CHAPTER XIX.
HYGIENE OF THE CIRCULATORY ORGANS
367. If any part of the system is deprived of blood, its vitality will cease; but, if the blood is lessened in quantity to a limited extent, only the vigor and health of the part will be impaired. The following conditions, if observed, will favor the free and regular supply of blood to all portions of the system.
368. The clothing should be loosely worn. Compression of any kind impedes the passage of blood through the vessels of the compressed portion. Hence, no article of apparel should be worn so as to prevent a free flow of blood through every organ of the body.
369. The blood which passes to and from the brain, flows through the vessels of the neck. If the dressing of this part of the body is close, the circulation will be impeded, and the functions of the brain will be impaired. This remark is particularly important to scholars, public speakers, and individuals predisposed to apoplexy, and other diseases of the brain.
370. As many of the large veins lie immediately beneath the skin, through which the blood is returned from the lower extremities, if the ligatures used to retain the hose, or any other article of apparel, in proper position, be tight and inelastic, the passage of blood through these vessels will be 173 obstructed, producing, by their distention, the varicose, or enlarged veins. Hence elastic bands should always be used for these purposes.
367–386. Give the hygiene of the circulatory organs. 367. What effect will be produced on the body if it is deprived of blood? If the blood is only lessened in quantity? 368. Why should the clothing be worn loose? 369. What is said of dressing the neck? To what persons is this remark applicable? 370. How are enlarged veins frequently produced?
371. An equal temperature of all parts of the system promotes health. A chill on one portion of the body diminishes the size of its circulating vessels, and the blood which should distend and stimulate the chilled part, will accumulate in other organs. The deficiency of blood in the chilled portion induces weakness, while the superabundance of sanguineous fluid may cause disease in another part of the system.
372. The skin should be kept not only of an equal, but at its natural temperature. If the skin is not kept warm by adequate clothing, so that chills shall not produce a contraction of the blood-vessels and a consequent paleness, the blood will recede from the surface of the body, and accumulate in the internal organs. Cleanliness of the skin is likewise necessary, for the reason, that this condition favors the free action of the cutaneous vessels.
Observation. When intending to ride in a cold day, wash the face, hands, and feet, in cold water, and rub them smartly with a coarse towel. This is far better to keep the extremities warm, than to take spirits into the stomach.
373. Exercise promotes the circulation of the blood. As the action of the muscles is one of the important agents which propel the blood through the arteries and veins, daily and regular exercise of the muscular system is required to sustain a vigorous circulation in the extremities and skin, and also to maintain a healthy condition of the system. The best stimulants to improve the sluggish circulation of an indolent patient, whose skin is pale and whose extremities are cold, are the 174 union of vigorous muscular exercise with agreeable mental action, and the systematic application to the skin of cold water, attended with friction.
371. Why should the temperature of the body be equal? 372. Why should the skin be kept at its natural, as well as at an equal temperature? What practical observation when intending to ride in a cold day? 373. Why does exercise promote health? What are good stimulants for sluggish circulation in the indolent?
Illustration. The coach-driver and teamster throw their arms around their bodies to warm them when cold. The muscles that are called into action in swinging the arms, force a greater quantity of blood into the chilled parts, and consequently, more heat is produced.
374. When a number of muscles are called into energetic action, a greater quantity of blood will be propelled to the lungs and heart in a given time, than when the muscles are in a state of comparative inaction. It is no uncommon occurrence, that before there is a proper expansion of the respiratory organs to correspond with the frequency and energy of the movements of the muscles, there is an accumulation of blood in the lungs, attended by a painful sensation of fulness and oppression in the chest, with violent and irregular action of the heart. This condition of the organs of the chest, called congestion, may be followed by cough, inflammation of the lungs, asthma, and a structural disease of the heart.
375. To avoid these sensations and results, when we feel necessitated to walk or run a considerable distance in a short time, commence the movements in a moderate manner increasing the speed as the respiratory movements become more frequent and their expansion more extensive, so that a sufficient amount of air may be received into the lungs to purify the increased quantity of blood forced into them. The same principles should be observed when commencing labor, and in driving horses and other animals.
Observation. When a large number of muscles are called into action after repose, as when we rise from a recumbent or 175 sitting posture, the blood is impelled to the heart with a very strong impetus. If that organ should be diseased, it may arrive there in larger quantities than can be disposed of, and death may be the result. Hence the necessity of avoiding all sudden and violent movements, on the part of those who have either a functional or structural disease of the heart.
Mention the illustration. 374. What is the effect when a number of muscles are called into energetic action? What effect has this accumulation of blood in the lungs? 375. How can such disagreeable sensations be avoided? Mention a practical observation.
376. The mind exercises no inconsiderable influence upon the circulatory organs. When an individual is stimulated by hope, or excited by anger, the heart beats more forcibly, and the arteries act more energetically, than when a person is influenced by fear, despair, or sorrow. Consequently, the system is more fully nourished, and capable of greater exertion, when the former condition obtains, than when the latter exists.
377. The quality and quantity of the blood modify the action of the heart and blood-vessels. If this fluid is abundant and pure, the circulatory vessels act with more energy than when it is deficient in quantity or defective in quality.
Illustrations. 1st. In an athletic man, whose heart beats forcibly, and whose pulse is strong, if a considerable quantity of blood is drawn from a vein, as in bleeding, the heart will beat feebly, and the pulse will become weak.
2d. When the blood is made impure by inhaling vitiated air, the action of the heart and arteries is diminished, which produces an effect similar to that which takes place when blood is drawn from a vein.
378. Hemorrhage from divided arteries should be immediately arrested. When large blood-vessels are wounded or cut, the flow of blood must be immediately stopped, or the person soon faints, and the heart ceases its action. If it is a 176 large artery that is wounded, the blood will be thrown out in jets, or jerks, every time the pulse beats. The flow of blood can be stopped until a surgeon arrives, either by compressing the vessel between the wound and the heart, or by compressing the end of the divided artery in the wound.
376. State some of the effects that the mind has on circulation. 377. What effect have the quantity and quality of blood upon the circulatory organs? Give illustration 1st. Illustration 2d. 378. What is necessary when large blood-vessels are wounded or cut?
Fig. 76.
Fig. 77.
Fig. 76. The track of the large artery of the arm. 1, The collar-bone. 9, The axillary artery. 10, The brachial artery.
Fig. 77. B, The manner of compressing the artery near the collar-bone. A, The manner of compressing the large artery of the arm, with the fingers. C, The manner of compressing the divided extremity of an artery in the wound, with a finger.
379. After making compression with the fingers, as described and illustrated, take a piece of cloth or handkerchief, twist it cornerwise, and tie a hard knot midway between the 177 two ends. This knot should be placed over the artery, between the wound and the heart, and the ends carried around the limb and loosely tied. A stick, five or six inches long, should be placed under the handkerchief, which should be twisted until the knot has made sufficient compression on the artery to allow the removal of the fingers without a return of bleeding. Continue the compression until a surgeon can be called.
What is shown by fig. 76? By fig. 77? 379. What is to be done after compressing the wound, as before described?
Fig. 78.
Fig. 79.
Fig. 78. A, B, The track of the large artery of the arm. The figure exhibits the method of applying the knotted handkerchief to make compression on this artery.
Fig. 79. A, C, The track of the large artery of the thigh. B, The method of applying the knotted handkerchief to compress this artery. In practice, the twisting stick B should be placed opposite the knot over the artery A, C.
380. When an artery of the arm is cut, elevating the wounded limb above the head will tend to arrest the flow of blood. In a wound of a lower limb, raise the foot, so that it shall be higher than the hip, until the bleeding ceases.
Illustration. On one occasion, the distinguished Dr. Nathan Smith was called to a person who had divided one of 178 the large arteries below the knee. After trying in vain to find the bleeding vessel, so as to secure it, he caused the foot to be elevated higher than the hip. At the first instant the blood was forced from the wound about twelve inches; in a minute, it was diminished to three or four; and, in a short time, the bleeding ceased. This Dr. S. called his “great” operation; and it was truly great in simplicity and science.
What is shown by fig. 78 and 79? 380. What suggestion relative to the position of a limb when bleeding? Relate a simple operation by Dr. Nathan Smith.
381. The practical utility of every person knowing the proper means of arresting hemorrhage from severed arteries, is illustrated by the following incidents. In 1848, in the town of N., Mass., a mechanic divided the femoral artery; although several adult persons were present, he died in a few minutes from loss of blood, because those persons were ignorant of the method of compressing severed arteries until a surgeon could be obtained.
382. In 1846, a similar accident occurred in the suburbs of Philadelphia. While the blood was flowing copiously, a lad, who had received instruction on the treatment of such accidents at the Philadelphia High School, rushed through the crowd that surrounded the apparently dying man, placed his finger upon the divided vessel, and continued the compression until the bleeding artery was secured by a surgeon.
383. In “flesh wounds,” when no large blood-vessel is divided, wash the part with cold water, and, when bleeding has ceased, draw the incision together, and retain it with narrow strips of adhesive plaster. These should be put on smoothly, and a sufficient number applied to cover the wound. In most instances of domestic practice, the strips of adhesive plaster are too wide. They should not exceed in width one 179 fourth of an inch. Then apply a loose bandage, and avoid all “healing salves,” ointments, and washes. In removing the dressing from a wound, both ends of the strips of plaster should be raised and drawn toward the incision. The liability of the wound re-opening is thus diminished.
381. Relate the first incident showing the utility of every person knowing the proper method of arresting the flow of blood from divided arteries. 382. The second incident. 383. How should “flesh wounds” be dressed?
Observation. The union of the divided parts is effected by the action of the divided blood-vessels, and not by salves and ointments. The only object of the dressing is to keep the parts together, and protect the wound from air and impurities. Nature, in all cases of injuries, performs her own cure. Such simple wounds do not generally require a second dressing and should not be opened until the incisions are healed.
Fig. 80.
Fig. 80. The manner in which strips of adhesive plaster are applied to wounds.
384. In wounds made by pointed instruments, as a nail, or in lacerated wounds, as those made by forcing a blunt instrument, as a hook, into the soft parts, there will be no direct and immediate union. In these cases, apply a soothing poultice, as one made of linseed meal, and also keep the limb still. It is judicious to consult a physician immediately, in punctured or lacerated wounds, because they often induce the most dangerous diseases.
385. Wounds caused by the bite of rabid animals or venomous serpents, should be immediately cleansed with pure 180 water. In many instances, the application of suction, either with “cupping glasses,” or the mouth, will prevent the introduction of the poisonous matter into the system by absorption. When this is effected, cover the wound with a soothing poultice, as one made of slippery elm bark.
What should be avoided? How should the strips of plaster be removed from a wound? How is the union of the divided parts effected? 384. How should punctured and lacerated wounds be dressed? 385. What is the treatment of wounds caused by the bite of rabid animals?
Observation. Although animal poisons, when introduced into the circulating fluid through the broken surface of the skin, frequently cause death, yet they can be taken into the mouth and stomach with impunity, if the mucous membrane which lines these parts is not broken.
Fig. 81.
Fig. 81. a, a, Representation of wounds on the back part of the arm and fore-arm b, b, Wounds on the anterior part of the arm and fore-arm. By bending the elbow and wrist, the incisions at a, a, are opened, while those at b, b, are closed. Were the arm extended at the elbow and wrist, the wounds at a, a, would be closed, and those at b, b, would be opened.
386. The proper position of the limbs favors the union of wounds. If the incision be upon the anterior part of the leg, between the knee and ankle, extending the knee and bending the ankle will aid its closing. If it be upon the back part of the leg, by extending the foot and bending the knee, the gaping of the incision will be diminished. When wounds occur upon the trunk or upper extremities, let the position of the person be regarded.
386 Does the proper position of the limbs favor the union of wounds?