Treatment.—The main thing is to lower the temperature. To do this, strip off the clothing, apply chopped ice wrapped in flannel to the head; rub ice over the chest, and place pieces under the armpits and at the side. If no ice can be had use sheets or cloths wet with cold water, or the body can be stripped and sprinkled with cold water from a common watering pot.
Cuts and Wounds.—In these the chief points to be attended to are: 1, arrest the bleeding; 2, remove from the wound all foreign bodies as soon as possible; 3, bring the wounded parts opposite to each other and keep them so; this is best done by means of strips of adhesive plaster, first applied to one side of the wound and then secured to the other; these strips should not be too broad, and space must be left between the strips to allow any matter to escape. Wounds too extensive to be held together by plaster must be stitched by a surgeon, who should always be sent for in all severe cases.
For washing a wound, to every pint of water add 21⁄2 teaspoonfuls of carbolic acid and 2 tablespoonfuls of glycerine—if these are not obtainable, add 4 tablespoonsful of borax to the pint of water—wash the wound, close it, and apply a compress of a folded square of cotton or linen; wet it in the solution used for washing the wound and bandage down quickly and firmly. If the bleeding is profuse, a sponge dipped in very hot water and wrung out in a cloth should be applied as quickly as possible—if this is not to be had, use ice or cloth wrung out in ice water.
Wounds heal in two ways. 1, rapidly by primary union, without suppuration, and leaving only a very fine scar. 2, slowly by suppuration and the formation of granulations and leaving a large red scar.
Bleeding.—This is of three kinds: 1, from the arteries which lead from the heart; 2, that which comes from the veins, which take the blood back to the heart; 3, that from the small veins which carry the blood to the surface of the body. In the first, the blood is bright scarlet and escapes as though it was being pumped. In the second, the blood is dark red and flows away in an uninterrupted stream. In the third, the blood oozes out. In some wounds all three kinds of bleeding occur at the same time.
The simplest and best remedy to stop the bleeding is to apply direct pressure on the external wound by the fingers. Should the wound be long and gaping, a compress of some soft material large enough to fill the cavity may be pressed into it; but this should always be avoided, if possible, as it prevents the natural closing of the wound.
Pressure with the hands will not suffice to restrain bleeding in severe cases for a great length of time and recourse must be had to a ligature; this can best be made with a pocket handkerchief or other article of apparel, long enough and strong enough to bind the limb. Fold the article neck-tie fashion, then place a smooth stone, or anything serving for a firm pad, on the artery, tie the handkerchief loosely, insert any available stick in the loop and proceed to twist it, as if wringing a towel, until just tight enough to stop the flow. Examine the wound from time to time, lessen the compression if it becomes very cold or purple, or tighten up the handkerchief if it commences bleeding.
Some knowledge of anatomy is necessary to guide the operator where to press. Bleeding from the head and upper neck requires pressure to be placed on the large artery which passes up beside the windpipe and just above the collar bone. The artery supplying the arm and hand runs down the inside of the upper arm, almost in line with the coat seam, and should be pressed as shown in [Fig. 185]. The artery feeding the leg and foot can be felt in the crease of the groin, just where the flesh of the thigh seems to meet the flesh of the abdomen and this is the best place to apply the ligature. In arterial bleeding the pressure must be put between the heart and the wound, while in venous bleeding it must be beyond the wound to stop the flow as it goes towards the heart.
In any case of bleeding, the person may become weak and faint; unless the blood is flowing actively this is not a serious sign, and the quiet condition of the faint often assists nature in staying the bleeding, by allowing the blood to clot and so block up any wound in a blood vessel. Unless the faint is prolonged or the patient is losing much blood, it is better not to hasten to relieve the faint condition; when in this state anything like excitement should be avoided, external warmth should be applied, the person covered with blankets, and bottles of hot water or hot bricks applied to the feet and arm-pits.