Part 11

=Apparent Death.=--Never assume that a person is dead because he appears to be. Summon a physician. A fairly good test of death is to hold the hand of the person apparently dead before a candle or other light, with the fingers stretched out, each touching the other. Gaze intently between the fingers, and if the person is alive, a red or pink color will undoubtedly be seen where the fingers touch each other. Another method is to take a cold piece of polished steel, like a razor blade or table knife, and hold before the mouth or nose of the person apparently dead. If moisture does not gather on it, it may be safe to assume that breathing has stopped; but these tests are not infallible.

=Bandaging.=--There are two kinds of bandages,--the roller bandage or the triangular or handkerchief bandage. They may be purchased at any drug store or be made on the spot in an emergency. The purchased bandages are made of gauze, or muslin, crinolin, elastic webbing, rubber, or other material. The roller bandages are absorbent, and are very thin and pliable. They should be placed next to the wound and hold the fluids. Muslin bandages are stronger than those made of gauze, and should be used for pressure and outside bandages. Bandages should be kept in a perfectly clean place, and always covered, either by being enclosed in a box or wrapped in paper. If an improvised bandage is used, care should be taken to use a clean cloth. The triangular bandage is made by cutting a piece of cloth about 36 inches square into two pieces diagonally. It can be purchased at a drug store, or any clean cloth can be used if it is of firm texture.

=Baths.=--Cold baths may be taken to reduce fever and in sunstroke and other cases when the temperature is high. It is well to have the temperature in the bath at 70° or 80° Fahrenheit, and to reduce the water until it reaches 60° or 65°. Tepid baths have a temperature of 80° or 90°, and warm baths are of a temperature from 90° to a little less than 100°. Hot baths may be used in case of shock, apparent drowning, depression, and similar troubles. The temperature of the water should vary from 98° to 110°. When the patient leaves the bath, he should be dried quickly and put to bed. Hot baths may produce fainting, and should be taken in the presence of an attendant. Do not guess at the temperature of the water; use a thermometer.

=Bleeding.=--Arterial blood, or blood coming from the arteries, is bright red, and is discharged in spurts or jets. Such bleeding is very dangerous, and unless a physician arrives almost immediately the patient is not likely to survive.

Venous blood, which comes from the veins, is of dark purple color and flows freely and steadily.

Capillary bleeding comes from injured small veins. It flows slowly, and such bleeding is dangerous only if it continues. Always summon a surgeon or physician, and put in a hurry call for him. Force the patient to lie down in a level position, preferably upon his back.

If the leg or arm is wounded, elevate it. Cut away the clothing quickly, so that it may be exposed. Press the bleeding places, but cover your finger with gauze or a clean handkerchief, or compress the part by using a strong cloth bandage.

If the bleeding comes from an artery, cover your finger with a few thicknesses of gauze or clean cloth, and press hard upon the wound and maintain the pressure, which may stop the bleeding. If the wound is large, crowd a lot of gauze into it, and push it in, then press on the flesh a little distance above the wound, that is, between the wound and the heart. This can be done by winding a bandage, a piece of rubber tubing, string, or rope, or a pair of suspenders may be used, above the wound.

If the arm or leg is crushed, do not press on the wound, but bring pressure to bear above it.

=Bleeding from the Veins.=--Lay a piece of gauze over the wound and bind it on with a firm bandage. Be very careful not to apply your naked fingers or hand to the wound unless you have washed them in some antiseptic, but even then it is better to cover your fingers with clean gauze or cloth. If the bleeding is very severe, apply cracked ice wrapped in gauze, and hard pressure below the wound. Varicose veins occasionally bleed. Elevate the arm or leg and bandage it very tightly, the bandage to be placed directly over the bleeding spot.

=Bleeding from Capillary Veins.=--As the blood oozes, and does not flow rapidly, expose the wound to the air for a short time, which will usually check it. The application of hot water is advisable, but warm water should not be used. Extremely cold water or cracked ice will stop some bleeding. If copious bleeding occurs around a tooth, it may be stopped by packing the place with plaster of Paris, or absorbent cotton may be used. In every case, keep the places warm. After the bleeding is stopped, give hot drinks, like hot tea, coffee, or milk, if much blood has been lost.

=Broken Bones.=--Do not attempt to set the break. Handle the patient carefully. Place him in a comfortable position and undress him, removing the clothing by cutting it to save time. If it is necessary to carry him a distance, improvise a splint made of wood or heavy pasteboard and fasten it around the broken part with bandages. Carry him to a physician or summon one at once, but let him lie quietly if a physician can reach him. It is well to have two splints, one on each side, to be held in place by the same bandages. If the arm is broken, bandage it and place it in a sling. In every case, summon a physician or carry the patient to one.

=Chilblains.=--Keep the feet warm and dry. Don't warm them at a fire or place them in hot water, but bathe them in cold water and rub with a dry towel. Apply turpentine, camphorated spirits, or oil of wintergreen.

Cleanliness

It is said that cleanliness is next to godliness. Good health is dependent upon the care of the body, and the body will not remain in a healthful state unless frequently bathed.

The fact that thousands of persons enjoy good health without even taking an infrequent bath, must not be used as an argument against regular bathing. These persons, if in health, live out of doors, and Nature seems to take care of them; but it is obvious that they would be healthier and stronger if they gave proper attention to bodily cleanliness.

The majority of city dwellers, and a large proportion of those living in the country, work indoors, and their health is dependent upon their personal cleanliness.

Opinions differ, and some hygienists do not consider the daily bath essential, but the majority of those who have studied the subject maintain that perfect health requires the daily bathing of the entire body.

Without the daily bath one does not begin his work refreshed or with exhilaration.

A scrub is not to be recommended more than once a week, but a bath should be taken daily, and the entire body rubbed with a dry towel, a bath towel to be preferred. Emersion in a tub of water is not necessary, although it is the best and easiest way of taking a bath, next to a shower bath. A sponge bath answers all purposes.

A cold plunge should not be taken without the advice of a physician. The shower bath is very refreshing. A hot bath is seldom advisable. It is better to have the water of a temperature not much higher than that of summer heat. A pure soap should be used, and care should be taken to rinse it from the body. The daily bath is the best preventive of colds. Comparatively few people who bathe daily suffer from more than transient colds.

The bath should not be taken in a draught. If the room is cold, work rapidly and use additional time for rubbing, continuing it until the skin glows.

The practice of partial bathing is not to be recommended. When you take a bath, take it all over.

If away from home, and sleeping in a hotel bed, which may have been occupied by a diseased person, it is well to go over the body carefully in the morning with an antiseptic soap. Every hotel, and all public conveyances, are laden with germs, and a bath will prevent many diseases.

A few drops of ammonia or a teaspoonful of borax placed in the water in which you bathe will remove the odor of perspiration, but ammonia should not take the place of good soap.

=Clothing Afire.=--Force the person afire to lie down and roll him over and over. Wrap him in a rug or blanket, or anything else at hand. Throw water upon him, but do not wait for water. Wrapping him in a blanket is sure to extinguish the flames. Under no circumstances allow the person afire to run about or out of doors.

=Colds.=--Use simple remedies, such as hot lemonade, but if the cold does not soon abate, consult a physician.

=Diphtheria.=--Consult your physician. Never go near a case of diphtheria or allow a dog, cat, or other animal to enter the sick-room. Be careful of every utensil, and do not allow any one else to use them until they have been washed in antiseptics. Never handle any clothing or other articles in a sick-room.

Disinfectants

The reader is warned against placing reliance upon any disinfectant, because it smells of carbolic acid, or has any other strong odor. Many of the advertised disinfectants are worthless, and some of them are merely deodorizers, which destroy smell and don't disinfect.

Sulphur or brimstone is probably the best fumigator. Sulphite of iron (copperas) is cheap and should be used for sewers and drains. Dissolve a pound and a half in a gallon of water. Two parts of sulphate of zinc to one part of common salt, dissolved in a gallon of water, is a good disinfectant for clothing, bed linen, etc.

Carbolic acid is an excellent disinfectant, but is efficacious only when used at considerable strength, 3 to 5 per cent. Its strong odor suggests qualities which do not exist, if it is much diluted.

There are many disinfectants upon the market, many of them being advertised to be efficacious. Some of them are thoroughly reliable, but others are almost worthless. I would advise the reader not to purchase or use a disinfectant which is not recommended by a reliable physician.

=Disinfecting Cellars, Yards, Cesspools, etc.=--Use a solution made of 60 pounds of copperas dissolved in a barrel of water. Sprinkle freely over cellar and put a pailful in a cesspool.

=Disinfecting the Sick-Room.=--Plenty of fresh air and cleanliness are to be first considered. The clothing, bed linen, and towels should be washed in a tub containing a zinc chloride solution, and the water should be boiling hot. A solution of copperas and water should be immediately placed in all vessels containing discharges.

=Dislocations.=--The novice should never attempt to treat a dislocation. All he can do is to place the patient in a comfortable position, using a sling or cushion to support the part injured. A physician should be summoned.

=Dog Bites.=--Wash the wound with antiseptic soap or pure soap and water, with borax dissolved in it to the strength of a teaspoonful to a pint. Hydrophobia occurs very infrequently, and many dogs, supposed to be mad, are suffering from some other ailment; but a surgeon should be summoned in all cases whenever it is possible to do so. The bite of a rat, cat, or other animal is not generally dangerous, but the wound should be washed with borax and water, as above. Better summon a surgeon. Suck the wound vigorously before applying washes. There is no danger to the person sucking a wound of this nature, unless the skin on his lips or in his mouth is cracked or bleeding, but he may wash his mouth with borax water if he feels uneasy about it.

Drowning

If the person is conscious tell him that you will save him, which will prevent him from losing his nerve. If you swim out for him, and he is struggling, seize him by the hair and turn him over on his back. Swim on your side, towing him along as you would a log of wood. You may hold his head with one arm, but do not attempt to support his entire body. If he struggles violently, hold his head under water until he is unconscious, so that you can better handle him. Loosen his clothing, drain water out of lungs by inverting body, clean out his mouth, and pull his tongue forward. Immediately begin artificial respiration, each movement to last from four to five seconds. Apply warmth and rubbing, and when he is conscious give him hot water, coffee, or lemonade. Artificial breathing is of greatest consequence. Do not give up. Many persons have been resuscitated after many hours of incessant labor. Artificial respiration may be performed in the following way:

First--Immediately loosen the clothing about the neck and chest, exposing them to the wind, except in very severe weather. Get the water out of the body, first by tickling throat with a feather, or applying ammonia to the nose; give a severe slap with the open hand upon the chest and soles of feet; if no immediate result, proceed as follows:

Second--Lay the body down in the open air with the head hanging down and with its weight on the stomach across any convenient object, such as a keg, box, boat timber, or your knees. Open the mouth quickly, drawing the tongue forward with handkerchief or cloth to let the water escape. Keep the mouth clear of liquid. To relieve the pressure on the stomach, roll the body gently from side to side and then back on the stomach. Do this several times to force the water from the stomach and throat.

Third--Lay the body on the back, make a roll of a coat or any garment, place it under the shoulders of the patient, allowing the head to fall back. Then kneel at the head of the patient.

Open patient's mouth and place some small object between teeth.

With tongue pliers or fingers covered with gauze or cloth, grasp his tongue and draw it out. Tie it down to his chin with cloth or rubber band.

Grasp the patient's arms at the middle of the forearms, fold them across his stomach, and raise them over his head to a perpendicular position, drawing them backward, straight, then forward overhead to the sides again, pressing the arms on the lower part of the ribs and side, so as to produce a bellows movement upon the lungs. Do this about fifteen times a minute.

Apply smelling salts, camphor, or ammonia to the nostrils to excite breathing.

Fourth--On signs of life, or when breathing is restored, remove the clothing, dry the body, wrap the patient in warm blankets or hot cloths. To encourage circulation briskly rub his limbs under the blankets toward the heart; brandy or aromatic spirits of ammonia may be given in small doses, with care to avoid strangulation.

Another Method

Another simple method of restoring breathing, one that is being rapidly adopted, is that known as the Schafer, or prone, method. It has the great advantage that it can be performed by one man alone. This method has just been endorsed as the preferable one by a commission representing the American Medical Association, the National Electric Light Association, and the American Institute of Electrical Engineers.

First--Lay patient on stomach with his head to side and withdraw his tongue, which itself then will hang out if teeth are held apart with small object. The operator then kneels astride the patient's thighs and with his hands across the lower ribs swings his body back and forth rhythmically, pausing about two seconds as his weight falls upon and is removed from patient. This movement is to be continued at the rate of about fifteen times a minute.

=To Prevent Drowning.=--The human body weighs, in the water, about one pound; that is, it is approximately one pound heavier than the water which it displaces. A stool, chair, or small box or board will overcome the tendency to sink and will keep the head above water. The feet, and the hand which is not clinging to an object, should be used as paddles. Every one should learn to swim. If he can take only a few strokes, the chances of death by drowning are small, for he is likely to be able to reach something which will support him. So much do I believe in the necessity of knowing how to swim, that I consider it a crime not to understand this art.

=Electrical Accidents.=--Immediately shut off the current, but do not handle the wire with your naked hands. If rubber gloves are not handy, cut the wire with an ax or knife, with a piece of woolen cloth wrapped around the handle. If you pull the sufferer away from the wire, do not touch him with your bare hands, but cover them with woolen cloth, or wear rubber or woolen gloves, or remove him by the use of a rope. The ordinary electric shock will not cause death unless the patient continues to receive it. Summon a doctor at once. Place the patient in the open air, with something under his shoulders. Loosen his clothing, open his mouth, and pull out the tongue. Clear the mouth from saliva. Force air into his lungs by pressing the base of the ribs about once in four seconds, then attempt to resuscitate him as you would a drowning person.

=Emergencies with Children.=--If the child suddenly suffers from vomiting, purging, and prostration, send for a doctor at once. In the meantime place him in a hot bath and then carefully dry him with a warm towel and wrap in warm blankets. If the hands and feet are cold, apply hot water bottles to the feet and hands. A poultice made of flaxseed meal (3/4) and mustard (1/4) should be placed over the body. Five drops of brandy in a teaspoonful of water may be given every 15 minutes. For sudden diarrhoea, administer one teaspoonful of castor oil or of spiced syrup of rhubarb. Allow the child to drink freely of cold water that has been boiled. Always summon a physician.

Emergency Medicines ..

The writer would emphatically discourage self-medication and dosing, and would oppose the taking of medicines of any kind, except the simplest remedies, without the advice of a physician. Hundreds of thousands of people have been made sick, because the wrong medicine was administered to them, and many more have taken medicine when they didn't need it.

The following emergency medicines are presented, with a distinct understanding that they should not be used except in simple cases:

=Ammonia.=--What is known as ammonia water, or liquor of ammonia, or as spirits of hartshorn, or hartshorn, is of several strengths and is highly irritating and poisonous if taken internally. Applied externally, if of considerable strength, it will cause blisters and pain. Ammonia should not be applied to an open wound or irritated surface, except in case of snake bites or stings of insects, where it is intended to neutralize the poisons. The vapor of ammonia water, inhaled through the nostrils, affects the nervous system and may be used in fainting or epilepsy, but always with caution, for a strong preparation of ammonia applied to the nose may produce a violent shock. It is better to saturate a handkerchief or wad of cotton and hold it a short distance from the nostrils. The buyer is cautioned against the use of the strongest ammonia water.

=Aromatic Spirits of Ammonia.=--This is a stimulant, and may be used in cases of sick headache, hysteria, cholic, or fainting, in doses of from 10 to 30 drops in sweetened water.

=Arnica.=--Tincture of arnica is supposed to be of value in accidents, and especially efficacious for sprains and bruises. It has some value, mainly from the alcohol it contains and partly because it is applied with friction. It is a poison, and never should be taken internally. For external use it should not be applied at full strength, as it is apt to cause inflammation if the skin is tender.

=Bicarbonate of Soda.=--Bicarbonate of soda, commonly known as baking soda or saleratus, is distinct from sal soda or washing soda. It is of great value in the treatment of burns, and may be used as an antidote in poisoning by acids.

=Camphor.=--Camphor is purchased in gum or in liquid form. It never should be taken internally, except by advice of a physician. Nor should it be applied in its full strength directly to the wounds or to irritated or inflamed surfaces.

=Ginger.=--The essence or extract of ginger is a very popular remedy for trouble with the digestive organs, bowel complaints, etc., and should be taken in doses of from 10 to 40 drops in sweetened water, milk, or other liquid. It never should be used habitually, because it may establish a drug habit; nor should large doses be taken to check diarrhoea, as it is often inadvisable to too rapidly check the discharges.

=Glycerin.=--Glycerin may be used for burns, and, mixed with equal parts of rose water, it is a good lotion for chapped hands or lips, but it is irritating to the skin of some people.

=Peppermint.=--The essence of peppermint may be used for stomach-ache and bowel complaints, the usual dose being from 10 to 20 drops on sugar or in sweetened water. Oil of peppermint should not be taken, except when prescribed by a physician.

=Turpentine.=--Turpentine is the base of most liniments, and it has some value, but mustard plasters are safer. Turpentine is inflammable, and never should be applied near an open fire. Turpentine should not be given internally, unless prescribed by a physician.

=Whisky.=--Whisky, brandy, wine, and all other spirits should be used sparingly. They are likely to do more harm than good. Hot water, hot coffee, hot tea, or aromatic spirits of ammonia are to be preferred. Children should never be given spirituous liquids, except in extreme cases, and then only 10 to 20 drops in water.

=Witch Hazel or Hamamelis.=--Used as a remedy for sprains, wounds, and swelling. It is a mild application for chapped hands, and used by the laity for burns, scalds, cuts, etc. It is not irritating, and is a good substitute for arnica. Its use externally is absolutely safe.

=Vaseline.=--It is to be recommended for burns, scalds, etc. It is nonirritating and is not poisonous. It can be used frequently.

=Cold Cream.=--A perfectly safe article to be used for chapped hands and lips, and skin roughness.

=Emetics and Stimulants.=--In practically all cases, and where poison has entered the stomach, it is well to empty the stomach immediately. If a stomach pump cannot be procured, an emetic should be administered. Doctors would administer ipecac, apomorphine, sulphate of zinc, tartar emetic, and other drugs, but none of them are likely to be available before the physician arrives. When notifying the physician tell him, if possible, the kind of poison taken, so he may be prepared. A dessert-spoonful of ground dry mustard in a glass of warm water is likely to produce vomiting. Follow the first dose with a second one. Then push the forefinger down the throat as far as possible, that the patient may vomit. Dissolve a teaspoonful of salt in water and give to the patient, or administer a teaspoonful of ipecac every few minutes to a child, and a tablespoonful to an adult. Follow the dose with a glass of water and then insert the forefinger in the throat. One who has taken opium does not vomit easily and strenuous efforts should be made to produce vomiting. If one emetic does not work, give another, and keep on repeating it.

Exercise

Physical exercises are absolutely essential to health. The working man, however, is likely to obtain enough of it from his daily action, but those of sedentary habits, especially those who work indoors, will not receive sufficient exercise from their labor.

While the gymnasium is to be recommended, and while it has done much to make weak people strong, I would not advise any one to take more than very simple gymnasium exercises without the advice of a physician. Exercises may be taken in the bedroom, with the use of light dumb bells, or without the use of any apparatus at all.

Walking is the best of all, for it can be enjoyed by those in poor health or physically weak. It takes one out of doors, and exercise out of doors is far better than that taken in a closed room. If you exercise at home, open all of the windows.