use friction and warmth.

[BREATH MAY BLOW OUT A CANDLE, AN EXTINGUISHER PREVENT FIRE.]

1351. Silver, Gold and Bismuth.

Silver: (_Lunar caustic; flowers of silver_);

Gold (_Chloride of_);

and Bismuth (_Nitrate; flowers of; pearl white_),

are not frequently met with as poisons.

E. Burning pain in the throat, mouth, accompanied with the usual symptoms of corrosive poisons.

A. For silver, common salt and water; for gold and bismuth, no antidotes are known.

T. Give milk and mucilaginous fluids, and castor oil.

1352. Acids.

(_Hydrochloric_, or _spirit of salt; nitric_, or _aquafortis; sulphuric_, or _oil of vitriol_.)

E. Acid burning taste, acute pain in the gullet and throat, vomiting of bloody fluid, which effervesces when chalk is added to it; hiccough, tenderness of the belly, cold sweats, pinched face, convulsions, and death.

A. Give _calcined_ magnesia, chalk, soap and water. Administer frequent draughts of water to weaken the acid with carbonate of soda, potass, or magnesia, to neutralize it; thick soap-suds made with common soap; chalk, or in default of the alkalies and chalk, break down the plaster of the wall or ceiling, mix in water, and give the sufferer. Excite vomiting, and repeat the remedies till all the acid is neutralized.

1353. Chlorine (_gas_).

E. Violent coughing, tightness of the chest, debility, inability to stand.

A. The vapour of caustic ammonia to be inhaled, or ten drops of liquid ammonia to one ounce of water to be taken.

T. Dash cold water over the face, and relieve urgent symptoms.

1354. Lead.

(_Sugar of; red lead; wine sweetened by; and water impregnated with_).

E. Sugary astringent metallic taste, tightness of the throat, pains as if caused by colic, violent vomiting, hiccough, convulsions, and death.

A. Epsom or Glauber's salt; plaster of Paris; or phosphate of soda.

T. An emetic of sulphate of zinc (twenty-four grains to half a pint of water); leeches to belly; fomentations if necessary; and a dose of castor oil mixed with laudanum.

1355. Phosphorus.

E. Intense burning and pain in the throat and stomach.

A. Magnesia and carbonate of soda.

T. Large draughts of cold water, and tickle the throat with a feather.

_Caution_. Do not give oil or milk.

1356. Lime.

E. Burning in the throat and stomach, cramps in the belly, hiccough, vomiting, and paralysis of limbs.

A. Vinegar or lemon juice.

T. Thin starch water to be drunk frequently.

1357. Alkalies.

(_Caustic potash; soda; ammonia_.)

E. Acrid, hot, disagreeable taste; burning in the throat, nausea, and vomiting bloody matter; profuse purging, pain in the stomach, colic, convulsions, and death.

A. Vinegar and vegetable acids

T. Give linseed tea, milk, almond or olive oil, and excite vomiting.

1358. Baryta

(_Carbonate, pure_, and _muriate_ of, _See_ LIME para. 1356.)

1359. Nitre.

E. Heartburn, nausea, violent vomiting, purging, convulsions, difficult breathing, violent pain in the bowels, kidneys, and bladder, with bloody urine.

T. Emetics, frequent draughts of barley water, with castor oil and laudanum.

1360. Narcotic Poisons.

(_Bane berries; fool's parsley; deadly nightshade; water hemlock; thorn apple; opium, or laudanum; camphor, &c._)

E. Giddiness, faintness, nausea, vomiting, stupor, delirium, and death.

T. Give emetics, large draughts of fluids, tickle the throat, apply smelling salts to the nose, dash cold water over the face and chest, apply mustard poultices, and, above all, endeavour to rouse the patient by walking between two persons; and, if possible, by electricity; and give forty drops of sal-volatile in strong coffee every half-hour.

1361. Vegetable Irritating Poisons.

(_Mezsreon; monk's-hood; bitter apple; gamboge; white hellebore, &c._)

E. Acrid, biting, bitter taste, choking sensation, dryness of the throat, retching, vomiting, purging, pains in the stomach and bowels, breathing difficult, and death.

T. Give emetics of camomile, mustard, or sulphate of zinc; large draughts of warm milk, or other bland fluids; foment and leech the belly if necessary, and give strong _infusion_ of coffee.

[TAKE CARE OF PENCE, POUNDS WILL TAKE CARE OF THEMSELVES.]

1362. Oxalic Acid.

E. Vomiting and acute pain in the stomach, general debility, cramps, and death.

A. Chalk.

T. Give large draughts of lime water or magnesia.

1363. Spanish Flies.

E. Acrid taste, burning heat in the throat, stomach, and belly, bloody vomitings, colic, purging, retention of urine, convulsions, death.

T. Large draughts of olive oil; thin gruel, milk, starch enemas, linseed tea, laudanum, and camphorated water.

1364. Poisonous Fish.

(_Old-wife; sea-lobster; mussel; tunny; blower; rock-fish, &c._)

E. Intense pain in the stomach after swallowing the fish, vomiting, purging, and sometimes cramps.

T. Give an emetic; excite vomiting by tickling the throat, and plenty of warm water. Follow emetics by active purgatives,

## particularly of castor oil and laudanum, or opium and calomel, and

abate inflammation by the usual remedies.

1365. Bites of Reptiles.

(_Viper; black viper; Indian serpents; rattle-snake._)

E. Violent and quick inflammation of the part, extending towards the body, soon becoming livid; nausea, vomiting, convulsions, difficult breathing, mortification, cold sweats, and death.

T. Suppose that the wrist has been bitten: immediately tie a tape between the wound and the heart, scarify the parts with a penknife, razor, or lancet, and apply a cupping-glass over the bite, frequently removing it and bathing the wound with volatile alkali, or heat a poker and burn the wound well, or drop some of Sir Wm. Burnett's Disinfecting Fluid into the wound, or cauterize the bite freely with lunar caustic, but not till the part has been well sucked with the mouth, or frequently washed and cupped. The strength is to be supported by brandy, ammonia, ether, and opium. Give plenty of warm drinks, and cover up in bed.

1366. Mad Animals, Bite of.

E. Hydrophobia, or a fear of fluids.

T. Tie a string tightly over the part, cut out the bite, and cauterize the wound with a red-hot poker, lunar caustic, or Sir Wm. Burnett's Disinfecting Fluid. Then apply a piece of "spongio-piline," give a purgative, and plenty of warm drink. Whenever chloroform can be procured, sprinkle a few drops upon a handkerchief, and apply to the nose and mouth of the patient before cauterizing the wound. When the breathing appears difficult, cease the application of the chloroform. A physician, writing in the _Times_, strongly urged this course, and stated, many years ago, that there is no danger, with ordinary care, in the application of the chloroform, while the cauterization may be more effectively performed.

1367. Insect Stings.

(_Wasp, bee, gnat, hornet, gadfly, scorpion._)

E. Swelling, nausea, and fever.

T. Press the barrel of a watch-key over the part, so as to expose the sting, which must be removed. Give fifteen drops of hartshorn or sal-volatile in half a wine-glassful of camomile tea, and cover the part stung with a piece of lint soaked in extract of lead.

1368. Cautions for the Prevention of Accidents.

The following regulations should be engraved on the memory of all:

i. As many sudden deaths come by water, particular caution is therefore necessary in its vicinity.

ii. Do not stand near a tree, or any leaden spout, iron gate, or palisade, in times of lightning.

iii. Lay loaded guns in safe places, and never imitate firing a gun in jest.

iv. Never sleep near charcoal; if drowsy at any work where charcoal fires are used, take the fresh air.

v. Carefully rope trees before they are cut down, that when they fall they may do no injury.

vi. When benumbed with cold beware of sleeping out of doors; rub yourself, if you have it in your power, with snow, and do not hastily approach the fire.

vii. Beware of damp.

viii. Air vaults, by letting them remain open some time before you enter, or scattering powdered lime in them. Where a lighted candle will not burn, animal life cannot exist; it will be an excellent caution, therefore, before entering damp and confined places, to try this simple experiment.