Wednesday, 19 October 2016

19 March 1881 - 'Some Useful Hints on Surgery' by Medicus - Part Two

I should not like to think that any of my girl readers were in the habit of teasing either dog or cat, and thus falling victims to a well-deserved bite or scratch, but I am not quite so sure about their brothers. Well then, if your brother has been naughty towards a dog, and the animal has retaliated, as dogs, according to Dr. Watts's hymns, have a perfect right to do, you must not for a single moment imagine there is any danger to be apprehended from the bite. Nothing is more harmless than a cut from the tooth of a dog that is not actually rabid at the time; his going mad on some future day would not have the slightest effect upon the person bitten. Nevertheless, to comfort the naughty boy and allay his fears, something should be done to the bite. If water is quite handy the bitten part should be laved in it; this, in itself, if the water were cold enough, would cause contraction of the vessels and prevent the absorption of any poison. The bite must next be sucked well, and afterwards washed in salt and water. If any other treatment is necessary, the sufferer should be taken to a chemist, in order that the wound may be cauterised with nitrate of silver. In nine hundred and ninety-nine cases out of a thousand there is no necessity for having a dog bite cauterised, except that it warns the youth who has been teasing the animal, and teaches him not to do so again.

Scratches from cats are not poisonous, only they seldom heal very kindly, because, like a cut with a rusty nail, they leave a ragged wound. They should be carefully washed to get rid of any dirt /t may lodge in them; and, if deep, bound up with a wet rag or, better still, a morsel of lint wetted in warm water with a little oiled silk placed over it. In a day or two, a simple dressing with cold cream, to exclude the air, will be all that is required.

We are very fortunate in this country in one way; our climate may well be called fickle and changeable, but we are free from the swarms of noxious insects and reptiles that make life in the tropics almost unendurable to us Europeans. We have no deadly tarantulas, no dreaded scorpions, nor six-inch-long centipedes. These creatures never creep from under our pillows; nor, while walking in our gardens, do venomous snakes hiss at us as they hang from the rose trees. We have, it is true, one poisonous serpent, the lovely little viper; but he seldom appears, and when he does he is far more afraid of you than you can be of him. But in summer seasons, when plums are plentiful and the farmers talk about potatoes as "a grand crop," we have in the country wasps in millions, and few escape being stung at least once before the cold weather comes on, and one ought to know what to do when such an accident occurs. There is no getting over the fact that certain people are more apt to be stung than others. I myself am a martyr to the playfulness of these yellow bees. I think they like to sting good people best, that is my way of looking at it; but I have some friends who permit wasps to alight upon and crawl upon their hands or faces. One day last summer I was prevailed upon by a lady relation, to allow one to alight on the back of my hand. This particular wasp just walked about the length of two of my knuckles, then he stopped as I said f some happy thought had just occurred to him. Next moment the wasp was calmly flying away through the open window, and I, the victim of misplaced confidence, was rushing frantically away  for the ammonia bottle. Yes, that is the cure - ammonia, strong hartshorn; just wet the stoper of the bottle and put it on the part that has been stung. Hive bees always leave the sting, wasps only sometimes, but if they do so, it must be carefully extracted. If no hartshorn be at hand, try salt and water, or strong soda (washing soda), then rub the part with olive oil.

In wooded portions of the country, especially where the land lies low and flat, young people suffer greatly while in bed at night from the bites of gnats. These things are really second cousins to the real mosquitos, and the bite raises a swelling just as painful. Here again ammonia is the cure. I have known cases where delicate girls and children were quite fevered from the loss of rest and blood poisoning, caused by the bites of these tormenting insects. The febrile disturbance is accompanied by weakness and nervous depression; it is best relieved by the tincture of yellow bark, a small teaspoonful in water three or four times a day. Coffee also does good; it may be made in the morning and drunk cold in small quantities during the day, without either milk or sugar.

Those who walk much in grassy paddocks or orchards are often bitten by an extremely , almost invisibly, small insect called the harvest bug; touching the spot with hartshorn destroys the poison and kills the animalcule if it has burrowed. The swelling and pain occasioned by the bite is best allayed by rubbing the part with spirits of camphor.

Children sometimes, while eating fish, especially if eating hurriedly, a habit which is most prejudicial to digestion, have the misfortune to get a bone stuck in the throat. It is usually a small one, s that some attempt should be made to immediately get it down. Swallowing a morsel of bread only half chewed may do this. If not, and the bone can be seen or felt, it should be hooked out with the fingers. Choking on a piece of meat is a terrible accident. Medical aid should be at one summoned; but very often this is too late, and the victim to hurry in eating is dead ere he arrives. A smart blow or two on the back will often tend to dislodge a piece of meat or food of any kind stuck in the throat, but if any attempt at swallowing can be made, a tablespoonful of salad oil should be taken.

Talking of things sticking in the throat brings me to say a word or two about foreign bodies in other places.

In the eye, for example. While walking or riding on a summer's evening or afternoon, minute flying beetles often get into the eye. These tiny little gentlemen, as soon as the alight anywhere, immediately fold up their wings and put them away under a kind of tippet they wear over their shoulders like a policeman's cape. I suppose they do this to teach human beings always to take the greatest care of their best things. Well, if one of these little beetles gets into your eye, and you have no companion b you to remove it with the corner of a handkerchief, gentle rubbing of the eyelid in one direction will bring it to the inner corner of the eye, from which the finger alone will be able to remove it. Or if this fails, lifting up one eyelid so as to get the other under it to sweep it will usually be effectual, but no harshness should be used.

Now, I know that any girl who can read this magazine is too old to be likely to amuse herself by poking peas or beans up her nostrils, but her tiny brother or sister may, by way of gaining new experiences. When such a thing happens the foreign substance must be dislodged somehow. A pinch of snuff - it must be a very tiny one - will often be effective by causing it to be sneezed out. And there is a right way and a wrong way of giving snuff to a child with this end in view. For the snuff must be drawn in very gently, else the pea itself may be sent further in, as, before sneezing, the breath is drawn in; you must hold the child's nose momentarily in order that he may take in his breath only by the mouth. Well, if this fails, you should take the child on your knee, lay him on his back, hold the nose above the pea to prevent it from getting farther back, and with the point of a bodkin slightly bent, you must get it under the object, and try to hook it out. If you fail, medical assistance must be had recourse to.

When a pea gets into the ear, the bent end of a hair-pin may be used to dislodge it, or a stream or water thrown in with a syringe to float it out. The ear may also be syringed to get rid of a fly or earwig, the annoyance from which, if lodged in the ear, is most distressing, not to say alarming. But olive oil had better be dropped into the ear first; this will kill the insect, and very likely also dislodge it.

When a ring cannot be removed from the finger,  it is just as much matter out of place as a pea in the nose or fly in the eye or ear. It is apt, too, to give rise to much pain and swelling. When you have tried in vain to remove the ring from your oiled or well-soaped finger, give up any further exertion for an hour or two, then after placing the hand in the coldest water for a minute or two and wiping it dry, take a long and fine thread and roll it tightly and closely round all the finger in front of the offending ring, beginning at the extreme tip, and as soon as you reach the ring, slip the end through beneath, and endeavour to work it gradually off. Failing this, it must be filed off, and this a surgeon must do.

The accident which is generally designated by the name of sprain or strain, is simply a stretching or wrenching of one of the tendons near a joint, or it may be even the laceration of one of the ligaments of the joint. There is usually much pain or tenderness and swelling. A very bad sprain may require the application of leeches to subdue the swelling. An ordinary sprain should be gently rubbed - remembering the rubbing must not cause much pain, no "thumbing" should be permitted - it should, I say, be gently rubbed with some such stimulating embrocation as opodeldoc, and then swathed in a flannel bandage, or hot fomentations may be necessary to soothe the pain and allay the swelling and inflammation; this may be followed by the application of a soothing brain poultice at bedtime. Rest of the sprained joint must be carefully enjoined, if it be a foot, a knee, or ankle it ought to be raised on a pillow at night and on a chair by day; if it be the wrist or hand it should be carried in a sling. Make no attempt to use the sprained joint until all the pain is gone, and even then you must be careful. The stiffness which often remains, accompanied sometimes with swelling, is best removed by salt water douches, or by pouring cold water from a height on the part.

When the pain from a sprain is very severe, great relief is obtained from the laudanum fomentation. An ordinary fomentation means the application of flannels wrung as hot as the hands will bear it; a laudanum fomentation is made by simply pouring a teaspoonful or two of tincture of opium on the flannel before it is applied. The mustard fomentation is used to the chest when during a cold the cough gives much pain. Here the flannels are wrung out of water in which two or three good handfuls of mustard have been mixed. It reddens the skin and gives much relief. The turpentine fomentation is also a good one in the same kind of cases; a tablespoonful of turpentine is poured upon the heated flannel and the chest well rubbed with it, or it may be simply laid upon the chest and changed for another hot flannel as soon as it begins to cool down.

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