Backwoods Surgery & Medicine

by Charles Stuart Moody

Two hours after the last tablet of calomel has been given, give a tablet of elaterin. When the latter has "worked," start in with the dosimetric trinity tablets and push them until the skin becomes moist and the fever falls below 100° F. Do not give any of the coal tar products in pneumonia, that is, do not give phenacetine or acetanilide. When the patient is recovering it is well to keep up the heart by strychnia or digitalin.

There is such a thing as giving too much of these heart stimulants though, and you should watch the pulse closely. Stimulating the heart too greatly is liable to cause congestion of the small blood vessels in the lungs and defeat the very purpose you set out to accomplish.

Taking "cold" is a very popular camp method of feeling bad. The man who does not at least once, while in camp, stuff himself full of a good old-fashioned "cold" feels that he has been cheated out of a part of the enjoyment of his outing. For the benefit of those of his companions who do not appreciate his "barking" in season and out, the following rules are suggested: First, take a bath; it may be painful but necessary. Second, assist overworked eliminants to remove the debris that has accumulated by reason of the failure of the ordinary processes of waste removal.

This can be done very nicely with a heroic dose of calomel; by heroic about three grains is meant. Follow up the calomel with several five-grain doses of phenacetine, or until the patient is in a profuse perspiration, roll him in warm blankets, and await developments. A careful observance of the foregoing will annihilate any able-bodied "cold" on earth.

The man who contracts rheumatism in camp has my sincere sympathy. It requires no special skill to tell when one has it, but it does require special powers of divination to tell when he will get rid of it. Medical science has discovered only one drug that will affect the progress of the disease in the least, and that only after an extended course. Salicylic acid in one or another of its various combinations furnishes the sheet anchor in the treatment of rheumatism. I purposely omitted it from our pocket case of drugs because of the fact that the combination that would suit one man's stomach would not another.

In practice we have to take many things into consideration in the administration of the salicylates. The man with rheumatism in camp can seek only to relieve the pain and assist Nature to eliminate the waste. A thorough flushing of the bowels should be the first thing, followed by aconitine, gr. 1/134, one tablet every hour for four hours; then one every three hours. At the same time keep dry. If it be a limb that is affected wrap it in blankets and "cook" it in front of the fire.

Cases of poisoning arising in camp will usually be confined to two causes—the eating of poisoned foods and eating poisonous mushrooms. In these days of tinned meats and vegetables it is not unusual to hear of persons becoming seriously and even fatally poisoned by eating certain canned goods. Canned fish and beef are the worst offenders in this regard.

The symptoms of ptomaine poisoning are characteristic and generally easily traced to the material producing them. There is a dryness and metallic taste in the mouth shortly after eating suspected food. This is followed by severe cramps, vomiting, violent purging, rapid loss of strength, great depression and coldness of the surface of the body. The hands and face break out in clammy sweat and the temperature falls below normal. The picture is very characteristic and when once seen is readily recognized.

The treatment consists in getting rid of the offending substance as quickly as possible. Nothing accomplishes this more readily than a quick emetic. Apomorphia hydrochlorate furnishes us with the most convenient emetic, though mustard water or hot salt water will do. Take a tablet of 1/10 gr. apomorphia hypodermically, or two tablets of the same size by the mouth, followed by a swallow of hot water. Hypodermically the emetic acts in a very short time; by the mouth it requires somewhat longer, say ten minutes. Purge the bowels with elaterin, one tablet, then keep up the vital forces by administering strychnia, 1/60 gr. every hour or two, watching the circulation meanwhile.

In severe cases, in addition to the strychnia, it may become necessary to resort to external heat, hot water bottles, hot stones, etc. The patient is much debilitated for several days and requires careful diet.