ACCIDENTS—BMEROENOlEIS—POiSO^S. t)1 human beings without necessarily communicating Hydrophobia. In the first place, the chances are that the saliva would be arrested by the fabric over tlie part bitten, if there should be saliva in the mouth of the dog at the instant; and if, as is said, the saliva is not itself poisonous, but that the poison is mixed with it, the saliva might not, at that moment, contain any. It is stated, by what is considered competent authority, that of dogs bitten by others known to be hydrophobic, scarcely more than one in four become affected; and it is likewise said, that among human beings, when no precautions are taken, not more than one in ten or fifteen are affected after being bitten. The celebrated surgeon, John Hun- ter, knew of twenty-one people who were bitten by the same dog, and only one of the number had the hydrophobia. It should be added, however, tliat it is not stated that this individual had not been bitten by some other dog than tlic one which bit him in com- mon with the rest. Besides, many persons have, undoubtedly, died, after having been bitten, with convulsions, not of hydropho- bia, but the result of anxiety and fright. One well-known physi- cian, after having been bitten, as a precautionary measure, blew out his brains. Some writers, of no mean repute, assert that the bite of a nealthy dog, when under a state of anger or fright, may communi- cate hydrophobia, or another disease like it, from some change effected by the emotion, in the character of the saliva. It is like- wise contended that it may spontaneously arise in animals. However, as these tilings can not be demonstrated to the satisfac- tion of the victim or his friends, and tlicre is no known remedy for the disease, it is always best, after a bite by a suspected dog, to act "on the safe side." Therefore, at once, remove the clothing, if any, from the bitten part, and apply a temporary ligature above the wound. This inter- rupts the activity of tlie circulation of tlie part, and to tliat extent delays tlie absorption of the poisonous saliva by the severed blood- vessels of the wound. "While other things are being hurriedly ^ ACCIDENTS—BMEftGENCtES—PotSOffS. prepared for, some one whose lips and mouth are free from breaks might attempt suction of the wound. The material extracted by the act, apparently chiefly of blood, should, of course, at once be ejected from the mouth of the person giving the assistance. The bite is really a lacerated and contused wound, and lying in the little roughnesses, and between the shreds, is this poisonous saliva. If by any means these projections and depressions affording the lodg- ment can be removed, the poison must go with them. If done with a knife, the wound would be converted, practi- cally, into an incised wound, and would require treatment aa such. If a Surgeon is about, he would probably stand a probe upright in the wound, and with a sharp knife cut the entire injured portion out. Professional aid is not always at command, and in such a case it would be well to take a poker, or other suitable piece of iron, heat it red hot, at least, in the fire, wipe off and destroy the entire surface of the wound. As fast as destroyed, the tissue becomes white. An iron at white heat gives less pain than one "black hot," as smiths say; for in the latter instance the heat is scarcely sufficient to destroy', but only irritates; while in the former, the greater heat at once destroys the vitality (kills) of the part with which it comes in contact. With a properly heated iron, not only the surface is de- stroyed, but the destructive influence extends beyond and into the Healthy tissue, far enough, if no point is neglected, to assure the purposes for which it is used. Some are inclined to think that if the wound is at once well wiped out, and a stick of solid nitrate of silver (lunar caustic) ra- pidly applied to the entire surface of the wound, little danger is to be apprehended. It acts, but in a milder degree, like the heal of the iron upon the tissues. In case the heat or the caustic have been used, poultices and warm fomentations should be ap- plied to the injury to hasten the slougMng away of the part whose vitality has been, in this instance, intentionally destroyed. There is a strange belief among the ignorant, particularly ACOttfiOTS—BMBMEHCIES—fOTSONS. 59 among the people from Ireland, that, whether the dog was "mad" or not at the time of giving the bite, if it should become so at my future time, the disease will appear in whatever individual the animal has bitten. A dog, after having bitten a person, is apt, under this mistaken belief, to be at once slain. This should not be done, but the suspected animal placed in confinement, and watched, under proper safeguards, for the appearance of the dis- ease. Should no satisfactory appearances indicate the disease in the dog, it can be seen, in a moment, what unnecessary mental distress can be saved the person bitten and his friends. This mysterious disease, although known from the days of Homer and Aristotle, has never yet been cured or understood. Animals communicate it to each other, and to men, by the bite; but no known instance is recorded where one human being has communicated the disease to another, although many patients, in their spasms of Hydrophobia, have bitten their attendants, as they have done in spasms from other causes. There arc many popular errors in reference to this disease, some of them most grotesque in character. This terrible malady is known among scientific men as Rabies Canina (Rage of Dogs); but, from one of its symptoms. Hydrophobia (Fear of Water). So far from fearing water, the poor animal seeks it ; bnt, owing to a spasm of tlie muscles of the throat, it is unable to quench its ter- rible thirst. Another prevalent but erroneous belief is, that the disease prevails among animals in the hot weather of midsummer, while the truth is, that it is more apt to occur in Winter, or the damp, cold days of Spring. As so little is known of the disease in the dog, and another common disease of the same animal (dis- temper) is often associated with it, the following, from Youatt, is inserted:
Mr. Youatt, whose description of Canine Madness is generally quo- ted and accepted, says, "The disease manifests itself under two forms: the furious form, characterized by augmented activity of the sensorial and locomotive systems, a disposition to bite, and a continued uecu- 60 ACOttENTS—fiMEfteENOIES— POISONS. liar barb. The animal becomes altered in habits and disposition, has an inclination to lick or carry inedible substances, is restless, and snaps in the air; but is still obedient and attached. Soon there is a loss of appetite, and thirst; the mouth and tongue swollen the eyes red, dull and half-closed; the skin of the forehead wrinkled the coat rough and staring ; the gait unsteady and staggering ; there is a peri- odic disposition to bite ; the animal in approaching is often quiet and friendly, and then snaps; latterly, there is paralysis of the ex- tremities ; the breathing and deglutition become affected by spasms the external surface irritable, and the sensorial functions increased in activity and perverted; convulsions may occur. Tliese symptoms are paroxysmal, they remit and intermit, and are often excited by sight, hearing, or touch. "The sullen form is characterized by shyness and depression in which there is no disposition to bite, and no fear of fluids The doe appears to be unusually quiet, is melancholy and lias depression of spirits ; although he has no fear of water, he docs not drink (The fear of water, it should be said, is acquired by experience, the effort of swallowing being attended with spasm of the muscles of the throat afterward often extending to the rest of tlie muscles of the body ) ' "He makes no attempt to bite, and seems haggard and suspicious avoiding society, and refusing food. The breathing is labored, and the bark is harsh, rough, and altered in tone ; tlie mouth is open from the dropping of the jaw ; the tongue protrudes, and the saliva is con- stantly flowing. The breathing soon becomes more difficult and laborious ; there are tremors, and vomiting, and convulsions." In a recent paper,* the writer refers to a large number of well- authenticated instances where the bite of the common Skunk, or Polecat (Mephitis mephitica) has been followed, after the usual period of incubation, by symptoms of Rabies (Hydrophobia). Of tlie forty-one cases mentioned, every instance but one (a farmer, who knew of the danger, and had taken the precaution of using prompt preventive treatment) ended in death. This is more fatal than the bite of the rabid dog. The wide distribution of this animal, the common Skunk, over the United States, and the readiness with which people might be * Rabies Mephitica. Hervey, Rev, H. 0. American Journal o1 the Sciences and Arts (Silliman's), May, 1874. p. 477. ACCIDENTS—EMEBGENCIE8——POISONS. 61 exposed to its bite, should lead persons so injured by it to at once resort to the peculiar measures advised for the treatment of bites of suspected dogs. WHITLOW. Whitlow or " felon " appears as a small painful spot, rapidly in- creasing in size. It is an inflammation between the bone and the nourishing membrane surrounding it. A drop of pus forms and gradually increasing, separates this membrane from its at. tachment, until tlie whole or a part of the bone dies (necrosis). So, the sooner tins pus is let out, the better, as no amount of poulticing will dispose of it. The formation of the pus is known by the peculiar throbbing at the joint—sometimes compared to the fluttering of a fly there. After opening freely, the little mass of dead tissue* ("core"), acting practically like a thorn or other foreign body, will come away as soon as completely detached ; and the wound slowly fills up. Whitlow is apt to occur in the spring and toward the end of summer, when people are debilitated, and unless this condition is corrected, a person who lias liad one, may liavc another. Some- times, it seems almost an epidemic. The best form of poulticing the finger is to keep a small cup or mug constantly filled from a supply of hot mush, and hold the finger in it with the heat as great as can be borne. The contents of the cup, if renewed every few minutes, will do the finger more good in twelve hours than a day's poulticing in the usual way. At night, if the pain is very great, a tea-spoonful of Laudanum may be applied to the finger. * By the word " tissue," physicians mean the simple structural ele- ments of the body, much in the same sense that the word '' material" is used by builders. There is brain tissue, nerve tissue, muscular tis- sue, bone tissue, etc., of the body ; just as there is floor material, roof material, wall material, etc., for a liouse. These "tissues" are compos- ed of still simpler structural elements ; and these, again, are compos- ed of tlic higher chemical arrangements of the yet more ultimate chemical elements, 62 ACCIDENTS—EMERGENCIES—POISONS. BOILS AND CARBUNCLES Occur most frequently in persons with a certain form of impo. verished blood, for which attention is often necessary. This does not mean a dose of "salts" as a "physic." The little boils threatening the face and neck, if taken in time, can often be dis- couraged by frequently touching the pimple with turpentine or with hartshorn liniment. If they proceed to the step further, the death of the little fragment of tissue, afterwards discharged when detached, as a "core," poulticing to favor this, must be resorted to. Laudanum added often mitigates the severe pain. A carbuncle is a much larger boil, and there is so much exhaus- tion from the discharges, loss of sleep from pain, etc., that the patient sometimes dies during the effort of nature to afford relief. EARACHE. Evaporate the alcohol from a tea-spoonful of Laudanum (p. 130); add half as many drops, as you started with, of Glycerine or Sweet-oil; make it milk-warm, and pour into the ear, catching hold of the tip and pulling upward toward the crown of tlie head (p. 67) ; or, wet a scrap of linen in a tea-spoonful of laudanum, dry before a fire, cut into bits, place in the bowl of a tobacco-pipe, light it, cover with a coarse handkerchief, insert end of the stem (mouthpiece), suitably protected so as not to hurt, into the ear of the child. Then apply the lips to the bowl and blow the smoke from the burning opium of the laudanum into the ear. Tobacco alone can be used in the same way. Either of these methods will afford instant relief in most cases. TOOTHACHE Is frequently neuralgia, and often due to decay. Heat to the face outside, and a heated half of a fig held inside, often relieve the former kind, and sometimes afford temporary relief in the latter kind. If the cavity can be cleansed out with a broom-splint ACCIDENTS—EMERGENCIES—POISONS. 63 and filled -with cotton, steeped in some of the evaporated laud". num, much comfort will be found from it. FACEACHE Usually is neuralgic, and heat applied is always grateful. A small liop-pillow heated and held to the face is useful; or the face may be batlicd with Laudanum, Tincture of Arnica, or any such substance. Mustard-plasters should not be used, as they leave a conspicuous mark, and often blister. Ordinary Cayenne pepper, mixed into a stiff paste, witli an equal bulk of Indian- meal and Honey, is quite as active, as useful, and does not blister the skin. CROUP. Some young children, and the young cliildren of certain fami- lies, seem peculiarly prone to this trouble. The well-known hoarseness of the voice, the rough, brazen cough coming on toward night, always suggest the possibility of an attack of croup. These symptoms, showing increased difficulty of breathing, rapidly grow worse, and all that is to be done must be done quickly. Of course, a physician should be sent for. Tlie first thing is to get the cliild to vomit, by giving it, every few minutes, a tea-spoonful of the Syrup of Ipecac, followed by draughts of warm water. As soon as vomiting commences, a warm batli should be given, the skin well dried with a soft warm towel, and the child returned to bed. A properly made and care- fully applied warm poultice may be placed against, the upper and front part of the chest, being very careful, after removing it, to sub- stitute a warm flannel. In doing these things, do not expose the skin to the slightest draught, of what may be to it, cold air. After the child vomits, or should it seem weak, five drops of the Aromatic Spirits of Ammonia in a tea-spoonful of water may be given every ten minutes until four or five doses shall have been taken. ihis is for a child of about two years of age. As improvement becomes marked, the domestic remedy consisting of equal parts of 64 ACCIDBNTS—EMERGENCIES—POISON8. honey or molasses, added to as much vinegar, with a small frag- ment of butter added, every little while, is a useful thing, in tea- spoonful doses. Croup is known as membranous and spasmodic. Experienced physicians assert tliat the latter is by far the most common. Tlicrc is often a relation existing between the severity of tlie attack and the amount of disturbance to the digestive tract by the presence of undigested food. Sometimes it is nuts or candy, given be- cause the child did not seem well. As it gets older and able to get these things in larger quantity, such an ill-kept child ceases getting the Croup, and gets Convulsions. Tlie stomach of a child susceptible to the croup can not be too carefully guarded, especially if -it is suffering from what is popularly known as a "cold." CONVULSIONS IN CHILDREN, Sometimes called '' fits," often result from undigested food in the stomach or bowels. The first thing to be done is to put the child in a bath of warm water, and some persons like to put some ground mustard in the water. In the course of a few minutes— which seems much longer to the mother and friends—tlie spasm relaxes enough to permit an emetic to be given, to dislodge what may'be in the stomach. The Syrup of Ipecac, as directed under " Croup," is as good as anything else for tlie purpose. Sometimes these convulsions arc one of the symptoms of Scarlet- fever, Measles, or other diseases of the kind. (See Convulsions, p. 71.) FOREIGN BODIES IN THE EYE. Particles of cinder, dust, or fragments of metal, often get into the eye, and cause a good deal of trouble. Sometimes they are dislodged, and washed out by the extra secretion of tears brought about by the irritation produced by the body. Sometimes this process does not give relief, and it is necessary to resort to some process of extraction. A popular, and often a useful plan is to taKe
ACCIDENTS——EMERGENCIES—POISONS. 65 hold of the lashes of the upper lid, separate it from the eyebaU, so that the lashes of the lower lid will slip up in the space, acting as a brush to the inner surface of the upper eyelid. This, of course, can not remove any thing, as a rule, from the eyeball. A better way is the usual one of holding a knitting-needle over the upper lid, i -;:?;? .^y close to and just under the edge of I s^J the orbit, then, holding it firmly, (/'"ll^ seize the lashes of that lid by the ^^^U f9'//W/ fingers of the disengaged hand, and gently turn the lid upward and back- ^B^P^^^^^^^^^^^^^^^^^^^ ward over the needle, or substitute used. Movement of the eyeball by ....^3'?^^^^^^:^i:; the sufferer, in a strong light, usual- "'^^^s^'" ' ly reveals the presence of the intrud- ing body, so that by means of a corner of a silk or cambric.hand- kerchief, it can be detached and removed. Should the foreign body be imbedded in the mucous membrane covering the eyeball or the eyelid (conjunctiva), a steady hand and a sharp-pointed instrument will usually lift it out. The foreign body often can not be seen, but the person assures us that he feels it. Often he does not really feel the presence of the body, as much as the roughness (really a wound) left by it. In such a case, or even if the body has been seen and removed, a soothing application to the injury is as useful as the same thing applied to a wound of the hand. Take a spoon or cup, heat it, and pour in a few drops of Laudanum. It will soon become dense and jelly-like. A few drops of water added will dissolve this gummy material, and the liquid thus formed may be applied by the finger to the "inside of the eye," as they say. The Laudanum is Opium dissolved in Alcohol. The Alcohol is somewhat irritating, but is easily evaporated by the gentle heat, leaving an Extract of Opium. which is dissolved in the water afterward added. The comfort derived from this simple and always accessible pi— w ACCIDENTS— EMERGENCIES—POISONS. . paration, after injury to the eye by a foreign body getting into ;t is of the most satisfactory kind. In no case use any of the popu lar " Eye Waters" or "Salves." Not an uncommon accident, is a fragment of lime in the eye The delicacy of the organ, and the activity of this powerful Alka^ li, require all that is to be done to be done at once. Do not waste time by attempting to pick it out, but neutralise the alkali by a few drops of Vinegar (which is dilute Acetic Acid) in a little wa ter. A few drops of Lemon Juice, in a little water, will answer just as well, if introduced, like the vinegar, into contact with the lime. Even when done rapidly, the ulccration caused by the U kali will be some days -n disappearing. In all cases where lime has entered the eye, even when these things have been used no time should be lost in going to a Surgeon. FOREIGN BODIES IN NOSTRILS AND EAR. The curious disposition of children to insert foreign bodies as grains of coffee, corn, peas, pebbles, etc., up the nostrils, and into the car, is too well know to be more than alluded to. If the body is soft, it absorbs moisture from adjacent parts, becomes pollen and more difficult to remove, If the body is Mrd, the irritation and znflammaUon set up by it in contiguous parts in a short time material increases the difficulties of removal. Hence the sooner these substances are removed, the easier it is to do so. Foreign Body up (he Nostril. If the foreign body is up the nostril, the child should be made to take a full inspiration ("a full breath"), then closing the other nostril with the finger, and the mouth with the hand, the air of the lungs, in escaping through the nostril closed to a decree bv the foreign body, assisted by a sharp blow from the palrn^f the hana to the back, will often expel the substance. It it will not e cape in this way, and it is near the openin^ of tue nostril, compression by the fingers, just above, will prevent it