3rd. To bring the injured parts nicely together. Any muscular fibre likely to prevent complete union should be snipped off with a pair of scissors, and after the sides of the wound have been accurately adjusted, they should be kept so by strips of adhesive plaster, first applied to that side of the wound which is most movable, and then secured to the other; good long strips should be used, to give as much support as possible to the parts. But in extensive wounds, where plaster would be insufficient, stitches must be employed.
4th. To promote adhesion. To secure this, the part should be kept at rest, and, if the injury be severe, the patient should remain in bed.
5th. When a wound is dressed, say once in every twenty-four hours, a sponge or rag should be wetted with warm water, and laid over the dressing, so that it may be removed without the risk of disturbing the surfaces which may have partially united. Often the lotion may be renewed by removing the oiled silk only, pouring a little lotion on the rag or lint, and then replacing the oiled silk.
6th. To control dangerous bleeding, as from a sharp-cutting instrument. When blood flows in a steady stream, and is dark- coloured, it is from a vein, and can generally be checked by applying cold water and exposing the cut surface to the cold air. But if large veins be wounded, they should be compressed by the fingers, or by a bandage. A few thicknesses of linen, with steady compression, are more efficient than heaping on a large quantity.
When the blood is bright-red, and flows in jets, it is arterial, and the same means must be adopted as just pointed out, unless the bleeding is excessive, in which case a handkerchief should be tied round the limb, near the wound, and between it and the heart, a stick inserted under the handkerchief, and a firm compress over the course of the blood-vessel; the stick should then be twisted until it stops the circulation, and, consequently, the bleeding. But this is only a temporary expedient, for wounded arteries of size require ligature or torsion by a surgeon before bleeding can be permanently arrested. If no surgeon can be obtained, a clever manipulator should grasp the wounded artery with a pair of forceps, and draw it slightly and gently forward, so that it may be securely tied by means of a strong ligature of silk.
7th. Should a wound or bruise be followed by constitutional disturbances, fever, chills and throbbing in the parts, medicine should be administered. Arnica (as prepared for internal use) and Aconitum will generally meet the requirements of such cases, and should be administered every one to three hours in alternation, for several times; Belladonna, pain and swelling of the injured part; Hepar Sulph., when suppuration is established; Silicea, unhealthy suppuration.
88. Poisoned Wounds Bites and Stings
The treatment consists in the prevention of the spread of poison through the body. This may be accomplished by 1. Destroying the poison at the seat of injury by cutting out the part. 2. Cauterising the wound with a knitting-needle made red hot, or with Nitrate of Silver (Caustic). 3. Tying a ligature tightly between the wound and the body. 4. Sucking the wound, and in doing so extract the poison. Before doing the last, the operator should be sure that his mouth and lips are free from fissures or cracks. If the mouth be sound, the poison can do him so injury.
When the wound results from a scratch with a rusty nail or any similar object, our first care should be to encourage bleeding. This may be done by sucking the wound, or by placing it in hot water. The wound can then be treated as an ordinary one (see preceding section). If, in spite of these precautions, the wound becomes painful and throbbing, a poultice of bread or linseed should be applied, and if suppuration (gathering) takes place, it should be opened with a large needle or penknife, and the poulticing continued.
The sting of bees or wasps should be treated by extracting the sting, which may often be seen in the wound, by pressing the open end of the tube of a small key over the seat of injury. Ledum is a useful local application. And Rhus or Apis may be given internally, as well as applied to the injured spot.
89. Foreign Bodies in the Eye or Ear
If a particle of sand, a fly, or a hair gets under the upper eyelid, let the patient sit down, and, standing behind him, place a pencil over the lid, take hold of the eyelashes, and turn the lid upwards, the offending body can then be removed with the corner of a handkerchief. If under the lower lid, turn it down, and remove in the same manner. If a particle of lime has got in the eye care should be taken not to use water to remove it. A weak solution of vinegar should be used. When the foreign body has been removed, Aconite should be given every half-hour, and Calendula-lotion may be applied to the eye on lint or soft linen. The patient should avoid rubbing the eye to remove a foreign body.
In the ear. If any insect gains admission to the ear, it may be killed by pouring in a few drops of olive oil. If a body such as a pea, bead, etc., is the offender, a piece of wire, with the tip slightly bent, to form a hook, should be introduced, above the foreign body, so that it may be turned out easily.
90. Bloodshot Eye
TREATMENT:
Two or three doses of Aconitum every three hours, and the eye frequently bathed with tepid water. If from mechanical cause and there be no abrasion of skin or mucous membrane, Arnica-lotion (six drops of strong tincture to a wineglassful of water) may be used. Arnica may also be administered internally. If the condition be chronic, or recur without mechanical injury, Arsenicum, thrice daily, should be administered.
91. Broken Bones (Fractures)
SYMPTOMS:
A broken bone may generally be detected by having felt it snap; there may be some deformity, such as bending, or shortening and if the upper end of the bone be held firmly by the hand, the lower part may be moved independently, and if the broken ends are rubbed against each other, a grating noise may be heard. There will further be pain, and loss of power in the injured part.
CAUSES:
Mechanical violence is the most frequent, but old age, paralysis, and prolonged disease of a limb, render bones liable to break from trifling causes.
TREATMENT:
Before moving the patient, a temporary splint should be adjusted, in order to prevent the certain jolting that would occur. Anything that will give support to the injured limb without adding much weight to it, will do. If the fracture is in the fore-arm, it should be immediately supported by a sling which may be made with a handkerchief and tied round the neck. If it is the leg that is injured, a roll of music or newspaper may be used to encircle the limb, or an umbrella or walking-stick may be placed at the side of the leg, and secured in position by means of three or four handkerchiefs.
The patient should now be raised gently, the injured part being supported, and special care taken to prevent the broken bone 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 little may be made of a couple of poles and a horse-cloth or sack; even a door or hurdle may severe the purpose. Placing on this, and carrying by two men, is much better than removing him 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 for him to superintend to movement.
If there be a wound in the skin and much bleeding, see “Wounds,” pp. 334-338.
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, in their natural form, and having done so, maintain them in perfect contact, and at rest, till firm union has taken place. To maintain the proper shape and length of the limb, bandages, splints, and various apparatus are required. Beyond the mere management of such accidents, however, till he arrives, only a surgeon can treat such cases.
BROKEN RIBS require a flannel bandage, about two hands broad, round the chest, and shoulder-straps to keep it up. A rather tight fitting bandage lessens the movement of the chest in breathing, and is a great comfort.
92. Sprain
TREATMENT:
In severe cases the chief point is to keep the parts at perfect rest, by means of a roller nicely applied, or controlling the motions of the joint by a splint. In simple cases the application of rags, saturated with Arnica or Rhus-lotion and covered with a piece of flannel, will hasten the cure. The use of oil silk should be avoided as dangerous. In all cases Arnica or Rhus should be given internally. When the pain and swelling subside, the joint may be partially liberated, and gentle motion allowed; but the greatest care must be observed for several weeks in using the limb, or the cure will be rendered difficult and tedious.
LICENTIATE OF THE ROYAL COLLEGE OF PHYSICIANS; MEMBER OF THE ROYAL COLLEGE OF SURGEONS; LICENTIATE IN MIDWIFERY, LONDON AND EDINBURGH, ETC. PHYSICIAN TO THE READING AND BERKSHIRE HOMOEOPATHIC DISPENSARY.
Author of "The Stepping Stone to Homeopathy and Health,"
"Manual of Homoeopathic Treatment". Editor of "The Homoeopathic World."