Arnica (as prepared for internal use, and Aconite will generally meet the requirements of such cases, and should be administered every three hours, in alternation, for several times; or if the injured part be very painful and swollen, with congestive headache, etc., Belladonna may be alternated with Aconite or with Hep-S. or Silicea when suppuration is established.
CUTS- The treatment of this variety of wounds, if only of moderate size, is generally simple. The edges of the cut should be brought together and maintained so by narrow strips of strapping-plaster; then, if necessary, a bandage applied over the plaster. In two or three days the plaster should be removed without disturbing the union, and replaced by new. If, however, inflammation and pain occur, the application of lint saturated with Calendula lotion, covered with oil-silk, and a bandage over all, is necessary.
242. Foreign Bodies.
TREATMENT- Any foreign body in the flesh glass, a thorn, splinter, broken needle, etc. should be removed as quickly as possible, by forceps, etc. or allowing water to trickle over the wound.
FOREIGN BODIES IN THE EYE- If sand, flies, or hairs are between the lids and the globe, they should be removed immediately by bathing the eye; but if the substance cannot be removed in this manner, the eye should be gently wiped with a soft, moistened handkerchief, or with a feather, or a bent bristle may be used, the two ends being held by the finger and thumb. In one of these ways, with a little perseverance, the offending substances may generally be removed.
If small pieces of flint or iron become fixed in the front part of the eye, they should be most carefully picked out with a needle or the point of a lancet. If the intruder be in the upper eyelid, the lid should be everted.
Mortar or lime is rapidly destructive. If seen immediately, the eye should be washed with a strong solution of sugar, or a few drops of oil instilled. Water must never be applied to these cases. The lids should be everted, and every particle of lime removed. Grains of gunpowder may be removed with plain tepid water.
When the foreign body is removed, a weak Arnica lotion should be applied to the eye by means of lint or soft linen, and covered to prevent evaporation.
FOREIGN BODIES IN THE EAR- Peas, stones, slate-pencil, glass beads, shells, etc., are sometimes found in the ear-passage; or cotton-wool which has been forgotten, or a portion of which only has been removed, is occasionally met with. If permitted to remain, such substances rarely occasion any untoward symptoms, although they may continue a long time till uneasiness in the ear leads to an examination of the tube. Any such body should be removed as gently as possible, either by syringing the ear with warm water, or other simple means. One caution is necessary respecting the use of the syringe, which is that when the foreign body is known to be of a vegetable nature, the moisture may cause it to swell, and so impede its ultimate removal. An insect will instantly retreat if a drop of sweet oil be let drop into the ear. If the foreign body cannot be removed by gentle means, the case should be submitted to a surgeon, so that a careful examination may be made by means of the ear-speculum and the aid of sunlight or a lamp. This examination is necessary for two reasons; for although a foreign body, if present, may generally be seen without such means, still the absence of such body cannot be affirmed without a complete exploration of the tube. Further instances often occur in which surgeons are requested to remove a foreign body when non exists, and a proper examination with the speculum would often prevent any injudicious meddling with instruments. Any soreness or inflammatory symptom that may ensue from the foreign body, or the attempts at extraction, should be met by the application of a week Arnica lotion (six drops of Arnica O to two tablespoonfuls of water).
243. Fracture Broken Bone.
A few words on the immediate management of cases of broken bones seem necessary in this Manual, as a surgeon is not always just at hand, and it is necessary to be prepared to act till surgical attendance can be had.
SYMPTOMS- A fractured bone may generally be detected by having felt or heard it snap; by some deformity, such as bending or shortening; by the fact that if the upper end of the bone is held firmly by the hand, the lower part may be moved independently; also by a grating noise (crepitus), which may be heard if the broken ends are rubbed against each other. Further, there will be pain, loss of power of the broken part, and other symptoms. Fracture is said to be simple when there is no wound of the skin communicating with it; compound when there is such a wound.
CAUSES- Mechanical violence is the most frequent; but muscular contraction is sometimes a cause. Old age, some diseases, excessive drugging with Mercury, and prolonged disuse of a limb, render bones liable to fracture from trifling causes.
A BROKEN LEG should be fastened to the whole one by a handkerchief at the ankle, and above and below the knee, before the patient is removed.
A FRACTURED ARM requires the immediate support of a sling, which may be made by a handkerchief or towel and fastened around the neck.
BROKEN RIBS require a flannel bandage about two hands broad, round the chest, with shoulder-straps to keep it up. A rather tight-fitting bandage lessens the movement of the chest in breathing, and is a great comfort. Flannel is better than linen, as it is more elastic.
The patient must be moved gently, and special care taken to prevent the broken bone from being forced through the flesh and skin. He should be placed on a stretcher or litter, and taken to his home, or to a hospital. A litter may be made of a couple of poles and a horse-cloth or sick; even a door or hurdle may serve the purpose. Placing him on this, and carrying him by two men is much better than removal in a cart or carriage. It is important not to be in a hurry, as an injury is often greatly aggravated by carelessness or too hurried measures. When a surgeon is within a moderate distance, after making the patient as comfortable as possible, it is better to wait a little, so that he may superintend the moving.
When there is a wound and much bleeding, see Section on “Wounds.”
When the patient has been placed on a firm bed or mattress, and the injured part examined, the surgeon will bring the broken ends of the bone into close apposition, and in their natural form, and having done this, maintain them so, and at rest, till firm union has taken place. To maintain the proper shape and length of the limb, bandages, splints, and other apparatus are required. Little can be done, however, beyond a merely temporary arrangement, until the surgeon arrives, as these cases can only be properly treated by a professional man.
244. Exhaustion of the Muscles Fatigue Over-Exertion.
DEFINITION- A condition of the muscular system induced by an undue drain on its strength.
TREATMENT- If the feet be swollen or blistered, or the ankles ache after walking, a warm foot-bath may be used, to which a teaspoonful of the strong tincture of Arnica has been added; the relief afforded is often immediate and permanent. If the hands or wrists ache from excessive or unaccustomed exertion, they may be bathed in about a pint of water, to which twenty or thirty drops of Arnica have been added. If necessary, in one or two hours the application may be repeated. In muscular fatigue from long- continued or severe exertion, affecting the hips, thighs, etc., a hip-bath, to which a drachm of the strong tincture of Arnica has been added, is an excellent remedy. The patient should remain in the bath about five minutes. Whatever kind of bath is used, and to whatever part applied, it should be warm if used in the evening or soon after exertion, but cold or tepid in the morning.
Arnica should be administered whenever there is muscular fatigue, from whatever cause. Its power to aid the restoration of exhausted muscle is truly wonderful.
ACCESSORY MEASURES- When suffering from fatigue a light repast only should be taken; a full heavy meal might occasion serious embarrassment to the digestive organs, as they equally suffer from the general weariness.
When it is known that a deleterious substance has been swallowed, as Arsenic, and other mineral poisons, Opium, poisonous fish, alcohol, etc. vomiting should be immediately excited, by tickling the back of the throat with a feather or the finger; or if this fail, by the administration of an emetic.
EMETIC- The following is a convenient emetic: for a child, a teaspoonful of mustard in a teacupful of warm water; for an adult a dessertspoonful in a breakfast cupful of water. This may be repeated as often as necessary, and followed by copious draughts of warm water, so as to empty the stomach as completely as possible. But if Arsenic, or Tartar Emetic, be the poison, no warm fluids should be used, as they tend to increase the activity of the drug.
The treatment of cases of poisoning must be considerably modified according to the nature of the poison, and a medical man should be summoned immediately, while the temporary measures just suggested may be resorted to until he arrives.