Care of Sunstroke.—A sunstroke is a very serious condition, and when it occurs, requires immediate efforts to save the life of the one suffering from it. It generally comes on suddenly, the patient first complaining of the head; he soon becomes unconscious, the skin hot and dry, and the pulse full and bounding. The treatment consists of taking the patient to a cool, shaded place, removing all unnecessary clothing, applying ice or cold water to the head, and bathing or sponging the body in cold water. If the patient recovers, the temperature will fall under this treatment. If the heart begins to fail, or the pulse becomes weak or fluttering, small doses of whiskey and water may be given and repeated.
Patients should not be taken out in the fields nor exposed places on very hot days, except as ordered by the physicians; they should wear light clothing and a straw hat; if permitted to go out, they should not overwork, and should be allowed frequently to rest in the shade. Patients are easily injured by working in the sun; headache caused, recovery retarded, and bad symptoms brought back, without having the alarming conditions of sunstroke.
Unconsciousness from Poisoning.—Opium and its preparations, including morphine, chloral, and the two extracts of hyoscyamus, now so much employed in asylums, namely, hyoscine and hyoscyamine, are medicines frequently given, that poison in over-doses and produce coma.
These medicines and their effects will be described in the next chapter, and at the same time the symptoms of poisoning by them, and the treatment.
Poisoning.—Poisonous drugs are not kept upon the wards. Attendants frequently have strong ammonia in their rooms to clean their clothing, and a patient may get it and drink it. It is a strong alkali, and burns the throat and mouth. Vinegar is the best ready antidote, but should be given immediately or not at all. Soft soap is a strong alkali, and if eaten becomes an irritating poison. Again vinegar is the best antidote.
The best antidotes for acids are soda, lime-water, soap-suds, and chalk; for alkalies, weak acids, such as lemons, oranges, vinegar, or cider. Olive oil, eggs, and mucilaginous drinks are the most bland and soothing remedies to give. To vomit a person who has taken poison, give a pint or a quart of lukewarm water; to it may be added one or two teaspoonfuls of mustard. Syrup of ipecac is a common remedy, the dose is a teaspoonful, and repeated in ten minutes if necessary. It assists vomiting to tickle the throat with a finger or a feather. If after poisoning there is depression or approaching coma, very strong tea or coffee is the best stimulant, and it is as well an antidote to many poisons. If the heart and pulse are very weak, whiskey diluted with water may be given and repeated.
Injury from Eating Glass.—Patients sometimes eat glass. This injures by the edges cutting and inflaming the walls of the stomach and intestines. This may be so severe as to cause death. In the treatment do not give an emetic or a cathartic. Such food as has a tendency to constipate the bowels, and such as will also enclose the glass and coat its sharp edges, is to be given. Potatoes, especially sweet, oatmeal, or thick indian-meal pudding, are appropriate. Cotton, which is generally at hand, will, if swallowed, engage the glass in its fibres, and so protect from injury.
Injury with Needles.—This is a self-injury, but it may be severe and require immediate attention. Patients may open a vein or an artery with a needle, or plunge it into the eye. But the more common way is for a patient to stick many needles under the skin, sometimes to the number of several hundred. Sometimes patients introduce them near the heart or lungs, and as a needle will often “travel” when in the flesh, it may work its way into a deeper part, and so a number get into the lungs or the heart, causing death. Within a few weeks I saw two needles taken from a man’s heart, who died in consequence of their presence there. An attempt or desire to so injure one’s self should be guarded against by the attendants, and if accomplished should be at once reported to the physician, that efforts may be made to extract the needle.