ACCIDENTS AND EMERGENCIES. (continued 2)

Poisons and their Antidotes.

In all cases of poisoning, it must be taken as a general rule that the person should be made to vomit, especially if seen immediately after taking the poison. A tea-spoonful of mustard, or two or three of alum, taken in warm water, will effect this purpose.

Only a few of the principal substances of a poisonous character which enter into the daily economy, with their antidotes are here given.

Acids. Sulphuric (oil of vitriol), Nitric (aquafortis), Muriatic (spirits of salt), Oxalic, or Oxalates. But not Prussic acid.

Treatment. Give plenty of calcined magnesia, an ounce to a pint of water, every two or three minutes, in a wine-glass. Whiting, chalk, or a piece of plaster broken off the wall and pounded small, will answer the purpose, if the magnesia be not ready at hand. A table-spoonful of soft soap, or common soap, cut up into small pieces, should be got ready, and given in tea-spoonfuls of water.

94Carbolic. Creosote. Administer plenty of white of egg and an emetic. One tea-spoonful of mustard in warm water, followed by a mixture of olive oil and magnesia.

Prussic Acid. (Oil of bitter almonds, laurel water, cyanide of potassium), used by photographers and others.

Treatment. Throw cold water over the face, head and back, even when convulsions have occurred. Give sal volatile and water, and apply smelling salts to the nose, but not too strong in either instance.

Arsenic. Every preparation of arsenic is an irritant poison. Amongst the commonest forms are: Scheele’s green, ague drops, rat poison, etc.

Treatment. Give plenty of raw milk and eggs, lime water, or flour and water, and then castor oil.

Antimony. (Tartar emetic, Butter of Antimony, Oxide of Antimony.) Poisoning by these, when taken accidentally in large quantities, cause severe vomiting and great prostration.

Treatment. If sufficient quantity has not been taken to produce vomiting, induce and facilitate it by copious draughts of warm water 95and by tickling the throat. Give strong tea, or a decoction of cinchona bark.

Alkalies. (Ammonia, or Hartshorn, Potassa Caustic, Soda Caustic, Lye of Wood Ashes, Quicklime.)

Treatment. Two or three table-spoonfuls, of vinegar, or lime juice, in as much again of water sufficient to neutralize the alkali. Then give olive oil or milk. Do not give emetics.

Bad Fish. (Mussels, Lobsters, Crabs, etc.)

Treatment. Empty the stomach as quickly as possible with a little mustard and warm water, salt and water, tickling the top of the throat. Then administer a good dose of castor oil with some warm spice; if necessary, put a mustard plaster on the stomach.

Bug Poison. (Corrosive Sublimate.)

This is the ordinary bed bug poison, which is often taken by accident.

Treatment. Mix up as quickly as possible the whites of six eggs in a pint of cold water, giving a glassful every three or four minutes, and in the interval plenty of milk, till the stomach can contain no more. Wheat flour mixed with water is a good remedy.

(See below Mercury and its compounds.)

96Copper Compounds. (Blue Vitriol, Verdigris.)

Mercury Compounds. (Corrosive Sublimate, White Precipitate, Red Precipitate, Vermilion).

Zinc Compounds. (White Vitriol.)

Treatment. Give abundance of white of eggs, then warm water with a tea-spoonful of mustard to induce vomiting. After vomiting administer white of egg and milk, or wheat flour and milk as a batter.

Iodine. (Tincture or Solution.)

Treatment. Give freely fresh paste of starch or wheat flour mixed with water, then a little mustard and warm water to excite vomiting. White of eggs and milk and mucilaginous drinks are excellent substitutes.

Lead Compounds (Sugar of Lead, White Lead, Red Lead, Litharge.)

Treatment. Induce vomiting in the usual way with a little mustard and warm water and by tickling the throat. Give an ounce of Epsom salts dissolved in water. If sulphate of zinc be at hand, give from 10 to 30 grains instead of the mustard as an emetic.

Lunar Caustic. (Nitrate of Silver.)

This has often been accidentally swallowed when used for touching a sore throat.

97Treatment. Give a large tea-spoonful of salt in a glass of water, repeated every ten minutes; then administer a dose of castor oil, and linseed tea or barley water for a drink.

Laudanum. (Opium, Morphine, Soothing Syrups.)

Treatment. Empty the stomach as quickly as possible by vomiting. Give finely powdered fresh charcoal (by quickly pounding coal from a wood fire). After the stomach has been well cleared, give very strong coffee or tea; put a mustard plaster around the calf of each leg, and if the patient be cold and sinking, give a good quantity of spirits and water. Keep the patient till the effect has passed off by beating the soles of the feet, dashing cold water on the face and keeping him as much as possible on the move. The inclination to sleep must under no circumstances be indulged in.

Chloroform. (Chloral, Ether.)

Treatment. Excite vomiting in the ordinary way, mustard and warm water, etc. Dash cold water over the head, face and body. Induce artificial respiration as in drowning (see page 63). Place a piece of ice in the rectum. 98Suspend the patient for a few moments by his legs.

Strychnine. (Nux Vomica, Rat Poison, etc.)

There is lockjaw and considerable twitchings and convulsions; the body being bent backwards.

Treatment. Empty the stomach by an emetic, and then give linseed tea or barley water, adding for an adult 30 drops of laudanum, occasionally to relieve the spasms. Two ounces of camphor dissolved in a quart of whiskey, and given freely, is said to be an excellent antidote.

Poisonous Plants and Seeds.

Children and others often suffer from accidentally eating poisonous fungi, mistaking them for mushrooms, etc. The stomach should at once be cleared by an emetic, warm water with mustard, or salt, or soft soap. If there be no purging, then administer a dose of castor oil. If the patient be in a faint and sinking condition, give stimulants.

Ivy-Poisoning.

Apply soft soap freely to the affected parts, or bathe them with a weak tincture of belladonna.

99Phosphorous. (Lucifer matches.)

Children often play with and suck these matches composed of this poisonous substance; the effect is similar to the symptoms caused by arsenic.

Treatment. Give large doses of warm water with mustard or magnesia, chalk, or even flour mixed with it. Induce vomiting, but give nothing of an oleaginous character.

GENERAL REMARKS.

It must be always remembered that cases of poisoning require prompt treatment.

In many cases of accident and diseases time is not of that essential consequence that it is in the cases of these. The life or death of the sufferer may depend upon the way you employ the few moments in which you have to act.

Sea Sickness.

This sickness is classified under the head of diseases of the general system. I placed it here for the benefit of those who are going to make an ocean voyage for the first time, as I know that most people never or seldom think 100to prepare themselves for it. Sea sickness has a number of varieties and is the great terror of persons who for the first time cross the ocean. At first there is no vomiting, but a feeling of constant dizziness, confusion of ideas and perhaps a dull headache take its place. Even in such cases there is more or less loss of appetite, and in nearly all there is obstinate constipation. Without doubt the close atmosphere of the vessel plays an important part in the production of the vomiting, since even those who are not much affected may lose control of their stomachs if they venture into the neighborhood of the cook’s galley. Intense as the suffering may be, it is rarely that the malady ends fatally.

For some reason consumptive persons appear less subject to sea sickness than most others, and it said that dark complexioned persons suffer more from it than others.

Persons about to proceed to sea should put their stomach and bowels in order by the use of mild aperients a few days before starting. If it can not be entirely prevented, it may be mitigated by lying flat upon the back. To lie on deck in the open air is much better than lying in the close air of the cabin or state-room. 101As the vessel descends, draw in the breath, and as it ascends, exhale the breath. (This prevents the movements of the organs which act immediately upon sea sickness.)

Hold fast by the ropes on the side of the ship so as to move with all its motions. Take a dose of some purgative that will empty the bowels. A wine-glassful of brandy or from 10 to 30 drops of laudanum will relieve the sickness very much. For a child it is sometimes sufficient to wet a cloth with laudanum and lay upon the pit of the stomach. Morphine is sometimes even better than laudanum. Creosote, one drop at a dose made into a pill, is excellent. Ten drops of hartshorn in half a tumbler of water is good for some.

But the best known remedy is chloroform taken in doses of from 40 to 60 drops in water by means of a little gum arabic.

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 103up 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 104flannel 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.

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 105bone 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, 106elbow, 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 107recovered their normal healthy condition, care must be taken not to encourage irritation and inflammation in the limb by using it too soon.

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 109above 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 110to 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.

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 111fatigued 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 112by 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 113for while the sufferer is undergoing the preliminary treatment above described, which must not be abated until his arrival.

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.

114Sometimes 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.

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 115consequence. 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 116teething, 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.

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 117the 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 118punctured 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, 119tightly 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 120sound. 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 121ordinary 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 122purgatives 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 123of 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.

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 124man’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 126latent 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 127tended 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.

THE END.

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