2617. BRUISES, LACERATIONS, AND CUTS.—Wherever the bruise may be, or however swollen or discoloured the skin may become, two or three applications of the extract of lead, kept to the part by means of lint, will, in an hour or little more, remove all pain, swelling, and tenderness. Simple or clean cuts only require the edges of the wound to be placed in their exact situation, drawn close together, and secured there by one or two slips of adhesive plaster. When the wound, however, is jagged, or the flesh or cuticle lacerated, the parts are to be laid as smooth and regular as possible, and a piece of lint, wetted in the extract of lead, laid upon the wound, and a piece of greased lint placed above it to prevent the dressing sticking; the whole covered over to protect from injury, and the part dressed in the same manner once a day till the cure is effected.
2618. BRUISES AND THEIR TREATMENT.—The best application for a bruise, be it large or small, is moist warmth; therefore, a warm bread-and-water poultice in hot moist flannels should be put on, as they supple the skin. If the bruise be very severe, and in the neighbourhood of a joint, it will be well to apply ten or a dozen leeches over the whole bruised part, and afterwards a poultice. But leeches should not be put on young children. If the bruised part be the knee or the ankle, walking should not be attempted till it can be performed without pain. Inattention to this point often lays the foundation for serious mischief in these joints, especially in the case of scrofulous persons. In all conditions of bruises occurring in children, whether swellings or abrasions, no remedy is so quick or certain of effecting a cure as the pure extract of lead applied to the part.
Burns and Scalds.
2619. BURNS AND SCALDS being essentially the same in all particulars, and differing only in the manner of their production, may be spoken of together. As a general rule, scalds are less severe than burns, because the heat of water, by which scalds are mostly produced, is not, even when it is boiling, so intense as that of flame; oil, however, and other liquids, whose boiling-point is high, produce scalds of a very severe nature. Burns and scalds have been divided into three classes. The first class comprises those where the burn is altogether superficial, and merely reddens the skin; the second, where the injury is greater, and we get little bladders containing a fluid (called serum) dotted over the affected part; in the third class we get, in the case of burns, a charring, and in that of scalds, a softening or pulpiness, perhaps a complete and immediate separation of the part. This may occur at once, or in the course of a little time. The pain from the second kind of burns is much more severe than that in the other two, although the danger, as a general rule, is less than it is in the third class. These injuries are much more dangerous when they take place on the trunk than when they happen on the arms or legs. The danger arises more from the extent of surface that is burnt than from the depth to which the burn goes. This rule, of course, has certain exceptions; because a small burn on the chest or belly penetrating deeply is more dangerous than a more extensive but superficial one on the arm or leg. When a person's clothes are in flames, the best way of extinguishing them is to wind a rug, or some thick material, tightly round the whole of the body.
2620. Treatment of the First Class of Burns and Scalds.—Of the part affected.—Cover it immediately with a good coating of common flour, or cotton-wool with flour dredged well into it. The great thing is to keep the affected surface of the skin from the contact of the air. The part will shortly get well, and the skin may or may not peel off.—Constitutional Treatment. If the burn or scald is not extensive, and there is no prostration of strength, this is very simple, and consists in simply giving a little aperient medicine—pills (No. 2), as follows:—Mix 5 grains of blue pill and the same quantity of compound extract of colocynth, and make into two pills—the dose for a full-grown person. Three hours after the pills give a black draught. If there are general symptoms of fever, such as hot skin, thirst, headache, &c. &c., two tablespoonfuls of fever-mixture are to be given every four hours. The fever-mixture, we remind our readers, is made thus:-Mix a drachm of powdered nitro, 2 drachms of carbonate of potash, 2 teaspoonfuls of antimonial wine, and a tablespoonful of sweet spirits of nitro, in half a pint of water.
2621. Second Class. Local Treatment.—As the symptoms of these kinds of burns are more severe than those of the first class, so the remedies appropriate to them are more powerful. Having, as carefully as possible, removed the clothes from the burnt surface, and taking care not to break the bladders, spread the following liniment (No. 1) on a piece of linen or lint—not the fluffy side—and apply it to the part: the liniment should be equal parts of lime-water and linseed-oil, well mixed. If the burn is on the trunk of the body, it is better to use a warm linseed-meal poultice. After a few days dress the wound with Turner's cerate. If the burn is at the bend of the elbow, place the arm in the straight position; for if it is bent, the skin, when healed, will be contracted, and the arm, in all probability, always remain in the same un natural position. This, indeed, applies to all parts of the body; therefore, always place the part affected in the most stretched position possible.—Constitutional Treatment. The same kind of treatment is to be used as for the first class, only it must be more powerful. Stimulants are move often necessary, but must be given with great caution. If, as is often the case, there is great irritability and restlessness, a dose of opium (paregoric, in doses of from sixty to a hundred drops, according to age, is best) is of great service. The feverish symptoms will require aperient medicines and the fever mixture. A drink made of about a tablespoonful of cream of tartar and a little lemon-juice, in a quart of warm water, allowed to cool, is a very nice one in these cases. The diet throughout should not be too low, especially if there is much discharge from the wound. After a few days it is often necessary to give wine, ammonia, and strong beef-tea. These should be had recourse to when the tongue gets dry and dark, and the pulse weak and frequent. If there should be, after the lapse of a week or two, pain over one particular part of the belly, a blister should be put on it, and a powder of mercury and chalk-grey powder, and Dover's powder (two grains of the former and five of the latter) given three times a day. Affections of the head and chest also frequently occur as a consequence of these kinds of burns, but no one who is not a medical man can treat them.
2622. Third Class.—These are so severe as to make it impossible for a non-professional person to be of much service in attending to them. When they occur, a surgeon should always be sent for. Until he arrives, however, the following treatment should be adopted:—Place the patient full-length on his back, and keep him warm. Apply fomentations of flannels wrung out of boiling water and sprinkled with spirits of turpentine to the part, and give wine and sal-volatile in such quantities as the prostration of strength requires; always bearing in mind the great fact that you have to steer between two quicksands—death from present prostration and death from future excitement, which will always be increased in proportion to the amount of stimulants given. Give, therefore, only just as much as is absolutely necessary to keep life in the body.
2623. CONCUSSION OF BRAIN—STUNNING.—This may be caused by a blow or a fall.—Symptoms. Cold skin; weak pulse; almost total insensibility; slow, weak breathing; pupil of eye sometimes bigger, sometimes smaller, than natural; inability to move; unwillingness to answer when spoken to. These symptoms come on directly after the accident.—Treatment. Place the patient quietly on a warm bed, send for a surgeon, and do nothing else for the first four or six hours. After this time the skin will become hot, the pulse full, and the patient feverish altogether. If the surgeon has not arrived by the time these symptoms have set in, shave the patient's head, and apply the following lotion (No. 2): Mix half an ounce of sal-ammoniac, two tablespoonfuls of vinegar, and the same quantity of gin or whisky, in half a pint of water. Then give this pill (No. 1); Mix five grains of calomel and the same quantity of antimonial powder with a little bread-crumb, and make into two pills. Give a black draught three hours after the pill, and two tablespoonfuls of the above-mentioned fever-mixture every four hours. Keep on low diet. Leeches are sometimes to be applied to the head. These cases are often followed by violent inflammation of the brain. They can, therefore, only be attended to properly throughout by a surgeon. The great thing for people to do in these cases is—nothing; contenting themselves with putting the patient to bed, and waiting the arrival of a surgeon.
2624. THE CHOLERA AND AUTUMNAL COMPLAINTS.—To oppose cholera, there seems no surer or better means than cleanliness, sobriety, and judicious ventilation. Where there is dirt, that is the place for cholera; where windows and doors are kept most jealously shut, there cholera will find easiest entrance; and people who indulge in intemperate diet during the hot days of autumn are actually courting death. To repeat it, cleanliness, sobriety, and free ventilation almost always defy the pestilence; but, in case of attack, immediate recourse should be had to a physician. The faculty say that a large number of lives have been lost, in many seasons, solely from delay in seeking medical assistance. They even assert that, taken early, the cholera is by no means a fatal disorder. The copious use of salt is recommended on very excellent authority. Other autumnal complaints there are, of which diarrhoea is the worst example. They come on with pain, flatulence, sickness, with or without vomiting, followed by loss of appetite, general lassitude, and weakness. If attended to at the first appearance, they may soon be conquered; for which purpose it is necessary to assist nature in throwing off the contents of the bowels, which may be one by means of the following prescription:—Take of calomel 3 grains, rhubarb 8 grains; mix and take it in a little honey or jelly, and repeat the dose three times, at the intervals of four or five hours. The next purpose to be answered is the defence of the lining membrane of the intestines from their acrid contents, which will be best effected by drinking copiously of linseed tea, or of a drink made by pouring boiling water on quince-seeds, which are of a very mucilaginous nature; or, what is still better, full draughts of whey. If the complaint continue after these means have been employed, some astringent or binding medicine will be required, as the subjoined:—Take of prepared chalk 2 drachms, cinnamon-water 7 oz., syrup of poppies 1 oz.; mix, and take 3 tablespoonfuls every four hours. Should this fail to complete the cure, 1/2 oz. of tincture of catechu, or of kino, may be added to it, and then it will seldom fail; or a teaspoonful of the tincture of kino alone, with a little water, every three hours, till the diarrhoea is checked. While any symptoms of derangement are present, particular attention must be paid to the diet, which should be of a soothing, lubricating, and light nature, as instanced in veal or chicken broth, which should contain but little salt. Rice, batter, and bread puddings will be generally relished, and be eaten with advantage; but the stomach is too much impaired to digest food of a more solid nature. Indeed, we should give that organ, together with the bowels, as little trouble as possible, while they are so incapable of acting in their accustomed manner. Much mischief is frequently produced by the absurd practice of taking tincture of rhubarb, which is almost certain of aggravating that species of disorder of which we have now treated; for it is a spirit as strong as brandy, and cannot fail of producing harm upon a surface which is rendered tender by the formation and contact of vitiated bile. But our last advice is, upon the first appearance of such symptoms as are above detailed, have immediate recourse to a doctor, where possible.
2625. TO CURE A COLD.—Put a large teacupful of linseed, with 1/4 lb. of sun raisins and 2 oz. of stick liquorice, into 2 quarts of soft water, and let it simmer over a slow fire till reduced to one quart; add to it 1/4 lb. of pounded sugar-candy, a tablespoonful of old rum, and a tablespoonful of the best white-wine vinegar, or lemon-juice. The rum and vinegar should be added as the decoction is taken; for, if they are put in at first, the whole soon becomes flat and less efficacious. The dose is half a pint, made warm, on going to bed; and a little may be taken whenever the cough is troublesome. The worst cold is generally cured by this remedy in two or three days; and, if taken in time, is considered infallible.