A Handbook of Health - Woods Hutchinson (whitelam books txt) 📗
- Author: Woods Hutchinson
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If the wound is small, the old-fashioned clean white rag that has been boiled and washed is as good as anything that can be used for a dressing. Tear off a narrow strip from one to two inches wide and as many feet long, according to the position of the wound, roll it round the finger or limb three or four times, and then take a turn round the wrist or nearest joint, to keep the bandage from slipping off. If the wound be likely to keep on oozing blood, put on first a thickness of surgeon's cotton, or prepared cotton-batting, an ounce of which can be purchased for ten cents at any drugstore. This is an excellent dressing, because it not only sucks up, or absorbs any oozing from the wound, but is a perfect filter-protection against germs of all sorts from the outside. Ninety-nine simple wounds out of a hundred dressed in this way will heal promptly and safely without danger of pus, or "matter."
If the wound happens to have been made with a knife or tool that you are not absolutely sure was perfectly clean, or if the wound gets manure or road-dirt or other filth rubbed into it, then it is best to go at once to a doctor and let him give it a thorough antiseptic dressing, which consists of cleaning it out thoroughly with strong remedies, called antiseptics,—which kill the germs, but do not injure living tissues,—and then putting on a germ-proof dressing as before. This is one of the "stitches in time" which will save not only nine, but ninety-nine.
If you have a wound with dirt in it, and cannot reach a doctor, one of the best and safest antiseptics to use is peroxide of hydrogen. This is non-poisonous, and can be poured right into the wound. It will smart and foam, but will clean out and kill most of the germs that are there. Another safe antiseptic is pure alcohol. It is a good thing to have a bottle of one of these in the medicine-closet, or in your "war-bag" when camping out. A package of surgeon's cotton and two or three rolled bandages of old cotton, linen, or gauze also should be on hand.
Dog-bites, rat-bites, or cat-bites should always be dressed by a doctor, or made thoroughly antiseptic, mainly on account of the germs that swarm round the roots of the teeth of these animals, and also because treatment of this sort will prevent hydrophobia—although this danger is a rare and remote one, not more than a few score of deaths from mad-dog bites occurring in the whole United States in a year.
The wonderful progress made by surgery within the last twenty or thirty years has been almost entirely due to two things: first, the discovery of chloroform and ether, which will put patients to sleep, so that they do not feel the pain of even the severest and longest operation; and, second, but even more important, keeping germs of all kinds out of the wound before, during, and after the operation. That sounds simple, but it really takes an immense amount of trouble and pains in the way of baking the dressings; boiling the instruments, and scrubbing with soap, alcohol, hot water, and two or three kinds of antiseptics, or germ-killers, the hands of the surgeon and of the nurse and the body of the patient. How enormous a difference this keeping of the germs out of the wound has made may be gathered from the fact that, while in earlier days, before Lister showed us how to avoid this danger, surgeons used to lose seventy-five per cent of their amputations of the thigh, from pus infection, or blood poisoning, now they can perform a hundred operations of this sort and not lose a single case. We can open into the skull and remove tumors from the brain; open into the chest and remove bullets from the lungs, and even from the heart itself; operate in fact upon any part, or any organ, of the body with almost perfect safety and wonderful success. Whereas, before, two-thirds of the patients so operated upon would die, probably of blood poisoning.
How to Treat Bruises. Bruises are best treated either by holding the injured part under the faucet, or pump, if convenient, or by plunging it into very hot water and holding it there for ten or twelve minutes. Then if the bruise still continues to throb or ache, wrap it up lightly with a bandage of soft, loose cotton or linen cloth, and pour over it a lotion of water containing about one-fourth alcohol until the bandage is soaked, moistening it again as fast as it dries. This is also a useful treatment for wounds that have been made by a fall, or by something blunt and heavy, so that there is bruising as well as cutting. Most of the household applications for wounds or bruises, such as arnica, camphor, witch-hazel, etc., owe their virtues to the five or ten per cent of alcohol they contain, which, by evaporating, cools the wound and relieves inflammation, kills germs and so acts as an antiseptic, and cleans the wound and the skin around it very thoroughly and effectively.
Bruises of all sorts, however, unless very severe, are much safer than cuts or scratches, because they do not break the skin, and consequently no germs can get into the tissues of the blood. Our skin, as you remember, is one of the most wonderful water-proof, germ-proof, hot-and-cold-proof coatings in the world; and as long as it remains unbroken, none but a few of the most virulent disease-germs can get through it into the body.
Boils and Carbuncles, their Cause and their Cure. Boils and carbuncles are almost the only instances in which pus germs can get into the body without some actual cut, tear, or breaking of the skin. They come always from other boils or ulcers or discharging wounds and are caused by the pus germs in these either being rubbed into the skin until it is almost chafed through, or else being driven down into the mouth of one of the hair follicles, or "pores." Here they proceed to grow and form a little gathering, which soon turns to pus; and this stretches the skin and presses upon the sensitive nerves in it so as to cause much pain. The best way to treat them in the beginning is to give a thorough scrubbing with hot water and soap, and then to drop right over the point, or "head," of the gathering two or three drops of a strong antiseptic, like formalin or peroxide or carbolic acid. If this does not check them, then they had better be opened up freely with a sharp knife that has been held in boiling water, or a needle that has been held in a flame until it is red hot and allowed to cool. Then pour peroxide into the opening, put on a light dressing, and keep soaked with alcohol and water, as for a bruise. This evaporating dressing is far superior to the dirty, sticky, germ-breeding poultice. If this does not clear it up within twenty-four hours, go to a doctor and have him treat it antiseptically.
How to Stop Bleeding. If a cut should go deep enough to reach an artery the size of a knitting needle, or larger, then the blood will spurt out in jets. There is then some danger of so much blood being lost as to weaken one. Our blood, however, has a wonderful power of clotting, or clogging, round the mouth of the cut artery, so that the risk of bleeding to death, except from quite a large artery, like that of the thigh, or the armpit, is not very great.
For a wound in the hand or foot, that spurts in this way, it will usually be sufficient to grasp the arm firmly above the wrist or the elbow, or the ankle, as the case may be, with the thumb over the artery, or even to press directly over the wound, until the bleeding stops and the blood is thus given a chance to clot. If the wound is small and deep, like that made by the stab of a knife, or the slip of a chisel, then firm pressure directly over the wound itself with a thumb, or both thumbs, will usually be sufficient to stop the bleeding.
A stone laid above the cut under the bandage will help to increase the pressure at this point.
Should, however, the spurting be from an artery like that of the pulse, or from that at the bend of the elbow or the knee, then the best thing to do is to tie quickly a handkerchief or strip of tough cloth loosely around the limb above the wound and, slipping a short stick or bar into the loop, twist upon it, as shown in the picture, until the blood ceases to flow from the wound. It is much better to use a handkerchief or piece of cloth than a cord, because the latter may cut into and damage the tissues, when drawn as tight as is needed to stop the circulation. It is not best to allow a bandage twisted tight enough to stop the circulation—called a tourniquet—to remain tight for more than half an hour at a time, as this may give rise to very dangerous congestion, or serious "blood starvation" of the tissues below it. It should be gently untwisted every half hour until the arm, or limb, below it reddens up again, and then, if the spurting begins, should be tightened as before. There is, however, a good chance that if the cut artery is not too large, the blood will have clotted firmly enough in this time to stop the bleeding; though the tourniquet had better be left on the arm, ready to be tightened at a moment's notice, until the doctor comes.
The Treatment of Burns. Burns require more careful treatment on account of the wide surface of the skin usually destroyed. The layer of the skin that is most alive and most active in the process of repair is the outer layer (the epithelial, or epidermis). A burn, or scald, if at all severe, is likely to destroy almost the entire thickness of this, over its whole extent. This gives both a wide surface for the absorption of pus germs and a long delay in "skinning over," or healing. As the same heat that made the burn has usually destroyed any germs that may be present, it is not necessary to wash or clean a burn, like a wound, unless dirt has been rubbed or sprinkled into it after it has been made. The first thing to be done is to coat it over so as to shut out the air; and this, for a slight burn, can be very well done by dusting it over with baking soda or clean flour or with one of the many dusting, or talc, powders on the market, containing boracic acid, or by laying over the burn a clean cloth soaked in perfectly clean olive oil or vaseline. If the oil or vaseline is not perfectly clean, put it on the top of a stove and heat it thoroughly before using.
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