Femina, A Work for Every Woman

by John A. Miller

These injuries have been classified into three divisions: First degree, superficial skin irritation. Second degree, cutaneous inflammation. Third degree, devitalization of the skin or deeper parts, or carbonization of a member, or the entire body. The first degree is only a superficial redness, fading without any definite edge into the natural skin. This may be produced by the sudden and momentary application of flame over a larger portion of the body, from an explosion of gas. The local injury is not dangerous, and the epidermis remains to protect the surface of the true skin until a new layer is produced, as the injured one peels off. This hardly calls for any other treatment but one or several applications of sweet oil. In the second degree, the local injury has penetrated a little deeper, and the sudden congestion of blood to the surface, raises the epidermis from the cutis in blisters filled with the serum of its vessels. Here there is a more serious condition, and indeed dangerous in proportion to the extent of surface that has become involved. Skirts draped largely with lace, and those made of cheese cloth, swiss, and other gauzy material are of a very inflammable nature, and when once ignited blaze into a flame that is almost sure to consume the material before it can be extinguished, so that it has been deemed advisable on the German stage, to first saturate these materials in a solution of sulphate of ammonia to make them non-inflammable; this does not interfere with ironing, nor with the texture or color of the fabric. Another source of scalds and burns is the wash boiler or tub on the floor, with hot or boiling water in it, so that little children stumble or reach into it. Vessels filled with hot water or other fluids standing on tables or on stoves within reach of little children, who innocently pull the vessel down, pouring its scalding contents over them, is another cause of numerous accidents.

The best course to pursue when skirts or clothing are on fire is to roll the victim, so as to smother the flames; but the patient herself has rarely enough presence of mind to do this. She will run for help, thus fanning the flames, the very worst thing she can do. Take the nearest blanket or quilt, or if that is not at hand, take an overcoat or wrap; wrap this around the burning person and throw her to the floor and roll her until the flames are smothered. Then get some cold water and pour it on the smoldering clothes until they are thoroughly saturated, for the hot charred clothing burns into the flesh. In scalding from hot water or steam the clothing should be cooled off in the same manner. Cold water must be poured over the hot and steaming clothes from head to foot, and thus the further action of the heat is suddenly checked. The patient should now be carefully removed to a warm room and laid in a blanket, on the table or floor. If he complains of thirst give a cupful of warm tea or a warm whisky toddy.

Visitors and strangers should now be requested to leave the room and the clothing should be removed from the body with the greatest care. The scissors or a sharp knife should be used to cut away the garments, so as to avoid all possible straining and dragging on the patient. The blisters must not be torn, and where they are very tense they can be pricked with a sharp needle, so as to allow the escape of the serum. The epidermis forms the best protection for the cutis, and where the skin is stuck to the linen do not tear this off, but allow it to remain and cut with a sharp scissors around it. The application of cold water generally increases the suffering, but sweet oil, lard oil, vaseline, castor and china nut oil will answer for the emergency or until a more suitable dressing can be obtained, after which the surface should be covered with cotton batting to exclude the air. A very useful application is a mixture of equal parts of lime water and sweet oil or linseed oil. Carbolized sweet oil is another useful dressing and superior to lime water liniment; it is made in proportion of half an ounce of carbolic acid to one pint of sweet oil; either of the above preparations can be poured over the burned surface and then it should be covered with cotton batting, or small pieces of soft linen cloth can be dipped and saturated in the oil and then applied over the burns. The advice of a physician should be sought in view of the dangerous complications that may occur from extensive burns.

(d) Frostbite is the result of exposure to cold, and in certain regions during the winter months a considerable number are liable to this accident. But extreme cold weather is not alone responsible for frostbite; very often this accident occurs in moderately cold weather, for instance, if persons exhausted from hunger or fatigued from long travels or stupefied by alcoholic drink lay themselves down and fall asleep, and a cold wind blows over them which withdraws the bodily heat, the same effects are accomplished on the system.

The first effect of dry, cold air is a sense of numbness and weight, with a peculiar prickling or tingling, and a rush of blood to the surface, giving the skin a lively reddish appearance. If the cold is maintained for any length of time the blood leaves the surface, which becomes now of a pale and whitish aspect, forming a striking contrast to the previous redness. When the cold is suddenly applied and very intense, the skin exhibits a mottled appearance, which is due to the presence of congealed blood in the subcutaneous veins.

Moist cold has a similar effect on the living tissues to dry cold. If the hand is immersed in iced water the blood rushes immediately to the surface, so that the color of the skin increases, which is followed by a marked degree of numbness, and an unpleasant burning and tingling sensation. A reaction comes on in a short time, the blood quits the surface, and the skin becomes bleached and contracts, the tissues underneath also shrink and become painful. There is no difference in the effect of either moist or dry cold, only that the former is more penetrating and its effects are sooner apparent. Those parts of the body that are more directly exposed and in which the circulation is not much protected by fatty tissue, suffer the most from the effects of cold; after exposure for an unusual length of time the toes, feet, heels, fingers, hands, nose, and ears, together with the lips and cheeks are for this reason oftener affected than other parts of the body. Persons whose constitutions are broken down by intemperance, starvation and other privations which lower the power of resistance are more susceptible to this accident.

The first effect of cold in the general system is bracing and stimulating; an agreeable glow is felt over the surface of the body and one feels strengthened and exhilarated. But if the cold temperature is unusually prolonged this agreeable sensation is changed into one of pain and drowsiness; the brain becomes inactive as if under the influence of a powerful opiate or narcotic, and the desire to go to sleep is so strong that it requires the greatest effort to keep awake. To yield to this inclination to sleep would result in slumber that knows no waking, for the blood would now rapidly accumulate in the internal organs, the breathing would become irregular and spasmodic, the nervous functions would soon be suspended and death would ensue from general paralysis. An individual thus exposed, so as to have become drowsy or unconscious and then suddenly brought into a hot room is likely to die from congestion of the brain and lungs, or if he should revive for a short time, the frost-bitten parts will be stricken with mortification. Professor Samuel D. Gross says: “The treatment of frostbite requires no little judgment and adroitness to conduct it to a successful issue. The great indication is to recall the affected parts gradually to their natural condition by restoring circulation and sensibility, in the most gentle and cautious manner, not suddenly, or by severe measures. The first thing to be done is to immerse them in iced water, or rub them with snow, the friction being made as carefully and lightly as possible, lest overaction be produced, as they are necessarily greatly weakened. If no ice or snow is at hand, the coldest well water that can be procured must be used; and if immersion is inconvenient, wet cloths are applied, with the precaution of maintaining the supply of cold and moisture by constant irrigation. Moderate reaction is aimed at and fostered. All warm applications, whether dry or moist, are scrupulously refrained from; the patient must not approach the fire, nor immerse his limbs in hot water, or even be in a warm room. Attention to these precepts must on no account be disregarded, as its neglect would be almost certainly followed by mortification or other disastrous consequences.”

(e) Drowning or the submersion of an individual until life is destroyed by suffocation is not an uncommon accident. “The immediate cause of death in drowning,” says Dr. Gross, “is suffocation or insufficiency of air. Respiration being thus arrested, the blood is unaerated and consequently unfitted for life, although the circulation may go on for a short time after breathing has completely ceased.”

The Navarino sponge divers whose occupation has accustomed them to live under water the extreme limit, average only seventy-six seconds, while the Ceylon pearl divers seldom remain under water with impunity more than two-thirds of that time.

Dr. Gross says: “The period at which a person after submersion may be resuscitated varies very much in different cases and under different circumstances. In some cases, for reasons not always explicable, recovery is found to be impossible at the end of one minute. The chances are never good after submersion of twice this length of time, especially when the water and the air are both uncommonly cold.