Part 2 — PART II. CHILDHOOD. (continued 4)

286. What are the best immediate applications to a scald or to a burn?

There is nothing more efficacious than flour. It ought to be thickly applied, over the part affected, and should be kept in its place either with a rag and a bandage, or with strips of old linen. If this be done, almost instantaneous relief will be experienced, and the burn or the scald, if superficial, will soon be well. The advantage of flour as a remedy is this, that it is always at hand. I have seen some extensive burns and scalds cured by the above simple plan. Another excellent remedy is cotton wool. The burn or the scald ought to be enveloped in it; layer after layer should be applied until it be several inches thick. The cotton wool must not be removed for several days.^[269] These two remedies, flour and cotton wool, may be used in conjunction; that is to say, the flour may be thickly 1305applied to the scald or to the burn, and the cotton wool over all.

Prepared lard—that is to say, lard without salt^[270]—is an admirable remedy for burns and for scalds. The advantages of lard are: (1) It is almost always at hand; (2) It is very cooling, soothing, and unirritating to the part, and it gives almost immediate freedom from pain; (3) It effectually protects and sheathes the burn or the scald from the air; (4) It is readily and easily applied: all that has to be done is to spread the lard either on pieces of old linen rag, or on lint, and then to apply them smoothly to the parts affected, keeping them in their places by means of bandages—which bandages may be readily made from either old linen or calico shirts. Dr. John Packard, of Philadelphia, was the first to bring this remedy for burns and scalds before the public—he having tried it in numerous instances, and with the happiest results. I myself have, for many years, been in the habit of prescribing lard as a dressing for blisters, and with the best effects. I generally advise equal parts of prepared lard and of spermaceti cerate to be blended together to make an ointment. The spermaceti cerate gives a little more consistence to the lard, which, in warm weather, especially, is a great advantage.

Another valuable remedy for burns is, “carron oil;” 1306which is made by mixing equal parts of linseed oil and lime-water together in a bottle, and shaking it up before using it.

Cold applications, such as cold water, cold vinegar and water, and cold lotions, are most injurious, and, in many cases, even dangerous.

Scraped potatoes, sliced cucumber, salt, and spirits of turpentine, have all been recommended; but, in my practice, nothing has been so efficacious as the remedies above enumerated.

Do not wash the wound, and do not dress it more frequently than every other day. If there be much discharge, let it be gently sopped up with soft old linen rag; but do not, on any account, let the burn be rubbed or roughly handled. I am convinced that, in the majority of cases, wounds are too frequently dressed, and that the washing of wounds prevents the healing of them. “It is a great mistake,” said Ambrose Paré, “to dress ulcers too often, and to wipe their surfaces clean, for thereby we not only remove the useless excrement, which is the mud or sanies of ulcers, but also the matter which forms the flesh. Consequently, for these reasons, ulcers should not be dressed too often.”

The burn or the scald may, after the first two days, if severe, require different dressings; but, if it be severe, the child ought of course to be immediately placed under the care of a surgeon.

If the scald be either on the leg or on the foot, a common practice is to take the shoe and the stocking off; in this operation, the skin is also at the same time very apt to be removed. Now, both the shoe and the stocking 1307ought to be slit up, and thus be taken off, so that neither unnecessary pain nor mischief may be caused.

287. If a bit of quicklime should accidentally enter the eye of my child, what ought to be done?

Instantly, but tenderly remove, either by means of a camel’s-hair brush or by a small spill of paper, any bit of lime that may adhere to the ball of the eye, or that may be within the eye or on the eyelashes; then well bathe the eye (allowing a portion to enter it) with vinegar and water—one part of vinegar to three parts of water, that is to say, a quarter fill a clean half-pint medicine bottle with vinegar and then fill it up with spring water, and it will be ready for use. Let the eye be bathed for at least a quarter of an hour with it. The vinegar will neutralize the lime, and will rob it of its burning properties.

Having bathed the eye with the vinegar and water for a quarter of an hour, bathe it for another quarter of an hour simply with a little warm water; after which, drop into the eye two or three drops of the best sweet oil, put on an eye-shade made of three thicknesses of linen rag, covered with green silk, and then do nothing more until the doctor arrives.

If the above rules be not promptly and properly followed out, the child may irreparably lose his eyesight; hence the necessity of a popular work of this kind, to tell a mother, provided immediate assistance cannot be obtained, what ought instantly to be done; for moments, in such a case, are precious.

While doing all that I have just recommended, let a surgeon be sent for, as a smart attack of inflammation 1308of the eye is very apt to follow the burn of lime; but which inflammation will, provided the previous directions have been promptly and efficiently followed out, with appropriate treatment, soon subside.

The above accident is apt to occur to a child who is standing near a building when the slacking of quicklime is going on, and where portions of lime, in the form of powder, are flying about the air. It would be well not to allow a child to stand about such places, as prevention is always better than cure. Quicklime is sometimes called caustic lime: it well deserves its name, for it is a burning lime, and if proper means be not promptly used, will soon burn away the sight.

288. “What is to be done in the case of Choking?”

Instantly put your finger into the throat and feel if the substance be within reach; if it be food, force it down, and thus liberate the breathing; should it be a hard substance, endeavor to hook it out; if you cannot reach it, give a good smart blow or two with the flat of the hand on the back; or, as recommended by a contributor to the Lancet, on the chest, taking care to “seize the little patient, and place him between your knees side ways, and in this or some other manner to compress the abdomen [the belly], otherwise the power of the blow will be lost by the yielding of the abdominal parietes [walls of the belly], and the respiratory effort will not be produced.” If that does not have the desired effect, tickle the throat with your finger, so as to insure immediate vomiting, and the consequent ejection of the offending substance.^[271]

1309289. Should my child be bitten by a dog supposed to be mad, what ought to be done?

Instantly well rub for the space of five of ten seconds—seconds, not minutes—a stick of nitrate of silver (lunar caustic) into the wound. The stick of lunar caustic should be pointed, like a cedar-pencil for writing, in order the more thoroughly to enter the wound.^[272] This, if properly done directly after the bite, will effectually prevent hydrophobia. The nitrate of silver acts not only as a caustic to the part, but it appears effectually to neutralize the poison, and thus by making the virus perfectly innocuous is a complete antidote. If it be either the lip, or the parts near the eye, or the wrist, that have been bitten, it is far preferable to apply the caustic than to cut the part out; as the former is neither so formidable, nor so dangerous, nor so disfiguring as the latter, and yet it is equally as efficacious. I am indebted to the late Mr. Youatt, the celebrated veterinary surgeon, for this valuable antidote or remedy for the prevention of the most horrible, heart-rending, and incurable disease known. Mr. Youatt had an immense practice among dogs as well as among horses. He was a keen observer of disease, and a dear lover of his profession, and he had paid great attention to rabies—dog madness. He and his assistants had been repeatedly bitten by rabid dogs; but knowing that he was in possession of an infallible preventive remedy, he never dreaded the wounds inflicted either upon himself or 1310upon his assistants. Mr. Youatt never knew lunar caustic, if properly and immediately applied, to fail. It is, of course, only a preventive. If hydrophobia be once developed in the human system, no antidote has ever yet, for this fell and intractable disease, been found.

While walking the London Hospitals, upwards of thirty-five years ago, I received an invitation from Mr. Youatt to attend a lecture on rabies—dog madness. He had, during the lecture, a dog present laboring under incipient madness. In a day or two after the lecture, he requested me and other students to call at his infirmary and see the dog, as the disease was at that time fully developed. We did so, and found the poor animal raving mad—frothing at the mouth, and snapping at the iron bars of his prison. I was particularly struck with a peculiar brilliancy and wildness of the dog’s eyes. He seemed as though, with affright and consternation, he beheld objects unseen by all around. It was pitiful to witness his frightened and anxious countenance. Death soon closed the scene!

I have thought it my duty to bring the value of lunar caustic as a preventive of hydrophobia prominently before your notice, and to pay a tribute of respect to the memory of Mr. Youatt—a man of talent and genius.

Never kill a dog supposed to be mad who has bitten either a child, or any one else, until it has, past all doubt, been ascertained whether he be really mad or not. He ought, of course, to be tied up, and be carefully watched, and be prevented the while from biting 1311any one else. The dog, by all means, should be allowed to live at least for some weeks, as the fact of his remaining will be the best guarantee that there is no fear of the bitten child having caught hydrophobia.

There is a foolish prejudice abroad, that a dog, be he mad or not, who has bitten a person ought to be immediately destroyed; that although the dog be not at the time mad, but should at a future period become so, the person who had been bitten when the dog was not mad, would, when the dog became mad, have hydrophobia! It seems almost absurd to bring the subject forward; but the opinion is so very general and deep rooted, that I think it well to declare that there is not the slightest foundation of truth in it, but that it is a ridiculous fallacy!

A cat sometimes goes mad, and its bite may cause hydrophobia; indeed, the bite of a mad cat is more dangerous than the bite of a mad dog. A bite from a mad cat ought to be treated precisely in the same manner—namely, with the lunar caustic—as for a mad dog.

A bite either from a dog or from a cat who is not mad, from a cat especially, is often venomous and difficult to heal. The best application is immediately to apply a large hot white-bread poultice to the part, and to renew it every four hours; and, if there be much pain in the wound, to well foment the part, every time before applying the poultice, with a hot chamomile and poppy-head fomentation.

Scratches of a cat are best treated by smearing, and that freely and continuously for an hour, and then afterward at longer intervals, fresh butter on the part 1312affected. If fresh butter be not at hand, fresh lard—that is to say, lard without salt—will answer the purpose. If the pain of the scratch be very intense, foment the part affected with hot water, and then apply a hot white-bread poultice, which should be frequently renewed.

290. What is the best application in case of a sting either from a bee or from a wasp?

Extract the sting, if it have been left behind, either by means of a pair of dressing forceps, or by the pressure of the hollow of a small key—a watch-key will answer the purpose; then, a little blue (which is used in washing) moistened with water, should be immediately applied to the part; or, apply a few drops of solution of potash,^[273] or “apply moist snuff or tobacco, rubbing it well in,”^[274] and renew from time to time either of them: if either of these be not at hand, either honey, or treacle, or fresh butter, will answer the purpose. Should there be much swelling or inflammation, apply a hot white-bread poultice, and renew it frequently. In eating apricots, or peaches, or other fruit, they ought to, beforehand, be carefully examined, in order to ascertain that no wasp is lurking in them; otherwise, it may sting the throat, and serious consequences will ensue.

291. If a child receive a fall, causing the skin to be grazed, can you tell me of a good application?

You will find gummed paper an excellent remedy; 1313the way of preparing it is as follows: Apply evenly, by means of a small brush, thick mucilage of gum arabic to cap paper; hang it up to dry, and keep it ready for use. When wanted, cut a portion as large as may be requisite, then moisten it with your tongue, in the same manner you would a postage stamp, and apply it to the grazed part. It may be removed when necessary by simply wetting it with water. The part in two or three days will be well. There is usually a margin of gummed paper sold with postage stamps; this will answer the purpose equally well. If the gummed paper be not at hand, then frequently, for the space of an hour or two, smear the part affected with fresh butter.

292. In case of a child swallowing by mistake either laudanum, or paregoric, or Godfrey’s Cordial, or any other preparation of opium, what ought to be done?

Give, as quickly as possible, a strong mustard emetic; that is to say, mix two teaspoonfuls of flour of mustard in half a teacupful of water, and force it down his throat. If free vomiting be not induced, tickle the upper part of the swallow with a feather; drench the little patient’s stomach with large quantities of warm water. As soon as it can be obtained from a druggist, give him the following emetic draught:

Take of—Sulphate of Zinc, one scruple;

Simple Syrup, one drachm;

Distilled Water, seven drachms:

To make a Draught.

Smack his buttocks and his back; walk him, or lead him, or carry him about in the fresh air; shake him by 1314the shoulders; pull his hair; tickle his nostrils; shout and holla in his ears; plunge him into a warm bath and then into a cold bath alternately; well sponge his head and face with cold water; dash cold water on his head, face, and neck; and do not, on any account, until the effects of the opiate are gone off, allow him to go to sleep; if you do, he will never wake again! While doing all these things, of course, you ought to lose no time in sending for a medical man.

293. Have you any observations to make on parents allowing the Deadly Nightshade—the Atropa Belladonna—to grow in their gardens?

I wish to caution you not on any account to allow the Belladonna—the Deadly Nightshade—to grow in your garden. The whole plant—root, leaves, and berries—is poisonous; and the berries, being attractive to the eye, are very alluring to children.

294. What is the treatment of poisoning by Belladonna?

Instantly send for a medical man; but, in the mean time, give an emetic—a mustard emetic;—mix two teaspoonfuls of flour of mustard in half a teacupful of warm water, and force it down the child’s throat; then drench him with warm water, and tickle the upper part of his swallow either with a feather or with the finger, to make him sick; as the grand remedy is an emetic to bring up the offending cause. If the emetic have not acted sufficiently, the medical man when he arrives may deem it necessary to use the stomach-pump; but remember not a moment must be lost, for moments are precious in a case of belladonna poisoning, 1315in giving a mustard emetic, and repeating it again and again until the enemy be dislodged. Dash cold water upon his head and face; the best way of doing which is by means of a large sponge, holding his head and his face over a wash-hand basin, half filled with cold water, and filling the sponge from the basin, and squeezing it over his head and face, allowing the water to continuously stream over them for an hour or two, or until the effects of the poison have passed away. This sponging of the head and face is very useful in poisoning by opium, as well as in poisoning by belladonna; indeed, the treatment of poisoning by the one is very similar to the treatment of poisoning by the other. I, therefore, for the further treatment of poisoning by belladonna, beg to refer you to a previous Conversation on the treatment of poisoning by opium.

295. Should a child put either a pea or a bead, or any other foreign substance, up the nose, what ought to be done?

Do not attempt to extract it yourself, or you might push it farther in, but send instantly for a surgeon, who will readily remove it, either with a pair of forceps, or by means of a bent probe, or with a director. If it be a pea, and it be allowed for any length of time to remain in, it will swell, and will thus become difficult to extract, and may produce great irritation and inflammation. A child ought not to be allowed to play with peas or with beads (unless the beads are on a string), as he is apt, for amusement, to push them up his nose.

296. If a child have put either a pea, a bean, a 1316bead, a cherry-stone, or any other smooth substance, into his ear, what ought to be done to remove it?

Turn his head on one side, in order to let the ear with the pea or bead in it be undermost, then give with the flat of your hand two or three sharp, sudden slaps or boxes on the other, or uppermost ear, and most likely the offending substance will drop out. Poking at the ear will, in the majority of cases, only send the substance farther in, and will make it more difficult (if the above simple plan does not succeed) for the medical man to remove. The surgeon will, in all probability, syringe the ear; therefore, have a supply of warm water in readiness for him, in order that no time may be lost.

297. If an earwig, or any other living thing, should get into the ear of a child, what ought to be done?

Lay the child on his side, the affected ear being uppermost, and fill the ear, from a teaspoon, with either water or sweet oil. The water or oil will carry the living thing, whatever it be, out of the ear, and the child is at once relieved.

298. If a child swallow a piece of broken glass, what ought to be done?

Avoid purgatives, as the free action on the bowels would be likely to force the spiculæ of glass into the mucous membrane of the bowels, and thus would wound them, and might cause ulceration, and even death. “The object of treatment will be to allow them to pass through the intestines well enveloped by the other contents of the tube; and for this purpose a 1317solid farinaceous diet should be ordered, and purgatives scrupulously avoided.”^[275]

299. If a child swallow a pin, what should be done?

Treat him as for broken glass. Give him no aperients, or it might, in action, force the pin into the bowel. I have known more than one instance where a child, after swallowing a pin, to have voided it in his motion.

300. If a child swallow a coin of any kind, is danger likely to ensue, and what ought to be done?

There is, as a rule, no danger. A dose or two of castor oil will be all that is usually necessary. The evacuations ought to be carefully examined until the coin be discovered. I once knew a child swallow a penny-piece, and pass it in his motions.

301. If a child, while playing with a small coin (such as either a threepenny or a fourpenny piece), or any other substance, should toss it into his mouth, and inadvertently allow it to enter the windpipe, what ought to be done?

Take hold of him by the legs, allowing his head to hang downward; then give him, with the palm of your hand, several sharp blows on his back, and you may have the good fortune to see the coin coughed out of his mouth. Of course, if this plan does not succeed, send instantly for a medical man.

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