Treatment.—At the very outset it may be possible to stop the progress of the felon by keeping the finger constantly wet by means of a bandage continually saturated with equal parts of alcohol and water, at night keeping it moist by covering with a piece of oil silk or rubber. Tincture of iodine painted all over the end of the finger is also useful, and the hand should be carried in a sling by day, and slung above the head to the headboard of the bed by night. If after twenty-four hours the pain increases, it is best to apply hot poultices to the finger, changing them as often as they cool. If the felon has not begun to abate by the end of forty-eight hours, the end of the finger must be cut lengthwise right down to the bone by a surgeon to prevent death of the bone or extension of the inflammation. Poultices are then continued.
"Run-around" is treated also by iodine, cold applications, and, if inflammation continues, by hot poulticing and incision with a knife; but poulticing is often sufficient. Attention to the general health by a physician will frequently be of service.
WEEPING SINEW; GANGLION.—This is a swelling as large as a large bean projecting from the back or front of the wrist with an elastic or hard feeling, and not painful or tender unless pressed on very hard. After certain movements of the hand, as in playing the piano or, for example, in playing tennis, some discomfort may be felt. Weeping sinew sometimes interferes with some of the finer movements of the hand. The swelling is not red or inflamed, but of the natural color of the skin. It does not continue to increase after reaching a moderate size, but usually persists indefinitely, although occasionally disappearing without treatment. The swelling contains a gelatinous substance which is held in a little sac in the sheath of the tendon or sinew, but the inside of the sac does not communicate with the interior of the sheath surrounding the tendon.
Treatment.—This consists in suddenly exerting great pressure on the swelling with the thumb, or in striking it a sharp blow with a book by which the sac is broken. Its contents escape under the skin, and in most cases become absorbed. If the swelling returns a very slight surgical operation will permanently cure the trouble.
CINDERS AND OTHER FOREIGN BODIES IN THE EYE.[4]—Foreign bodies are most frequently lodged on the under surface of the upper lid, although the surface of the eyeball and the inner aspect of the lower lid should also be carefully inspected. A drop of a two per cent solution of cocaine will render painless the manipulations. The patient should be directed to continue looking downward, and the lashes and edge of the lid are grasped by the forefinger and thumb of the right hand, while a very small pencil is gently pressed against the upper part of the lid, and the lower part is lifted outward and upward against the pencil so that it is turned inside out. The lid may be kept in this position by a little pressure on the lashes, while the cinder, or whatever foreign body it may be, is removed by gently sweeping it off the mucous membrane with a fold of a soft, clean handkerchief. (See Figs. [6] and [7].)
| Fig. 6. | Fig. 7. |
REMOVING A FOREIGN BODY FROM THE EYE.
In Fig. 6 note how lashes and edge of lid are grasped by forefinger and thumb, also pencil placed against lid; in Fig. 7 lid is shown turned inside out over pencil.
Hot cinders and pieces of metal may become so deeply lodged in the surface of the eye that they cannot be removed by the method recommended, or by using a narrow slip of clean white blotting-paper. All such cases should be very speedily referred to a physician, and the use of needles or other instruments should not be attempted by a layman, lest permanent damage be done to the cornea and opacity result. Such procedures are, of course, appropriate for an oculist, but when it is impossible to secure medical aid for days it can be attempted without much fear, if done carefully, as more harm will result if the offending body is left in place. It is surprising to see what a hole in the surface of the eye will fill up in a few days. If the foreign body has caused a good deal of irritation before its removal, it is best to drop into the eye a solution of boric acid (ten grains to the ounce of water) four times daily.
FOREIGN BODIES IN THE EAR.—Foreign bodies, as buttons, pebbles, beans, cherry stones, coffee, etc., are frequently placed in the ear by children, and insects sometimes find their way into the ear passage and create tremendous distress by their struggles. Smooth, nonirritating bodies, as buttons, pebbles, etc., do no particular harm for a long time, and may remain unnoticed for years. But the most serious damage not infrequently results from unskillful attempts at their removal by persons (even physicians unused to instrumental work on the ear) who are driven to immediate and violent action on the false supposition that instant interference is called for. Insects, it is true, should be killed without delay by dropping into the ear sweet oil, castor, linseed, or machine oil or glycerin, or even water, if the others are not at hand, and then the insect should be removed in half an hour by syringing as recommended for wax (Vol. II, p. 35).