362. Bites of Mad Dogs. Remove the clothing at once, if only from the bitten part, and apply a temporary ligature _above_ the wound. This interrupts the activity of the circulation of the part, and to that extent delays the absorption of the poisonous saliva by the blood-vessels of the wound. A dog bite is really a lacerated and contused wound, and lying in the little roughnesses, and between the shreds, is the poisonous saliva. If by any means these projections and depressions affording the lodgment can be removed, the poison cannot do much harm. If done with a knife, the wound would be converted, practically, into an incised wound, and would require treatment for such.

If a surgeon is at hand he would probably cut out the injured portion, or cauterize it thoroughly. Professional aid is not always at our command, and in such a case it would be well to take a poker, or other suitable piece of iron, heat it _red_ hot in the fire, wipe off and destroy the entire surface of the wound. As fast as destroyed, the tissue becomes white. An iron, even at a white heat, gives less pain and at once destroys the vitality of the part with which it comes in contact.

If the wound is at once well wiped out, and a stick of solid nitrate of silver (lunar caustic) rapidly applied to the entire surface of the wound, little danger is to be apprehended. Poultices and warm fomentations should be applied to the injury to hasten the sloughing away of the part whose vitality has been intentionally destroyed.

Any dog, after having bitten a person, is apt, under a mistaken belief, to be at once killed. This should not be done. There is no more danger from a dog-bite, unless the dog is suffering from the disease called _rabies_ or is "mad," than from any other lacerated wound. The suspected animal should be at once placed in confinement and watched, under proper safeguards, for the appearance of any symptoms that indicate rabies.

Should no p.r.o.nounced symptoms indicate this disease in the dog, a great deal of unnecessary mental distress and worry can be saved both on the part of the person bitten and his friends.

363. Injuries to the Blood-vessels. It is very important to know the difference between the bleeding from an artery and that from a vein.

If an artery bleeds, the blood leaps in spurts, and is of a bright scarlet color.

If a vein bleeds, the blood flows in a steady stream, and is of a dark purple color.

If the capillaries are injured the blood merely oozes.

Bleeding from an artery is a dangerous matter in proportion to the size of the vessel, and life itself may be speedily lost. Hemorrhage from a vein or from the capillaries is rarely troublesome, and is ordinarily easily checked, aided, if need be, by hot water, deep pressure, the application of some form of iron styptic, or even powdered alum. When an artery is bleeding, always remember to make deep pressure between the wound and the heart. In all such cases send at once for the doctor.

[Ill.u.s.tration: Fig. 157.--Showing how Digital Compression should be applied to the Femoral Artery.]

Do not be afraid to act at once. A resolute grip in the right place with firm fingers will do well enough, until a twisted handkerchief, stout cord, shoestring, suspender, or an improvised tourniquet[53] is ready to take its place. If the flow of blood does not stop, change the pressure until the right spot is found.

Sometimes it will do to seize a handful of dry earth and crowd it down into the bleeding wound, with a firm pressure. Strips of an old handkerchief, underclothing, or cotton wadding may also be used as a compress, provided pressure is not neglected.

In the after-treatment it is of great importance that the wound and the dressing should be kept free from bacteria by keeping everything surgically clean.

364. Where and how to Apply Pressure. The princ.i.p.al places in which to apply pressure when arteries are injured and bleeding should always be kept in mind.

Experiment 192. _How to tie a square knot_. If the student would render efficient help in accidents and emergencies, to say nothing of service on scores of other occasions, he must learn how to tie a square or "reef" knot. This knot is secure and does not slip as does the "granny" knot. The square knot is the one used by surgeons in ligating vessels and securing bandages. Unless one knew the difference, the insecure "granny" knot might be subst.i.tuted.

[Ill.u.s.tration: Fig. 158.--Showing how a Square Knot may be tied with a Cord and a Handkerchief.]

A square knot is tied by holding an end of a bandage or cord in each hand, and then pa.s.sing the end in the _right_ hand over the one in the left and tying; the end now in the _left_ hand is pa.s.sed over the one in the right and again tied.

If in the finger, grasp it with the thumb and forefinger, and pinch it firmly on each side; if in the hand, press on the bleeding spot, or press with the thumb just above and in front of the wrist.

For injuries below the elbow, grasp the upper part of the arm with the hands, and squeeze hard. The main artery runs in the middle line of the bend of the elbow. Tie the knotted cord here, and bend the forearm so as to press hard against the knot.

For the upper arm, press with the fingers against the bone on the inner side, and just on the edge of the swell of the biceps muscle. Now we are ready for the knotted cord. Take a stout stick of wood, about a foot long, and twist the cord hard with it, bringing the knot firmly over the artery.

For the foot or leg, pressure as before, in the hollow behind the knee, just above the calf of the leg. Bend the thigh towards the abdomen and bring the leg up against the thigh, with the knot in the bend of the knee.

365. Bleeding from the Stomach and Lungs. Blood that comes from the lungs is bright red, frothy, or "soapy." There is rarely much; it usually follows coughing, feels warm, and has a salty taste. This is a grave symptom. Perfect rest on the back in bed and quiet must be insisted upon.

Bits of ice should be eaten freely. Loosen the clothing, keep the shoulders well raised, and the body in a reclining position and absolutely at rest. Do not give alcoholic drinks.

Blood from the stomach is not frothy, has a sour taste, and is usually dark colored, looking somewhat like coffee grounds. It is more in quant.i.ty than from the lungs, and is apt to be mixed with food. Employ the same treatment, except that the person should be kept flat on the back.

366. Bleeding from the Nose. This is the most frequent and the least dangerous of the various forms of bleeding. Let the patient sit upright; leaning forward with the head low only increases the hemorrhage. Raise the arm on the bleeding side; do not blow the nose. Wring two towels out of cold water; wrap one around the neck and the other properly folded over the forehead and upper part of the nose.

Add a teaspoonful of powdered _alum_ to a cup of water, and snuff it up from the hand. If necessary, soak in alum water a piece of absorbent cotton, which has been wound around the pointed end of a pencil or penholder; plug the nostril by pushing it up with a twisting motion until firmly lodged.

367. Burns or Scalds. Burns or scalds are dangerous in proportion to their extent and depth. A child may have one of his fingers burned off with less danger to life than an extensive scald of his back and legs. A deep or extensive burn or scald should always have prompt medical attendance.

In burns by acids, bathe the parts with an alkaline fluid, as diluted ammonia, or strong soda in solution, and afterwards dress the burn.

In burns caused by lime, caustic potash, and other alkalies, soak the parts with vinegar diluted with water; lemon juice, or any other diluted acid.

Remove the clothing with the greatest care. Do not pull, but carefully cut and coax the clothes away from the burned places. Save the skin unbroken if possible, taking care not to break the blisters. The secret of treatment is to prevent friction, and to keep out the air. If the burn is slight, put on strips of soft linen soaked in a strong solution of baking-soda and water, one heaping table spoonful to a cupful of water. This is especially good for scalds.

[Ill.u.s.tration: Fig. 159.--Dotted Line showing the Course of the Femoral Artery.]

_Carron oil_ is one of the best applications. It is simply half linseed-oil and half lime-water shaken together. A few tablespoonfuls of carbolic acid solution to one pint may be added to this mixture to help deaden the pain. Soak strips of old linen or absorbent cotton in this time-honored remedy, and gently apply.

If carbolized or even plain _vaseline_ is at hand, spread it freely on strips of old linen, and cover well the burnt parts, keeping out the air with other strips carefully laid on. Simple cold water is better than flour, starch, toilet powder, cotton batting, and other things which are apt to stick, and make an after-examination very painful.

[Ill.u.s.tration: Fig. 160.--Showing how Hemorrhage from the Femoral Artery may be arrested by the Use of an Improvised Apparatus (technically called a _Tourniquet_).]

368. Frost Bites. The ears, toes, nose, and fingers are occasionally frozen, or frost-bitten. No warm air, warm water, or fire should be allowed near the frozen parts until the natural temperature is nearly restored. Rub the frozen part vigorously with snow or snow-water in a cold room. Continue this until a burning, tingling pain is felt, when all active treatment should cease.

Pain shows that warmth and circulation are beginning to return. The after effects of a frost bite are precisely like those of a burn, and require similar treatment. Poultices made from sc.r.a.ped raw potatoes afford much comfort for an after treatment.

369. Catching the Clothing on Fire. When the clothing catches fire, throw the person down on the ground or floor, as the flames will tend less to rise toward the mouth and nostrils. Then without a moment's delay, roll the person in a carpet or hearth-rug, so as to stifle the flames, leaving only the head out for breathing.

If no carpet or rug can be had, then take off your coat, shawl, or cloak and use it instead. Keep the flame as much as possible from the face, so as to prevent the entrance of the hot air into the lungs. This can be done by beginning at the neck and shoulders with the wrapping.

370. Foreign Bodies in the Throat. Bits of food or other small objects sometimes get lodged in the throat, and are easily extracted by the forefinger, by sharp slaps on the back, or expelled by vomiting. If it is a sliver from a toothpick, match, or fishbone, it is no easy matter to remove it; for it generally sticks into the lining of the pa.s.sage. If the object has actually pa.s.sed into the windpipe, and is followed by sudden fits of spasmodic coughing, with a dusky hue to the face and fingers, surgical help must be called without delay.

If a foreign body, like coins, pencils, keys, fruit-stones, etc., is swallowed, it is not wise to give a physic. Give plenty of hard-boiled eggs, cheese, and crackers, so that the intruding substance maybe enfolded in a ma.s.s of solid food and allowed to pa.s.s off in the natural way.

371. Foreign Bodies in the Nose. Children are apt to push beans, peas, fruit-stones, b.u.t.tons, and other small objects, into the nose.

Sometimes we can get the child to help by blowing the nose hard. At other times, a sharp blow between the shoulders will cause the substance to fall out. If it is a pea or bean, which is apt to swell with the warmth and moisture, call in medical help at once.

372. Foreign Bodies in the Ear. It is a much more difficult matter to get foreign bodies out of the ear than from the nose. Syringe in a little warm water, which will often wash out the substance. If live insects get into the ear, drop in a little sweet oil, melted vaseline, salt and water, or even warm mola.s.ses.

If the tip of the ear is pulled up gently, the liquid will flow in more readily. If a light is held close to the outside ear, the insect may be coaxed to crawl out towards the outer opening of the ear, being attracted by the bright flame.

373. Foreign Bodies in the Eye. Cinders, particles of dust, and other small substances, often get into the eye, and cause much pain. It will only make bad matters worse to rub the eye. Often the copious flow of tears will wash the substance away. It is sometimes seen, and removed simply by the twisted corner of a handkerchief carefully used. If it is not removed, or even found, in this way, the upper lid must be turned back.

[Ill.u.s.tration: Fig. 161.--Showing how the Upper Eyelid may be everted with a Pencil or Penholder.]