PLAIN DIRECTIONS 
FOB 
ACCIDENTS, EMERGENCIES, 
AND POISONS. 
ENLARGED EDITION. 
KEEP THIS WHERE YOU CAN READILY FIND IT. 
FELLOW OF THE COLLEGE OF PHYSICIANS OF PHILADELPHIA •% 
BY A 
niYSICIAN TO SEVERAL OF TIIE CHARITABLE INSTITUTIONS OF TnE SAaS^uTp^ 
AND 
ALL RIGHTS RESERVED BY THE AUTHOR. 
ONE HUNDRED AND TWENTIETH THOUSAND. 
DISTRIBUTED TO ITS POLICY-HOLDERS BY THE 
MUTUAL LIFE INSURANCE COMPANY OF NEW-YOE 
F. S. WF,r 7, President. Entered according to Act of Congress, in the year 1875, by 
The Mutual Life Insurance Company, 
in the Office of the Librarian of Congress, at Washington. 
W. Green, Printer, 
t8 Jacob St., N. Y. INTRODUCTORY. 
The object of Ibis little book, as it is hoped every page will 
show, is to give a few plain directions as to what should be 
done in cases of the commoner accidents, emergencies, and 
poisons, until the arrival of skilled assistance. 
It is written by a physician for gratuitous distribution, and 
the entire expense of preparing the cuts and publication 
has been borne by a kind friend. Both of them will feel 
amply rewarded for the trouble taken in carrying out this 
intention, by knowing that what is here Avritten has in any 
way tended to prevent unnecessary suffering, or has in a 
degree contributed to save the life and activity of some useful 
member of the community. 
A. P. T. 
Howard Hospital and Infirmary for Incurables, 
1518 and 1590 Lombard Street, Philadelphia. 
August, 1875. ACCIDENTS—EMERGENCIES—POISONS. 
Scarcely a month passes by, to many persons, without meeting 
somewhere an accident or an emergency in which a little reliable 
information is not of the greatest service. One of the difficulties 
usually to be contended against in such cases is, loss on the part 
of the bystanders to know just what should be done. It will be 
found, as a rule, that the simplest things, usually the most useful, 
are neglected, while there is a disposition to rely upon cumbrous 
appliances, often of disadvantage, and sometimes positively hurt- 
ful. 
The object of the writer of this pamphlet is to present in a 
compressed form, for easy recollection and ready reference, a few 
suggestions as to what should be done in certain cases of emer- 
gency, until the arrival of skilled professional assistance. It is 
not saying too much, perhaps, that what is to be done to give re- 
lief or save life, in the greater number of cases, must be done by 
some one else before the aid of a physician can be procured. It 
has been truly said, “ for want of timely care, millions have died 
of medicable wounds.” 
As far as possible, the use of technical terms will be omitted, 
although where necessary they will be used, with a brief definition 
inclosed in brackets ; but the writer would respectfully suggest, 
that, whenever possible, the scientific terms should be remembered 
and used, instead of the popular expressions for the same thing. 
A scientific term, the world over, means but one thing; while a po- 
pular expression, in one place, means one thing, and in another, 
two or three things ; and, possibly, nothing at all. ACCIDENTS—EMERGENCIES—POISONS. 
ACCIDENTS IN GENERAL. 
An accident anywhere, if there are people about, assembles a 
crowd around the victim. The first thing to be done is to dis- 
perse it ; or, at least, get the people to keep away from theinjur- 
ed person. A space of at least ten feet on every side should be 
kept wholly free from everybody except the one or two in charge of 
the operations for relief. If others are needed for a moment, to 
assist in some special duty, as lifting, removing of dress, etc., 
they can be specially selected from the crowd ; and, having been 
of service, can immediately return where they came from. In se- 
veral instances, the writer has seen a person just removed from 
water, or gas, so closely surrounded by a dense mass of “rela- 
tives” and “ friends,” that it was impossible for the physician to 
freely use his arms. The Tcindest tiling a bystander can do, is to 
insist upon a free space as large as suggested, and select from the 
crowd persons to hold themselves in readiness to start for what- 
ever the physician or the individual in charge of the case may re- 
quire. To show how little real interest the inside layer of the 
crowd usually takes in the restoration of the patient, it will ofteu 
be found that it is almost impossible to get one of them to run an 
errand in the interest of the sufferer. 
If the person has been thrown from a carriage, injured by a fall 
from a height, blow or other cause ; while there may be no frac- 
ture, or other external injury evident, the nervous system has re- 
ceived what is called a “ shock.” As is commonly said, the per- 
son is “ faint.” 
A person suffering -with such symptoms should, if possible, be 
placed flat on the back, with the head, neck, and shoulders 
slightly raised. The limbs, at the same time, should be straighten- 
ed out, if practicable ; so that the heart, already depressed in ac- 
tion, may act at as little disadvantage as possible. The cravat, col- 
lar, and every thing else calculated to in any way impede the cir- 
culation toward the head, or the movements of the chest, should 
be loosened or removed. If the injury is slight, reaction will soon ACCIDENTS EMERGENCIES POISONS. 
7 
come on after giving the person a sip of cold water ; brandy and 
water (tea-spoonful in a table-spoonful of cold water every couple 
of minutes) ; or Aromatic Spirits of Ammonia (twenty drops in a 
table-spoonful of cold water) every couple of minutes. Gentle 
frictions to the extremities, a few drops of cologne-water on a 
handkerchief to the nostrils ; if the weather is hot, the use of a 
palm-leaf fan ; hot flannels to the limbs and epigastrium (pit of 
the stomach) ; are all likewise useful in assisting reaction. 
By this time, should a surgeon have arrived, he will examine 
and decide upon the special nature of the injury, and inaugurate 
measures of special relief. Should he not have appeared, and it is 
thought best to remove the patient to the hospital, or his home, a 
stretcher should be secured, or a substitute, in the shape of a settee 
or shutter, provided. The injured person should then be gently 
slipped on, seeing that the body is supported as much as possible 
along its length, something thrown over or held over the face, to 
prevent, as much as practicable, the uncomfortable feeling of being 
stared at in passing along. Four persons of uniform gait should 
then gently lift the stretcher and slowly carry the person to his 
destination. In most cities, appliances for carrying injured 
persons arc required to be kept at the station-houses, and 
can be obtained, on application, as well as the services of a good 
policeman. The authority of the latter is almost invaluable in 
keeping away the crowd referred to, and in securing useful atten- 
tion in conveying the person through the streets. If the person 
is to be taken to the hospital, a dispatch from a police-station 
will secure from most of them, free of charge, an ambulance, 
with competent persons to take charge of the injured individual. 
Directions for fractures and dislocations are given elsewhere, 
p. 34. 
This commonly-used word is from the Greek, signifying an ab- 
sence of pulse. It states a fact, but not the cause. Like many 
other old words, the original meaning has been set aside, and it 
ASPHYXIA. 8 
ACCIDENTS—EMERGENCIES —POISONS. 
now means suspended animation, produced by the non-conversion 
of the venous blood in the lungs into arterial. The supply of 
good air to the lungs being cut off by some cause, the necessary 
purification at that point no longer takes place, and death of the 
entire body ensues from the absence of arterial blood, or the pre- 
sence of venous blood ; some physiologists regarding it from one 
cause, others from the other. In other words, as is often said, 
the person dies because the blood is not purified. 
It will be seen there can be several varieties of Asphyxia, as, 
(1) Asphyxia from submersion, as in the ordinary drowning in 
water or other fluids ; (2) Asphyxia from mechanical causes, as by 
strangulation, or hanging, and by foreign bodies in the windpipe 
or its approaches ; (3) Asphyxia by inhalation of gases, known as 
suffocation; (4) Asphyxia from torpor of the medulla oblongata 
(an important portion of the brain, at the junction of the spinal 
cord and what is called the brain), produced by the introduction 
into the blood of certain poisons. 
Drowning. 
As said above, this is Asphyxia from submersion iu water or 
other fluids. This accident is of such frequent occurrence, and 
what is to be done must be done so quickly, that it is the duty of 
every member of the community to understand the measures of 
relief in such cases.* 
The body should be recovered as soon as possible from the wa- 
ter ; the face turned downward for a moment, with the forefinger 
of a bystander slightly curved and thrust backward, to depress 
the tongue, to favor the escape of a small quantity of water or 
*A series of brief and easily understood “Directions for Restor- 
ing the Apparently Drowned,” have been prepared and printed in 
large type, on cards suitable for banging. Responsible individuals 
willing to personally undertake tlie placing of them at ferry-slips, 
bridge-approaches, boat-houses, and such places, will be gratuitously 
furnished with cards, on application to the Howard Hospital and 
Infirmary for Incurables, 15, 18 and 20 Lombard street, Philadelphia. ACCIDENTS EMERGENCIES—POISONS. 
9 
mucus, or other substances, often collected at the base of the 
tongue, over the entrance to the trachea (windpipe), which tends 
to obstruct the entrance of air to the lungs. The barbarous prac- 
tice of rolling the person over a barrel, or hanging him head 
downward, to permit the escape of water from the lungs, has al- 
most ceased, in view of the fact, now generally known, that no 
water can get into the lungs. 
This can be done as the body is being conveyed to the nearest 
house, a messenger having been previously dispatched to make the 
arrangements involved in the following: As soon as the body 
arrives, it should be stripped of the clothing, rapidly dried, 
placed on a bed, previously warmed, the head, neck, and shoulders 
raised a very little, if any ; frictions with the dry hands used to 
the extremities, and heated flannels kept applied to the rest of 
the body. 
For an instant imagine the condition of affairs. Each atom of 
the body requires arterial blood, which is blood purified in the 
lungs by exposure to the air breathed. This purification has been 
suspended, and to that extent the life of the body is suspended. 
Movements of the chest, by which air is inhaled, are at a stand- 
still, and can not, of themselves, be resumed. If artificial breathing 
can be carried out for some time, it will be seen that these impu- 
rities may be so far removed that natural respiration can take 
place. Two methods are usually employed for the purpose—the 
first known as “ Silvester’s Heady Method.” 
This consists, after the above suggestions have been carried out, 
in pulling the tongue forward which better favors the passage of 
air along the base of the tongue into the trachea (windpipe), and 
then drawing the arms away from the sides of the body and up- 
ward, so as to meet over the head, by means of which the ribs are 
raised (expansion of the chest) by the muscles (pectoral) running 
from them to the arms near the shoulder. A vacuum is thus 
created in the lungs, the air rushes in, and the blood then is puri- 
fied by the passage of the impure gases in the blood-vessels to the 10 
ACCIDENTS—EMERGENCIES TOISONS. 
air, and by the giving up by the air of a portion of its oxygen to 
the blood. The arms are now brought down to the sides, and the 
elbows made to almost meet over what is called the “ pit of the 
stomach.” This produces contraction of the walls of the chest, 
and expulsion of the impure air from the lungs. 
These two movements constitute an act of respiration, and 
should be persisted in, without interruption, at the rate of about 
sixteen to the minute. In other words, each complete movement 
should occupy about four seconds, which is about the natural rate 
of respiration in health. 
The second ‘‘Ready Method,” a3 it is called, is that of Marshall 
Hall. 
The person whose breathing is to be restored is placed fiat on 
the face, gentle pressure is then made on the back, the pressure 
removed, the body turned on its side, or a little beyond that. 
The body is then turned again on the face, gentle pressure again 
used to the back, then turned on the side. This should be done 
about sixteen times in a minute. 
Both of these methods have the same object in view ; either may 
he exclusively used, or one may be alternated with the other. 
Most physicians express a preference for the first described ACCIDENTS—EME11GENCIES—POISONS. 
11 
(“ Ready Method of Silvester.”) Both of these procedures might 
be practiced, in advance, by the reader, because such practice 
might be more easily remembered than a concise rule. The appli- 
cation of the tourniquet, or pressure of the fingers, described else- 
where, to a blood-vessel, might also be practiced at the same timo. 
There are few people, in an ordinary life, who will not find knowr- 
ledge of this kind, at their fingers’ end, of the greatest use. 
In speaking of the restoration of persons drowned, it is often 
said that he was a good swimmer, and must have been attacked 
with “cramp.” This is a spasmodic contraction of the muscles 
beyond the control of the individual, and occurs after exhaustion 
of the muscles from over-exertion. Persons suffering from debi- 
lity, especially the debility peculiarly affecting the nervous sys- 
tem, should never be induced to go beyond depth in the water, or 
out of reach of immediate assistance. There is no warning in ad- 
vance of the seizure, and the person sinks at once. Many lives 
are lost each season, in shallow as well as in deep water, from 
these seizures, which could have been avoided had the bather, 
perhaps just recovering from an attack of sickness, or even of in- 
disposition, not neglected the precautions stated. 
Recovery from Asphyxia from drowning can scarcely be expect- 
ed to take place after an immersion of five or six minutes, although 
there are well-authenticated cases where restoration has taken 
place after an immersion of as much as twenty minutes. The 
effort ought to be made, and persisted in until the arrival of a 
physician, or for at least a couple of hours. As soon as returning 
vitality permits, a few drops of brandy, in a little water, may be 
given; and, as the strength of the person is usually completely 
exhausted, from muscular efforts of the most violent and conti- 
nued character, to save himself from drowning, some beef-tea, or 
other easily-digested nourishment, should be given. 
Here death results from Asphyxia induced by pressure applied 
to the trachea (windpipe) from the outside, as in strangling, or 
Hanging. 12 
ACCIDENTS—EMERGENCIES—POISONS. 
hanging. The body, if hanging, should be at once cut down, tak- 
ing care not to let it fall, so as to complicate the trouble. If the 
knot can be untied readily, it should be done; if not, cut the li- 
gature. Remove, by the finger, as in directions in drowning, any 
accumulation of mucus at the base of the tongue, place the body 
on [the back, just as directed for a person taken from the water. 
If the body is still warm, after removal of the clothing, the face, 
head, neck, and chest should be dashed freely with cold water. 
To do this successfully, a person should stand off six feet, or even 
more, with a bowl of cold water, and then throw its contents, 
with as much force as possible, against the person. After using 
for a suitable length of time, the water should then be rapid- 
ly wiped off with a towel. There is little difference in essential 
features, after removal of the ligature from the neck, in the con- 
dition of a person who has been hanged or who lias been drown- 
ed. In both it is Asphyxia : in one case, the air was kept from 
the lungs by a ligature; in the other, by a liquid. Artificial respi- 
ration in both of them must be used, assisted for the same reason, 
and in the same manner, by like auxiliaries. 
There is an impression, quite prevalent among the ignorant, 
that a penalty is incurred at law for cutting down the body of a 
person found hanging, unless the sanction of the coroner is ob- 
tained. No such delay is necessary nor even justifiable; and an 
effort should at once be made to restore suspended animation by 
the methods given. 
Suffocation. 
There are several gases, which, when inhaled, are followed by 
symptoms of Asphyxia. The little valve (epiglottis) over the en- 
trance of the trachea (“ windpipe”), is so extremely sensitive that 
it will not even permit a drop of water to pass without a spasmo- 
dic closure of the opening, followed by coughing. It is not only 
sensitive to solids and liquids, but also to the presence of most 
gases. At one time it ivas thought that all gases were taken past 
it into the lungs, and absorbed from thence into the blood. The ACCIDENTS—EMERGENCIES—rOlSONS. 
13 
opinion now seems to prevail that most of them irritate the valve 
spoken of at the entrance of the trachea (windpipe), and closure 
of the entrance follows. The breathing is thus interrupted much 
as it is in drowning, where the liquid cuts off the passage of air to 
the lungs ; or as in hanging, where the ligature prevents the en- 
trance of air. In such cases, death results from Asphyxia. 
Asphyxia, by inhalation of gas, takes place as soon as the per- 
son comes within the influence of this compound, and takes it in 
with the breath. A sudden sense of suffocation is felt, with diz- 
ziness of the brain and inability to stand. If a person is stand- 
ing at the time the air is taken into the lungs, and falls over, he 
is in a position, while down, to inhale more of the carbonic acid 
gas, for, being heavier than the air, much more of it is to be ex- 
perienced at the bottom of the well, or cavern, than five feet 
higher up. 
Carbonic Acid Gas. 
This gas, sometimes known under the name of “ Choke Damp,” 
is produced in the ordinary process of fermentation, in burning 
and slaking lime ; and it is also found in mines, particularly coal- 
mines ; and in wells, cellars, or caves which have been long closed 
up. It is considerably heavier than the atmosphere, and is con- 
sequently found lying on the floor of the cavity where confined. 
ISTo well, vat, old cellar, or cavern of any kind, should ever be 
entered without first lowering down into the deepest point a 
lighted candle. If the flame is extinguished, or burns dimly, indi- 
cating the presence of this gas, no one, under any circumstances, 
should be permitted to enter without removing this foul air. It 
lies at the bottom, because too heavy to ascend. It is not so heavy, 
however, that a strong current of common air will not dislodge 
it. Buckets of water dashed down into the well, or masses of 
lighted shavings or blazing paper, give enough movement to the 
carbonic acid gas to dislodge it from its resting-place. After 
testing the success of the effort by again introducing the lighted 14 
ACCIDENTS—EMERGENCIES—POISONS. 
candle, it can soon be known whether a person may enter with 
impunity. Freshly-slaked lime also rapidly absorbs it. 
Often there may be no such gas shown in the cavity, but the 
efforts of the workmen will dislodge it from an adjacent space into 
the one in which he is breathing. This possibility should never be 
lost sight of. 
When a person appears overcome by this Carbonic Acid gas, he 
is, of course, wholly unable to help himself, and he must at once 
be removed by another. Sometimes a grapnel-hook can be used 
with advantage, but often the better way is to rapidly lower 
some bold, clear-headed person, witli a rope securely fastened 
around his middle, who can seize and bring to the surface the un- 
fortunate individual. No time should be lost in descending or 
arising, as the person lowered depends upon doing every thing 
during the interval he can hold his breath ; for, of course, should 
he inhale the gas, his position, in this respect, would be but little 
better than the man he attempts to succor. A large sack is some- 
times thrown over the head and shoulders of the person who de- 
scends. It contains enough air to serve for several inhalations, 
while the texture of the material prevents, to a hurtful degree, the 
admission of the deleterious gas. 
The person suffering from Asphyxia from the gas, immediately 
after being brought out, should be placed on his back, the neck 
and throat bared, and any other obstacles to the breathing quick- 
ly removed. Ilis body should then be quickly stripped, and if 
he have not fallen into water on being overpowered by the 
gas, his head, neck, and shoulders freely dashed with cold water. 
Remember, this is not “ simnkling,” as commonly practiced; 
but, as said before, a person should stand off some distance, with 
a bowl of cold water, and throw its contents, with as much force as 
possible, against the parts. Others should follow without an in- 
terval for half a minute, while one can count thirty slowly, then the 
dripping water wiped away by a towel. This procedure should 
be repeated from time to time, as apparently required. Some- ACCIDENTS—EMERGENCIES—POISONS. 
15 
times, if a brook of water is near, the stripped person might be 
dipped again and again ; being careful, of course, not to dip in liis 
face. Artificial respiration should be used with as little intermis- 
sion as possible. 
Should the person have fallen in water and become chill- 
ed, the use of the cold water, in this manner, had better be avoid- 
ed, as the evaporation of the moisture absorbs more heat than can 
be manufactured by the exhausted and overpowered system. In 
such a case, the body of the person should be put into a warmed 
bed, with hot applications, and Artificial Respiration (p. 10) at 
once established, as in the Asphyxia from drowning and hanging. 
While artificial respiration is being used, friction applied to the 
limbs should be kept up. 
Burning Charcoal. 
Certain gases (Carbonic Oxide Gas) of a very poisonous char- 
acter, are given off during the burning of charcoal, and when in- 
haled for a sufficient length of time, rapidly prove fatal. The 
person quickly drops insensible, and dies of Asphyxia in many 
respects like the person who has succumbed to the Carbonic Acid 
Gas, just described. The treatment there advised should at 
once be carried out. 
These also, ■when burned in a close room, as a kitchen shut up 
for the night with an open stove of these burning coals, give off, 
to a degree, the peculiar poisonous gas alluded to as coming from 
burning charcoal; Carbonic Oxide Gas ; as well as other noxious 
gases. Persons sleeping in such a room, under the circumstances, 
unless awakened as the air becomes fouled, will be found sense- 
less or dead, soon after. The treatment should be as described in 
the preceding pages, in Asphyxia from inhaling Carbonic Acid 
Gas. 
Anthracite and Bituminous Coal. 
Common Burning' Gas. 
Persons retiring at night often leave the gas “ turned down,’’ 
and the flame becomes extinguished. Enough gas often escapes ACCIDENTS—EMERGENCIES—POISONS. 
to give trouble to the sleeper unless the room is well ventilated. 
Persons have been known to “ blow it out” as they would a can- 
dle, and suffocation more of less complete has followed. 
Treat as in the Asphyxia from other gases just described. 
Foreign Bodies in the Throat. 
A piece of food or some other body often gets back into the 
mouth, and cannot be swallowed. In such a case, the finger will 
often be able to thrust it downward, should that be thought best. 
A liair-pin, straightened and bent at the extremity, will often 
drag it out. If the body is firm in character, a pair of scissors, 
separated at the rivet, and one blade held by the point, will fur- 
nish a loop, which often can be made to extract it. 
This is usually Sulphureted Hydrogen, and arises from the de- 
composition of the residual matters usually found there. Great 
caution, on this account, should always be observed on opening 
and entering such places, or places in possible communication with 
them, especially if they have been long closed. A small quantity 
of pure Sulphureted Hydrogen, if inhaled, is usually fatal; but, 
in the cases referred to, the gas usually exists diluted with com- 
mon air. The breathing becomes difficult, the person loses his 
strength, falls, becomes insensible and cold, lips and face blue, and 
the mouth covered with a bloody mucous secretion. 
Foul Air in Drains and Privies. 
The person should be removed as quickly as possible beyond 
the influence of the foul air, and the treatment under the head of 
“ Carbonic Acid Gas” pursued. 
Tho possibility of such a disaster slioukl always be borne in 
mind in opening long-closed drains or privy-vaults, and the dan- 
ger lessened by taking a few pounds of chloride of lime (bleach- 
ing salt) dissolving it in a pailful of water, and dashing it into the 
cavity. In the absence of this, lime and water, in the form of the 
common “whitewash,” may be employed. This gas readily ACCIDENTS—EMERGENCIES—TOISONS. 
17 
combines with lime ; to that extent freeing the air of the poison- 
ous compound. 
SUNSTROKE. 
Ordinary exhaustion, from overwork in a heated atmosphere, is 
about the only disorder likely to be confounded with sunstroke. 
In directions for popular use, like these, the distinction between 
the two will not be attempted, as there is no essential difference 
in the treatment. 
Contrary to what is generally supposed, exposure of the head to 
the direct rays of the sun is not necessary, as statistics show it oc- 
curs in the shade, under shelter, and even at night; sometimes, 
even in persons who have not been exposed to the sun for days be- 
fore. Intense heat always appears necessary to produce it; but 
the heat need not be solar, but may be artificial. Workmen in 
sugar refineries and laundries have been attacked. 
Sunstroke appears to be decidedly favored by intemperance; 
want of acclimatization ; and the debility which has been brought 
on by fatigue in a heated atmosphere, also favors it. Occupants 
of badly-ventilated sleeping apartments appear to be oftener at- 
tacked than those who sleep in purer air. 
Symptoms.—It is generally thought by the non-professional, 
that the symptoms of sunstroke come on without any warning 
whatever. Most cases, however, are preceded by pain in the 
head ; wandering of the thoughts, or an inability to think at all; 
disturbed vision ; irritability of temper ; sense of pain or weight 
at the pit of the stomach; inability to breathe with the usual ease 
and satisfaction. These symptoms become more marked until in- 
sensibility is reached, sometimes preceded by delirium. 
The skin is very hot, usually dry, but when not dry, covered 
with profuse perspiration. The face is dusky, or, as the saying 
is, “blue;” breathing, rapid and short, or slow and sighing. 
The action of the heart, indicated to the hand placed over it, is 
weak, rapid, and tremulous, often compared to the “fluttering of 
a bird.” In many instances, from what is popularly termed the 18 
ACCIDENTS EMERGENCIES TOISONS. 
commencement of the attack until it ends in death, the patient does 
not move a limb, nor even an eyelid. 
The breathing gradually fails ; the blood, therefore, is not puri- 
fied in the lungs, as is indicated by the livid, purplish appearance 
of the surface. We are led by it to conclude that death takes 
place by Asphyxia, as described under the heads, “Drowning,” 
“Suffocation,” etc., pp. 10-12. 
Causes.—While we know certain things favor the disorder; that 
a high temperature is necessary to produce it ; and advise certain 
measures of precaution and relief, found by experience useful in 
such cases ; but little is known of the nature of the malady. It 
would seem that the great heat of the body induces some change 
in the character of the blood, disqualifying it for the usual pur- 
poses of blood. From this peculiar condition of the blood, the 
portions of the brain or nervous system controlling the action of 
the muscles of the chest and heart lose their ability to superintend 
properly the movements of breathing and circulation, and, as said 
before, the person dies from Asphyxia. 
Treatment.—The person attacked should at once be carried to a 
cool, airy spot, in the shadow of a wall, or to a large room in a 
house with a bare floor; or, what is often better, if there is no 
sun, he should be placed in a lach yard, on the pavement. Un- 
necessary bystanders must be kept at a distance, as the person in 
this, as in every other accident, needs all the pure air about. 
The clothing should be at once and gently removed, and the 
patient placed on his back, with the head raised a couple of inches 
by a folded garment. Then the entire body, particularly the 
head and chest, dashed with cold water, in profusion. "While 
preparations are being made for this, a messenger should be dis- 
patched for a good supply of ice. A large fragment should be 
placed in a towel, and struck a few times against the side of the 
house to rapidly reduce it to small pieces. These pieces, mixed 
by the hand into a bucket of water, will rapidly supply ice-water. 
Two buckets can be used, each half full of the small ice, and as ACCIDENTS EMERGENCIES—POISONS. 
soon as the water of one is used for dashing against the patient, 
another will be ready for the same purpose. The ice-water must 
not be sprinJcled over the person, but dashed against him in large 
bowlfuls, particularly against the head and chest. While one 
person makes the ice-water, and another uses it, a third should, 
in the same manner, with a towel, break some ice in fragments 
not larger than almonds. A double handful, at least, of these bits 
should be placed in a thin, coarse towel, the ends gathered up and 
fastened with a string, as you would a pudding. Then holding to 
the tied portion of the collection of ice, the entire surface of the 
body should be rapidly ruJjbed. Indeed, two other persons might, 
each at the same time, be engaged at different portions of the 
body—not forgetting the head. 
These measures are to reduce the heat of the body from the high 
temperature, evident even to the hand of a bystander, to some- 
thing like a natural temperature. When the decline in the 
heat is noticed, the cold applications should be abandoned, 
the patient carefully removed to a dry spot, and the entire 
surface of the body dried off with towels. Should a tendency 
to a return of the high temperature be seen, as sometimes 
happens, even after consciousness is restored, it must be met by 
a renewal of the cold applications. The rise again in tempera- 
ture need not seem surprising, when the amount of highly heated 
blood within the body, not yet exposed to the cold applications, 
is taken into consideration. 
Artificial respiration, until the natural returns, must be resort- 
ed to as soon as the heated condition of the body i3 overcome. 
The dashing of cold water over the chest and face is a useful 
means of encouraging a return of the suspended breathing, and is 
practiced in asphyxia from other causes (p. 14). The Ready Me- 
thods of p. 11, however, had better be relied on for this purpose- 
Medicines in this malady, it will be seen, can be of little value. 
A stimulant, however, may be useful. Brandy, or any other form 
of alcohol, should be carefully avoided. The best stimulant in 20 
ACCIDENTS EMERGENCIES—POISONS. 
all such cases, if it can be obtained, is the Aromatic Spirit of Am- 
monia;* fifteen or twenty drops in a table-spoonful of water, 
might be given every few minutes, until taken three or four times. 
Prevention.—During the heated term, as it is called, all use 
whatever of malt, fermented, or distilled drinks should be ab- 
stained from. Not only do they favor, in a general way, a condi- 
tion of the system in many respects similar to that which leads to 
sunstroke, but they deaden sensibility at the very time it ought 
to be on the alert; and the person is less able to detect slight 
changes in his feelings, which otherwise might have served as 
useful warnings in his behalf. The use of such substances, under 
the circumstances, seems as unwise as it would be for a person, in 
a time of great danger, to prepare for watchfulness by taking a 
dose of laudanum ; or for a worker with his hands among hot me- 
tal to apply something to them by which sensibility would be 
deadened or destroyed. By night, perhaps, he would have no 
fingers left. 
Every thing in any way calculated to impair the strength should 
be avoided. Sleep is a most wonderful restorer of strength, and 
the want of it is often caused by a badly-assorted late meal of the 
evening before. Defective ventilation leads to a condition of affairs 
favorable to the malady under consideration. Every night a bath 
should be taken; but as this is not always possible in every house, 
the entire body should be washed off each night before lying 
down. Laboring men who work in the sun have no excuse for 
neglecting this, for water costs nothing, and three minutes of time 
is all that is required. 
* The Aromatic Spirit of Ammonia, and Brandy, quite indepen- 
dent of tlieir intrinsic worth, are the two stimulants usually referred 
to, because most likely of all others to be found in an emergency. 
For the same reason, all through this treatise, but few simple appli- 
ances are directed, and these easily secured. It is an application of 
the principle of, one good thing always to be had ; rather than a dozen 
better, which can not. ACCIDENTS—EMERGENCIES—POISONS. 
21 
Drinking large quantities of cold water, merely because it is cold, 
should be avoided immediately before, during, and after meals. 
The debility resulting from the heat weakens the digestive pow- 
ers, and water unnecessarily used to excess at the times named 
tends still further to retard the digestion of the food, by further 
weakening the solvent action of the secretions of the stomach. 
In other words, if there is a time above all others, the year 
around, when every precaution for the preservation of health is re- 
quired, it is during the hot months of summer. 
Loosely fitting light garments should be ‘worn, if possible. Par- 
ticular attention should be given the head. It should be protected 
from the heat of the sun, and at the same time the covering worn 
should favor the circulation of a free current of air over the scalp. 
A straw hat of loose texture, with a lining to the crown which 
could be kept constantly wet, ought to be worn ; and if it has 
brim enough to protect the neck, and even the shoulders, the 
wearer is just that much more fortunate than other people. 
While attention should be paid to these things in hot weather, it 
is particularly necessary, should any of the named symptoms be 
observed on any special day, that the greatest care should be 
taken, if work in the sun is absolutely necessary, that the symptoms 
do not extend into an attack of sunstroke. Discontinuance of 
work, if possible, until the symptoms disappear, in such a case, 
would seem to be the lest course to be pursued. 
It is said that persons who have once suffered from sunstroke, 
for a long time after are unable to bear exposure to the heat, with- 
out a recurrence of the symptoms of the malady. 
ACCIDENTS FROM LIGHTNING. 
A person struck by lightning is usually rendered more or less 
unconscious by it, •which lasts for a longer or shorter time. Cases 
are on record where a person struck exhibited no sign of life for 
an hour, and then recovered. Temporary paralysis of a portion of 22 
ACCIDENTS EMERGENCIES—rOISONS. 
the body may remain for a while, as well as disturbance of some 
special function, as the sight, smell, taste, or hearing. 
The burns caused by lightning should receive the same attention 
as a burn from any other cause. Sometimes an injury observed is 
not directly due to the electricity, but from a fragment detached 
by that agent from a neighboring substance. 
When death takes place, it is from shock, as it is called, to the 
brain and nervous system. When the person exhibits little or no 
signs of life, the clothing should be rapidly and inmediately re- 
moved, the body exposed to a dashing of cold water; then dried, 
placed in bed, and warmth applied, particularly to the “ pit of the 
stomach,” by means of bottles filled with hot water, or the tin ves- 
sel kept in some households for such application. It is somewhat 
concave on one surface, filled with hot water, and, if it can be 
had, is well adapted to the purpose. 
Artificial Respiration should be kept up until the parts of the 
brain and nervous system in charge of this duty shall have reco- 
vered enough to attend to it. As said before, recoveries after an 
hour of supposed death are on record. 
Some stimulant, as the Aromatic Spirit of Ammonia, may be 
used. Twenty drops in a table-spoonful of water, every few mi- 
nutes, may be given ; or a tea-spoonful of Brandy instead. 
SHOCK. 
Mild forms of Shock, or Collapse, as it is sometimes called, are 
often, by the non-professional, confounded with Fainting (Synco- 
pe). As far as the symptoms extend, the symptoms of an ordinary 
attack of Fainting are analogous to those of Shock. The symp- 
toms between the two vary rather in degree and duration than in 
kind. 
Life may l>e destroyed by certain agencies, as a blow upon tlie 
“ pit of the stomach,” or a sudden and powerful emotion of the 
mind, and no visible trace be left in any part of the body. It is 
called “ Death from Shock.” This is the extreme result of Shock. ACCIDENTS—EMERGENCIES POISON'S. 
23 
Usually the patient lies in a state of utter prostration. There is 
pallor of the whole surface ; the lips are bloodless and pale. The 
eyes have lost their lustre, and the eyeball is usually partially co- 
vered by the drooping upper lid. The nostrils are usually dilat- 
ed. The skin is covered with a cold, clammy moisture, often ga- 
thered in beads of sweat upon the forehead. The temperature is 
cold, and perhaps the person shivers. The weakness of the mus- 
cles is most marked ; as the phrase is, “ the patient is prostrated.''1 
The mind is bewildered, often insensibility occurs, unless aroused ; 
and, in many cases, nausea and vomiting. In extreme cases, the 
nausea and vomiting are not so apt to occur. 
Sudden and severe injuries, particularly if extensive in character, 
and involving a large amount of texture, cause Shock. Burns—es- 
pecially of children—extending over a large extent of surface, even 
if not extending to a great depth, are often followed by Shock, and 
this complication requires often the earliest attention. 
Certain poisons, as Tobacco, and Tartar Emetic, act in this man- 
ner, depressing the system. So does a current of electricity, as is 
seen in the effects of lightning. 
Loss of Blood produces or aggravates Shock. Hence a slight 
injury, with much loss of Hood, may be attended with more Shock, 
than a comparatively more severe injury without the loss of blood. 
Debility favors the influence of Shock. A weak system is more 
easily impressed by it, and, as should be expected, reaction from 
its effects is longer in taking place. 
As the vital powers of life decline, from engrafted or natural 
causes, there is less power available as a reserve to meet contingen- 
cies. In youth there is an available fund of this kind; in the 
adult the resources of the system may be equal to the task of ordi- 
nary maintenance, but in the aged, as said before, there is much 
less ability to deal with sudden losses of strength. The aged, there- 
fore, are slow to rally from the effects of Shock. They have 
more power of resistance than the young. The shock docs not rea- 
dily make an impression, as it does in the young, but when it 24 
ACCIDENTS—EMERGENCIES POISONS. 
does, the impression endures. In the young the impression is more 
easily made, but sooner subsides. 
Treatment of Shock 
Consists in first placing the patient as flat on his back as possible, 
•with the head raised not over an inch. This is an important point 
in cases of ordinary Fainting, and whenever the vital powers aro 
depressed. Stimulants are required. The aromatic character of 
Brandy enables it to be retained by the stomach when Whisky and 
other forms of Alcohol are rejected. A tea-spoonful in a table- 
spoonful of water every minute, until six or eight have been 
taken, is the best way to give it. If the temperature of the body 
is raised by it, and there seems a revival of the action of the heart, 
enough Brandy has been given. Twenty drops of the Aromatic 
Spirit of Ammonia in a tea-spoonful of water may be given every 
couple of minutes, until four or five doses have been taken. The 
applications of heat to the extremities and ‘ ‘ pit of the stomach” 
are very useful. Flannels wrung out in hot water, or bottles of 
hot water properly wrapped up, should not be neglected. In 
some households, a tin can, somewhat concave on one surface, to 
fit the curvature at that point, and with a stopple in the upper 
surface for the introduction of the hot liquid, can be usefully em- 
ployed for heat to the epigastrium (“ pit of the stomach”). Mus- 
tard-plasters to the same place are often used, but they are so in- 
ferior to heat for the purpose, if that can be applied, and so apt 
to blister, thereby making it impossible to use any thing else on 
the surface, that some reluctance is felt in advising them. Nau- 
sea and vomiting often are seen in Shock, and can best be allayed 
by getting the patient to swallow whole, small chips of ice. Ice, 
by the way, can be easily chipped by standing the piece with the 
grain upright, and splitting off a thin edge with the point of a 
pin. 
Ammonia (smelling salts), applied to the nostrils, is often use- ACCIDENTS—EMERGENCIES—POISONS. 
ful ; and cologne, on a handkerchief, is often pungent enough to 
be of service in the same way. 
Shock from Bathing in or Drinking Cold Water. 
In the hot weather, cases often occur where death or great pros- 
tration ensues from drinking ice-water, or bathing in cold water, 
while the body is exhausted from heat or exercise. The same 
thing happens to animals under similar circumstances. Cold water 
in hot weather, if the person is heated, should always be drunk in 
small quantities at a time. If not, although neither death nor pros- 
tration may follow, a troublesome derangement of the digestive 
tract ensues, often laying the foundation for other troubles. 
When the body is heated, or exhausted, a bath in cold water 
ought never to be taken. A sponge bath will answer, until the 
vigor of the body has had time to be restored. 
These troubles can be referred to Shock, and should be prompt- 
ly treated as such, according to the given directions. 
Persons often faint without any proportionate cause. Debility 
of the nervous system favors it. While the author would not like 
to say that the tendency to swoon can be intentionally acquired, 
he is compelled to think it can be unintentionally perpetuated 
under many circumstances. 
The treatment usually followed is, perhaps, the best; but peo- 
ple are apt to raise the head of the patient. Even in carrying her 
to the bed or sofa, it should be kept lower than the rest of the 
body. Indeed, there is no better restorative in such cases than 
such a relative position of the extremities. Should the person be 
sitting in a chair at the moment, do not remove her, but stand be- 
hind the chair, reach the hands over in front, so as to grasp the 
sides of the back of the chair, take a step backward to give 
room, and then slowly depress the back, supporting the head until 
the floor is reached. An assistant, by holding to the dress over 
FAINTING. 26 
ACCIDENTS EMERGENCIES POISONS 
the knees, will prevent lateral slipping off from the scat of the 
chair. It is so rapidly and easily done, besides so effective in its 
operation that little else remains to be done. Usually the back of 
the head of the patient scarcely reaches the floor before conscious- 
ness returns. 
BURNS AND SCALDS. 
These common accidents, by receiving early and suitable atten- 
tion, are often deprived of much of their inconvenience. Of 
course, the first thing i3 to put the fire out, and then, if the in- 
jured parts require it, the clothing should be cut away, so as to 
get at the entire extent of the injury with as little trouble to the 
patient as possible. Should any fragment of garment appear ad- 
herent to the burned surface, the sticking part should be left, as 
the violence required to remove it must necessarily increase the 
damage to the injured part. 
When the clothing catches fire, throw the person down on the 
ground, as the flames will tend less to rise toward the mouth and 
nostrils. Then without a moment’s delay, roll the person in the car- 
pet or hearth-rug, so as to stifle the flames, leaving only the head out 
for breathing. If no carpet or rug can he had, then take off your 
coat 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 wrap- 
ping. ACCIDENTS EMERGENCIES—POISONS. 
27 
If the burn or scald involves considerable surface, symptoms of 
shock are observed, from the extreme of mere weakness to that 
of utter prostration. This at once requires prompt attention, and 
a few drops of Aromatic Spirit of Ammonia in water, or a little 
Brandy, should be given every few moments until a return of the 
strength is seen. A burn, superficial as far as depth is concerned, 
but covering a largo surface, especially in the case of small 
children and aged people, is usually considered more dangerous, 
as far as life is concerned, than a burn smaller in extent but deep- 
er and more complete. Never mind how slight the injury ap- 
pears, if there is reason to suppose the heated air or steam ha3 
been inhaled, no time should be lost in taking the opinion of a 
physician as to the result of the injury to the throat and lungs. 
Treatment. 
If the burn or scald is slight in character, one of the best appli- 
cations is the Water Dressing, p. 32, as there said, keeping the 
linens used, constantly wet with cold water. In a short time after 
the pain shall have moderated, one of the best things for use, and 
readily procured, is a dressing of pure hog’s lard. The common 
lard of the stores will scarcely answer, from the impurities it con- 
tains. At the Infirmary in Lombard street, they usually direct 
that a half pound, or less, of the best lard should be bought, and 
put into a vessel of hot water, boiled a few moments, being stirred 
with a stick until it is thought all the salt used for preserving the 
lard, and the alum put in to bleach it, have been washed out. 
The vessel is then set aside until the floating lard hardens. It is 
then collected, placed in a bowl, which in turn is placed in a ves- 
sel of hot water on the stove, and kept there until the water me- 
chanically held by the lard has been driven off. The bowl of 
lard is heated by surrounding water, to prevent scorching. 
After thus prepared, tlie lard may be considered perfectly 
pure, and can be put away in suitable vessels until required for 
application. 28 
ACCIDENTS E M E RGE NCI ES POISONS. 
It is much better than the commonly used Linseed Oil and 
Lime Water, as the Linseed Oil is rarely pure, but contains irri- 
tating substances left in the manufacture, or added for the 
purposes of adulteration. Wheaten Flour is often dusted over 
the burn; but this, with the discharges, hardens, and is of as 
little comfort as an application of small crusts of bread would be 
to the injured part. 
Cotton wool (carded cotton, cotton batting) is often used, but 
the fibers become imbedded in the discharges, and then can not be 
detached without unnecessary pain and disturbance of the wound. 
If the burn or scald, particularly the latter, is superficial in cha- 
racter, a simple and useful dressing is the application, by a brush, 
or a soft wisp of old muslin, of the White of Egg to the injury. 
As soon as the first layer dries, another should be used. In super- 
ficial burns and scalds, this treatment is especially grateful. 
A lather of soap from the sliaving-cup, applied by the brush in 
the same way, is often followed by immediate relief. These sub- 
stances appear to protect from the action of the air the irritated 
nerves beneath. As before said, do not apply “cotton” to the 
injury, as sooner or later it increases the pain, and without having 
done any special good. 
If a physician has been sent for, it is better not to make any 
domestic applications to the burned parts. Such things frequent- 
ly prevent him from using those better adapted to the wants of the 
person, and keep him, too, from forming a correct estimate of the 
real extent of the injuries. 
Where the effects of the burn or scald extend deeper, involving 
the subcutaneous tissue, or even the parts beneath that, as the mus- 
cle, other considerations must not be overlooked. There probably 
will be more shock. The portion whose vitality has been destroy- 
ed by the burn can not do otherwise than become detached from 
the uninjured parts beneath thrown off in the shape of shreds or 
larger masses, during the process of sloughing. After water- 
dressing has given a degree of relief to the part, and this is some- ACCIDENTS EMERGENCIES l’OISONS. 
29 
times sooner secured by adding Laudanum (Tincture of Opium) to 
the water, a system of Poulticing* must be commenced. After 
being used for a short time, a mark of well-defined separation is 
seen at the junction of the burned and the unburned parts. The 
edge of this dead portion often falls away, like a piece of wet 
buckskin, showing, except at the edges, a union of the dead and 
the living parts. This process of separation continues for some 
time, attended with such profuse discharges that the poultices 
must be changed several times a day to preserve neatness ; but 
after a while the entire mass lies loose, attached only at the cen- 
tre to a raw suppurating surface below. A short time after the 
whole mass becomes detached and is removed. Then at the edges 
and surface of the uninjured parts a process of filling up the 
wound by “granulation” must commence. The newly-formed 
substance begins first to be deposited at the edges of the wound, 
generally reducing the area. This process, in such a wound, the 
result of a burn, is much less rapid than might be supposed by 
the unprofessional, and is attended with much suppuration (mak- 
ing of pus). 
Whenever the destructive process of suppuration goes on in the 
body, from whatever cause, there is exhaustion of the strength. 
This must be combated by a judiciously selected diet; and some- 
times by appropriately selected tonics. Often, the surface under- 
going repair is benefited by local applications ; but these can only 
be appropriately selected by a physician, so nothing need be said 
about them here. 
As remarked above, in burns beyond a certain degree of de- 
struction, the process is one of repair rather than restoration. In- 
stead of the destroyed portion being replaced, the reparative mate- 
rial is of such a character that it undergoes contraction; and 
great deformity may result from its dragging effects upon adja- 
cent healthy parts. These effects may often be mitigated in ex- 
* “ Recipes for Sick People.” Sometimes bound with this. 30 
ACCIDENTS—EMERGENCIES—POISONS. 
tent, but can not be wholly prevented. Thus, if the arm, at the el- 
bow, is burned or scalded, so that a scar results, the contraction 
of this tissue will often draw up the forearm to aright angle, from 
which it can not be straightened. A burn or scald at the front of 
the neck is often followed by a dense white scar, which, contract- 
ing, draws the chin down toward the chest, and the lower lip 
down toward the chin, ending in the greatest deformity. The 
medical attendant is sometimes unjustly censured for these things. 
From what has been said, it must be observed that Burns and 
Scalds practically differ but little from each other. Scalds are 
usually more confined to the outer cuticle, unless the substance 
containing the heat is viscid in character, as oil, pitch, etc., and 
does not rapidly run off the part with which it came in contact. 
As far as popular assistance is concerned, the two may be regarded 
as presenting no essential difference. 
Cloths wet with cold water may be kept constantly applied, 
and if the destruction of the skin is not too complete, nothing 
more will be required. 
Burns by Lime, Caustic Potash, and other Alkalies. 
As a rule, these are troublesome, since there is not only removal 
of the cuticle, superficial skin, but destruction of the soft parts be- 
low. Lime is a powerful alkali, and rapidly destroys the parts 
with which it comes in contact. It is useless to attempt to pick 
it off, for the fingers remove no more than it gets hold of, so an 
application should at once be made of something to unite with the 
Alkali, to form a comparatively harmless preparation. Vinegar di- 
luted with water; the acid in Lemon-juice, or any other dilute 
Acid, will answer. These things do not undo what has been done, 
they only prevent further mischief. The portion of the tissue al- 
ready destroyed, must separate as if it had been destroyed by heat 
in the case of a Burn or Scald; must be aided by the same means; 
must heal in the same manner, and must be followed, of course, 
by the same ultimate contraction of the reparative material. And ACCIDENTS—EMERGENCIES—I’OISONS. 
31 
what has been said about the Alkali known as Lime, may be said 
about the other Alkalies; Potash, Soda, Ammonia, etc. 
Burns by Acids—Sulphuric Acid (Oil of Vitriol), Nitric Acid 
(Aqua Fortis), etc. 
As Alkalies destroy the living tissues they come in contact with; 
so will Acids of sufficient concentration. In such cases, applica- 
tions of water will dilute them beyond their capacity to injure. 
Alkalies applied neutralize acids into harmless preparations. 
Common Earth, gathered almost anywhere, applied in handfuls, 
contains alkali enough of one kind or another to entitle it to the 
consideration of being one of the best (and at the same time most 
easily secured) applications in cases of Burns by Acids. 
CONTUSIONS. 
These common injuries are termed “ Bruises” by some people, 
and are the only other injuries besides wounds and fractures, pro- 
duced by blows or pressure. The injury may be the simple form; 
only a slight shaking or jarring of the texture, with no visible change, 
except what results from the rupture of the blood-vessels. This 
is the most frequent. In the more severe but less frequent form, 
the Contusion mean3 broken blood-vessels, muscles, and tissues 
between and around them; the parts are thoroughly crushed, 
sometimes to a pulp; damaged beyond recovery, and ready to 
perish in the gangrene resulting as the extreme form of such an in- 
jury- 
The quantity of blood escaping from the ruptured vessels de- 
pends, in a large degree, upon the size and number of the vessels 
injured, but in a larger degree upon the space into which the 
blood can accumulate. A single divided vessel in the scalp, ow- 
ing to looseness of the tissue there in which the vessels are distri- 
buted, may permit a swelling, the result of the escape of blood, 
extending in area over a half of one side of the head. 
In Contusions, the first conspicuous symptom is that of Shock, 
which generally, hut not always, hears a relation to the extent of 32 
ACCIDENTS—EMERGENCIES—POISONS. 
the injury. Thus a crushed finger is attended, as a rule, with 
much less shock than a crushed hand or foot. Contusion of cer- 
tain parts, as the larger joints, breasts, anti other portions of the 
body, are followed by most severe symptoms of shock. The pain 
is not always as severe as might at first be thought, for it is said 
the nerves are so much injured as to be deprived of their ability to 
receive and transmit the necessary impression. The swelling de- 
pends, at first, largely upon the blood poured out by the injured 
vessels, and as just said, this depends upon the number and size 
of the divided vessels, as well as upon the character of the part 
containing them. 
Treatment. 
In the milder Contusions, there is but little shock. Should 
there be more, place the patient on the back, head not elevated, 
and give stimulants as directed. See Shock, p. 25. The next 
thing is to limit the consequences likely to ensue from the ruptur- 
ed blood-vessels. This is best done by lessening the supply of 
blood to the part by elevating it, if possible, above the heart, and 
using cold applications in the shape of powdered ice, tied up in 
towels, to the part; and along the course of the larger vessels go- 
ing to the injury. 
A large piece of ice secured in a towel, so the fragments can not 
escape, can be reduced to fine fragments by a blow or two against 
the wall. After it has remained on for a time, the water may be 
substituted in the shape of a drip;* or several thicknesses of wet 
towel may be applied, only they must be dipped in cold water, 
squeezed out, and changed every sixty seconds. If not changed, 
the wet towels really act as poultices to the part, inviting what we 
should try to prevent. "When the Surgeon appears, special mea- 
* A pitcher, or some other vessel of water, placed higher than the 
limb, with a moistened string or strip of linen. The end of the 
string is placed in the water, the other hangs down on the outside, 
so the water will drip along the string from the vessel to the injured 
part. ACCIDENTS—EMERGENCIES—TOISONS. 
33 
sures will be directed by him. Recollect it takes a great deal of 
heat to convert ice into water, and water into vapor, and if the 
patient has not got this heat, symptoms of chilliness will be ob- 
served. When this happens the application must be stopped and 
the moisture must be taken up by a towel; particular attention 
always being paid to keep the bed-clothing, and every thing else, 
perfectly dry and neat. 
Discoloration is due to the color of this escaped blood, seen 
through the cuticle, and varies from blackness usually indicating 
intense injury, so that the blood itself is poured out, through 
dark blue, purple, crimson, down to delicate pink, indicating 
only a blood-stained fluid. 
After 'preventing the escape of blood from the vessels, as far as 
practicable, there remains to get rid of what has already been poured 
out. In some forms, the assistance of professional advice will 
have been secured. In simpler cases, the blood, at this later 
stage, should be encouraged to flow through the now repaired 
vessels and the neighboring vessels as much as possible. By this 
means the diseased particles are, as it were, picked up, as physi- 
cians say, absorbed, and replaced by healthier ones. The color of 
the part gradually fades in proper time, and the injury is said to 
be restored. Gentle frictions of the part and neighborhood, the 
application of dry heat, and stimulating lotions, as Alcohol, Cam- 
phorated Soap Liniment, with other simple things of the same cha- 
racter, are often used with the intention of assisting this process 
of nature. 
A common accident is a “ mashed finger” from the member 
getting caught in a closing window, or want of precision in using 
a hammer. The firm bone beneath and the blow above usually 
contuse (bruise) the tissues (veins, vessels, muscle, etc.) between, 
and often the pain and other symptoms last some days. 
Wrap up in a bandage of old muslin, keep constantly wet with 
cold water, If there is ruucli pain add Laudanum (p. 130), or the 34 
ACCIDENTS—EMERGENCIES—POISONS. 
Tincture of Arnica (p. 129), recollecting they are not curative 
agents, but only lessen the pain by benumbing the injured nerves. 
It is unnecessary to say that a “ mashed toe” is to be treated in 
the same way. 
The discoloration and swelling (p. 34) may remain some days 
after the pain subsides. Stimulating Liniments can now be used 
to encourage an extra flow of pure blood to the part, and the 
washing away of the injured blood. 
FRACTURES AND DISLOCATIONS. 
It is often evident to a bystander that a Fracture or Dislocation 
exists, without knowing what can be done in the interval which 
must elapse before the arrival of competent professional assistance. 
Of course no one but a very ignorant and bold man would attempt 
to do more than make the sufferer comfortable in the meanwhile. 
In instances of suspected Fracture or Dislocation of the lower 
extremity, the injured parts should be placed in comfortable po- 
sition, and as well supported as possible, to prevent the twitchinga 
of the leg from the spasmodic action of the muscles of the injured 
extremity. If necessary to remove the patient to his home or the 
hospital, from the spot where the accident happened, the arrange- 
ment of the limb should be made after he has been placed on the 
stretcher or substitute. 
If found necessary to carry the injured person some distance, 
and a litter for the purpose can not be had, the arrangement of the ACCIDENTS EMERGENCIES—POISONS. 
35 
fractured limb against the other, and kept the re by handkerchiefs, 
as shown in the cut, is often of great comfort to the sufferer. 
If the general character of the injury is evident, in sending for 
the surgeon it is best to tell the messenger, so that, as far as pos- 
sible, the necessary appliances can be provided before leaving the 
office. 
In the mean while, under no circumstances, should the bystanders 
be permitted to handle the affected part beyond what is absolute- 
ly necessary. As a general rule, a much longer time than is com- 
monly supposed, by most people, may pass between the occurrence 
of the accident and the arrival of the surgeon without serious in- 
jury to the patient or ultimate disadvantage to the fracture. 
Many persons, thinking that the broken bone must immediately 
be “ set,” are apt to accept the services of the first person arriving 
asserting lrimself qualified to do it. Such an individual necessa- 
rily makes a more painful examination than is necessary, applies 
the splint—perhaps not at all the most useful—which the surgeon, 
arriving later, is obliged, out of consideration for the condition of 
the sufferer, to acquiesce in. 
If the injury is to the upper extremity, the part should be placed 
in a supporting sling, and kept in a comfortable position. 
Sometimes, owing to the severity of the injury, or the condition 
of the general health of the person at the time, symptoms of 
Shock, from the mildest expression to insensibility, are observed. 
In such a case, the measures of treatment suggested under that 
head can be followed until other advice is obtained (p. 24). 
Dislocations. 
These result from force applied in such a way as to dislodge 
the surface of one bone from another; what is called the head of 
the bone slipping oil into a neighboring depression. Of course the 
ligaments binding the parts together are tom and stretched, be- 
yond the point of slight elasticity found in such tissues, and the 
adjacent parts are badly contused (bruised), p. 8. 36 
ACCIDENTS EMERGENCIES—POISONS. 
No direction can be given for detecting a dislocation. It is some- 
times evident to the sight, but the possibility of a fracture must 
be remembered, and the patient made comfortable, without hand- 
ling the injured parts until aid can be summoned. A dislocated 
joint is always afterward a weak one, and a small part of the force 
originally used will produce a return of the trouble. 
Sprains. 
In a sprain, the joint is twisted, so that the ligaments binding 
the parts together are severely stretched or even tom, with 
consequent violence to the delicate lining of the joint. A sprain 
is understood to be short of displacement of the surfaces of the 
bones, which would be a dislocation. 
They most frequently occur at the wrist and ankle-joints. The 
injury is rapidly followed by inflammation of the joint and adjacent 
parts. Not only is the joint directly weakened by the injury, but if 
there is a tendency to rheumatic disorders, or the constitutional 
leaning known as strumous, no little future trouble often follows. 
There is, of course, great pain, and if it is the ankle or wrist- 
joint injured, often nausea. The tendency to inflammation should 
be discouraged by resting the whole body, and keeping the 
sprained joint elevated. Cold water in the shape of a “drip” 
(p. 32), should be used plentifully until the opinion of a physician 
can be taken. Complete rest must be kept up until the inflam- 
mation shall have passed and the probably tom ligaments been 
restored. Later, stimulating liniments can be used. Often a 
fracture of the shaft of the bone results in a speedier restoration 
than the sprain of an ankle-joint. 
WOUNDS. 
For systematic study, 'wounds may be classified according to 
their direction, or depth, or locality ; but for our purpose they 
may be arranged after the mode of their infliction : (1.) Incised 
■wounds, as cuts or incisions, including the wounds where portions ACCIDENTS—EMERGENCIES—POISONS. 
37 
of the body are clearly cut off ; (2.) Punctured wounds, as stabs, 
pricks, or punctures ; (3.) Contused wounds, which are those com- 
bined with bruising or crushing of the divided portions ; (4.) Lace- 
rated wounds, where the separation of tissue is effected or com- 
bined with tearing of thorn; (5.) Poisoned wounds, including all 
wounds into which any poison, venom, or virus is inserted. 
Any of these wounds may be attended with excessive hemorrhage 
or pain or the presence of dead or foreign matter. As all wounds 
tend to present several common features, a few words will be said 
about them before describing the distinctive characteristics of 
each. 
The first is hemorrhage (bleeding). This depends, as to quanti- 
ty, upon several conditions, the chief of which is the size of the 
Mood-vessels divided ; and, to a degree, upon the manner in which 
it has been done. A vessel divided with a sharp instrument pre- 
sents a more favorable outlet for the escape of blood than one that 
has been divided with a Munt or serrated instrument, or one that 
has been tom across. Except in the first named, the minute 
fringes or roughness necessarily left around the edges of the vessel 
at the point of division retard the escape of blood, and furnish 
points upon which deposits 
of blood, in the shape of 
clots, can take place. Hence, 
all other things being equal, 
an Incised wound is usually 
attended with more hemor- 
rhage than Contused or Lace- 
rated wounds. 
Personal peculiarities of 
the patient, ancl the health 
or disease of the wounded 
part of the body, may exert 
much influence upon the he- 
morrhage. Usually it ceases in a short time by the coagulation 38 
ACCIDENTS EMERGENCIES POISONS. 
(clotting) of the blood in the severed extremity of the vessel, 
without further attention than the application of cold, which 
favors contraction of the blood-vessel divided, as well as those 
leading to the injured part. Should an artery or branch have 
been divided (indicated by a spurting of a spray of bright blood 
at each beat of the heart), the bleeding may not cease at once. 
To stop it, the firm pressure of the finger for some time to the 
point of division should be used, to diminish the size of the ves- 
sel at that point, until a clot is formed there. 
Sometimes, pressure to the supposed seat of the injured vessel 
does not reach the artery. In such a case, the pressure must he 
used to some known trunk between the original supply of the 
blood and the injured branch. Thus, if the finger or the toe is 
the seat of the arterial hemorrhage, firm pressure applied eacli side 
of the finger, close to the hand (as in the cut) or toe, close to the 
foot, compresses the arteries 
passing along to be distributed 
to the extremity. If the hand 
or foot is the seat of injury, 
pressure on the wrist, over the 
point where the artery is felt 
for the “pulse,” or at the in- 
side of the ankle, will material- 
ly retard the passage of the 
blood beyond those points. 
Should pressure by the thumb 
at these suggested points not 
answer the purpose, the main 
trunk of the artery, higher up, 
should be compressed by a tourniquet. Before this is done, 
it is always well to place the person injured fiat on his back, and 
hold the arm and hand in a perpendicular position for a time, as 
the heart will then be unable to throw the blood with its usual 
force to the extremity. Pressure applied by the fingers, with ACCIDENTS EMEKGEXCIES—TOISONS. 
39 
broken ice in a towel bound round the arm, in conjunction with 
the elevation of it, will often stop the hemorrhage, or retard it, 
until professional aid is secured. If the foot is the seat of the 
injury, elevate the whole limb in the same way, applying pressure 
and pounded ice on the same principle. 
In wounds of the scalp, there is usually much loss of blood, ow- 
ing to the abundant blood supply of that part. The firm skull 
below offers a good point for pressure, and the vessel rarely fails 
to be compressed if the thumb is applied over the point of divi- 
sion of the severed vessel. 
Tlie amount of blood actually lost is apt to be much over-esti- 
mated. Quite a small quantity will seem “ a half pint ” if distri- 
buted over the clothing, and a gallon of water requires no great 
amount added to it to give it quite a blood-red color. It is esti- 
Note.—The arm and forearm, witli dotted lines, indicate the 
course of the arteries, and points at which pressure can be most ju- 
diciously applied. 
The arrow points the course of the current of the blood of the ar- 
tery, from the heart to the extremities. 40 
ACCIDENTS—EMERGENCIES—POISONS. 
mated that about one eighth of the weight of the entire human 
body is blood ; in other words, the quantity of blood in a human 
body weighing 144 pounds would be about 1G or 18 pounds. Of 
course, this amount, nor half of it, perhaps, can be withdrawn 
from the vessels without fatal results ; but it is merely mentioned 
to show that the entire quantity asserted to exist by physiologists 
is much larger than is popularly supposed. When hemorrhage 
from a divided blood-vessel is seen, there is usually much more 
apprehension and excitement about it than is warranted. 
This figure slio-ws the method of exerting pressure by the fin- 
gers along the course of the Brachial Artery ; between the divid- 
ed vessel and the heart. 
If the wound should be in the arm above the point indicated by 
the fingers, or in the axilla (“ arm-pit”), pressure could be made 
Note.—The arm and forearm, with dotted lines, indicate the 
course of the arteries, and points at which pressure can be most ju- 
diciously applied. 
The arrow points the course of the current of the blood of the ar- 
tery, from the heart to the extremities. ACCIDENTS—EMEBGENCIES POISONS. 
41 
by the thumb, a blunt stick, properly protected, or the handle of 
a door-key upon the Sub-clavian Artery, which passes, as the name 
suggests, along under the clavicle (“ collar-bone”) and down the 
arm, where it is called the Brachial Artery—just spoken of. Fur- 
ther down the arm at the elbow, this vessel is subdivided into 
two others, each following a bone of the forearm to the wrist. At 
the wrist, over one bone, near the surface, the pulsation of the 
heart is sought by the finger of the physician. 
Permanent pressure exerted by means of a temporary tourni- 
quet to the Brachial Artery is spoken of on the other page. A 
common folded handkerchief, with a firm, sharply-defined knot 
tied at the middle, a long strip of muslin torn from a shirt-sleeve, 
or a suspender, with a suitable knot in it, is rather loosely tied 
around the arm, and the slack taken up by twisting with a cane 
Note.—The thigli and groin, with dotted lines, suggest the course 
of the large arteries, and point at which pressure can be most success- 
fully used. 
The arrow indicates the direction of the current of the blood of the 
artery, from the heart to the extremities. 42 
ACCIDENTS EMEltGENCIES—POISONS. 
or stick until the knot, kept over the vessel, exerts enough pres- 
sure to prevent the passage along it of the blood. 
This is easily done if you proceed to it quietly, without talking; 
especially if previously practiced once upon the extremity of a 
friend. 
The method of exerting pressure by the fingers along the course 
of the Femoral Artery, between the wound and the heart. 
Sometimes it is easier to find the artery nearer the surface, at a 
point long the dotted line, or a little higher up toward the groin. 
The two thumbs placed together furnish firm resistance ; and a 
blunt stick, suitably protected, will often answer to keep up the 
pressure until a tourniquet can be extemporized. 
The muscular condition of the entire leg does not permit the 
pressure of the fingers to be as successfully exerted along the main 
arteries, as in the case of the arm just spoken of. 
This cut presents the tourniquet made as directed on page 41, 
Note.—The thigh and groin, with dotted lines, suggest the course 
of the large artery, and point at which pressure can be most success- 
fully used. 
The arrow indicates the direction of the current of the blood of the 
artery, from the heart to the extremities. ACCIDENTS EMEKGENCIES—POISONS. 
43 
by getting a large firm knot in a handkerchief, or any thing else of 
the kind. A small pebble has often been introduced for the pur- 
pose, into the knot, with success. Twist the ligature with the 
leverage obtained by passing under it a cane or stick. 
Get the knot over the artery—keep the knot there, and tighten 
until the pressure of the knot closes the vessel. 
It is much easier done than imagined, especially if the indivi- 
dual has some day spent three minutes practicing the preparation 
of the ligature, and its application over the course of the artery 
of a friend. 
There is no necessity for the alarm often shown, especially as it 
obscures the judgment of those who, if they would but reflect a 
moment, could much more serve the true interests of the sufferer 
by keeping cool and collected. 
Pain, it may be said, accompanies all wounds, for it is almost im- 
possible to sever a blood-vessel without severing nerves. It is 
usually much less severe than might be thought, and as little can 
be done immediately to relieve it, other prominent features of 
wounds in general will be spoken of. 
Fainting, after a severe hemorrhage, or in “ nervous” persons, 
frequently requires attention, after the loss of blood has been 
placed under control. Often it is due to the sight of the blood, and 
an undefined apprehension as to the extent of the injury on the 
part of the wounded person. The latter feeling is in part derived 
from the excited and frightened appearance of those about. A per- 
son with a wound attended with hemorrhage, ignorant of its extent 
and consequences, seeing his friends, upon whom he must neces- 
sarily rely for succor, in such a state of alarm that he can expect 
little real aid from them, can not be said to be in a comfortable 
state of mind—and is apt to faint. 
The symptoms of fainting are too well known to need descrip- 
tion here, especially as something is said about them under the 
head of “Shock,” p. 22. The person suffering from fainting 
should be placed on the back, if possible, the head slightly raised, 44 
ACCIDENTS—EMERGENCIES—POISONS. 
if at all, obstruction to the circulation in the shape of cravat and 
collar removed, and any obstacle to perfect movement of the chest 
likewise dispensed with. For an adult, a tea-spoonful of Brandy, in 
a little water, may be given every few minutes, until consciousness 
and restored action of the heart is observed. Twenty drops of 
Aromatic Spirits of Ammonia, in a tea-spoonful of water, at short 
intervals, say every five or ten minutes, is quite as useful, but not 
always as easily secured. Too much stimulation in such a case 
might do harm, by causing the heart to send the blood with such 
force as to disengage the little clots spoken of at the divided ex- 
tremity of the vessel. 
If the loss of blood has been great, or the condition of the pa- 
tient before the receipt of the injury such that the loss can not be 
rapidly restored, the fainting may not rapidly or completely dis- 
appear. In such cases, beef-tea and easily digested nutritious 
food, and even tonics, will probably be recommended by the me- 
dical attendant. 
Foreign matters, such as have been introduced into the wound at 
the time of the injury or subsequent to it, of course, should be care- 
fully removed. 
Having thus referred to certain features common to most wounds, 
the special, and what may be called the distinctive points of each 
class, according to the arrangement herein adopted, will now be 
given. 
After the hemorrhage ceases, and the clots, with any foreign mat- 
ter, have been carefully and gently removed, by a judiciously di- 
rected stream of water from a sponge, the separated surfaces and 
edges of the wound should be brought carefully together. To re- 
tain them in position until union has taken place, strips of adhe- 
sive plaster may be used. This being a resinous preparation, it 
soon becomes dry, and useless for the purpose. Hence get but 
little at a time, and replenish with recently prepared as often as is 
necessary. In cities, it can usually be had good from the large 
Incised Wounds. ACCIDENTS—EMERGENCIES—POISONS. 
45 
shops, where large sales prevent an accumulation of stock. With 
a pair of scissors, cut it lengthwise, into uniform sized strips of 
about a quarter of an inch in width, or even less in some instances. 
These can be subdivided in length, so as to extend across the 
wound, and far enough on 
each side to secure a suit- 
able hold on the skin. 
Warm the plaster side of 
the strip at the fire until 
it becomes thoroughly and 
uniformly melted, then be- 
ginning with one end (re- 
collecting that the centre 
of the strip should cross 
the incision) rapidly and 
completely attach it to the 
skin, as a rule at right an- 
gles to the line of the cut. 
As the middle part ap- 
proaches the wound, with 
the fingers bring up the skin toward the incision, from the other 
side, upon which the other half of the strip is to rest ; then ra- 
pidly attach the rest of the strip. 
If this is not done, the strip of jfiastcr will be found in folds, 
owing to the yielding of the soft skin beneath, and the edges of the 
wound separated. If one strip will keep the edges approximated 
along the whole length of the wound, no more is needed. If not, 
use others. Where more than one is used, the edge of the strip 
should be brought across a short distance from the extremity of 
the wound, so as to permit the ready exit of blood or pus. Con- 
finement of either or both by the plaster, or any thing else, favors 
“burrowing,” as it is called, and consequent separation of the 
wounded surfaces. On the scalp, the face of men, and the extre- 46 
ACCIDENTS EMERGENCIES—rOISONS. 
mities of some persons, the hairs must first be shaved off the skin, 
or the plaster will not remain attached. 
Most persons, in using adhesive plaster on a "wound, apply a 
large piece, or several small pieces, so as to completely cover it. 
This must not be done. A few drops of blood retained after such 
an arrangement, even when the edges of the wound have been 
carefully brought together, undergoes decomposition, irritates and 
inflames the parts, loosens the plaster, and changes what otherwise 
should have been the result of the accident. 
Adhesive plaster is best for use, but as it is not portable, often 
in an emergency it is easier to get Isinglass plaster. This is a thin 
tissue of silk spread on one side with a solution of isinglass or 
other gelatinous substance. Heat is necessary to soften adhesive 
plaster; but moisture dissolves Isinglass plaster. As in most 
wrnunds there will be some liquid discharged, it can be seen at a 
moment’s thought why Adhesive plaster will remain attached, 
while Isinglass plaster wrill become detached. 
When Isinglass plaster only can be procured, it should be cut 
into narrow strips, the adhesive side moistened, and then applied 
as above directed. The black variety of Isinglass plaster, usually 
sold in small envelopes, is scarcely fit, as a general rule, to be used. 
Speaking of plasters, the writer will say that on one occasion, 
■where none was to be had, the edges of an incised wound of some 
length were successfully brought together, and held there, by a 
postage-stamp divided lengthwise into four strips. 
In shaving the face, cuts are sometimes made "which bleed to a 
troublesome extent. A crystal of common alum should always be 
kept with the apparatus, the bleeding absorbed by a fold of the 
towel, and then, before the blood can accumulate, thrust into the 
incision the edge of the crystal, holding it there a few minutes. 
If the bleeding continues, it is because the alum does not reach 
the divided vessel, and the wound should be wiped out until it can. 
If tlie incision is deep, or there are not good points for attach- 
ment of the plaster, sutures are often employed by the surgeon. ACCIDENTS—EMERGENCIES POISONS. 
47 
Ho definite rule can be given for the circumstances requiring them 
or the method of using them. An ordinary sewing needle will not 
answer, but a needle with a cutting edge, such as saddlers and 
glovers use for stitching leather, can be secured, if the regular 
surgeon’s needle can not be procured. The suture is of white silk, 
or possibly white flaxen thread might answer in an emergency. 
Surgeons nowr generally use fine wire of silver or iron, as metal ir- 
ritates the part it comes in contact with less than a rough thread. 
Tlie edges of the wound having now been properly brought to- 
gether, and retained there, the next thing is what is called the 
“dressing.” All manner of things were once used for this pur- 
pose, under the impression that they were healing. They are now 
used by surgeons simply for protective purposes. The simplest are 
therefore the lest. Hence "water is now used, under the name of 
Water Dressing. As Isinglass plaster is softened by moisture, 
water can not, of course, be employed when this material has been 
used for retaining purposes. 
Take two or three thicknesses of what is called Patent Lint, if 
it can be conveniently had ; if not, of old linen, or even old mus- 
lin, somewhat larger than the wound.* With a pair of scissors or 
a sharp-pointed knife perforate the folds, dip in cold water, and 
after squeezing out the excess, evenly apply to the wound. To 
retain in position, a strip or two of adhesive plaster can be thrown 
over, or a small roller (bandage) may be lightly applied. Keep 
the linen, or substitute, constantly wet, not moist, with water. 
Sometimes the wounded member is supported in a sling. 
This dressing is so simple, and at the same time so useful, that 
surgeons are apt to use no other in simple wounds ; but, unfortu- 
nately, it is so simple, that many pei’sons, unless they are intelli- 
gent, have no confidence in it. They prefer pain-killers, lini- 
* By “ old linen,” many persons think the linen bosoms of old 
sliirts is meant. For tlie purpose mentioned it is practically useless. 
An old damask linen table-cloth furnishes the best, and next to it, 
perhaps, old linen sheeting, quite coarse in texture. ACCIDENTS—EMERGENCIES POISONS. 
ments, herbs, and salves. Remember, the natural reparative pro- 
cess unites the parts, and the effort of the surgeon is only to put 
the parts in the position best calculated to favor this to advantage. 
All foreign matters, never mind under what name, as a rule, are 
obstacles, not aids, to this process of nature. 
In using water as a dressing, or application of any kind to the 
surface, if a sense of chilliness appears, its use should be disconti- 
nued for a time. As said elsewhere, the conversion of the liquid 
to a vapor requires much more heat than might at first be sup- 
posed. When the chilliness is observed, a little of some kind of 
stimulant may often be useful. 
If the pain is severe, sometimes opium, in the form of Tincture 
of Opium (Laudanum) is added to the water applied. 
After a certain time, usually twenty-four hours, occasionally 
sooner, sometimes later, the outside strips of plaster holding down 
the lint should be divided, the parts removed, and the lint care- 
fully removed, after loosening it as far as is practicable by moist- 
ening writh tepid wrater. Should any portion be closely adherent 
to the wound, or any part of it, through coagulation of blood or 
escape of pus, and fail to become detached under delicate mani- 
pulation, with a sharp pair of scissors divide the lint as near as con- 
venient to the point of adhesion, letting the fragment remain, 
W'ith the hope that by the next time separation can be secured. 
The adhesive plaster now only remains, and if it has been pro- 
perly applied, the condition of the wound can be easily determin- 
ed. If there is no discharge of blood or other material, the plas- 
ter should be let alone, and another piece of lint and retaining 
strips applied, and kept wret with water as before. 
The next day the same examination should be made. If blood 
or pus is found, remove it with a soft piece of moistened sponge, 
being very careful not to disturb the wound or the strips of adliC' 
sive plaster. Should any strip have become loosened, remove it 
by catching hold of the extreme end and separating it gently and 
slowly until detached almost up to the line of the incision ; then ACCIDENTS—EMERGENCIES—POISONS. 
49 
drop that extremity, taking up the other, and go through with the 
same thing until only the central portion over the wound remains 
to be separated. This is done too lessen the chance of tearing the 
wound apart, which pulling at one end of the strip would favor. 
With a little soap and water then remove the remains of the resi- 
nous portion of the plaster from the skin, dry gently and well, 
and apply a fresh strip as a substitute for the old, observing all 
the precautions suggested. 
These remarks apply, of course, to a simple incised wound, 
when union takes place at once, or with but little suppuration (mak- 
ing of pus). This can not always be secured, from suppuration 
of the sides of the wound after the dressing has been applied, or 
an unfavorable condition, as it is said, of the blood. In such a 
case, the blood or pus must be removed once a day, as a rule, the 
surfaces of the wound kept together as much as possible, by ad- 
hesive strips, until a junction is effected. Do not use too much 
soap and water, as the only object of them is to better and more 
easily remove the foreign matters (blood and pus), which, if re- 
tained, act as irritants ; but not to remove the reparative mate- 
rial poured out by nature for joining the separated surfaces. 
If, owing to the general health of the patient, or a new charac- 
ter given the wound by some unavoidable mishap during the 
course of treatment, there should be decided suppuration, the in- 
jury may require more frequent dressing, especially in hot wea- 
ther. In such a case, if the wound has up to this point been 
without professional advice, it may be better to consult a physi- 
cian, as a suitable tonic, a different diet, or even some local applb 
cations to the seat of injury, may be followed at once by an int= 
provement in its appearance. 
A common accident is a “cut finger.” Sometimes there is 
considerable loss of blood, but this usually ceases on bringing 
the edges of the wound together and then gently compressing 
the part. Do not use “ plaster,” but bring the surfaces together 
properly and apply a suitable bandage. 50 
ACCI1) K NTS—E M E B« E XCI ES —P OISOXS. 
“Arnica” and “ liniments” can really be of little use, for get- 
ting between the wounded surfaces they tend to act as a thin 
wedge and discourage union. If there should be much pain, a 
little Laudanum (p. 130), Tincture of Arnica (p. 129), can be 
added to the water used for keeping the bandage wet. 
Under the classification adopted, have been included with in- 
cised wounds those instances where portions of the body have been 
cleanly cut off. Never mind what part it is, if the excision has 
recently taken place, the separated portion should be taken, rapid- 
ly freed from any foreign matter, and applied to the part from 
which it has been separated, in the position it previously occupied. 
Should the weather be cold, some raw cotton might be applied 
around it to preserve the wartnth, and some measures inaugurated 
by which gentle and uniform pressure can be kept up for a reason- 
able time. After making all allowances for the remarkable stories 
told in reference to such things, there is no doubt that much can 
be said in favor of the practice and little against it ; for if circu- 
lation and adhesion are not restored, it can be said that only a lit- 
tle time has been lost. 
Punctured Wounds. 
These vary in their importance, not only according to the depth 
of the wound and the structures penetrated, but according to the 
instrument inflicting them. The chief peculiarity and danger of 
these wounds is, that their nature does not afford sufficient facility 
for the escape of blood, other fluids, or foreign matters. The re- 
tained fluids decompose, or, by mere pressure, irritate the adja- 
cent parts, or, by distention, enlarge the original wound. 
In punctured wounds the essential idea is to treat os an incised 
wound; but their peculiar character, greater in depth than external 
area, requires a somewhat different plan of procedure. Remove 
whatever foreign matters have entered the wound, and apply a pad 
to the outer wound, so that it will, if possible, moderately and uni- 
formly exert some pressure along the deeper portion. The wound 
fills up with blood, and as it can not escape externally, on account ACCIDENTS—EMERGENCIES—POISONS. 
51 
of the pad, it clots, and closes the open ends of the divided ves- 
sels, by q>ressing upon them. If the wound was made with a Uunt- 
pointed instrument, it is practically, as far as union of the divided 
surfaces is concerned, a contused wound, which will next be allud- 
ed to, and will heal as such. If with a sharp instrument, the wound 
often heals as an incised wound ; and if there is no discharge to 
require it, the pad may be left in position, as strips of adhesive 
plaster would be in an incised wound, without disturbance, until 
union of the divided surfaces is complete. 
In case much pain follows, with signs of inflammation around 
the injury, the dressing (pad) must be removed, to permit the es- 
cape of the results of inflammation of the deeper portions of the 
wound. Sometimes even the external opening of the original 
puncture is not large enough for the exit of pus and other dis- 
charges. In such a case, the surgeon must enlarge it until the re- 
quirements in this respect are properly met. 
Once a day, or oftener if the wound is discharging, it should 
have the dressing changed, to insure neatness and escape of pus. 
If certain structures are invaded by the puncture, the surgeon is 
often at a great deal of trouble to insure healing at the bottom of 
the wound first, to guard against the burrowing, as it is called, of 
pus between the muscles and other contiguous parts. 
Under the head of “Punctured Wounds” may be mentioned a 
trivial set of injuries, quite frequent in occurrence and often at- 
tended with serious consequences. They are produced by the run- 
ning in of a thorn, splinter of wood, or a piece of metal. The 
foreign body is pulled away in most cases, if it can be done rea- 
dily ; if it can not, it is let alone, as the phrase is, “to work out.” 
In all cases, if a splinter or thorn, it should be got out. Not by 
poking at it with a needle, or something of the kind, which adds 
to the irritation, but by making an incision along its course, so as 
to expose it enough to get a sufficient hold upon it. If the inci- 
sion should not permit a removal, a more ready escape has been 
made for the foreign body and any pus (“ matter”) that may form; 52 
ACCIDENTS—EMERGENCIES—POISONS. 
thus lessening the probability of the constitutional excitement ex- 
erted through the nervous system known as Tetanus (Lock-jaw). 
If the splinter is under the finger-nail, and can not be pulled out, do 
not waste the outside end by picking at it. The nail immediately 
above should be scraped as thin as possible by a piece of glass, and 
then the thin nail overlying should be split with the blade of a 
knife, or an incision made on each side of the splinter, the little 
tongue of nail between the incision removed, exposing the upper 
surface of the splinter along its entire course. The restrain- 
ing pressure of the nail upon the foreign body is in this way 
gotten rid of, and at the same time an outlet for the products of 
inflammation is given. 
A piece of lint, wet in water, to which a good deal of Laudanum 
lias been added, should be applied, and kept wet with it as long 
as may be necessary. 
When the finger or hand, toe or foot, has been pricked, particu- 
larly by any thing foul, as a rusty knife or nail, a dirty piece of 
horn, or bone, the opening does not permit the escape of the re- 
tained foreign particles, and inflammation results. The skin on 
these parts is so thick that it can not yield when the parts beneath 
are irritated and inflamed, and the inflamed portion, as it were, 
tightly bound up, or squeezed as in a vice, by the hard skin, and 
the almost always fatal condition of affairs known as Tetanus 
(Lock-jaw) supervenes in many cases. Whenever such wounds, 
to such parts, are received, an incision should be made into the 
puncture, thereby providing a suitable escape for the blood, pus, 
etc. ; and a piece of linen dipped in Laudanum forced into the 
wound. This can be done by almost any one, and may save serious 
trouble. 
Ill washing clothing, scrubbing ancl scouring, a fragment or 
even an entire needle is sometimes forced beneath the skin. Do 
not attempt to get it out, but hold the part perfectly quiet until a 
surgeon can be procured. The slightest movement often places it 
beyond detection of the sight or touch. When this happens, ACCIDENTS EMERGENCIES POISONS. 
53 
there is no occasion to be alarmed, as the needle slips in between 
the muscles, and can not even be felt as painful. It does no harm 
there, as inflammation almost never results. Occasionally it is 
unexpectedly found near where it entered, and in a position favo- 
rable for extraction. 
Contused Wounds. 
As the name implies, these are divisions of the tissue with con- 
tusion (bruising) of the parts. Some of the tissue is generally re- 
moved, the edges rough and irregular, but there is generally less 
gaping of the edges and less bleeding, than of incised wounds of 
the same extent. The contusion impairs the contractility, as it is 
termed, of the parts, hence the less gaping of the edges ; and the 
blood-vessels have been torn, and the roughened extremity of 
each vessel soon favors a clot there, hence the less bleeding. 
Contused wounds especially need careful cleaning out and re- 
moval of clots. The general procedure of treatment may be the 
same as for Incised Wounds, but with more watching for the oc- 
currence of deep-seated inflammation and sloughing away of the 
contused edges and surfaces during the later process of suppura- 
tion. As soon as any alarming bleeding has been checked by the 
application of ice or cold water to the blood-vessels, or, if neces- 
sary, by pressure upon them, bring the edges of the wound toge- 
ther by strips of adhesive plaster; remembering, in applying them 
to a contused wound, that there must necessarily be inflammation 
of the Irrmsed parts, with consequent discharges. It is rarely 
that the entire wound is contused, although that may be its gene- 
ral character ; so a portion of it, often the extremities, unite as 
an incision, leaving the rest of it to pursue a different course. 
After sloughing (separation of the part whose vitality has been de- 
stroyed by the contusion from the living portion) has begun, poul- 
tices are often of use in favoring the process. After due time, the 
parts damaged beyond repair become detached, and the contused 
wound appears as a cavity more or less superficial in depth, lined 
with a velvety surface, more or less obscured with pus. After a 54 
ACCIDENTS—EMERGENCIES—POISONS. 
while the gap is filled up by these granulations (new, but imma- 
ture flesh). When these granulations get above the surrounding 
edges of the wound, before they become consolidated, the appear- 
ance is popularly termed “ proud flesh,” and wrongly supposed to 
prevent the healing of the wound. 
These granulating surfaces are sometimes stimulated to increas- 
ed activity by the application of some simple stimulating oint- 
ment, or by gently brushing once a day, by means of a camel’s- 
hair pencil, or the floating edge of a clean, soft feather, with a 
solution of Sulphate of Copper (blue vitriol), say a piece as 
large os a grain of coffee, dissolved in a couple of table-spoonfuls 
of water. 
Lacerated Wounds. 
Lacerated Wounds are made by rending or tearing the parts, 
rather than by cutting, as in Incised, or by breaking, as in Con- 
tused Wounds. The treatment follows that of the latter named 
injuries, to which they bear a strong resemblance in most re- 
spects. The chances for union are subject to about the same 
probabilities, and should be favored the same way. These 
wounds often occur in the scalp ; sometimes a large piece is de- 
tached, and left hanging by a small attachment. Never, under 
any circumstances, permit the fragment to be removed, as the scalp 
is so largely supplied with blood-vessels, that injuries there of the 
most unfavorable aspect to an ordinary observer are often rapidly 
and completely repaired. 
Poisoned Wounds. 
This includes all wounds into which any poison, venom, or virus 
is introduced. The •(round is not always made at the time of the 
introduction of the poison, but often exists previously. Thus, a 
scratch, fissure, or ulcer may exist on the hand or other part, and 
afford entrance to alkalies, acids, or other such irritants. When 
such a wound of the skin exists, and may be exposed to any irri- 
tating substance, great care should be exercised to prevent trouble ACCIDENTS—EMEltGENCIES POISONS. 
55 
arising. Persons with such injuries to the hand have suffered 
most severely from skinning animals which have died of pleuro- 
pneumonia and other diseases. Physicians often decline making 
a post-mortem examination because a wound exists on the hand, and 
many have died under the circumstances, because they did not ab- 
stain. 
If a poison should be introduced, and at once observed, before 
absorption by the system has taken place, a stick of Nitrate of Sil- 
ver (lunar caustic) should be thrust into the wound, or, what is 
more certain would be to heat a large nail red hot and force the 
end into the opening. 
Another variety of poisoned wound is when the poison is intro- 
duced at the time of the injury, as in the case of bites and stings 
of insects, and the bites of serpents and animals. 
In this latitude, there are but few insects known whose bites can 
really be considered poisonous. A swollen face which can not 
otherwise be accounted for is often attributed to the bite of a Spi- 
der. Trouble rarely results from it, and when it does it will often 
be safe to ascribe a portion to the condition of the general health 
at the time. The bites of certain flies have been followed by 
symptoms of local poisoning, but it would be well, should it hap- 
pen, to know where the fly had been just before. 
The stings of insects, as Hornets and Bees, are always painful, 
and sometimes followed by great swelling. A stimulating appli- 
cation to the injury, as a drop of Aromatic Spirits of Ammonia, 
will often afford the greatest relief. A pinch of common table 
salt, dampened with water and rubbed in, is very useful for the 
same purpose ; likewise a slice of onion rubbed on gives almost 
instant comfort. 
There are few serpents, likewise, in this latitude, whose bite is 
followed by poisonous symptoms. The bite of the common Rat- 
tlesnake is a well-known exception to the rule. Where a person 
has been bitten by one of these serpents, there is usually little 
time to be lost. If it is the hand or other accessible part, the 56 
ACCIDENTS EMERGENCIES POISONS. 
fold of the skin containing the puncture should be gathered be- 
tween the teeth, and the strongest suction of the lips used to ex- 
tract the venom. If there is no laceration or other injury to the 
skin of the lips, or the mucous membrane of the mouth, it can 
be done with impunity. 
The symptoms are a slackened action of the heart, indicated by 
a feeble pulse and other appearances of prostration, indicating 
the free use of stimulants. Marvelous stories are told of the 
quantities of whisky and brandy taken under these circumstances 
by persons not addicted to the use of them. Either are usually 
to be had on such occasions, and it might be wise to give of them 
freely at brief intervals, until symptoms of slight intoxication ap- 
pear. As the heart is much enfeebled in its powrer, it would readily 
suggest that the person bitten should be made to lie down on his 
back, as that is the position where the strength of the heart is 
least taxed. 
BITES. 
Independent of the consideration whether any poison has been 
introduced through the wound, Bites may be regarded as a lace- 
rated as well as a contused wound. There is usually a good deal 
of sloughing of the bitten parts, and no small amount of pain, 
owing to the nature of the wound. Care should be taken to re- 
move from the wound any particles of clothing, should any have 
been forced into it, then wrash out writh tepid water with a little 
Castile soap. Usually the part is so much contused that no effort 
is made to secure adhesion of the opposite sides of the wTound; 
but water dressing is at once applied, and suppuration and slough- 
ing awaited. The pain is often quite severe, owing to injury 
to the nerves, in which case some anodyne, in the shape of Lauda- 
num, should be added to the water used as the dressing. 
Bites of Dogs. 
Rabid dogs arc much less frequejit, perhaps, than is generally 
thought ; and a rabid dog, it may be supposed, might bite many ACCIDENTS EMERGENCIES—POISONS. 
57 
human beings without necessarily communicating Hydrophobia. 
In the first place, the chances are that the saliva would be arrested 
by the fabric over the 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, that it is not stated that this individual had not 
been bitten by some other dog than the 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 
healthy dog, when under a state of anger or fright, may commu- 
nicate 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 things can not be demonstrated to the satis- 
faction of the victim or his friends, and there 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 the circulation of the part, and to that extent 
delays the absorption of the poisonous saliva by the severed blood- 
vessels of the wound. While other things are being hurriedly 58 
ACCIDENTS—EMERGENCIES—POISONS. 
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 
as 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 wTould 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 
heat 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 sloughing away of the part whose 
vitality has been, in this instance, intentionally destroyed. 
There is a strange belief among the ignorant, particularly ACCIDENTS EMERGENCIES—POISONS. 
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 any future time, the disease will appear in whatever indivi- 
dual 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 are 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; but, owing to a 
spasm of the 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 quot- 
ed and accepted, says, “ The disease manifests itself under two forms: 
ike furious form, characterized by augmented activity of the sensoxj- 
al and locomotive systems, a disposition to bite, and a continued pe- ACCIDENTS—EMERGENCIES—POISONS. 
culiar bark. 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 pe- 
riodic 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. These 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 dog 
appears to be unusually quiet, is melancholy and has depression of 
spirits; although he has no fear of water, he does 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 the muscles of the body.) 
“ lie 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 ; the 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 la- 
borious ; there are tremors, and vomiting, and convulsions.” 
In a recent paper,* the writer refers to a large number of well- 
authenticated instances were the bite of the common Skunk, or 
Polecat (Mephitis mepliitica) has been followed, after the usual pe- 
riod of incubation, by symptoms of Rabies (Hydrophobia). Of 
the 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 Mepliitica. Hervey, Rev. H. C. American Journal of 
the Sciences aud Arts (Silliman’s), May, 1874, p. 477. ACCIDENTS—EMERGENCIES—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 the whole or a part of the bone dies (necrosis). 
So, the sooner this 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 has had one, may have 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 house. These “ tissues” are compos- 
ed of still simpler structural elements ; and these, again, are compos, 
ed of the 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 docs 
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, afterward 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 the 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 lauda- 
num, much comfort will be found from it. 
FACEACIIE 
Usually is neuralgic, and heat applied is always grateful. A 
small hop-pillow heated and held to the face is useful ; or the 
face may be bathed 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 still paste, with an equal bulk of Indian- 
meal and Honey, is quite as active, as useful, and docs not blister 
the skin. 
CROUP. 
Some young children, and the young children 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. 
The first thing is to get the child 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 
warn bath 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. 
This is for a child of about two years of age. As improvement 
becomes marked, the domestic remedy consisting of equal parts of 64 
ACCIDENTS—EMERGENCIES—TOISONS. 
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 that the latter is by far the most common. There 
is often a relation existing between the severity of the 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. The 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—the 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 any thing else for the purpose. 
Sometimes these convulsions are one of the symptoms of Scarlet- 
fever, Measles, or other disease 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 useful plan is to take ACCIDENTS EMERGENCIES—TOISONS. 
65 
hold of the lashes of the upper lid, separate it from the eyeball, 
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, 
close to and just under the edge of 
the orbit, then, holding it firmly, 
seize the lashes of that lid by the 
fingers of the disengaged hand, and 
gently turn the lid upward and back- 
ward over the needle, or substitute 
used. Movement of the eyeball by 
the sufferer, in a strong light, usual- 
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 docs 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 pro- 66 
ACCIDENTS EXIEKGENCIES POISONS. 
paration, after injury to the eye by a foreign body getting into it, 
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 neutralize 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 ulceration caused by the Al- 
kali will be some days in disappearing. In all cases where lime 
lias 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 ear, is too well know to be more than alluded to. If the body 
is soft, it absorbs moisture from adjacent parts, becomes swollen, 
and more difficult to remove. If the body is hard, the irritation 
and inflammation set up by it in contiguous parts in a short time 
materially increases tire difficulties of removal. Hence the sooner 
these substances are removed, the easier it is to do so. 
Foreign Body up the 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 degree by 
the foreign body, assisted by a sharp blow from the palm of the 
hand to the back, will often expel the substance. 
If it will not escape in this way, and it is near the opening of 
the nostril, compression by the fingers, just above, will prevent it A COT DTC NTS — EM IS 110 IS NCI ES POISONS. 
getting further up, and it can be hooked out with the bent end of 
a wire or bodkin. Should these measures not remove the foreign 
body, the child should at once be taken to a Surgeon. 
Foreign Bodies in the Ear. 
Foreign bodies in tlie ear are more troublesome to deal with. 
No effort to remove them with a probe, or any thing of the kind, 
should be made by any one, except a professional man, for fear of 
permanent injury to the car. The head of the child, face down- 
ward, should be held firmly between the knees, and with a Matt- 
son’s or Davidson Syringe a stream of tepid water should be in- 
jected into the car. The nozzle of the syringe should not be in- 
troduced into the cavity, as its presence may prevent the dropping 
out of the desired body after the water has been forced past and 
beyond it. 
Should this means not succeed, consult a Surgeon without delay. 
Insects sometimes get into the ear. The best way of getting 
them out is to hold the head of the person with the disabled ear 
upward, and fill the cavity with sweet-oil or glycerine. It drowns 
the animal, by closing up its breathing pores, and in a short time 
it floats to the surface of the fluid used. The tube of the ear is 
somewhat curved, and when straightened somewhat by catching 
hold of the upper tip, and gently pulling it upward toward the 
crown of the head, the liquid flows in more readily. 
BLEEDING FROM THE NOSE. 
Bleeding from the nose is sometimes troublesome, but not often 
fatal. Professional assistance can usually be had, and if not, the 
remedies and appliances to be used, can not be properly described, 
here. The most important thing is not to disturb the forming clot 
involving and closing the little ruptured vessels, by blowing the 
nose. 68 
ACCIDENTS—EMERGENCIES—POISONS. 
SPITTING OF BLOOD 
Often proceeds from the back of the throat, having trickled 
down and brought up by the movement of coughing. If the blood 
comes from the lungs, it is suggestive of trouble there, but not 
always so in young people, especially in young women. The 
amount of blood lost is rarely in itself fatal. As salt is always 
given in such cases, it has acquired a good deal of popular con- 
fidence for arresting the loss of blood. It and fragments of ice 
may be given. 
POISON-VINE ERUPTION. 
Several varieties of the Rhus, popularly known as the Swam]) 
Sumach or Poison-Sumach, Poison-Vine, and Poison-Oak, when 
brought in contact with the skin of many persons, produce itch- 
ing, redness, a sense of burning, tumefaction, and even vesication. 
Sometimes the swelling is so great as to disguise the features. 
Persons coming within the influence of even the emanations from 
different species of the Rhus experience the same symptoms. The 
poisonous effects are usually observed shortly after exposure, and 
begin to decline within a week. 
Weak alkaline solutions—say a tea-spoonful of common baking 
soda to a quart of water, or even lime-water, kept to the part by 
dipping pieces of linen in them, are useful in allaying the inflam- 
mation. Laudanum added relieves the pain. Weakened-down 
Lead-Water is also recommended. Cream from milk is perhaps as 
useful as any thing else. 
FROST BITE. 
Exposure to the cold, of severe degree, often leaves the lingers 
and toes, nose, ears, and lips, more or less frozen. Tills condi- 
tion, short of absolute death of the part, is termed Frost Bite. It 
will be observed that the portions of the body just enumerated 
are those most exposed, in area, to the influence of the cold, and 
are furthest situated from the heart; and it will, perhaps be un- ACCIDENTS—EMERGENCIES—POISONS. 
necessary to remark that persons who are debilitated are more apt 
to suffer with the same amount of exposure than the robust. 
When the circulation of any part begins to succumb to the in- 
fluence of the cold, it becomes puffy, blueish, and smarting. This 
is because the blood moves more slowly than natural through the 
vessels exposed near the surface. Boon this blueness disappears, 
and the part becomes pallid, as if the influence of the cold had 
contracted the vessels to an extent incompatible with the passage 
of blood through them. The pain at this point ceases ; indeed, 
until he meets a fi'iend, he often does not know of his mishap. 
At this stage, the injury has become so great that, unless proper 
means are taken to restore circulation, complete death of the part 
ensues, and in due time sloughs away, and is detached from the 
line of living tissue. 
What takes place in a part of the body, known as Frost Bite, 
may take place in the whole of it, which is known as “ Frozen to 
Death.” The blood of the extremities being gradually forced 
from them, under the continued subjection to the cold, is forced 
inward upon the larger blood-vessels, heart, lungs, and brain. 
There is increasing difficulty in breathing, owing to the engorged 
state of the chest, and, what would always be remembered by one 
so exposed to cold, an unconquerable desire to sleep. To sleep then 
is to die. If the person exhibits such a symptom, he must, by all 
means, be kept constantly moving. 
Treatment. 
Persons exposed like those just described must be treated 
promptly, and with one thing never lost sight of. That is, keep 
the frozen person away from the heat. A person taken up insen- 
sible, or approaching it, from exposure to the cold, should be tak- 
en into a cold room, his clothing removed, and thoroughly rubbed 
with snow, or cloths wrung out with ice-water. The friction to 
every part of the body, particularly the extremities, must be con- 
tinued for some time, until signs of returning animation appear. ACClL>ENTS— EM KKG K NOES' — POISONS. 
When the frozen limbs show signs of life, the person should be 
carefully dried ; put in a cold bed in a cold room ; Artificial Re- 
spiration used until the natural is established ; then brandy given, 
also ginger-tea and beef-tea. Usually, by this time medical ad- 
vice will have been secured to direct further treatment. Should 
it not, do not forget that the patient is to be brought by degrees 
into rather warmer air; and lest in some fart there might still be 
defective circulation, the person should be kept away from expo- 
sure to the heat of the fire. 
Milder degrees of the same condition, as suspension of life in the 
car, nose, finger, or toe, from exposure to cold, must be treated 
■with the same general directions in view. The part should be 
kept away from the heat, and rubbed with handfuls of snow, or 
towels dipped in cold water, until circulation appears re-establish- 
ed. Exposure of the part to the heat before, we may say, it has 
been almost rebuilt, is apt to be followed by sloughing. 
CHILBLAIN, 
As the name implies, is when the circulation of the part has be- 
come chilled—disturbed, not destroyed. It is generally attended 
with much itching, tingling, and smarting, and is usually found in 
the toes, outside edge of the feet, just where the toe emerges, or 
in the heel. Sometimes, in persons of debilitated state of health, 
the hands suffer. These symptoms arc particularly annoying just 
after lying down in bed, owing to the exposure to the heated air 
formed and retained between the bed-clothing by the body. 
The most useful thing for these annoying symptoms, and a con- 
dition which often extends into ulceration and sloughing, is to 
keep away from the fire, and every night, before retiring, to bathe 
the feet in cold water, or rub them with snow. They should then 
be well dried with a soft towel. After this, the application of the 
ordinary Compound Resin Ointment of the apothecaries is often of 
use in stimulating the circulation through the part. The efficien- 
cy of this ointment for this special purpose can be increased by ACCIDENTS—EMERGENCIES—l’OlSONS. 
71 
asking the apothecary to add to an ounce of it a couple of 
drachms of the Oil of Turpentine. It may be remarked, that per- 
sons who suffer in winter from cold feet are often benefited to a 
surprising degree by bathing them at night, before retiring, in 
cold water. Such persons should always keep their feet away 
from the fire. 
CONVULSIONS. 
Convulsions, or “ fits,” as they are often called, are a frequent 
cause of alarm in the streets, or at public assemblages. In the 
decided majority of instances, the convulsions may be safely pre- 
sumed as Epileptic; so, unless otherwise specified, the remarks 
here made apply to that form. Ordinary fainting may be con- 
founded with it; but here the face is pale, the person perfectly 
still, and there is no perceptible breathing. Besides, in fainting 
there are no convulsive movements. 
Often the Epileptic seizure is ushered in with a peculiar sharp 
cry, as the person falls over. It does not always occur, but when 
it does there can be no doubt, if it is a convulsion at all, that it is 
Epileptic. There is frothing of the mouth, sometimes tinged 
witli blood from the tongue or a fold of the lips having been 
caught between the teeth at the moment the spasm commenced in 
the muscles of the jaws. Sometimes there are general convulsive 
movements of the whole body ; often of parts of it only. At first 
the face is pale, but usually, in the course of a few moments, it 
becomes livid, except around the mouth, which often continues 
pale, in strong contrast with the color of the rest of the face. As 
a general rule, it may be said that the convulsive feature of attack 
does not last much longer than four or five minutes, although to 
bystanders the time naturally seems longer. Then the person 
opens his eyes with a certain degree of intelligence, or revives 
enough to speak; and, as will be said, it is at this point of the 
attack that most must be done. Sometimes there is nothing be- 
yond it, and the individual gets up, hurriedly puts on his hat, and 
walks off, apparently the least concerned of any body about. ACCIDENTS EMERGENCIES—POISONS. 
If this happy termination does not take place, this brief semi- 
conscious interval gives way to a, heavy stupor, varying in duration 
from thirty minutes to three or even six hours. 
In Epileptic Convulsions, there is usually nothing to be done. 
Ignorant people on such occasions are apt, upon the general plea, 
“ if you do not know what to do, do something, ” to insist upon 
“opening the hands,” as the phrase is, saying that the patient 
will be better as soon as they can do it. The truth is, they can 
not do it until the patient is better. All interference of this kind 
is hurtful, and no good can come of it. All rude efforts aggra- 
vate the trouble, perhaps, by exhausting still further the muscular 
strength of the patient. 
All that can be done is to keep the person from injuring himself 
or hurting others during the violent convulsive movements, by 
removing him to some clear space where there is nothing to strike 
against. Do not attempt even to hold the limbs, but loosen 
every thing about the throat and chest. 
Wait a few minutes for the convulsive movements to cease, and 
the semi-conscious state to appear. As said above, it will soon 
be seen. Then, if the person is a stranger, get his name and resi- 
dence, if possible, with such other knowledge as may be useful. 
In the mean while, keep the crowd away. This is a very impor- 
tant measure of assistance in convulsions, as in every other emer- 
gency. By this is not meant so that people can not bend over the 
victim, but that a perfectly free space of at least two feet on each 
side should be kept, with none in it but the one or two imme- 
diately assisting him. 
Treatment, 
Thirty drops of the Aromatic Spirits of Ammonia, in a tea- 
spoonful of water, may be given the patient, as it is thought by 
many physicians to lighten and shorten the later stupid stage. 
The spasmodic condition of the muscles of the jaws can usually 
be overcome enough, with a little gentle dexterity, to permit it to ACCIDENTS—EMERGENCIES—POTSONS. 
73 
be got into the mouth with the assistance of another spoon or a 
piece of smooth stick. After getting the liquid into the mouth, 
press down the base of the tongue, and the mixture will readily 
run down the throat. As much of it will necessarily be lost dur- 
ing the operation, double the quantity may be prepared for use. 
If more than the thirty drops should be given, no trouble from it 
need be feared. 
If the name and residence have been secured, as it often can, at 
the interval alluded to, the friends of the person can be advised. 
If not, he should be taken to some place of security until con- 
sciousness returns. 
Persons liable to Epileptic Convulsions should never be permit- 
ted to go from the house without a strip containing the name, re- 
sidence, and disease, attached inside of the coat, where it will at 
once be seen upon unbuttoning the coat over the chest. A refe- 
rence on it to a memorandum in some pocket containing a sugges- 
tion as to the duration of the attack, useful remedy, if any, in as- 
sisting restoration, would often materially add to the comfort and 
advantage of the afflicted person. 
Other Convulsions are Apoplectic. These are not common, in 
comparison with others. As a rule, little can be done by bystan- 
ders, further than loosening every thing about the neck. This 
should be done in all Convulsions. 
The Convulsions known as Hysterical are usually found in 
young women who arc not very strong. Until assistance conies, 
act as directed in Epileptic Convulsions. The distinction be- 
tween them can not be expressed, to a useful extent, to unprofes- 
sional persons. 
RHEUMATISM AND NEURALGIA. 
Persons susceptible to Rheumatism or Neuralgia are often liable 
to an attack, which as completely disables them as a broken bone. 
When Rheumatism is here spoken of, it does not mean Inflammatory 74 
ACCIDENTS—EMERGENCIES—POISONS. 
Rheumatism, but the other troubles with similar symptoms and 
immediate results, but possibly of a different origin. 
A person constitutionally disposed, or who has acquired Rheuma- 
tism. can never be too careful of himself. Every thing like 
exposure of the surface of the body, especially the soles of the 
feet, to currents of cold air, or to cold surfaces, must be avoided. 
Warm suits of inside flannel, with plenty of buttons, should be 
put on early and taken off late. The predisposed often favor an 
attack by allowing garments of muslin or linen, when moist 
with perspiration, to dry upon the skin. The quiet chill, some- 
times evident, from the rapid evaporation, can be avoided, and 
with it, what it leads to ; by wearing flannel next to the skin all 
the year round. Many people known to the writer have been 
remarkably benefited by wearing suits of buckskin undercloth- 
ing over their muslin inside shirts and drawers. Not only 
invalids suffering from Rheumatism, but debilitated persons, 
and known as the somewhat aged, have been relieved to a 
surprising degree of distressing wandering pains and other like 
symptoms, by hoarding the heat of the body by such suits.* 
Heavy soles to the boots, which may even be warmed inside be- 
fore putting on, should be used. It may here be remarked that, 
in changing the boots, during the day, for another pair, it is often 
better to keep on the wet ones if they are warm than to chill the 
moist feet with a pair that are dry, but cold. These are little 
things, but very important to people who dislike to be sick. 
The digestion is often poor in persons suffering with what is 
known as Neuralgic Rheumatism, and improves on attention to 
preserving the heat of the body. 
Every thing said here about Rheumatism applies to general as 
well as local Neuralgia. The pain of Neuralgia has been said by a 
celebrated German physician to be the ‘ ‘ prayer of the nerve for 
healthy blood.’’ 
* They can he had of most furnishing-stores. ACCIDENTS—EMERGENCIES—POISONS. 
CHOLERA. 
In the early spring of almost every year, a visit of this epide- 
mic is predicted from some source, and every few years cases 
enough occur to justify the sagacity involved. The general na- 
ture of the malady even is unknown, and the treatment wholly 
empirical. One thing can be asserted without dispute, and 
that is, want of cleanliness, overcrowding and bad water, not only 
invite the malady, but at the same time increase its fatality. 
Where cholera is to be feared, the strictest attention should be 
paid each of these favoring causes. All, except the latter, may 
be evident to the senses, but often there is no known means to or- 
dinary persons of detecting the latter. Cholera and other epi- 
demics quickly and effectually solve the problem of overcrowd- 
ing. 
Water of surface origin, never mind how far down the bottom 
of the well; or likely to be contaminated with sewer or kindred 
emanations, should be carefully avoided. If nothing better can 
be done, the water from melted Northern ice can be used for 
drinking purposes. If this is not to be had, ordinary water can 
be boiled under cover, for a few moments, to destroy the animal 
and vegetable features. “Filtering” water does not necessarily 
purify” it in the popular sense, but merely strains out particles 
too big to pass. What is left often is the dangerous element. 
Heat destroys that, and with the exception of a little “ flatness” 
to the taste, the water is quite palatable. In the absence of some- 
thing better in traveling, water can be thus prepared for drinking 
by heating in a cup over the flame of gas or a lamp. 
Nothing likely to invite or force the blood to.the mucous mem- 
brane must be permitted. Hence, all indigestible articles, or of 
difficult digestion, must be avoided. Meals, after fatigue, unless 
of easy digestion, must be avoided, and especial care should be 
paid the late meal of the day, when at all times there is less 
strength than earlier. Articles of any kind, even although tolera- 
ted by the stomach in robust health, may prove irritating in warm 76 
ACCIDENTS—EMERGENCIES—POISONS. 
weather, when Cholera prevails. The usual debility of late sum- 
mer, especially if the nights arc cool, permits exposure while 
sleeping, to bring about congestion of the bowels and relief as a 
diarrhoea; just as the debility of late winter, under the influence 
of exposure, favors congestion of the lungs and relief to the mu- 
cous membrane there as expectoration. 
When an epidemic exists, all related affections assume the gen- 
eral features of the prominent disease; and it is noticed that when 
Cholera exists, the most trifling irregularity, in a greater or less de- 
gree, assumes the well-known symptoms of that disorder—show- 
ing, it is said, the prevalence in the blood, perhaps of every body, 
of a fractional part of the requirement of that poison necessary to 
constitute a pronounced case of the malady. What is wanting, 
indiscretion can provide. 
The treatment really should begin with the slightest appearance 
of a relaxed condition of the bowels. With this there must be a 
studious avoidance of everything known to increase it. The gen- 
eral disposition seen during the epidemic, to this state of things, 
is known as ‘ ‘ Choleraine, ” and a slight neglect will lead to an at- 
tack of Cholera. A tea-spoonful of Paregoric, with ten drops of 
the Tincture of Ginger (“ essence of ginger” may answer), can be 
taken by an adult, every hour or so, until relief is felt. 
The attack is ushered in with symptoms more or less like the 
ordinary diarrhoea. They soon become more urgent, and in a 
short time follow cramps and profuse evacuations of “ rice-water” 
liquid. The entire watery portion of the blood seems to be rap- 
idly passing off in this shape, leaving the blood viscid, darker in 
color, and lessened in quantity. The changed circulating fluid 
gives the skin, particularly of the face, quite a dark color, and na- 
turally enough, under the circumstances, a shriveled look. As 
should be expected also, the skin and the entire body seem quite 
cold. 
The latter symptoms, together, give what is known as “ col- 
lapse,” and the person probably dies, from the blood circulating so ACCIDENTS EMERGENCIES—POISONS. 
77 
slowly that the necessary purification for the demands of the body 
does not take place in the lungs. 
Medicines of the aromatic and pungent character, combined 
with others containing Opium, are usually given. There are 
many popular things of the kind. The following combination is 
as useful as any : 
Aromatic Sulphuric Acid,) h 30 , D 
Tincture of Capsicum, f eacQ> du <Irops- 
Tincture of Opium, 1 , . id d 
Tincture of Camphor, ( eacu 1 mna aram- 
Tincture of Ginger, 2 fluid drams. 
Compound Tincture of Cardamom, 10 fluid drams. Mix. 
A tea-spoonful in a table-spoonful of water, every hour, two hours, or three hours, 
until the patient seems better. Or it might be given every half or every quarter 
of an hour. * 
As might be expected, under the circumstances, absorption of 
medicines or food takes place slowly, and no surprise need be 
felt if immediate improvement docs not at once take place during 
the attack. 
No time should be lost in an attack, in trying to arrest the evi- 
dent tendency of the blood to seek the bowel, by diverting it out- 
ward by applications of heat in various forms. Hot flannels, ves- 
sels of hot water, with stimulating applications, diligently used to 
the body and limbs, and friction by the hands, moving them from 
the extremities toward the heart, should not be omitted. 
There is great thirst, owing to the rapid abstraction of the wa- 
ter from the system, and small pieces of ice and little water 
may be given every little while. 
Cholera is not a contagious disease, nor is it near as fatal as ge- 
nerally believed. Many die, it is true,but because so many are at- 
tacked. As long as there is any life, there is hope in this affec- 
* This mixture can be made by any apothecary, or compounded 
from tlie usual medicines kept on hand by most families. It keeps 
well, is not impaired by age, nor disagreeable to the taste, and is com 
pact in bulk. As a prudential measure, it might be placed in a hand- 
satcliel in traveling; where a change in the water brings on attacks of 
diarrhoea. ACCIDENTS—EMERGENCIES—POISONS. 
tion, and people who have been considered dead have revived 
and lived. During the prevalence of an epidemic of this disease, 
especially in the case of strangers, the linal steps preceding inter- 
ment should never be taken without the most positive proof that 
death has really taken place. 
CHOLERA MORBUS. 
The symptoms of this attack are so much like Cholera, as often 
to suggest the epidemic. There are violent movements in the 
muscular coats of the entire intestinal canal, giving rise to great 
pain; expulsion of the contents of the stomach, known as vomit- 
ing ; and of the contents of the bowels, known as diarrhoea. The 
cause usually can be traced back to an excess of ordinary food, or 
the use of articles incapable of digestion in the condition of the 
system usually found toward the end of summer. Drinking free- 
ly of water, by further weakening digestion, materially aids it. 
Cholera Morbus is a natural process, and tends to relieve itself 
as scon as every thing in the canal shall have passed away, and 
the tract has had an opportunity of recovering from the special 
exertion. Paregoric, Ginger, and such things arc to be used. In- 
deed, the treatment named for Cholera is safe and useful. Care 
will prevent an attack. 
For the practical purpose of this little treatise, it may be said 
that ordinary Diarrhoea of warm weather is a milder effort, than 
in Cholera Morbus, of the digestive tract to get rid of irritating 
substances, and may be treated in the same way. 
DIARRHOEA. 
DYSENTERY. 
Tins is often epidemic, and quite fatal. In ordinary cases, the 
symptoms are that of a severe Diarrhoea, with griping and strain- 
ing. In a general way, it may be stated that this straining, after 
each evacuation, is the distinctive symptom between Dysentery and 
Diarrhoea; showing that the large bowel, or rather the extreme ACCIDENTS—EMERGENCIES—rOISONS. 
portion of it, has become irritated and inflamed. An injection of 
twenty-five drops of Laudanum in a little thin-cooked starch, every 
few minutes, will often relieve this very distressing symptom. 
What is better, as a matter of convenience, is a one-grain Opium 
suppository as frecpiently. The prescription given under “ Cholera,” 
or its equivalent, may be given as there directed. 
TO CHECK VOMITING. 
If due to mere irritability of the stomach or nervous system, the 
Aromatic Spirits of Ammonia, in twenty-drop doses in ice-water, 
every few minutes, iced Mineral-water, iced Champagne, thirty- 
drop doses of brandy, every few minutes, a mustard-plaster, ca- 
yenne-pepper plaster, broken ice in a bladder to the stomach, or 
opposite, over the spine, arc all useful. The last often succeeds 
where other things fail. A common tumbler with fragments of 
paper dipped in Alcohol or Cologne, and ignited, to act as a “ cup,’’ 
used to the pit of the stomach, is likewise useful. 
Sometimes the vomiting is a proper effort to get something out 
of the stomach that ought not to be there. If this is known to be 
the case, assist it with a solution of salt and water, or pulverized 
Ipecacuanha. 
Under this head are several distinct affections, but with several 
general features in common up to a certain point. They are all 
infectious and contagious—that is, by absorption of tainted emana- 
tions from the affected person through the air, and by direct con- 
tact. From the time of absorption of the poison into the system, a 
period of incubation exists, then constitutional disturbance of the 
system, ending in the appearance of a distinctive eruption. This 
runs a well-defined and natural course, which can not be cut short. 
ERUPTIVE FEVERS. 
The natural tendency of them all is to run a favorable course, 
but sometimes there is a peculiar condition of the blood of the 
people of the community inviting the disease to an unfavorable 
end. Often, again, an individual peculiarity does the same, and it 80 
ACCIDENTS—EMERGENCIES—POISONS. 
can be seen that a person prepared by these two things, especially 
if living in bad air and on poor food, is not at all well off in the 
presence of an attack. The distinguishing feature of this class of 
affections appears to be the eruption ; so they are presented for 
purposes of comparison: 
Period of incubation 
and latency, from 
Scarlet fever, 4 to 8 days. 
Measles, 7 to 8 “ 
Small pox, 8 to 14 “ 
Appearance after commencement of evi- 
dent constitutional disturbance. 
18 to 24 hours. 
72 hours. 
48 
Scarlet Fever. 
Scarlet Fever (called Scarlatina by physicians, which is not, as 
some people think, from the termination of the word, a mild 
case of the disease) appears with the symptoms common to what 
are known as the other eruptive diseases, Measles, Small-pox, 
Chicken-pox, and Erysipelas. Few children live to the age of six- 
teen months without having had all the general symptoms, and the 
case turning out only a “cold.” 
There appear more or less headache, symptoms of oppression and 
weakness, as if the strength were gone, flashes of heat and shiver- 
ing—sometimes the latter can be called the chill found in the 
whole class of eruptive diseases. In from eighteen to twenty-four 
hours, an eruption appears over the skin, of a bright scarlet color, 
not crimson; much the color of a boiled lobster. 
Pressure of the finger to one spot, leaves a white point or stripe, 
remaining for some moments after removal of the force. It is 
often difficult to tell Scarlet Fever and Measles from each other. 
Between them are the following points of resemblance: 
IN SCARLET FEVER. 
The eruption is a bright scarlet. 
Appears on the second day. 
The eruption does not seem raised to touch. 
Blotches of uniform tint. 
Disappear on pressure. ACCIDENTS EMERGENCIES —POISONS. 
No mucous discharges from eyes and nostrils. 
No sneezing nor sensibility to light. 
No hacking cough. 
The eruption is a cherry red, or crimson color. 
Appears on third or fourth day of disturbance. 
Seems elevated above surrounding surface of skin. 
Arranged in irregular or crescentic masses. 
Does not disappear, leaving white spot. 
Face swollen, discharges from eyes and nostrils. 
Sneezing, hides eyes from the bright light. 
Frequent hacking cough. 
MEASLES. 
Besides attacking the external skin, the scarlet-fever poison ap- 
pears to he precipitated also upon the mucous membrane of the 
throat, especially about the mass of secreting depressions there, 
known as the tonsils. Measles does not. In “sore throat,” 
which is an inflammatory activity in the same parts, without the 
specific poison under notice, much the same appearance presents to 
the uneducated eye. And if there should be a “ cold” affecting the 
general system, enough general symptoms often occur, to suggest 
during the prevalence of the disease in a neighborhood, the feared 
malady, but the absence of the described eruption decides the case. 
In the course of a few days, the inflamed skin comes off in 
scraps and shreds. The under skin is naturally quite tender and 
sensitive to the cold air; and the physician never fails to impress 
upon the attendant the danger likely to occur from it. While 
plenty of the purest air must be kept in the room, it had better 
pass through an adjacent chamber to deprive it of the “ draughty” 
character. After the new skin shall have become complete in 
structure, and the broken-down condition of the blood common 
to this as well as the other eruptive diseases, shall have been no- 
ticed, these precautions may be relaxed. 
Until the arrival of a physician, warm, acidulated drinks, as 
lemonade, may be given, and the other popularly esteemed things 
done for “bringing out the rash.” Sponging the parched and 82 
ACCIDENTS—EMERGENCIES—POISONS. 
inflamed skin with a soft sponge, well w-rung out in cold water, is 
not only grateful, but useful to the patient. 
As no person ever thinks of attending a case of scarlet fever 
without professional advice, nothing will be said about the treat- 
ment. It may be added, however, that the poison alters the cha- 
racter of the blood in such a wray as to give the kidneys a great 
deal of trouble for a time; so care must be taken to prevent chill- 
ing of the surface of the body in any wray by forcing the blood 
inward upon these already overtaxed organs. The liquid which 
can not be excreted (thrown out) by the kidneys oozes out into the 
vacant spaces of the body, and is retained there under the name of 
dropsy. 
The scarlet-fever poison, as we may term it, not only attacks 
the skin and visible, mucous membrane of the throat, but extends 
to the unseen extensions of it to the large mass of communicating 
cavities back in the head, above the roof of the mouth, where the 
throat and nostrils meet. The inflammation travels along the canal 
(eustachian tube) on eacli side leading from the throat to the in- 
side ear, leading to such a mechanical derangement of the parts as 
to damage the hearing. For obvious reasons, the worst of it is 
that any thing like special prevention is out of the reach of the 
medical attendant. 
Scarlet fever is highly contagious, and the room of the patient 
should have all hanging articles and unnecessary pieces of furni- 
ture removed to prevent adhesion and preservation of the germs 
of the disease. 
Measles. 
Measles is ushered in with much the same general symptoms as 
scarlet fever. The points of difference between the two affections 
have been pointed out. In measles, the rash appears rather in blot- 
ches, which can be seen to be made up of little irregular, crescent- 
shaped crimson spots, unlike the uniform scarlet distribution of 
the eruption of scarlet fever. The eyes and nostrils discharge ACCIDENTS EMERGENCIES—TOISONS. 
83 
mucus, there is sneezing, a cough, and a dislike to light, not seen 
in Scarlet Fever. 
The treatment consists in preventing exposure until removal 
and restoration of the skin to its natural duties. Sometimes the 
blood does not seem to readily return to its normal character, and 
the health remains impaired. This is often the case where the 
general health was not good before the attack. The chest symp- 
toms point out a tendency, upon slight provocation, for the lungs 
to become troubled with catarrh and kindred disorders, unless 
due care is taken. 
Warm teas of Saffron, and the garden herbs, are usually given as 
domestic remedies to “ keep out the rash,” and often this is all 
the treatment the child gets. 
Small-Pox. 
The general symptoms of small-pox are more violent than in 
either of the named affections. The fever, and especially the 
pain in the small of the hack, are strongly marked. There is 
thought to be a general relation between the urgency of these 
symptoms and the amount of eruption that should appear. In 
the early stage, it is not always an easy matter to tell by the sight 
alone the eruption of Small-pox from that of Measles. The rash 
of Measles offers no special resistance to the touch, while in Small- 
pox it seems rough, as if a layer of minute mustard-seed were 
scattered under the skin. Later, the minute red pimples become 
marked at the apex by a pearly point, changing still later to a 
pustule with a central black point, giving an optical appearance 
of depression in the centre. 
The appearance of the eruption should be favored by careful 
attendance and a free use of warm drinks. “ Pitting,” as it is 
called, can often be prevented to a considerable degree, but the 
tendency to use the nails to the face, at certain late stages, al- 
most neutralizes the best efforts of the physician, unless the nurse 
gives close attention to the patient. 
Small-pox is not to be cured, but to be prevented. There is no 84 
ACCIDENTS—EMERGENCIES—POISONS. 
doubt as to the reliability of Vaccination to do this. If it docs 
not pre'cent the disease altogether, as it does in most people, Jthe 
attack is so modified that death almost never takes place. If the 
vaccination has “run out,”of course the person is little better off 
than if he never had been protected. As there is no uniformity 
among people about this, each person probably should have vac- 
cination attempted, every few years—say, five or six. If pro- 
tected by the previous attempt, it will not “ take,” and if partially 
protected, the effort probably completes it. The virus from re- 
vaccination, even if it “ takes,” should never be relied upon for 
other people, when that from a first vaccination from small chil- 
dren can be had. The appearance of an epidemic, like that just 
passed through, •was due to a feeling of general security upon the 
subject permitting an accumulation of material on hand adapted 
for an attack. That a few people in this large community are op- 
posed to Vaccination, on “conscientious scruples,” is no argument 
whatever against its usefulness. 
The writer believes, from ample observation, that the greatest 
care is taken by physicians in avoiding possible sources of error 
in selecting crusts for use. It is not thought that diseases can be 
transmitted in that way, although the practice among physicians 
very properly is to act as if they might. While the writer has seen 
eruptions appear after Vaccination, he has seen the same after a 
cut; and in a large experience, in connection with public institu- 
tions, he has never seen a case of transmission of disease by it, nor 
docs he personally know a physician whose opinion in other mat- 
ters is of value, who has. 
Well-asserted cases doubtless exist, but they arc not more re- 
spectably vouched for, than the statements made when Vaccination 
was first introduced to the public by Dr. Jenner, that horns from 
the head and hoofs from the hands, had followed the efforts of that 
very useful man. 
Varioloid, or the disease modified by Vaccination, is contagious 
to a very susceptible person; and some persons are so susceptible ACCIDENTS—EMERGENCIES—rOISONS. 
85 
that frequent Vaccination does not always secure exemption from 
exposure to even a small amount of the emanation. 
Malaria is an intangible and almost undefinable product of heat, 
moisture, and decomposing vegetable matter, which, when ab- 
sorbed into the blood in sufficient quantities, gives rise to certain 
well-known symptoms termed intermittent—that is, at certain 
calculable, recurring periods, more or less fever occurs, with more 
or less chilliness. Instead of both or either of these sensations, 
it is another, as pain in some part of the body. 
MALAKIA. 
In the United States, wherever heat and moisture are able to 
decompose vegetable matter in a certain manner, Malaria is found. 
In summer, it is not prevalent, probably because the fresh life of 
such matter successfully resists the peculiar decomposition. 
Later, in the early autumn, before the killing frosts, it abounds. 
The temperature of evening and night favors its production, and 
ns the vital powers are then somewhat weakened from the labors 
of the day, this is a favorable time for absorption into the body. 
A moderate temperature seems to invite its formation, perhaps by 
furnishing the necessary quota of moisture. The heat of the sun, 
or of a common fire, discourages the production, hence localities 
can be visited at midday, usually avoided at other times; and 
heating the air of a house by a fire, is a well-known precaution. 
As vegetable matter and moisture exist in greater abundance 
near the ground, the lower strata of air soonest become saturated, 
and the air as high up as the second story often contains much less. 
Malaria is about the same density of common air; so it travels 
for a certain distance entangled in the volume of atmosphere in 
■which it originated. Hence, a gentle breeze carries it to spots 
where not produced. In passing a mile or so over an active 
stream or other non-producing surface, unless especially virulent, 
Malaria becomes so diluted or dispersed as to lead to the practical 
belief that this distance affords, under ordinary circumstances, a 
safeguard from its influence. Trees, or other solid substances, may ACCIDENTS—EMERGENCIES—POISONS. 
act as a screen to a spot; hence removal of such barriers often extends 
the influence of the poison. If generated about a dwelling, trees 
or close shrubbery, by keeping out the heat and light of the sun, 
may prevent the diffusion of the produced Malaria to a more de- 
sirable area. The upper stories of a house near the place of forma- 
tion may escape, because elevated above the diseased layer of air, 
but a house on a bluff, a mile or so off, may suffer because the im- 
pregnated volume of air moving along the ground may be rolled 
up the elevation to the dwelling at the edge of the height; but 
passes above, by deflection, a dwelling a little further back. 
In places where Malaria exists, or during the season, and under 
circumstances where it should be intelligently feared, rooms above 
the ground are furthest from active production, and these, with 
windows opening toward the same places, should be avoided. 
Doors and windows of houses possibly liable to the introduction 
of it should be closed before sunset, and kept shut during the en- 
tire night. The outside air is not pure air, but can be made free 
from this poison by passing through a room heated by afire. The 
air from near the ground should be avoided, as the time suitable 
for production comes with the diminished heat between early sun- 
set and high sunrise next morning. 
As absorption by the blood, for simple reasons, is most active, 
the vessels are not distended with the products of recent digestion; 
there should be no unnecessary exposure in the morning until after 
a full breakfast. Surface water containing vegetable matter 
must be carefully avoided for drinking. All things favoring a 
reduction of the vital powers, invite the absorption of Malaria, aud 
especially secure all its disadvantages. 
A shallow swamp or damp ground produces the poison, while 
deeper water or a running stream need not, because deep water 
docs not permit the growth of the required amount of vegetable 
matter. A newly drained area, exposing much succulent vege- 
table material in the bottom to the heat of the sun, leads to it; or 
turning up the surface earth to the same influence will do the ACCIDENTS—EMERGENCIES—POISONS. 
87 
same. Malaria has been known to appear along a line of newly- 
thrown-up public works, executed toward the end of summer. 
The damming of a stream often introduces it into a neighborhood ; 
and, what is worse, is'the removal of such a work of long stand- 
ing in hot weather. A heavy rain will often, for a short time, 
interrupt the production, and a frost heavy enough to destroy 
rank vegetation gives relief. 
These are all degrees of susceptibility, both natural and acquired. 
Some need but little to feel its effects, others more. In temperate 
latitudes, the result is “fever and ague,” at the Isthmus, the 
annually-recurring “Chagrcs fever,” and on certain coasts the 
rapidly fatal “African fever.” With typhoid poison in the 
army, the result was the disastrous “ Chickahominy fever,” and 
with the defective drainage of Havana and New-Orleans, “ yel- 
low fever.” In all these, malaria is an active and hurtful auxi- 
liary. 
The poison rapidly exerts a destructive action, of no brief dura- 
tion, upon the corpuscles and other prominent features of the 
blood. The blood is prepared by a previous absorption for a sub- 
sequent one at another season. Under this acquired susceptibility, 
a fraction only of the original quantity is necessary to induce an 
attack of intermittent fever—a quantity which might not prove 
observably hurtful to an ordinary person. In the South, a person 
is spoken of as “acclimated,” a term originally used, perhaps, 
with grim humor, to refer to an individual not quite killed by it. 
Where business or other tilings will not permit the observance 
of all necessary precautions in localities where Malaria should be 
feared, Quinine and its related salts act as an antidote. Like 
other antidotes elsewhere spoken of, the amount must bear a re- 
lation to the amount of poison to be neutralized. The antidote 
can not undo what has already been done—that is done by nature, 
in the absence of more of the poison, under the direction of a phy- 
sician. 
One of the first observable symptoms of malarial poisons is a ACCl DE NTS—EME KG E NCI ES—POISONS. 
sense of slight chilliness, preceded by “ yawning” and “stretch- 
ing” at a certain part of the day. With it is a sense of ill-defined 
debility and indisposition to mental exertion. These symptoms 
arc often more evident, for obvious reasons, to a friend than the 
victim. The Sulphate of Quinine in two-grain doses, on aris- 
ing and retiring, should be used as a precautionary measure. Sul- 
phate of Cinchonia and the Sulphate of Cinchonidia, salts left in 
extracting the earlier discovered Quiuia from the Cinchona (‘ ‘ Peru- 
vian”) bark, in somewhat larger doses—say one half—are quite as 
useful as the much more expensive Sulphate of Quinia. 
When there is a complete interval between the paroxysms, the 
attack is known as intermittent fever, “chills,” or “fever and 
aguewhere there is only a remission in the symptoms, it is Re- 
mittent fever. After an attack of either, especially the former, it 
is almost necessary to restore the blood by tonics and.such things, 
and then, during the entire season of malarial production, one of 
the named anti-pcriodics must be used every seven or fourteen 
days to neutralize the peculiar tendency to recur at such periods. 
POISONS. 
Under this term, people are inclined to place only those tilings 
which, if taken internally, produce death. Physicians, however, 
consider it merely a relative term, and call any thing a Poison that 
docs more harm than good to the body. A little of a good tiling 
may be useful, but, beyond the point of usefulness, may be inju- 
rious. An exaggerated injury, from the same cause, may well be 
termed a poison. There is not a single poison in the entire list 
which, in proper quantities, and under favorable circumstances, 
may not be used with advantage to the human body ; and, on the 
other hand, there is scarcely a single thing in ordinary use, which 
if indulged in beyond the requirements of the body, or its ability 
to properly dispose of it, may not be followed by symptoms of 
derangement of the economy ; and, in the above qualified sense, 
is not miscalled, if termed a Poison. ACCIDENTS—EMERGENCIES—POISONS. 
In the majority of cases, the poison is introduced into the body 
through the stomach. As soon as swallowed, a portion of the 
agent may commence destructive action upon the mouth, throat, 
or stomach, as in the case enumerated of Acids, Alkalies, Arsenic, 
Phosphorus, etc. While some substances act in this way, others 
pass from the stomach, through the mucous membrane, without 
injuring it, into the Hood, and are carried by it to the brain and 
other portions of the nervous system, where the really injurious 
action begins, by overpowering them ; so that the breathing and 
action of the heart are not kept up. To this class of poisons be- 
long Alcohol, Aconite, Belladonna, Opium, Strychnia, etc. 
A slight knowledge of the mode of action of a substance will, 
therefore, of itself suggest an antidote or remedy. If an Alkali 
has been taken, an Acid will neutralize it, converting it into a 
compound less hurtful. The new compound is, perhaps, injurious, 
but not so active, and can be removed from the stomach somewhat 
at leisure. On the other hand, if an Acid has been taken, an Alkali 
would naturally suggest itself as an antidote. 
Some substances can not be neutralized by any convenient arti- 
cle ; the poison is then to be removed from its lodging-place as 
soon as possible, and its effects counteracted. 
If the agent does not act upon the stomach directly, but upon 
the brain and nervous system, reaching it through the blood, a re- 
collection of what was said when certain gases have been inhaled 
will meet the case. Artificial respiration would, of course, be re- 
sorted to. This should continue until enough of the poison in 
the blood has been eliminated (thrown out) by the natural pro- 
cesses constantly going on in the body, until the brain and 
nervous system are able to resume one of their old duties, of at- 
tending to the respiration and circulation of the blood. 
As few persons have the necessary knowledge of the different 
poisons, each of these substances will be spoken of somewhat in 
detail, and alphabetically arranged, so that, in case of need, im- 90 
ACCIDENTS—EMERGENCIES—TOISONS. 
mediate reference can be made to the particular substance suppos- 
ed to have been taken. 
Before saying any thing further, it should never be lost sight of, 
that the substance swallowed as a poison must be considered as 
three parts : the portion of that taken which has already had an 
opportunity of acting upon the mucous membrane (lining) of the 
throat and stomach, if the poison acts in that way, or which has 
already passed from the stomach into the blood, if the poison acts 
in the other way ; and the portion of the poison in the stomach 
yet to be disposed of. 
It is the latter portion, perhaps, in most instances, we are called 
upon to first deal with ; and the means employed is, to evacuate 
the stomach with the least possible loss of time. This is done 
with the stomach-pump and by emetics. 
Stomacli-Pump. 
No directions for poisons are complete without reference to this 
piece of apparatus. With people who know nothing about the 
matter, it is very popular. The writer knows of but one physi- 
cian among all his acquaintances who professes to keep one, and 
unless this particular instrument is different from all other com- 
plicated instruments rarely used, he does not believe the owner of 
it could get it to work in an emergency, if he wished. Not a 
single apothecary, as far as he knows, keeps one ; and the writer 
does not know, among all his intelligent acquaintances, a single 
non-professional person who could use a stomach-pump with suc- 
cess if he had a dozen of them at his command. A handful of salt 
and a tumbler of water can always be had ; and any body can mix 
a heaping teaspoonful of ground mustard with a cup of water, 
and get a person to swallow it. Either, swallowed, will empty 
the stomach ; a “ stomach-pump1’ will do no more. 
As has probably been observed, the simplest things, and those 
most likely of all others to be had everywhere, are the ones only 
spoken of in this pamphlet. The same purpose carried out at this ACCIDENTS EMERGENCIES—rOISONS. 
91 
point, leads us to say nothing now about the stomach-pump; and, 
for the same reason, it possibly will not be referred to again. 
EMETICS. 
For the purpose of rapidly emptying the stomach, in the decid- 
ed majority of cases, before the arrival of a physician, and after it 
too, there is nothing like an Emetic. The easiest had, also, is 
usually the best. There are few places where these things can not 
be had—Ground Mustard, Common Salt, and Warm Water. 
Ground Mustard.—Take a table-spoonful, mix with a tumbler 
of water to about the consistence of milk. Give the person one 
fourth of it at once. Then follow with a cup of warm water. In 
about a minute, give the person the same quantity again, followed 
by the warm water. If vomiting does not take place, continue 
giving until it does, letting a minute or so pass between each 
dose. Plentiful draughts of tepid water materially assist the action 
of the emetic, and the free use of it should, therefore, not be 
omitted. Mustard is not only useful as an emetic, easily found, 
and as readily given as any thing else, but it is stimulating in 
character. This feature gives it a peculiar value in most cases 
where an emetic is demanded, for there is often, with the ne- 
cessity for its use, a stimulant needed. The amount derived 
from Mustard is not always enough ; sometimes it is ; but when 
not, so much has been contributed. 
Common Salt is even easier had than ground mustard, and is as 
certain in action. It is given, a teacup of water with as much salt 
dissolved as the water will hold, every minute or so, until vomit- 
ing occurs. 
Warm water, given cup after cup, is a safe emetic; but as the 
duplicate above-mentioned articles are so easily had, it is rarely 
relied on alone for the purpose. Usually it is given to assist the 
action of the others, on the principle, perhaps, that a distended 
stomach is often more easily emptied than one with little in it. 
After vomiting has occurred, frequent draughts of warm water are 92 
ACCIDENTS—EMERGENCIES—POISONS. 
often given to cleanse out the stomach. In many instances, for 
this purpose, warm milk, gum-arabic water, flour and water, the 
white of an egg in a teacup of tepid water, and such substances, 
are given instead, with the expectation that their gummy, viscid 
properties fit them to entangle and detach particles of the poison 
adherent to the mucous membrane (lining) of the stomach. Be- 
sides, they are soothing to the perhaps irritated condition of the 
parts. 
Tickling the inside of the throat by the finger, or with the tip 
of a feather, in many instances, alone will induce vomiting. Usual- 
ly, after an emetic has been given, this is used to hasten its action. 
Sulphate of Zinc is another valuable emetic, often found in pri- 
vate-houses. As much as will lie heaped up on a common two- 
cent piece is twenty grains, which is a dose, when dissolved in 
water. This quantity should be given at a single draught, fol- 
lowed by a cup of tepid water, and repeated every three minutes 
until three or four doses have been taken, or vomiting occurs. If 
there is none in the house, send to the nearest apothecary for sixty 
grains of the Sulphate of Zinc (“White Vitriol”). Empty the 
package containing this quantity into half a pint of tepid water. 
Stir rapidly with a stick, and it will soon dissolve. One third of 
this half-pint should contain, of course, twenty grains of the sixty 
put in, and that quantity should be given at a single draught, fol- 
lowed, as all emetics should be, by d auglits of tepid water. In 
a few minutes repeat, as directed about Mustard, unless profuse 
vomiting takes place. 
Pulverized Ipecacuanha is another valuable emetic, particular- 
ly for children. It can be had of any apothecary by a messenger. 
Sixty grains (one drachm) of it may be requested. It is a ground 
root, and, as would be expected, does not dissolve in water, but 
mixes with it, like ground Mustard. One third of the sixty 
grains, which is twenty grains (as much in bulk as will heap up a 
two-cent piece) may be given, mixed with a small teacup of tepid 
water, followed by a draught of tepid water. In a few moments, ACCIDENTS EMERGENCIES—POISONS. 
93 
if vomiting does not occur, give another third, as you gave the 
first, to be followed in sixty seconds more by the last. 
A good deal of trouble is often experienced in getting the per- 
son to swallow. This may be due to insensibility, fright, or stub- 
bornness. The thumb of each hand may be slipped in outside and 
close against the teeth, along the line of junction, until the spot is 
reached behind where there are no teeth. Then through that va- 
cant space slip the tips of the thumbs in between the jaws, when 
a separation can be readily effected. The thumbs should be kept 
there, for the patient can not bite the attendant while his fingers 
are in such a position, and the handle of a strong iron or silver 
spoon, or piece of smooth stick, thrust back far enough to forci- 
bly depress the tongue. The liquid can then be poured down the 
throat, if the person is lying on his back. At first it would fill up 
the space at the base of the tongue, but a little more depression of 
the tongue by the leverage given by the spoon or stick will cause 
it to run down the throat. There need be no fear of the fluid get- 
ting into the windpipe, for a very sensitive valve over the entrance 
of the trachea (windpipe) amply protects it. 
The first vomiting, as said before, does not necessarily clear the 
stomach of its contents. Much of the poison may remain adherent 
to the mucous membrane, requiring frequent washings, as it were, 
for detachment and removal. After the first vomiting, there is 
usually little trouble in keeping it up, by simply giving plenty of 
tepid water. Warm water alone is often, as said above, an Eme- 
tic ; and when none of the mentioned things can be had, must be 
wholly relied upon for the purpose. 
Before the action of an Emetic can begin, a portion of the poi- 
son usually escapes from the stomach into the contiguous bowel. 
No vomiting can affect it; so, after the contents of the stomach 
have been removed by the action of the Emetic, it is always well, 
if the poison belongs to what is called, for convenience, the Mine- 
ral class (p. 83), to administer good quantities of milk, which, 
passing down, eilgages the activity of the poison. Flour and 94 
ACCIDENTS—EMERGENCIES rOlSONS. 
water will answer, but what is better, perhaps, is the white of 
eggs, mixed with Avater. 
Now, Ave will suppose all the poison has been removed by the above 
efforts from the stomach. The next tiling is the removal of the 
consequences of the portion of the poison which has already com- 
menced its work. If the mucous membrane has been injured, it 
should have rest from its usual work—digesting food—and be 
treated by suitable soothing applications, as barley water, gum- 
arabic water, and such things. This should follow Avhere the poi- 
soning is due to any of the articles embraced in the first class of 
substances treated of. 
POISONING BY MUSHROOMS. 
Persons not well acquainted with the differences between the 
poisonous and edible Mushrooms had better buy them of those 
who are, or go without. There are distinctions between them, 
but they are not of such a character as can be made evident in a 
place like this. 
When poisoning from eating Mushrooms does take place, the 
contents of the stomach should at once be evacuated by an Emetic. 
(See page 91.) After vomiting has commenced, it should be pro- 
moted by draughts of warm water, barley Avater, but particularly 
by drinking copiously of warm milk and water, to which sugar has 
been added. 
What has passed along into the bowels should be hurried out as 
fast as possible, by some cathartic, before further absorption into 
the blood can take place. Castor Oil might be peculiarly useful 
in such a case. 
If there is much prostration of the strength, some easily-procur- 
ed stimulant might be useful, as the Aromatic Spirit of Ammonia, 
or Brandy. 
POISONOUS MEATS. 
Eating meats of diseased animals is often followed by symptoms 
of a poisonous character. Animals in otherwise perfect health, ACCIDENTS EMERGENCIES—rOISONS. 
but which have been butchered and prepared for food after long 
and exhaustive confinement, are unfit for eating. Not only is the 
meat of such animals lacking in nutritive character, when com- 
pared with the meat of animals killed from the pasture without 
excitement, or after being kept until proper recovery from the 
effects of the journey to market, but it is much less savory, and 
shows a disposition to much more readily decompose. It might 
be here stated that it has been estimated by competent authori- 
ties, that between the two kinds of meat there is, in a commercial 
sense alone, as far as nutriment is concerned, a difference of near- 
ly fifty per cent in favor of the meat of healthful animals, butcher- 
ed after complete recovery from the excitement and fatigue of 
drive or carriage to market. The additional cost per pound of 
meat to cover the expenses of extra care and precaution before 
butchering, would amount to but a small fraction of the per- 
centage named, leaving the rest of it a true profit to the con- 
sumer. 
The eating of this overdriven meat, it is said, is often followed 
by symptoms of irritation of the stomach and bowels ; but they 
can, in the ordinary sense of the word, scarcely be said to be of r. 
poisonous character, however much the use of them may tempora- 
rily derange the health. 
POISONOUS FISH. 
Several varieties of Fish, at all seasons of the year, are reputed 
to be poisonous. Of course, they should always be let alone. 
Should they have been eaten by accident, the best treatment is 
that given under the head of “ Poisoning by Mushrooms,” p.94 . 
Shell-fisli, at certain seasons of the year, after spawning, are 
considered poisonous when eaten ; at least, they are unhealthy. 
This process of nature is known to be very exhausting; during 
which, or just afterward, the individual is so reduced in vita- 
lity as to be unable to resist ordinary tendency to decomposition. 
Oysters in hot weather are often unwholesome, perhaps from 
the causes suggested ; or it may be that the collection of liquid 96 
ACCIDENTS EMERGENCIES—POISONS. 
secretion between tlic shell and the contained animal, in hot wea- 
ther, is in a state favorable to putrefaction upon slight exposure to 
the air ; and the disagreeable symptoms often said to arise after 
partaking of this fish as food is due to this as much as any thing 
else. 
ALKALIES, ALKALINE EARTHS, ACIDS, METALS, Etc. 
Ammonia. 
MINERAL POISONS. 
The ordinary Aqua Ammonioe, sometimes known as “ Harts- 
horn, ” acts on the mucous membrane of the stomach, as would 
naturally be expected after knowing its effect upon the mucous 
membrane of the nostrils. When swallowed, it acts as a rapid 
corrosive poison. Owing to its pungency, it can scarcely be given 
by mistake in a state of purity. With Olive Oil, it forms the com- 
mon “ Hartshorn Liniment,” and has thus been given internally. 
A violently-acting corrosive substance, like Ammonia, leaves no 
time for Emetics. It is an Alkali, and the common dilute Acid 
known as Vinegar will neutralize it. Lemon-juice also would an- 
swer the purpose. 
Other concentrated alkalies, as Lime, Soda, and Potash, act in 
the same manner as Ammonia, and when taken internally must be 
combated in the same way, and witli the same difficulties in view. 
Mineral Acids. 
The common Acids, Acetic, Muriatic, Nitric (“ Aqua Fortis”), 
Sulphuric (“ Oil of Vitriol”), are all highly corrosive in their ac- 
tion, unless largely diluted, and act with even greater rapidity 
when taken internally than when applied externally (seepage 30). 
They are about as troublesome in this respect as concentrated Al- 
kalies. 
When taken, the Acid should be neutralized, as far as possible, 
by giving some harmless Alkali. Lime-water is usually about as 
convenient as any thing else for the puipose. Common Soap, from 
the Alkali it contains, might be given. ACCIDENTS—EMERGENCIES—POISONS. 
Antimony. 
This metal is rarely accessible in its purity. One of its salts, as 
Tartar Emetic, or the Wine of Antimony (which is Tartar Emetic 
dissolved in Wine), is the usual source of the poison. Vomiting is 
one of the most distressing and prominent symptoms of poisoning 
by this substance. Assisted with copious draughts of tepid wa- 
ter, sugar and water, flaxseed water, much of the poison in the sto- 
mach may be gotten out. Another symptom is great prostration. 
If a small quantity only is known to have been swallowed, a tea- 
spoonful of Paregoric in a little sweetened water may be divided 
into three portions, one of them being given every ten or fifteen 
minutes. It soothes the irritated and excited stomach. 
The Antidote usually recommended is Nut-Galls, or Oak-Bark in 
powder. Half a dozen of the former, finely powdered, may be 
given, mixed with water. The active principle in each of these is 
what is called Tannin, now to be had of every Apothecary and 
Dyer. Ten grains of it (a teaspoonful—it is very light) in water 
will be equivalent to the Nut-Galls mentioned. A strong infusion 
of common Green Tea contains enough tannin to make it useful 
as an antidote. An insoluble, and perhaps inert, Tannate of An- 
timony is formed. 
Arsenic. 
In some places this is called “Ratsbane,” and poisoning often 
occurs from it. The Yellow Sulphuret of Arsenic (Orpiment), the 
Red Sulphuret of Arsenic (Realgar), and the Arsenite of Copper 
(Paris Green), are used as paints, and have all been used internally 
with fatal effects. The latter, Paris Green, has lately been much 
used by farmers for destroying injurious insects among plants. 
All these sources of poisoning by Arsenic should be surrounded by 
every possible precaution to prevent them from being accidentally 
used. 
Many “fly poisons” contain it, and what is used in medicine 
under the name of Fowler’s Solution is a solution of Arsenic. 98 
ACCIDENTS—EMERGENCIES—POISONS. 
Arsenic acts as an irritant to the stomach and bowels, in many 
respects like Antimony and its preparations. As soon as it be- 
comes known that Arsenic or any of its preparations has been 
swallowed in poisonous doses, the poison taken should be dis- 
lodged from the stomach, as far as j>ossible, by vomiting (see 
“Emetics,” page 91), assisted by the finger to the throat, or the 
feather part of a quill. Free drinking of Milk, White of Egg and 
Water, or Flour and Water, should be encouraged. Not only do 
these things encourage vomiting and tend to dilute the poison, 
but they offer something upon which the poison can expend its en- 
ergy, to that extent saving the living tissue, and at the same time 
they tend to envelop tjie particles of the poison until the mass 
can be removed from the stomach. 
The Antidote to Arsenic is the freshly-prepared Hydrated Per- 
oxide, of Iron. This can be had of any Apothecary in a few mo- 
ments of time. It is quite harmless in character, and may be giv- 
en in almost any quantity. The iron, in this particular form, 
combines with the Arsenic, forming a temporarily harmless prepa- 
ration. This newly-formed compound should not be permitted to 
remain and be digested, but must be dislodged afterward by an 
Emetic, which the bulk of the antidote favors. 
Another Oxide of Iron, closely allied to, and said to be a useful 
substitute for, the Hydrate Peroxide, can be made by almost any one 
in a few moments, if some Aqua Ammoniae (“ Hartshorn”), p. 96, and 
some of the common Muriated Tincture of Iron can be had. Both of 
these articles can be found in many houses, and if not there, in every 
Apothecary-shop, or the office of every country practitioner. 
Take a glass tumbler, or a graduated measure, pour in three or 
four table-spoonfuls (quantity not of much importance) of Aqua Am- 
moniae, and then a table-spoonful or more of the Muriated Tincture of 
Iron. 
A tliick, dark, reddish precipitate, like brick-dust, is at once seen in 
the mixed liquids, which may he increased in quantity by gently stir- 
ring with a broom-splint. 
'I his precipitate is the Oxide sought, and must be separated from 
the liquid by spreading a fine handkerchief or closely woven piece of ACCIDENTS—EMERGENCIES—POISONS. 
muslin over a cup and pouring on the mixture. The liquid will run 
through, leaving the desired Oxide of Iron as a reddish-brown, jelly- 
like powder. To free it from any excess of either substance used in its 
formation, a half pint or so of tepid water should be poured on in a 
gentle stream to wash the precipitate. The washed precipitate is 
now ready for use. 
A tea-spoonful of this powder may be given every few minutes. 
Calcined Magnesia and Pulverized Charcoal have also been re- 
commended as antidotes in poisoning by Arsenic, but of their 
value nothing can be said by the writer. 
Baryta. 
This substance, largely used to adulterate certain paints, is 
sometimes accidentally swallowed in poisonous doses. 
The Antidote is Water, acidulated to about the strength of le- 
monade with Sulphuric Acid, which converts the Baryta into an 
insoluble compound, which must be dislodged from the stomach 
by an Emetic. 
Bismuth. 
Some of the preparations known as “ Toilet Powder” are largely 
made up of this substance, and when swallowed are followed by 
poisonous symptoms. The first object in such a case is to secure 
prompt and thorough evacuation of the stomach by an Emetic, 
followed by copious draughts of Milk. 
Copper. 
The most common form of poison from this cause is through the 
careless use of utensils made from it. Most Acids form soluble 
salts with Copper ; hence Acids should never be used for cooking 
purposes in copper vessels. Many of the ordinary vegetables and 
fruits contain enough to form poisonous salts with this metal. 
Even Sugar, from the ease with which solutions of it are changed 
into Acids, should be cautiously used in contact with copper. 
When Copper is mentioned, it must be understood to apply to 
Brass, and other alloys into which Copper enters as a necessary 100 
ACCIDENTS—EMERGENCIES—POISONS, 
component. Indeed, there is scarcely an excuse for the use of 
Copper or Brass as vessels any longer, owing to the superior ad- 
vantages of similar vessels of Iron lined -with porcelain, popularly 
known as “ Enameled.” 
The stomach must at once be emptied by an Emetic, and co- 
pious draughts of Milk, or the White of Eggs mixed with Water. 
Carbonate of Soda (the ordinary Baking Soda of the kitchen may 
answer) is said to be an Antidote. As much as will lie heaped 
up on an ordinary nickel cent can be given every five minutes, in 
water, or in the other named liquids. Iron Filings, or the Ferro- 
cyanide of Potassium (Prussian Blue), in tea-spoonful doses every 
three minutes, may be given. 
Gold. 
All preparations of Gold taken into the stomach act as the irri- 
tant poisons just described. The only difference in the treatment 
compared with that from poisoning by Copper is the Antidote. 
This is the Sulphate of Iron (Copperas, Green Vitriol). As much 
as will lie heaped up on a cent may be dissolved in water, and 
one third of the solution given every three or four minutes. 
Iodine. 
The common Tincture of Iodine, used for external application, 
is the usual form of this poison. There appears no antidote, in 
the usual acceptance of the term. Starch, in water, may be freely 
given until vomiting is secured by an Emetic. 
Iron. 
The form usually taken is a solution of the Sulphate of Iron 
(Copperas, Green Vitriol). Its action is, like most of the poisons 
heretofore described, an irritant poison to the mucous membrane 
(lining) of the stomach and bowels. The Antidote is Carbonate 
of Soda. (See remarks upon this, under “ Copper,” page 99.) ACCIDENTS—EMERGENCIES—POISONS. 
101 
Lead. 
The form from which poisoning by this substance usually takes 
place is the Acetate of Lead (Sugar of Lead). The Carbonate of 
Lead, the “ White Lead” of the painters, and the Red Oxide 
(“ Red Lead”) are also sometimes swallowed in poisonous doses. 
They al 1 act as irritant poisons. 
The treatment of such cases consists in giving, as an Antidote, 
water acidulated to about the strength of Lemonade with Sulphu- 
ric Acid (“ Oil of Vitriol”). 
Sulphate of Magnesia (Epsom Salts), or the Sulphate of Soda 
(Glauber’s-Salt), in water, arc also reputed antidotes. After the 
antidote has been given in poisoning by Lead, an Emetic should be 
given. 
When Lead is taken for some time, in any of its soluble forms, 
in small doses, as when water has been kept in leaden vessels, or 
food kept or cooked in vessels “ glazed ” with lead, or the use of 
wines ‘ ‘ sweetened” with the same metal, a peculiar train of 
symptoms slowly follows, known as “ lead-poisoning,” or “ pain- 
ters’ colic.” All such possible sources of the introduction of Lead 
into the system should be carefully avoided; and as soon as the 
effects of the absorption begin to be suspected, no time should be 
lost in consulting a physician. 
If accidentally administered, acts like Ammonia (p. 96). 
Lime. 
Mercury. 
The Bichloride of Mercury (Corrosive Sublimate), often used as 
a solution in houses for destroying vermin about beds, is one of 
the most active poisons, when taken internally. The Red Oxide 
of Mercury (Red Precipitate) is another dangerous salt of the same 
metal. When swallowed, the White of Eggs should at once be 
given, and often repeated. In the absence of this form of albu- 
men, common Milk can be used, or wheat Flour beaten up with 
Water. 102 
ACCIDENTS EMERGENCIES—POISONS. 
These Salts of Mercury not only irritate the stomach, but so ra- 
pidly inflame and destroy it that some writers discourage the use 
of Emetics. If one can be given, however, before the poison has 
had time to produce these extreme results, there can be no objec- 
tion to its use. The continued administration of the mentioned 
Antidotes is soon followed, as a rule, by free vomiting. 
There appears to be little excuse for keeping such Poisons 
about the house as Corrosive Sublimate or Red Precipitate. They 
are merely poor substitutes for good housekeeping with some 
people. 
Potash. 
The Caustic Potash, in the form of common Lye, or the Concen- 
trated Lye, when swallowed, acts as other Alkalies of the same 
general character. (See Ammonia and Lime.) 
Nitrate of Potash (Saltpetre), in large doses, say half an ounce 
or more, taken internally, is followed by poisonous symptoms. 
There is pain, with heat in the stomach, vomiting, and purging of 
blood, great prostration, and' other symptoms denoting the action 
of an irritant poison. 
No antidote is known. The treatment consists in rapidly eva- 
cuating the contents of the stomach by an Emetic, and the free 
administration of mucilaginous drinks, with some Paregoric every 
little while, to allay the pain and irritation of the inflamed parts. 
Phosphorus. 
This is not often taken in a state of purity, perhaps. It is the 
active ingredient of most of the popular “ Exterminators” for rats 
and other vermin. Children have been known to eat it with fatal 
results. They have also eaten the ends of common matches with 
similar consequences. Phosphorus acts as an irritant poison, in- 
flaming the mucous membrane with which it comes in contact. 
There is no antidote known. Some Calcined Magnesia may be 
given, in plenty of water, to be rapidly followed by an emetic, and 
then an abundance of mucilaginous drinks. ACCIDENTS EMERGENCIES POISONS. 
103 
Tin. 
Several compounds of this substance are used by Dyers, and 
have been used as poisons. They all act as irritant poisons. The 
treatment consists in copious draughts of Milk, White of Eggs in 
Water, and Flour and Water. Practically, the treatment advised 
under the head of “ Copper” may be followed. 
Zinc. 
The Sulphate of Zinc (White Vitriol) may be termed poisonous 
in very large doses, were it not for the fact, constantly turned to 
good use, that it at once causes vomiting, and is brought up be- 
fore damage can be done. Hence it is regarded as one of our 
most valuable Emetics. 
Soda. 
The same things are to be said about this Alkali as about Pot- 
ash, Ammonia, and Lime. The rapid action of these substances 
upon the parts with which they come in contact leaves little to be 
done with much confidence. 
Silver. 
The chief source of this poison is the Nitrate of Silver (Lunar 
Caustic), either solid or in solution. Its action as a “ Caustic ” is 
well known, and it is in this manner that it acts upen the throat, 
stomach, etc., when taken internally, in solid stick or in solution. 
Nitrate of Silver (Lunar Caustic) is the base cf the numerous 
popular “ hair dyes,” and under this form has been accidentally 
and criminally taken. 
The Antidote for the Salts of Silver is Common Salt, which im- 
mediately decomposes and destroys its activity. The rapidity and 
completeness with which this is done is seen in the well-known 
domestic precaution of preventing solutions of Silver employed as 
indelible Ink from staining, by immediately, while the spot is 
moist, touching it with salt and water. 104 
ACCIDENTS—EMERGENCIES—POISONS. 
Alcohol. 
Alcohol itself, or in the form of Brandy, Gin, Rum, Whisky, 
taken in large quantities, is followed by symptoms of a violent poi- 
sonous character, and if relief is not at once had, death often en- 
sues. It is not an unfrequent occurrence for the press to report 
instances where children have swallowed Alcohol left accessible to 
their reach, and have died in consequence. 
When quantities have been taken sufficiently large to be follow- 
ed by alarming symptoms, the contents of the stomach should be 
evacuated without delay, by tickling the throat with a feather or 
the tip of the finger, by an Emetic, such as Ground Mustard and 
Water, Pulverized Ipecacuanha, or Sulphate of Zinc ; or the sto- 
mach-pump may be used, if convenient. The vomiting should be 
assisted by copious draughts of warm water, or other things of 
the kind. 
The Alcohol in the stomach having thus been disposed of, the 
portion which passed from the stomach into the blood, and was 
carried to the Brain and the rest of the Nervous System, where its 
poisonous action is being exerted, should next claim the attention, 
if the symptoms appear to demand it. The action of Alcohol and 
its preparations upon the Brain and Nervous System is seen under 
the common name of Intoxication. This may exist as mere stu- 
por, or the Brain and the Nervous System may be so completely 
overcome by the presence of such a quantity of the poison in the 
blood that the action of these parts upon the muscular movements 
of the Chest and the Heart is no longer kept up, and death ensues 
from Asphyxia, as described under that head. 
VEGETABLE POISONS. 
Most of the class of Poisons termed Vegetable act as Narcotics 
or as Acro-Narcotics. With some modifications, which will be 
mentioned in place, the treatment of all cases of Narcotic poison- 
ing is essentially the same ; and a similar statement may be made ACCIDENTS—EMERGENCIES—TOISONS. 
105 
in reference to the treatment of all cases of Aero-Marcotic Poison- 
ing. Hence, in speaking of the Vegetable Poison standing first in 
the alphabetical arrangement of these substances, the directions 
have been given under two heads : the nature of the Acrid or irri- 
tating symptoms and the treatment of the Narcotic symptoms. In 
speaking of the other poisons, in turn, to save space and avoid re- 
petition, the reader will be directed, for details of treatment, to 
one of the substances, when directions are given in full. 
Aconite. 
Aconite is known under the names of “ Monkshood!” and “ Wolfs- 
bane.” When swallowed in an overdose, it is rapidly followed by 
symptoms known as acro-narcotic; in other words, irritating to 
the part, and narcotic to the Brain and Nervous System. The 
treatment naturally would consist in getting out of the stomach 
all the poison there not already absorbed into the blood. In this 
Acro-Narcotic Poison we have two reasons in view for such a 
course : first, to avoid, as much as possible, the irritating features 
of the poison to the mucous membrane (skin lining the stomach 
and approaches), and, secondly, to prevent further absorption into 
the blood and narcotization of the Brain and Nervous System. 
The contents of the stomach are removed by tickling the throat 
and base of the tongue by the finger or a feather. An Emetic (page 
91) of Mustard and Water, Pulverized Ipecacuanha, or Sulphate of 
Zinc, Flaxseed Tea, Gum-Arabic Water, Sugar and Water, Milk, 
White of Egg, or things of this general character, should be freely 
given at the same time to protect the mucous membrane of the sto- 
mach from the irritating feature of the poison. 
There is nothing known to neutralize or destroy the poison in 
the blood thus acting through the Brain and Nervous System upon 
these important organs of breathing and circulation, so tbe efforts 
for relief must consist in keeping up the respiration by artificial 
breathing (page 10) until the kidneys, skin, and other organs have 
had time to eliminate (throw out) the aconite, and so little re- 106 
ACCIDENTS EMERGENCIES—POISONS. 
mains in the blood as to no longer seriously interfere with breath- 
ing and circulation. We shall, therefore, refer the reader to “ As- 
phyxia from Carbonic Acid Gas” (page 14), which is said to act in 
the same manner upon the human body. Also see “ Opium” (page 
109). 
Belladonna. 
Belladonna, or “ Deadly Nightshade,” has been introduced into 
our gardens as an ornamental flower, and poisoning sometimes 
occurs from eating the berries or leaves. Solutions of the active 
principles of this plant are used under various forms as an applica- 
tion to the eye or brow, for certain purposes, by the surgeon, and 
should never be left where they can be swallowed by mistake. 
Belladonna acts as a Narcotic poison, like Opium in many re- 
spects, only there is dilatation, to a marked degree, of the pupil of 
the eye, and a peculiar redness or suffusion of the face, which are 
not seen in poisoning by Opium. This duskiness of the face is 
the symptom first observed by the physician. To discriminate 
between the two, it may be remarked, that Stramonium (Thorn 
Apple, Jimson Weed) gives results closely resembling Belladonna. 
Both of these substances, Belladonna and Stramonium, are attend- 
ed, when swallowed in large doses, with a peculiar dryness of the 
throat and mouth, delirium, not accompanied at first with stupor, 
like Opium, but with violent gestures, often violent laughter, and 
a peculiar disposition to pick in the air, or at the clothing, for 
imaginary objects. 
Treatment.—The poison in the stomach must be immediately 
gotten out by an Emetic (page 91), and the treatment under the 
head of “Narcotics,” in the preceding page, followed out as 
seems required. 
The root of this plant, when swallowed in sufficient quantity,- 
acts as an acrid, highly irritating poison. It is quite a common 
plant in Europe, hut less seen in the United States. 
If taken in poisonous quantities, empty the stomach as soon as 
Bryony. ACCIDENTS EMERGENCIES—POISONS. 
107 
possible ; and, as in the case of all highly irritating poisons, this 
should be followed by free drinking of Milk, Flaxseed Tea, White 
of Egg andWater, Sugar and Water, Gum-Arabic Water, and si- 
milar things. 
When taken in large doses, Camphor acts as a narcotic poison. 
The contents of the stomach, in such cases, should be evacuated by 
an Emetic (page 91), followed by draughts of warm water, Flax- 
seed-Tea, Gum-Arabic Water, Milk, and similar substances. The 
strong odor of Camphor in the breath and perspiration, in case of 
poisoning, with narcotic symptoms, would naturally point out the 
peculiar agent employed. 
Camphor. 
Draughts of strong Coffee, it would seem, might be as useful in 
the case of narcotic poisoning from Camphor as in the case of nar- 
cotic poisoning by Opium and other substances of this class. (See 
“ Opium,” page 109.) 
Conium (“Hemlock”). 
This well-known plant is an active poison, when taken internal- 
ly in sufficient quantity. It is supposed to be the narcotic used by 
the Greeks, and other nations, to destroy the life of condemned 
criminals. Socrates and Phocion, it will be remembered, were 
compelled by the Athenians to drink a decoction of it. 
Its action is that of a narcotic, and the treatment consists in get- 
ting out of the stomach, as soon as possible, by an Emetic (page 
91), all the vegetable there, and then counteracting the effects of 
that which has been absorbed into the blood, and tends to over- 
}>ower the brain and nervous system. 
See remarks on“ Alcohol” (page 104), and “ Opium,’’(page 100). 
Digitalis (“ Foxglove”). 
This beautiful plant of the garden, cultivated in this country 
for its flower, and used, in proper quantities, as a valuable medi- 
cine, is a poison of the narcotic class, with a disposition to over- 108 
ACCIDENTS—EMERGENCIES TOISONS. 
come the portion of the nervous system controlling the action of 
the heart. 
The same treatment should be pursued, when Digitalis has been 
taken in poisonous quantities, as recommended for other narcotics. 
The peculiar tendency to stop the action of the heart should be 
specially combated by giving twenty or thirty drops of Aromatic 
Spirits of Ammonia every three or four minutes in a table-spoonful 
of water, or some other stimulant. 
Dulcamara (“Bitter Sweet,” “Woody Nightshade”). 
This well-known plant belongs to the narcotic class of poisons, 
with symptoms like those of Belladonna and Stramonium. 
The treatment is about the same as heretofore spoken of since 
we began our remarks upon the Vegetable Poisons. See “ Bella- 
donna,” (page 10G). 
Hyoseyainus (“ Henbane”). 
This vegetable, made use of in medicine, if taken internally in 
improper quantities, acts as a narcotic poison, like others of the 
same natural order (Solanacae), as Belladonna, Dulcamara, and 
Stramonium. 
As the treatment of a poison depends upon the action of the 
agent, we would naturally treat poisoning by Ilyoscyamus as by 
other articles acting the same way. See “ Belladonna,” page 106; 
“Stramonium,” page 115. 
Lobelia (“Indian Tobacco”). 
This vegetable is not now much used as a medicine by physi- 
cians, as the comparatively recent discoveries in chemistry have 
added substitutes to the list of drugs, without the peculiar disad- 
vantages of this substance. 
In poisonous quantities, Lobelia belongs to the class of acro- 
narcotics spoken of under the head of “Aconite” (page 105). 
Fortunately one of the symptoms following its use is vomiting. 
This should be encouraged by drinks of tepid water, Gum-Arabic ACCIDENTS—EMERGENCIES—rOISONS. 
109 
Water, etc.; and, if kept up until all the poison is rejected by 
the stomach, a favorable issue may be expected. Should vomit- 
ing not occur at once, as a symptom, enough of the poison may be 
absorbed into the blood to exert a fatal narcotic influence upon 
the brain and nervous system; or, perhaps, to speak more pre- 
cisely, through these organs upon the movements of respiration 
and circulation of the blood. 
Opium. 
This substance, or the numerous preparations of it used in medi- 
cine, is one of the most frequent causes of poison a physician is 
called in to see. A fruitful source of mistake is that of confound- 
ing together of Laudanum and Paregoric. When the latter is 
supposed to have been given by the nurse, the mistake is not 
found out until it is often too late to be of material service in 
averting a fatal end. Morphia, the active principle of Opium, 
is often kept as a solution, in private houses, for domestic use. 
Any of these preparations of Opium, in improper doses, are fol- 
lowed by symptoms of narcotic poisoning. Not only these, but 
many popular nostrums, as “Infant Cordials” and “Soothing 
Syrups ” of various kinds, depend for their utility upon some pre- 
paration of Opium, and are hence often followed by symptoms of 
narcotic poisoning. None of these things should be used. If 
a child cries, it is usually because it feels pain; and, instead of 
making it so stupid with narcotics that it can not feel the pain, it 
is better to go to work and find out the cause of the pain, and re- 
move it. There is some reason for the suspicion that, in many 
instances, where a modicum of the popular remedies of this class 
are not furnished by the mother to the nursery, the enterprise of 
the nurse, “rather than see the child suffer,” secures it for the 
charge committed to her care, from a neighboring apothecary- 
shop. 
Opium, its preparations, and the active principle of the drug, 
Morphia, all act in the same way, by absorption into the blood, 110 
ACCIDENTS—EMERGENCIES—POISONS. 
and distribution by it to the brain and nervous system. Through 
these organs, the movements of the chest and heart become more 
or less interfered with. In this respect, its action is essentially like 
that of Carbonic Acid Gas, Alcohol, and most of the vegetable 
poisons herein described, without, however, any acrid or irritating 
complication. 
Treatment.—It is safe to say that at present there is no known 
Antidote to any of the narcotic poisons, using the word Antidote 
as understood by physicians. What is in the stomach must be 
taken out, to prevent further absorption, and what is in the blood 
must be worked out, under proper guidance, by the processes of 
nature constantly engaged with such products. If the breathing 
and circulation tend to cease, because of the inability of the brain 
and nervous system to temporarily discharge these duties, these 
essential movements must be taken charge of by a friend. 
An active Emetic, like Ground Mustard, must be given at once, 
remembering that trouble may be found in getting it to act, owing 
to the diminished sensibility to its presence, from the local stupe- 
fying action of the Opium to the mucous membrane of the sto- 
mach. The action of the Mustard should be assisted by tickling 
the inside of the throat with the fingers or a feather. 
Sulphate of Zinc, Salt and Water, Pulverized Ipecacuanha 
(page 92) may be given; in fact, any thing, to empty the stomach 
as soon as possible. 
The narcotic effects upon the brain at the same time, as far as 
possible, must be attended to. If the respiration is yielding to the 
poison, that is, falling much below the standard of about twenty 
to the minute, it must be sustained by assistance. As directed 
under the head of “Asphyxia from Carbonic Acid Gas” (page 
14), the exposed body of the patient should be dashed with cold 
water, not neglecting the head, face, and chest. After the cold 
water has been sufficiently used in this way, the body should be 
dried, removed to a dry spot, and hot applications made to the ex- 
tremities and other parts. Ths is necessary, owing to the heat- ACCIDENTS—EMERGENCIES—POISONS. 
producing power of the body being impaired by the suspended or 
diminished respiration. 
If the respiration is not suspended, but is going on at a dimin- 
ished rate, say six or eight to the minute, artificial respiration is 
not required, unless the number of respiratory movements of the 
chest falls below that; but the other measures may be used. In 
addition to these, a strong stimulant, in the shape of twenty or 
thirty drops of Aromatic Spirits of Ammonia in a table-spoonful of 
water, may be given three or four times, at intervals of a couple or 
more minutes. It is better than brandy, or any thing alcoholic, 
because the mode of the action of brandy is much the same upon 
the brain as Opium, and it might be rather adding to instead 
of taking from the poison that is at work. The often referred 
to Aromatic Spirits of Ammonia will give the advantage without 
the suggested disadvantage. A few table-spoonfuls of very strong, 
freshly made Coffee is a useful thing to give in such cases. 
Among measures to keep in activity the circulation and respira- 
tion, as well as to promote the elimination (casting out) from the 
blood of the poison acting as a narcotic, there are few things 
moi’e useful than muscular exercise. If the circumstances permit 
it, this is often effected by a person getting on each side of the 
individual under the influence of the narcotic, supporting him 
under the arms, and walking up and down the floor with him. 
The writer saw a case where the person under the influence of this 
narcotic (Opium) was wholly unconscious, and with breathing not 
over six to the minute. A relay of persons walked him up and 
down a long room for three hours, a person walking behind to 
hold the head of the patient in a natural position over his shoul- 
der. Occasionally he was stopped at a suitable place, the blanket 
around him removed for a moment, and he was dashed with cold 
water. The body was then rapidly dried, and the blanket in the 
mean while having been heated, was reapplied. Once the respira- 
tion became so feeble that he was placed on his back, and the 
artificial breathing (Silvester’s method, page 8) used for some min- 112 
ACCIDENTS—EMERGENCIES—POISONS. 
utes. While this was being clone by one person (a policeman in 
this case), under the directions of the physician, another individual 
caught hold of each ankle, bent the knee, pushed the knee upward 
until it touched the stomach, and then straightened out the entire 
leg. This was done several times a minute, and perhaps was as 
useful as walking the patient up and down the floor, besides not 
interfering in any way with other measures of relief. Indeed, 
there is some reason for thinking the action of the heart would be 
more favored by such muscular movements, with the patient on 
his back, than if the person was standing upright. 
Whipping the body by a folded towel wrung out in cold water 
is of the greatest use is cases of narcotic poisoning. 
In case medical assistance shall not have been secured, and the 
patient shows signs of improvement, in the shape of more frequent 
respirations, stronger pulse, and returning consciousness, many 
of these measures may be omitted as the apparent necessity disap- 
pears. In a short time, the patient will appear as a person who is 
soundly sleeping from the effects of a full dose of Opium or other 
narcotic; the quantity beyond that having been parted with by the 
blood. He may now be let alone, unless some return to the pre- 
vious condition is noticed, when a dose or two of the strong and 
easily procured stimulant, Aromatic Spirits of Ammonia, may again 
be given him. 
It must be recollected that a person who has been in such a state 
as to require all these artificial muscular movements is, practically, 
in about the condition, as far as strength is concerned, of a man 
who has run hurriedly several miles without resting. He, of 
course, has consumed all his available strength, and the sooner it 
is made up to him by beef-tea, and such things, the sooner he will 
be -where he was before the narcotic was taken. 
Oxalic Acid. 
This substance is largely used in the arts, and in private house- 
holds, for removing stains of iron from textures and surfaces, ACCIDENTS—EM E EG E NCI ES—I>OISONS. 
113 
which it does by combining with an otherwise insoluble salt of 
iron, and converting it into a soluble oxalate of iron, easily re- 
movable by water. From the strong resemblance Oxalic Acid 
bears to Epsom Salts, it has often been taken instead of the well- 
known purgative of that name. To avoid the possibility of such 
an accident, Oxalic Acid should be kept in another part of the 
house from where medicines are kept, and no precaution omitted, 
by label and other marking of the parcel, to make the difference 
between them as decided as possible. It is well to remember, 
also, that, wholly unlike Epsom Salts, the taste of Oxalic Acid, ap- 
plied to the tip of the tongue, is quite sour. 
When swallowed internally the activity of this poison admits 
of no delay. It belongs to the class of irritant poisons spoken of 
so often, and produces death, it is said, by destructive action on 
the mucous membrane (lining) of the throat, stomach, and bowels. 
Time can scarcely be lost to give an Emetic; but something 
must be given to rapidly combine with it, and divert its activity 
from the parts mentioned. It has a strong affinity for Lime, form- 
ing with it a comparatively insoluble Oxalate of Lime; and for 
Magnesia, forming with it an insoluble Oxalate of Magnesia, which 
can be dislodged with less haste. A tea-spoonful of Lime from 
a whitewash-bucket or at the bottom of the bottle of Lime-Water, 
when made as directed in another place (page 132), mixed with a 
cup of water, might be given every few minutes, or some crushed 
Chalk (a Carbonate of Lime), or some Magnesia, may be given. 
All these things can easily be had, and not a moment need be lost 
in getting the person to swallow them. The common “Whiting,” 
used for polishing glass, making cheap paint and putty, is essen- 
tially the same as prepared Chalk. 
Scraping the ceiling or wall will not get the antidote if Plaster 
of Paris has been used instead of common lime, as is often the 
case. The often recommended mantel images of Plaster of Paris 
are likewise of as little use. Lime in the sulphate (Plaster of 114 
ACCIDENTS—EMERGENCIES POISONS. 
Paris) is too firmly united to the Sulphuric Acid to give it up for 
Oxalic. 
After the Oxalic Acid is supposed to have been neutralized, an 
emetic of ground mustard or pulverized ipecacuanha may be 
given. 
Pulsatilla. 
The eating of this plant, “Meadow Anemone,” or parts of it, has 
been followed by symptoms of acro-narcotic poisoning. The plant 
is so active at times that when applied externally, irritation to the 
parts touched is felt. When poisoning results from swallowing it, 
the course of treatment recommended under “ Aconite” (page 105) 
may be followed. 
Sanguinaria (u Blood-Root ”)» 
Taken internally in an overdose, acts as acro-narcotic poison. Sec 
“Aconite” (page 105). 
Savine. 
This is an active irritating poison, inflaming the stomach and 
bowels. When thus taken, vomiting, by tickling the throat with 
the finger or a feather, should be at once induced. The mucous 
membrane (lining) of the bowels should be protected from the irri- 
tating action of what has escaped beyond the stomach before it 
could be emptied by vomiting, by drinking large quantities of 
water or milk, with good quantities of Gum-Arabic dissolved in 
it. If the Oil of Savine, which is the usual form of the substance 
when used with a criminal intent, has been taken, it might be 
well to take a dose of Castor Oil. 
Spigelia. 
The use of this plant, commonly called “ Pink Root,” as a de- 
stroyer of worms, was given, it is said, to the whites, by the Che- 
rokee Indians, and has become very general throughout the entire 
country. It is given with a great deal of confidence and reckless- 
ness, and is often followed by symptoms of a narcotic character. ACCIDENTS—EMERGENCIES—POISONS. 
115 
attended also with convulsive movements. When such poisonous 
symptoms follow its use, vomiting should be promoted, and kept 
up by frequent draughts of warm water. As in the case of other 
narcotics, a drink of strong coffee may be of service. Acidulated 
drinks, as water and vinegar, water with lemon-juice, are thought 
to be useful, and probably are, in favoring the elimination (throw- 
ing out) of the poison absorbed into the blood, by the action of 
the skin and kidneys, which they promote. 
Stramonium, 
Usually known as “Thorn Apple,” or “ Jimson Weed, ” belongs 
to the same natural order in botany as Belladonna, Dulcamara, 
and Hyoscyamus; and when taken internally, in improper quan- 
tities, is followed by shnilar general symptoms. Children 
often gather the seeds and eat them. A history of the case, the 
evidence of some of the seeds or capsules, the narcotic symptoms, 
with the peculiar duskiness of the face and dryness of the mouth 
and throat mentioned when speaking of Belladonna, are sufficient 
to point out the vegetable used. There is a decided disposition 
to laugh, and pick at imaginary objects, on the part of the person 
under its effects. 
Treatment has been given under the head of “Belladonna” 
(page 106). 
Strychnia. 
This is the active principle of the Nux Yomica, or “Dog But- 
ton,” as it is sometimes called, from the use often made of it. The 
action of this poison is so rapid that, like Prussic Acid, little can 
be done to delay death. This poison acts in a peculiar manner 
upon the nervous system, throwing the muscles of the body into 
strong convulsive movements. The convulsions from Strychnia 
are attended with one strongly-marked and peculiar feature. It 
is a disposition, during the convulsion, for the heels and the back 
of the head to meet (opisthotonos), under the influence of the vio- 
lent muscular movements. Whenever this is seen, and if seen it 116 
ACCIDENTS—EMERGENCIES—POISONS. 
will surely be remembered, the coincidence between it and the use 
of Strychnia should be remembered. 
The stomach should be evacuated with the least possible delay, 
if it is known the person has just taken the poison. If convul- 
sions have occurred, and death taken place, it may be well to re. 
member that death resulted from Asphyxia, the spasmodic action 
of the muscles attached to the ribs having prevented movements 
of respiration. Artificial breathing, in such a case, should be 
tried, with the hope that something might possibly be done to 
invite back the natural movements. 
Tobacco. 
To a person not accustomed to its effects, by beginning with 
small quantities, and persisting in its use, tobacco is an acro-nar- 
cotic poison, agreeing in its essential character with Aconite, 
and others of the same general class. The movements of the 
heart become so much interfered with that death may take place 
unless proper assistance is at once given. Fortunately, like 
Lobelia, it acts as an Emetic, and before enough can be absorbed 
into the blood from the stomach, the contents of that organ are 
rejected. Hence, when death has ensued from the direct use of 
Tobacco, we find that it was used as an injection, a form in which 
it should never be given. 
Other Vegetable Poisons. 
Besides those enumerated in the foregoing pages are many 
others, whose names even can not be here given. Most of them 
belong to the Acro-narcotic class, and may be treated as advised in 
speaking of those mentioned under that head. See “Aconite” 
(page 93). 
SIGNS OF REAL DEATH. 
Usually it is not a difficult matter to pronounce with confi- 
dence whether a person is really dead, or whether it is an instance 
of what is called suspended animation; but sometimes it becomes 
a question not easily determined, even with professional assistance. ACCIDENTS—EMERGENCIES—POISONS. 
There are few fears, perhaps, as widely and as universally en- 
tertained as the fear of being buried alive; and there is probably 
no apprehension which, after a careful and extended examination, 
has as little in fact to support it. Where it has become necessary, 
in some few reported instances, to examine the remains after 
burial, the change in position of the body from that in which it 
was supposed to have been at the moment of interment, is doubt- 
less due in most instances to the formation and sudden escape of 
gases, the result of decomposition, from cavities of the body. Any 
one who has attended a funeral, and observed the movements 
necessarily given the casket in taking it from the house to the 
cemetery, must see how readily the cylindrical form given the 
corpse by the conventional manner of pinioning the arms to the 
chest, and the feet to each other, permits it to be influenced in car- 
rying ; and it is rather a matter of surprise that the expected posi- 
tion, flat on the back, is as often found as it is. Either of these 
explanations will account for the change of position sometimes seen 
after burial, without for an instant calling in the dreadful and 
unjustifiable supposition that burial had taken place before life 
was extinct. 
A gentleman who for years past has given his attention to inves- 
tigating every reported case of premature or near premature 
burial in this country, states that he has never found substantial 
truth in one of them. In the majority of instances, there were no 
such persons, or they had no knowledge even of the related cir- 
stances. , 
Ill many countries in Europe, where the remains of persons de- 
ceased are exposed under official inspection for some time aftea- 
reported death, statistics of the most reliable character extending 
over an uninterrupted period of many years, do not reveal, among 
the hundreds of thousands thus placed, that one has ever after- 
ward shown a sign of life. 
While it is possible that a person might be supposed to be dead 
and yet not, the usual method practiced in cities by undertakers, 118 
ACCIDENTS—EMERGENCIES—POISONS. 
carefully and completely surrounding the body with ice, as soon 
as they can, is well calculated to do away with the possibility of 
being buried alive. It is not an unheard-of thing for the remains 
to be so packed within three hours after supposed death; and 
that, too, without any reason being apparent for the indecent 
haste, except the possible convenience of the men sent by the un- 
dertaker. 
Under scarcely any circumstance should this be permitted, 
especially in the case of those who have died on the highways, at 
hotels, and other places, away from relatives and personal friends. 
During the prevalence of fatal epidemics, particularly of cholera, 
where there is fear of contagion, every known precaution should 
be taken to prevent even the most remote possibility of the 
thought ever afterward arising that undue haste occurred in plac- 
ing the remains beyond friendly assistance in case it could have 
been of use. 
Among the tests usually applied to a person supposed to be 
dead, is the absence of sensibility. While it is true that sensibi- 
lity to punctures, pinches, blisters, and burns demonstrates that 
the person is not dead; the want of sensibility to such things only 
proves that the individual docs not feel them; or feeling, is inca- 
pable of responding to them. 
Another test is the absence of circulation as revealed by the 
action of the heart to the hand of a bystander; or the absence of 
the impulse of the blood by that organ to the artery at the wrist, 
properly known as the pulse. There is little real value in the ab- 
sence of both of these signs. The heart may be acting feebly, or 
the attendant unable to detect the movement. 
The cessation of breathing is also often relied upon. There may- 
be no movement of the walls of the chest, as is often seen in per- 
sons just brought from the water, exposed to carbonic acid and 
other gases, who afterward revive without even assistance. Be- 
sides, the method employed for learning whether breathing takes 
place may be unreliable. A mirror held for the purpose near the ACCIDENTS—EMERGENCIES—POISONS. 
mouth, to collect the moisture of the breath, does not always re- 
veal it even when there; nor is the force of the breath always 
strong enough to deflect the flame of a candle held near, nor to 
give movement to a wisp of cotton held near the lips. 
It is sometimes thought that the person is dead when he is cold, 
and alive if he preserves his warmth. A moment’s reflection will 
show how little reliability can be placed in these signs. For in- 
stance, the drowned are often and the frozen always cold; and both 
have been restored. It is -said, too, that those suffocated by stran- 
gulation or inhalation of certain gases preserve their heat, for 
some time after undoubted death, as long even as twelve hours 
after unconsciousness has commenced. 
The general appearance of the face, the softness, sinking, and 
relaxation of the countenance, and dimness of the eyes have all 
been considered, from the days of Hippocrates, as furnishing valua- 
ble signs of death. While of recognized value to the mind of the 
physician, they can not, of themselves, be wholly relied on for the 
purpose, but must be regarded, when properly interpreted, as only 
presumptive evidence of the possibility of near or complete death. 
In this connection, it ought to be remarked that the commonly 
resorted-to test of suspected death, of exposing the eye to the 
light, is of much less value in establishing the fact of complete 
dissolution than is commonly imagined. Life maybe present, but 
the eye as lacking in sensibility to light as other organs to their 
proper stimuli; besides, contraction of the pupil may be already 
so complete that more should not be expected. 
One of the most reliable signs of death evident to ordinary ob- 
servers, is the peculiar stiffness or rigidity of the body (rigor mor- 
tis), but as a sign closely resembling it is sometimes seen in life 
as well as in suspended animation, certain essential points of dis- 
tinction between the two must be kept in mind to establish the 
difference between them. 
If the contraction or rigidity of the muscles is due to their con- 
vulsive action, instead of being the stiffness of death alluded to 120 
ACCIDENTS—EMERGENCIES—rOISOXS. 
considerable difficulty will be found in changing the position of 
the limb, and after it has been done, there will be a constant dis- 
position to revert to its fonner state. In death, however, the limb 
is apt to remain as last placed. 
In the peculiar nervous condition known as Catalepsy, the ten- 
dency for tlxe limb to remain as placed is likewise seen as it is in 
the rigor mortis, and in some cases of this disease, professional 
advice may be necessary to decide the difference between them. 
When the body has been subjected to the influence of cold, as 
when the person is “frozen,” a stiffness like that of death is 
found, but it affects not only the muscles different from the stiffness 
of death, but extends in like degree to the abdomen, breast, and 
other organs. Besides, when the position of a frozen member is 
changed, a slight cracking noise is made and felt, caused by the 
movements against each other of the atoms of ice contained in the 
part. 
If from any cause the person supposed to be dead is cold and 
soft, while a certain degree of stiffness ought to be seen, interment 
should not take place, but might be postponed until a physician 
can make a satisfactory examination of the case. 
It is well known that all inanimate bodies, whatever may be 
their nature or composition, under the influence of the law of 
the diffusion of heat, acquire the same temperature as other suit- 
ably exposed bodies about. Animate bodies, unless cold-blooded, 
on the other hand, keep nearly a fixed temperature of their own. 
Never mind how the inanimate body feels to the hand, a ther- 
mometer, properly applied, shows that it possesses about the 
same heat, and that is the heat of the air of the room ; that is, of 
course, if the piece of furniture, clothing, etc., has been long- 
enough exposed in the room. 
A human body, if life no longer exists, is as inanimate as any 
thing else; and, after exposure to the currents of air of the room, 
should show by the thermometer, throughout its entire mass, a ACCIDENTS—EMERGENCIES—POISONS. 
121 
uniform degree of heat, no greater than the bed on which it lies, 
or the table standing by. 
This test, for obvious reasons, is not practicable unless the tem- 
perature of the room is considerably below the range of 98° and 
105° Fahrenheit. 
All authorities, however, agree upon the reliability of one 
symptom of death, and, it may safely be said, the only reliable 
one: it is a well-marked putrefaction. 
By this is not meant the appearance of putrefaction, but the un- 
doubted fact of it. In some forms of Dysentery, a peculiar cada- 
veric odor is present, but it does not by any means imply that 
death has taken place, nor even that it must. The same sugges- 
tive odor is seen when gangrene of a limb has occurred, or destruc- 
tive ulceration is going on. Purple blotches of the skin, with 
other signs of decomposition, are occasionally met with, occurring 
with other supposed signs of death, without death really having 
taken place, or in fact a likelihood of it. 
The putrefaction under consideration cannot well be detected by 
the unprofessional, but the question should always be submitted 
to the skill of a medical man. It usually makes its first appear- 
ance over the abdomen, close down toward the groin and ex- 
tending upwards. At these and contiguous points the skin first 
turns a dusky yellow, soon merging into a greenish tint, more or 
less mottled, and in a short time becomes softened to the touch, 
with the evident of odor of decomposition. The color alone is 
not to be depended on, but the mentioned later stages, of what 
the color may be the beginning of, should positively decide the 
case. APPENDIX. 
In a number of instances, it has been found necessary to speak of 
a few articles of medicine usually kept on hand in private houses, 
factories, and places where accidents are likely to happen.* It is 
scarcely necessary to point out how great a risk is assumed in not 
keeping a little supply of such things on hand, ready for use at a 
moment’s notice. Most prudent people do keep them, although 
physicians know of cases where an apothecary has been rung up of a 
cold night to supply ten cents’ worth of paregoric for a sick child. 
There is scarcely any excuse for such effrontery. Often there is a 
disposition to purchase these domestic medicines wherever they are 
said to be kept, and at the lowest price. This should never be done 
with articles intended for internal use, as the education of the buyer 
does not permit him to j udge of the purity, strength, or activity of 
the drug. They should invariably be bought of the most reliable 
apothecary or retail druggist, if in the city or large town; or if in 
the country, at the office of a reputable practitioner of medicine, who 
has made, or will guarantee the named essential features of the dif- 
ferent articles. 
Wliat is left unused of prescriptions ordered by the physician, 
should not be preserved, as there is not one chance in a hundred that 
* Wherever spoken of, reference is had to what are called the standard articles 
prepared according to the United States Pharmacopoeia, a volume revised every 
ten years, containing the accurate standard for the regulation of the strength and 
purity of medicines used by the physicians of the United States, and everywhere 
recognized by them as an authority upon all matters therein contained. It bears 
as close a resemblance as practicable to similar works, of the same obligatory charac- 
ter, of Great Britain and the different countries of Europe. This is the reason 
why physicians write the names of medicines and directions for preparation in 
Latin, so that wherever presented, no doubt can arise, from comparison with the 
works, as to what the writer intended. APPENDIX. 
the same special combination will ever be required again ; unless it 
is some liniment, or constituent of one, which can be utilized. Be- 
sides, as a rule, medicines do not keep well ; and the more bottles of 
such things there are about the house, the greater the chance of a 
mistake in getting hold of one, when another is needed. 
But a small quantity should be bought at once, for the reason just 
stated, that most of them undergo changes in character after being 
kept on hand some time. Each substance shoul4. be kept in a flint 
glass bottle with a closely fitting cork stopple ; or, what is better, a 
carefully fitted ground-glass stopple, as many medicines erode the 
delicate cork, permitting the escape of a valuable element or giving 
access of the air to the contents of the bottle. Each bottle should 
likewise be correctly and distinctly marked with a printed label; 
and when the medicine is poured out, pour from the side of the neck 
opposite the label, so the last drop, if any, will not trickle down 
upon the label and deface it. 
When not in immediate use, all medicines should be kept in a 
separate closet or other well-defined space, where nothing else is 
kept, unless the little appliances of domestic surgery. It should be 
wholly free from dampness, as moisture impairs or destroys the 
activity of most drugs, especially those in powder, if it can get access 
to them. If the closet can be kept under lock and key, so much the 
better. Light must be excluded, as it destroys many substances, as 
the Sweet Spirits of Nitre ; and injuriously modifies the character of 
the oil of turpentine. A low uniform temperature is likewise needed, 
otherwise the heat will vaporize the alcohol or ether of many pre- 
parations, and the supposed strength of the article may be danger- 
ously interfered with. Besides this, heat destroys many medicines. 
Syrups, or medicines containing sugar, when poured from a bottle, 
care should be taken to keep the neck at the cork free from the mix- 
ture. Independently of the neatness, the stopple and neck of the 
bottle should be wiped on each occasion of use, to prevent the collec- 
tion and decomposition of the saccharine matter, as the character of 
the medicine may be modified by it. 
Liniments for external use, in tlie majority of cases, and the s 125 
APPENDIX. 
w .rue of Lotions, depend for their usefulness upon articles not to be 
taken internally. They should be kept in a distinct corner by them- 
selves, labeled “ Poison,” and as soon as used, returned to the spot 
they belong. Many of them, containing chloroform, ether, or other 
volatile substances, are apt to dislodge the stopple, and this element, 
perhaps the active one, rapidly evaporates. When ordered for im- 
mediate use, these substances can scarcely be preserved in their 
proper proportions to the other ingredients until consumed, even 
when an attempt is made to tie down the stopple. 
Powders should be kept in tight metal boxes ; or, what is better, 
wide-moutli bottles with closely fitting ground-glass stopples. 
Ointments (“ Salves”) should never be kept in any quantity, or 
for any length of time. Unless purchased in large cities, at the re- 
tail shops, where large and rapid sales compel a constant renewal of 
stock, they are usually rancid. This is especially true of what is 
called “ cold cream.” A rancid ointment is unfit for use to a delicate 
part. It is quite as difficult, as a general thing, fqj* an apothecary to 
keep ointments from becoming rancid, as it is for a housekeeper to 
preserve butter in its original freshness. 
Pills kept for some time, particularly tliose containing certain 
articles, become so hard that they are about as soluble in the stomach 
as grains of coffee. This is especially true of sugar-coated pills. 
This defect can be overcome by inclosing the number to be taken in 
a piece of muslin and reducing them to fragments by a blow.* 
* There are few observant physicians who will not say that these things are 
nsed much too often when not really necessary. 
Many people take them because they are what they call “bilious,” which, in 
nineteen cases out of twenty, and this is said thoughtfully, means that the person 
has eaten too much food ; not diminished the consumption of heat-producing 
articles, as fatty matters, as the heated weather approached ; or has taken food 
which did not digest properly, owing to its nature, the mode in which taken, or the 
condition of the stomach at the time. In such cases, absence from food until the 
material already there can have passed ofF, and the alimentary track restored, is 
all that is needed. A little thought afterward, with a little common forbearance, is 
all that is needed to keep from getting “bilious” again.' 
Another thing is to “ purify the blood.” But how do you know that it needs it J- 126 
APPENDIX. 
Medicines to be taken internally are usually ordered by drops, 
tea-spoonful, dessert-spoonful, or table-spoonful ; not because these 
measures of quantity are correct, but because they are convenient. 
Drops vary in size, according to the temperature of the liquid, the 
shape of the edge over which it is poured, and the specific gravity 
and general character of the substance poured. All other things 
being equal, drops of ether are, perhaps, not more than one third as 
large as a drop of syrup. However, the physician usually takes all 
these things into consideration when medicines are ordered, so if 
the directions as to the number of drops is followed, no danger need 
be apprehended from this source. 
A Tea-spoonful means the quantity occupying the space occupied 
by forty-five drops of pure water. Some tea-spoons now the style 
hold much more than this ; hence in every house should be kept a tea- 
spoon known, by exact measurement, to contain just a typical tea- 
spoonful, or forty-five drops of water of ordinary purity. With this 
correct standard, another can be found holding just twice as much, 
and this will be what is called, in measuring medicines, a Dessert- 
spoonful. This doubled, or four tea-spoonfuls, is the Table-spoonful 
of medicine, or half an ounce. 
Wliat is best of all, is the common graduated measure, as it is 
called, used by apothecaries and all who wish to accurately estimate 
quantities of liquid. Not only the technical characters should be cut 
on the glass, but the quantities written out in full in plain English. 
There is a kind in the market with the characters pressed on the 
glass instead of being etched, but some think them, as a rule, less 
accurate than the other kind. If a true one can not be had, take some 
Read over wliat has just been said abouti- bilious” people, and see if there is not 
some suggestion there to meet the case. 
Another thing -often alleged is “ constipation.” Now there is often apparent 
reason in this. Physicians will say, however, that what is a necessity for one per- 
son twice a day, will not be for another twice a week ; and one enjoys as good 
health as the other. If the reader has reached the age of forty years, and will 
think back over thngs, he will find things which were once a necessity have be- 
come useless ; and things once not needed, can not now be dispensed with. There- 
fore, because things do not happen now as they once did, or happen now that 
once did not, remember there may be nothing wrong about it; at least, not 
enough to excuse the wrong of taking a lot of pills without consulting a physician 
as to whether they are really needed. APPENDIX. 
127 
water and count out forty-five drops until a “ tea-spoon” is found of 
the precise size to hold it. 
One tea-spoonful = 1 dram = forty-five drops pure water. 
One dessert-spoonful = 2 drams, or 2 tea-spoonfuls. 
One table-spoonful = 4 drams = 4 tea-spoonfuls or 2 dessert- 
spoonfuls, and is also equal to one half of a fluid ounce. Two table- 
spoonfuls, of course, make one fluid ounce. 
While speaking of certain articles of domestic medicine which 
should always be kept on hand, especially should several large and 
reliable apothecary-shops not be in the immediate neighborhood, 
there is one practice to be decidedly condemned. 
For some reason or another, or perhaps more correctly to say for 
lack of reason, certain persons persist in keeping about the house 
a parcel of Arsenic, Corrosive Sublimate, and if particularly favored, 
a few grains of Strychnia. They are often purchased under the de- 
lusion that they are intended for “ rats,” or something else. Some- 
times, even, they are carried around in the waistcoat-pocket, or kept 
on the mantel, or in a well-known conspicuous place on the clock, to 
be displayed and their merits dwelt upon in the most reckless man- 
ner whenever a listener can be found. The fondness for doing such 
things apparently belongs to the same order of mental obliquity that 
leads some innocent-minded people to keep dangerous firearms, 
largely loaded, constantly about the house; or with as little reason, 
a ferocious dog in the front yard. Independently of the danger of some 
one getting and taking such dangerous substances by accident, it 
should always be remembered that an unnecessary familiarity with 
such things is of no advantage to any one. While, perhaps, harm- 
less in some hands, it should never be forgotten that often “ the sight 
of means to do ill deeds, make deeds, ill done.” 
When it is necessary to get such tilings, tell the apothecary the 
use to be made of them, and ask him, as a precautionary measure, 
to add something to give offensive bulk to the poison -without impair- 
ing its usefulness for the purpose intended. 
Further, solutions of Corrosive Sublimate and Oxalic Salt should 
always be kept in a receptacle the appearance of which, alone, inde- 
pendent of the name of the substance and the word Poison and other 128 
APPENDIX. 
marks, will suggest unpleasant ideas, should the contents be used 
otherwise than legitimately intended. 
Several of the commonly kept medicines have individual pecu- 
liarities not generally known, but it will be so readily seen that the 
value of the article depends upon them that they will therefore be 
briefly mentioned in detail. 
Alcohol.—This is kept in most houses for various purposes. In a 
close bottle, it will keep for an indefinite length of time. 
Aqua Ammonise (Water of Ammonia) “ Hartshorn.”—As the 
name implies, this is water, saturated, as the chemists say, with a 
known quantity of Ammonia, a substance, for practical purposes, 
existing in the form of a gas. The strength, of course, depends upon 
the quantity of the gas held by the water. As the Ammonia is readily 
driven from the water by moderate heat, and rapidly leaves it on ex- 
posure to the open air, it can be seen that the strength of the Aqua 
Ammonite, compared with the standard, even when purchased of the 
best dealers, may vary a great deal. Owing to the difficulty of keep- 
ing it, a small quantity only should be purchased at one time. As 
the ammonia rapidly corrodes the common cork, and finds an outlet 
for escape from the bottle, the liquid should be kept under a ground- 
glass stopple. 
It is never used internally, but chiefly in combination with other 
substances, as a stimulating liniment. If the necessary articles are 
to be had, a useful Liniment, when there are no breaks in the skin, 
can be easily prepared by mixing equal quantities of Aqua Ammo- 
nise, Tincture of Opium (Laudanum), Oil of Turpentine, or Glycerine, 
or Tincture of Camphor. Any three of these will answer. No more 
need be mixed at a time than will last for a few applications. 
This Ammonia, united with Carbonic Acid Gas, gives the Carbo- 
nate of Ammonia ; which, coarsely bruised, and scented with various 
substances, constitutes the common smelling-salts, so much used by 
ladies as a nasal stimulant in fainting and hysteria. 
Aromatic Spirits of Ammonia.—This is suitably prepared 
Aqua Ammonia?, with other substances. No house should be without APPENDIX, 
129 
this valuable article. If the supply can readily be replenished, 
no more than an ounce need be bought at once. The value of it as 
a medicine depends, of course, upon the useful agent in it, which is 
the Ammonia previously spoken of, so care should be taken to keep 
up a fresh supply, and take proper care of what you get. If, in an 
emergency, it can not be felt that the article is reliable, the dose may 
be increased. 
Aromatic Spirits of Ammonia is what physicians call a diffusible 
stimulant, in many respects like Brandy, and in some instances bet- 
ter. The Ammonia in it is an Alkali ; so ft is also called an antacid, 
and given internally to neutralize a supposed excess of acid in the 
stomach. 
As a stimulant, the dose is twenty drops in a tea-spoonful of cold 
water, every couple of minutes, until certain results sought are ob- 
tained. 
Aromatic Sulphuric Acid.—Five or ten drops in a wine-glass of 
water is used internally. Like the acid of sour fruit, or pickles, this 
acid “ sets the teeth on edge ;” so immediately after using it, the 
mouth should be rinsed out with some water, with a little alkali in 
it—say the common baking soda. This will neutralize any particles 
of the acid adherent to the inside of the mouth. 
Tincture of Arnica—“ Arnica.” This popular name is as in- 
correct as it would be to call Tincture of Opium (Laudanum) 
“Opium.” It consists of tlie active principle of the flowers of the 
plant, suitably exhausted and kept in solution by Alcohol. It is use- 
ful as a Liniment by itself or mixed with other things ; but perhaps 
of less value than popularly supposed. It has no more “ healing ” 
properties, when applied to wounds and bruises, than Laudanum, and 
is, in fact, not as soothing. As there is no necessity, unless to soothe 
pain, for using Laudanum for this purpose, there is none for pouring 
on Tincture of Arnica, as many simple-hearted people do. 
Tincture of Arnica, internally, is poisonous, like Aconite (see Poi- 
soning by Aconite, p. 105). 130 
APPENDIX. 
Tincture of Camphor.—This is Camphor dissolved in Alcohol (2 
ounces of Camphor to a pint of Alcohol, U. S. P.) 
Tincture Of Capsicum.—A few drops of this in a little water is a 
pure stimulant— equal, in many respects, to brandy. 
Tincture of Myrrh.—A tea-spoonful, with thirty drops of the 
Tincture of Capsicum, added to a couple of ounces of sage-tea, with 
as much Chlorate of Potash as will lie heaped upon a two-cent piece, 
is a good domestic gargle. The throat should first be cleansed by 
gargling it out with some warm water, or salt and water, then fol- 
lowed by the mixture. 
Tincture Of Opium—“ Laudanum.” This, as the name implies, 
is the active principle of Opium exhausted by alcohol. This valu- 
able preparation should always be purchased of a most reliable 
apothecary. The Tincture of Opium sold in the rural stores often 
contains scarcely a trace of opium, and may, therefore, be said to be 
useless. An ounce is enough, as a rule, to keep on hand. If the 
stopper becomes loosened, from any cause, the Alcohol, of course, 
evaporates, which might occasion serious inconvenience, by increas- 
ing its strength beyond the officinal standard. 
The dose of Opium is one grain, and twenty-five drops of the 
Tincture of Opium (Laudanum) contain this quantity. Hence, 
twenty-five drops is a dose for an average person in health. 
Tincture of Rhubarb and Senna—“ Warner’s Gout Cordial ” 
—is a useful cathartic for the weak, especially used in cold weather, 
when there is an instinctive repugnance to the alkaline class of such 
medicines as Epsom Salts, Seidlitz-powders, etc. From a tea-spoonful 
to a table-spoonful is a dose. 
Camphorated Tincture of Opium—“ Paregoric,” “Paregoric 
Elixir.” The name suggests its components to a degree ; but it con- 
tains several other things, none of which interfere with the action of 
its prominent ingredient—Opium. 
This should be kept as suggested for the Tincture of Opium 
(Laudanum). APPENDIX. 
131 
A table-spoonful (which is half a fluid ounce, two dessert-spoon- 
fuls, or four tea-spoonfuls, p. 127), contains one grain of Opium. 
Hence, for an adult a table-spoonful would be a dose ; but is rarely 
used by adults for producing sleep. 
A tea-spoonful, therefore, contains one-fourth of a grain of Opium, 
and is equivalent to about six drops of the Tincture of Opium 
(Laudanum). 
It is given to children, however, in preference to Laudanum, for 
producing sleep. Dose for an infant of one year of age is ten drops ; 
for a child of two years, twenty-five drops. 
Camphorated Tincture Of Soap, “ Soap Liniment,” is a well- 
known and valuable Liniment for ordinary domestic use. 
Tincture of Ginger, “ Essence of Ginger,” is something that 
every body buys, but rarely has ; because the bottle it comes in is not 
suitable for keeping it. This tincture should be kept as carefully as 
the other tinctures named. It should be purchased of the apothe- 
cary, but in traveling, when needed, that made by Mr. Frederick 
Brown, of this city, and sold under the name of “ Essence of Jamaica 
Ginger,” can be used. 
Castor Oil.—The juice of half a lemon squeezed into the dose of 
the warmed oil makes it more palatable, and it is said nearly doubles 
its activity. 
Olive Oil—“ Sweet-oil.”—When given internally, the best, per- 
fectly free from rancidity, should be used. One third of sweet-oil 
and two thirds of the Aromatic Syrup of Rhubarb, is a desirable com- 
bination for infants and small children. 
For “ hartshorn liniment,” the commoner commercial oil may 
answer. 
Oil of Turpentine.—It is said that unless one purchases Oil of 
Turpentine of the apothecary, he is apt to get something more or less 
adulterated with Benzine. The writer does not know this to be true, 
but he would suggest that the article should be bought where there 
can be no doubt of its purity. Owing to the action of light upon this 132 
APPENDIX. 
substance, it should be kept in a colored bottle, or a bottle pasted 
over with a piece of thick blue paper. In using it, keep away from 
flame. 
Elixir of the Valerianate of Ammonia (Hubbell’s).—Directions 
found on the bottles. If not, a tea-spoonful may be given every few 
minutes until relief is obtained. 
Monsell’s Solution.—This powerful styptic is sometimes very 
useful in stopping bleedings. It acts by direct contact, clotting the 
blood and plugging up the injured vessel to that extent; so, to get 
the benefit, great care must be observed in cleansing out the wound 
and applying the solution. If it is a superficial cut, a thin, small 
slip of linen, wet in it and applied to the wound, closes the vessels, 
and it may be left there, if there is no bleeding nor discharge of pus. 
The mouth of the bottle and stopple must be kept free from the 
solution by wiping after using, or it causes the applied surfaces to 
gum so firmly that the stopple can not be withdrawn when necessary. 
A good way is to keep the dry salt of the Persulphite of Iron in a 
bottle ; as much as will lie on a penny in a table-spoonful of water, 
will rapidly form the desired solution. 
Lime-Water.—A large bottle of this easily-prepared compound 
should always be kept prepared for use. It is not only desirable as 
an antidote to many poisons, as Oxalic acid, but it is a valuable ant- 
acid, when such a thing is required. 
To make it, take a piece of unslaked lime (never mind the size, be- 
cause the water will only take up a certain quantity); put it into a 
perfectly clean bottle and fill the bottle up with cold water; keep 
the bottle corked, and in a cool, dark place, such as a cellar. In a 
few minutes it is ready for use, and the clear lime-water can be 
poured off whenever it is needed. When the water is exhausted, 
fill the bottle again. This may be done three or four times, after 
which some new lime must be used, as in the beginning. 
Hoffmann’s Anodyne.—Tile dose of this is a half tea-spoonful or 
more every few minutes. APPENDIX. 
133 
Like the Sweet Spirits of Nitre, it should be kept in a colored 
bottle, or in one covered with thick blue paper. 
Aromatic Syrup of Rhubarb.—Dose for an infant, a tea-spoon- 
ful. When given for costiveness, this quantity, with half as much 
of the best olive-oil (“ sweet-oil ”) may be added with advantage. 
Sweet Spirits of Nitre.—Half a tea-spoonful in water or lemonade 
is gfrven every two or three hours in certain febrile states. 
It should be protected from the light. See Hoffmann’s Anodyne 
above. 
Compound Tincture of Lavender—(Compound Spirit of Lav- 
ender).—Half a tea-spoonful on a lump of sugar, about as often as 
the Tincture of the Oil of Peppermint, should be given. 
Tincture of the Oil of Peppermint (“ Essence of Peppermint”). 
—Half a tea-spoonful on a lump of sugar is a dose. 
In all these things, reference is had to reliable articles from the 
apothecary’s. 
Compound Syrup Of Squill, “Cox’s Hive Syrup,” improperly 
called “Syrup of Squill,” which is the correct name of another 
thing, has a well-established use over the country, and is held in es- 
teem by many of the older physicians. Many others, particularly the 
j unior members of the profession, do not like it, from containing a 
small quantity of Tartar Emetic. 
Having in several instances seen a good deal of unnecessary subse- 
quent prostration follow from this ingredient of the Compound Syrup 
of Squill, the writer feels inclined to recommend the Syrup of Ipe- 
cacuanha instead, as an Emetic, leaving the other to be taken when 
specially ordered by the medical attendant. 
Syrup of Ipecacuanha.—Tliis is often known by tlie popular ab- 
breviation of “ Syrup of Ipecac,” and when there are children in the 
house, especially in the winter season, when croup is prevalent, 
should be kept on hand in quantities of an ounce or so. Children 
can be made to swallow it easier than they can the pulverized Ipe- 134 
APPENDIX. 
cacuanha or Mustard, when vomiting is required, and from the ten- 
dency of small children to dispose of so many things by swal- 
lowing them, this syrup is often needed without the time to send 
far for it. It will keep for some months in a properly secured 
bottle. 
The dose, as an emetic, for a child one or two years old, is a tea- 
spoonful or more. This may be repeated every few moments until 
it acts. In croup and some analogous disorders, the sensibility of 
the nerves to the stomach appears to be so much impaired, that 
even this will not act as an Emetic, unless assisted by a Warm Bath. 
Chalk-Mixture Powder.—If kept in tin-foil until ready for use, 
is better for preservation than the liquid mixture. 
Mustard,—Pulverized Mustard, or, as it is commonly called, 
Ground Mustard, should always be kept in every house, and in a 
place where it can always be found. The kitchen can not always be 
depended on for a supply. The time the last is used there is not as 
often reported, as when some more is needed. The delay caused in 
sending and getting some, in case of many poisons, often decides 
the case. It is not easy to get it pure, but if there is any doubt about 
this, an extra quantity can be given as an emetic, as it will all be 
rejected, and none is absorbed into the blood. Great care should be 
observed in keeping the mustard in a tight, wide-moutli bottle, other- 
wise the delicate active principle will escape from the powder into 
the air and be lost. 
As an Emetic, a tea-spoonful rubbed down in a tea cup of warm 
water should be given every two or three minutes until vomiting 
commences, when draughts of warm water should be freely given 
until there is reason to think the contents of the stomach have been 
rejected. 
Pulverized Ipecacuanha, “Ipecac.”—This valuable Emetic (p. 
92), should he kept in every house or place where it might he em- 
ployed. A couple of drams is enough to get at once, and it slum d 
he kept in a bottle with a close-fitting cork As much as will lie 
heaped up on an ordinary two-cent piece weighs about ten grains. APPENDIX. 
135 
When it is desired in an attack of Croup to give an Emetic, there 
is nothing better for a child than this substance, as it does not appear 
to be absorbed into the blood to any extent, or if it does, no harm 
seems to occur, and it can be given without the fear of giving too 
much. Even if there should be more given than necessary, like 
ground mustard, the excess is brought up with the first effort of vo- 
miting. See Syrup of Ipecacuanha (p. 133). 
Sulphate of Zinc, “ White Vitriol,” is a prompt Emetic when 
given in solution in water, in the dose of about twenty grains, as 
much as will twice lie heaped up on a two-cent piece. This should 
be repeated every few minutes until vomiting follows. Although 
universally recommended as an Emetic in cases of Poisoning, and 
when on hand is most valuable, it is always better, instead of wait- 
ing for it, to give mustard or common salt. Not that the Sulphate 
of Zinc is inferior, but because it is so much easier to get ground 
mustard, and easier still to get common salt, which, in doses of a 
heaping table-spoonful dissolved in water (four or five tea-spoonfuls), 
is as good as either of the others. It should be given in this quantity 
every couple of minutes until it acts. 
Persons have managed to take an ounce or more of the Sulphate of 
Zinc for the Sulphate of Magnesia, which its crystals resemble some- 
what. If not vomited, it would so greatly irritate the stomach and 
bowels in such a dose, as to entitle it to be called an irritant poison. 
Half an ounce is enough, therefore, to keep in the house, and it should 
be kept in a bottle, not a paper. 
Husband’s Magnesia is as good, and much cheaper than the best 
English makes. Dose, a tea-spoonful for an adult. 
Seidlitz Powders.—These depend for their value upon their re- 
liability, and this upon the apothecary who sells them. They should 
be truly made, of active ingredients, freshly compounded, and kept 
perfectly dry in a cool place. Dissolve each pawder separately in less 
than half a tumbler of water ; mix together, and drink down while 
in a state of effervescence. 
They should be taken early in the morning, before breakfast, and 136 
APPENDIX. 
the water should not be ice-water, for the cold condenses the escap- 
ing gas (Carbonic Acid) as it forms, and there is no effervescence. 
The components of the Seidlitz Powder, or articles in most respects 
like them, are combined in various ways as “granular salts,” and it 
is possible, owing to palatability, readiness of carrying, and small 
bulk, may, in the course of time, as effectually displace the Seidlitz 
Powder, with many people, as the Seidlitz Powder did the less ele- 
gant “ Epsom Salts,” “ Rochelle Salt,” and other things of the kind. 
Tarrant’s Seltzer Aperient.—Directions on the bottle. All 
these effervescing preparations must be kept from exposure to air, or 
tlieir efficiency will become impaired. 
Opium Pills, of one grain each, may be kept on hand, and as a 
precautionary measure, reduced to a powder before taken. One 
grain of opium is contained in twenty-five drops of laudanum, and in 
ten grains of the Dover powder. 
Opium Suppositories.—If kept in a dry, cold place, will preserve 
their efficiency for a long time. The small form known as children’s 
are quite large enough. One grain of Opium to each is a convenient 
size to keep. If needed, one can be followed by a second. Few 
things can be found more useful if kept on hand ; and if the physi- 
cian speaks of a Laudanum injection for relieving pain anywhere in 
the lower part of the body, he should be told of the supply of suppo- 
sitories on hand. 
As the three next salts still maintain quite a reputation, it may be 
well to say something about them. 
Epsom Salt, “ Sulphate of Magnesia.”—The medium dose of this 
salt, often termed “ salts,” is an ounce. In bulk this is about two 
table-spoonfuls. 
It should be dissolved in water, no more than is sufficient for the 
purpose. 
In using Epsom Salt, always be sure not to take another sub- 
stance much resembling it in appearance, and often kept about the 
house. This is Oxalic Acid, a powerful and rapid poison. The Ox- 
alic acid is sour to the taste, the Epsom Salt is not. APPENDIX, 
137 
It also resembles in color, and has been mistaken for the Sulphate 
of Zinc. 
Rochelle Salt, “ Tartrate of Potassaand Soda.”—The dose of this 
salt is about half an ounce, or about a table-spoonful. 
It should be dissolved in water. It is one of the constituents of 
the Seidlitz Powder. 
Glauber’s Salt, “ Sulphate of Soda.”—This old-fashioned, disa- 
greeable salt is gradually disappearing from use, having been super- 
seded by the Sulphate of Magnesia (Epsom Salt), which is less dis- 
agreeable to take. 
The dose is half an ounce, dissolved in water, and taken like all 
other medicines of the class, of a saline character, upon getting up, 
before breakfast. A little lemon-juice, or a pinch of cream of tartar, 
is said to make it more acceptable to the taste. 
Pills. —The persistent use of cathartics, whether in shape of pills, 
salt, or liquid, is sure to bring on trouble which nothing else for the 
rest of the life may correct. Be careful of what you eat, how you 
eat, and when you eat, and in a few months, never mind how much 
medicine of the kind is now taken, you will find, unless it is an ex- 
ceptional case, a marked improvement in health. 
If medicines, particularly pills, must be taken, do not use the 
wretched “ vegetable” varieties, when there are so many better, to 
be had of any Apothecary, freshly made, of the best material, in pro- 
per quantities, and, as some people will say, at a much less price. 
The physician in the country, too, makes the same thing, in the 
same way, and under the same name. There are several of them, 
but the two to be remembered are the 
Compound Cathartic Pill. 
Compound Rhubarb Pill.—Three or four of either are a safe, 
gentle cathartic, acting by morning, when taken at late bedtime. 
Two will often answer. 
These two kinds of pills being made according to the precise direc- 
tions of the IT. S. Pharmacopoeia, can be had of any Apothecary, in 138 
APPENDIX. 
any quantity ; and as they are made of the best material, they may 
be relied upon for the purpose intended. Beside these advantages, 
they are so constantly ordered by Physicians in prescriptions, that 
they are usually freshly made. 
The “Compressed Pills,” now so generally preferred on account 
of the purity of their components, as well as the ease with which 
they dissolve, will often be found more active than the same number 
of pills as usually prepared and kept. 
Sugar of Lead (Acetate of Lead).—Used as a substitute for Lead- 
water, by taking of it pulverized a tea-spoonful dissolved in a pint of 
water, adding a table-spoonful of cider vinegar. It is quite as useful 
as the expensive “ Goulard’s Extract” of lead, and much less cost- 
ly and easier to geu. 
Laudanum can be added to this lead-water the same as to any 
other. 
Chlorate of Potash is not very soluble in water. Some of the 
salt made into a saturated solution is a popular gargle. 
Quinine.—Two-grain quinine pills ordinarily can be best kept, re- 
ducing them to powder, to insure digestion at the time of using. 
In malarious regions, it is kept in larger quantities. By the ounce 
(437 grains) it can be ordered, per post, of wholesale dealers, at quite 
a moderate price. Any of the responsible dealers can supply it. The 
dose depends so much on circumstances that nothing can be said 
about it. It is soluble in the Aromatic Sulphuric Acid often found 
in houses. The best way to take it is to place the compact bulk on 
the tongue, and wash it down with a swallow of water. 
It is much easier, by taking it, to prevent malarial poisons, than 
to break the “chills” afterward. 
Sulphate of Cinchonia, and the Sulphate of Cinehonidia, 
as stated on page 88, are now much used as economical substitutes 
for the above salt. They much resemble Quinia in appearance and 
taste, and in a little larger quantity may be given under the same 
circumstances. For use on plantations, they can be best ordered per 
post, by the ounce, of some reliable dealer. INDEX. 
Accidents ; general directions, G, 7. 
Acids ; concentrated, burns by, 31 ; poisoning by, 96. 
Aconite, 105. 
Adhesive plaster, how to use, 45. 
Adhesive and isinglass plasters, 4G. 
After-treatment of wounds, 47-49. 
Alcohol, 128 ; poisoning by, 104. 
Alkalies, burns by, 30. 
Alkaline Wash, 68. 
Ambulance, in case of accidents, 7. 
Antimony, 97. 
Apoplectic convulsions, 73. 
“ Aquafortis,” nitricacid, 31, 96. 
Aqua ammonise, 128 ; poisoning by, 96. 
Aromatic spirit of ammonia, 128 ; note, 20. 
Aromatic sulphuric acid, 129. 
Aromatic syrup of rhubarb, 133. 
Arsenic, 97. 
Arteries, wounds of, how known, 38. 
Artificial respiration, 10,11 ; in case of drowning, 10 ; in accidents 
from lightning, 22 ; in sun-stroke, 19 ; in poisoning, 89. 
Asphyxia ; meaning of word, 7 ; different kinds of, 7 ; from submer- 
sion under water, 7 ; from breathing certain gases, 7 ; from 
hanging by the neck, 7 ; from narcotics, 91 ; condition of affairs 
in, 7 ; what is to be done in, 110. 
Baryta, poisoning by, 99. 
Belladonna, poisoning by, 106. 
“ Biliousness” (note), 125. 
Bismuth, poisoning by, 99. 
Bites, 56 ; of insects, 55 ; of dogs, 56 ; of persons with hydrophobia, 
59 ; of serpents, 55 ; of skunks, 60. 
“ Bitter-sweet,” Dulcamara, 108. 
Bleeding, see Hemorrhage, 87. 
Bleeding from Lungs, 68. 
Bleeding from Nose, 67. 
“ Blood-root,” Sanguinaria, 114. 
Blood, quantity in human body, 41. 
Boils, 62. 
Brachial artery, pressure upon, 39. 
Brandy, as a stimulant (note), 20. 
Broken ice ; how to prepare, 19 ; along blood-vessels in hemor- 
rhage, 39. 
Bruises ; see Contusions, 31. 
Bryony, poisoning by, 106. 
Burns, 26 ; by acids, 31 ; by alkalies, lime, caustic potash, etc., 30 ; 
by lightning, 22. 
Burns and scalds, 26 ; difference between. 30 ; treatment of, 27 ; 
shock from, 27 ; necessary deformities from, 29 ; how repaired, 29. 
Burning gas, common, effects when breathed, 15. 
Burning clothing, how to quench flames of, 26. 
Cathartic medicines, 125. 
Camphor, 107. INDEX, 
Camphorated soap liniment, 131; tincture of opium, “ paregoric,” 
130 ; tincture of soap, “ soap liniment,” 125. 
Canine madness (hydrophobia), 56. 
Capsicum, 130. 
Carbonic acid gas, 8. 
Carbuncle, 62. 
Castor-oil, 131. 
Cellars, old, precautions on entering, 13. 
Cesspools, foul air from, 16. 
Chalk-mixture, powder, 134. 
Charcoal, burning, gases from, 15. 
Chilblain, 70. 
Chilliness after applications of water, 33, 48. 
Chlorate of potash, 138. 
“ Choke-damp,” carbonic acid gas, 8. 
Cholera, 75-78. 
Cholera mixture, 77. 
Cinclionia, Sulphate of, 88, 139. 
Cinclionidia, Sulphate of, 88, 139. 
Conium, 107. 
Contusions, 31-35. 
Cold water ; as a drink in hot weather, 21 ; drinking or bathing in, 
while heated, 25. 
Coagulation of blood in wounded vessel, 37. 
Copper, poisoning by, 99. 
Corrosive sublimate, 101. 
Compound cathartic pills, 137 ; rhubarb pills, 137 ; syrup of squill, 
133. 
Concentrated Lye, 102. 
Concentrated Potash, 102. 
Contused wounds, 53. 
Convulsions, 71, 74 ; apoplectic, 73 ; cataleptic, 119 ; children, 64, 68 ; 
epileptic, 71 ; hysterical, 73 ; lrom strychnia, 115. 
Cramp ; in bathing, 11; precautions to prevent, 12. 
Croup, 63-64. 
Cotton wadding, as dressing to burns and scalds, 28. 
Cuts, see “ Incised Wounds,” 44-50. 
Cut face, from shaving, 49. 
Cut finger, 49. 
Dashing body with cold water, 14. 
Diarrhoea, 78. 
Diarrhoea mixture, 77. 
Discoloration ; causes of, in contusion, 33 ; as a sign of death, 121. 
Dislocations, 35. 
Dressing wounds, 48. 
Drip for injuries, how to prepare, 32. 
Death, signs of, 116-121. 
Digitalis, 107. 
“ Dog-button,” 100. 
Drowning, 8, 14; what to do in, 8 ; condition of affairs in, 9. 
Dysentery, 78. 
Dulcamara, 108. 
Earache, 62. 
Elixir of the valerianate of ammonia (Hubbell’s), 132. 
Emetics, 91. 
Epileptic convulsions, 71-75. INDEX, 
141 
Eruptive fevers, 79. 
Eye, foreign bodies in, 65. 
Exhaustion attending suppuration, 29. 
Faceache, 62. 
Fainting, 25 ; treatment of, 25 ; after wounds, 43 ; after loss of blood, 
43 ; after certain injuries, 32. 
Felon, 61. 
Fevers, eruptive, 79. 
Finger, “ cut,” 49, and “ maslied,” 33. 
Fish, poisoning by, 95. 
Fits in children, 64-68. 
Foreign bodies in eye, 65 ; in ear, 67 ; in nostril, 66 ; in throat, 16 ; 
under the nail, 52 ; in the hand or foot, 52. 
Foul air in wells, mines, drains, privies, etc., 16. 
“ Foxglove,” Digitalis, 107. 
Fractures and dislocations, 35. 
Fracture of the arm, 34 ; of the leg, 34 ; what to do until the arrival 
of surgeon, 35. 
Frost-bite, 68. 
Frozen to death, 69. 
Gases, effects of different kinds when breathed, 15 ; from anthracite 
or bituminous coals, 15 ; from drains, mines, wells, etc., 14. 
“ Glauber’s salt,” 137. 
Gold, salts of, as poisons, 100. 
Ground mustard, 134 ; as an emetic, 91. 
Graduated measure, 126. 
Hemorrhage ; from artery, compression, 39 ; from wounds of finger, 
38 ; from wounds of foot, 38; from wounds of hand, 38 ; from 
wounds of scalp, 38. 
Hanging by the neck, 12 ; superstition about, 13. 
“ Hemlock,” conium, 107. 
Henbane, 108. 
Hoffman’s anodyne, 132. 
Hydrophobia, 56-58. 
Hyosyamus, 108. 
Hysterical convulsions, 73. 
Ice, broken, how to prepare, 19. 
Ice-water, when not to be used, 21, 25. 
Immersion under water, duration, restoration, 12. 
Incised wounds, 44-50. 
Incubation of eruptive fevers, 80. 
“ Indian Tobacco,” Lobelia, 108. 
Iodine, as a poison, 100. 
Ipecacuanha, as an emetic, 92. 
Iron, salts of, as poisons, 100. 
Isinglass plaster, 46. 
“ Jimson Weed,” 115. 
Lacerated wounds, 54. 
Lard, in burns and scalds, 27. 
Lather of soap and water to burns and scalds, 28. 
Laudanum, to allay pain in wounds, 50 ; poison, 109. 
Lavender, compound tincture, “ spirits of,” 133. 
Lead, 101. 
Lightning, accidents from, 21. 
Lime, burns by, 30 ; poisoning by, 101. 142 
Lime, in the eye, 60. 
Lime-water, 162. 
Lime as an antidote for oxalic acid, 113. 
Liniments, 128. 
Linseed-oil and lime-water for turns, 28. 
Lobelia, 108. 
“ Lock-jaw,” tetanus, 52. 
Loss of blood producing shock, 23. 
Linen, what surgeons mean by term, 47. 
Lunar Caustic, 101. 
Magnesia, Husband’s, 135. 
Mashed toe, 33. 
" Meadow Anemone,” Pulsatilla, 114. 
Measles, 82. 
Measuring liquid medicines, 127. 
Meats, poisonous, 94. 
Medicines, domestic, how to preserve, 123-140. 
Mercury, salts of, as poisons, 101. 
Mineral poisons, 96-104. 
Mushrooms, poisoning by, 94. 
"Monkshood,” Aconite, 105. 
Monsell’s solution, 132. 
Morphia, " morphine,” see Opium, 109. 
Mustard, as an emetic, 91. 
Nails of fingers, Injuries to, 51. 
Nail, or rusty knife, dangerous injuries from, 52. 
Needle, in hand or foot, 52. 
Neuralgia, 73-75. 
Neuralgic rheumatism, 74. 
Nitrate of Silver, 101. 
Nitric acid, burns by, 31. 
Nose, bleeding from, 69, 70. 
Nux Vomica, as a poison, 115. 
Oil of turpentine, 131. 
" Oil of vitriol,” sulphuric acid, burns by, 31. 
Ointments, 125. 
Old linen, what surgeons mean by it, 47. 
Olive oil, 131. 
Opium, 109-112. 
“ pills, 136. 
“ suppositories, 136. 
Oxalic acid, 112. 
Pain in wounds, 43, 54, 55. 
Paris-green, as a poison, 97. 
Peppermint, tincture of the oil of, 133. 
“ “ essence of,” 133. 
Phosphorus, as a poison, 102. 
Pills, 125, 137. 
“ “ compressed,” 137. 
“ Pink root,” Spigelia, 114. 
Plasters, application to wounds, 45. 
Poison, definition of, 88. 
Poisoning ; by acids, mineral, 96-99 ; Alcohol, 104 ; Aconite, 105 ; 
Antimony, 97 ; Aqua Ammoniae, 96 ; Arsenic, 97 ; Baryta, 99 ; 
Belladonna, 106 ; “ Bitter-sweet,” Dulcamara, 108 ; Bryony, 106 ; 
Bismuth, 99 ; Camphor, 107; Copper, 99 ; Corrosive Sublimate, 
INDEX. INDEX, 
143 
101; Conium, 97 ; “ Deadly Nightshade,’ Belladonna, 10G ; Digi- 
talis, 96 ; “ Dog-button,” Nux Vomica, 115 ; Dulcamara, 108 ; 
“ Foxglove,” Digitalis, 107 ; Gold, Salts of, 100 ; “ Hemlock,” 
Conium, 107 ; “ Henbane,” Hyoscyamus, 108 ; Hair-dye, see 
Silver, 105; Iodine, 100 ; Iron, Salts of, 100 ; Laudanum, 
Tincture of Opium, 109 ; Lead, Salts of, 101; “ Leopard’s Bane,” 
Aconite, 105 ; Lime, 107 ; “ Lunar Caustic,” Nitrate of Silver, 
103 ; Lye, concentrated potash, 102 ; Mercury, Salts of, 101 ; 
Morphia, see Opium, 109 ; Nux Vomica, 115 ; Opium and prepa- 
rations, 109-111 ; Oxalic Acid, 112 ; Orpiment, 97 ; Paris-green, 
97 ; Potash, 102 ; Prussic Acid, 105 ; Pulsatilla, 114 ; Phosphorus, 
102 ; Realgar, 97 ; “ Red Precipitate,” 97 ; Sanguinaria, 114 ; 
“Saltpetre,” Nitrate of Potash, 102 ; Savine, 114 ; Silver, Salts 
of, 91 ; Soda, 91 ; Spigelia, 103 ; Stramonium, 114; Strychnia, 
115 ; Tin, Salts of, 103 ; Tobacco, 116 ; “ Wolf’s Bane,” Aco- 
nite, 105 ; Zinc, Salts of, 103, 
Poisons, 88-116. 
Poisonous, fish, 95 ; meats, 94, 95 ; wounds, 54. 
Poison-Vine eruption, 68. 
Portions of bodies cleanly cut off, 50. 
Potash, internally, 102. 
Powders, how to preserve, 125. 
Precautions to be observed in hot weather, 20. 
“Proud flesh,” granulations, 54. 
Pulsatilla, 114. 
Pulverized Ipecacuanha, 134 ; as an emetic, 92. 
Punctured wounds, 50 ; how to treat, 51 ; dangers to be appre- 
hended from, 52. 
Pus ; formation of, 53 ; discharge of, 50-51 ; effects of excessive for- 
mation on strength, 28-29. 
Quinia, and substitutes, 88, 138. 
“ Red precipitate,” as a poison, 101. 
Rheumatism, 73-76. 
Rochelle salt, 137. 
Rubbing with broken ice, 19. 
Sanguinaria, 114. 
Salt, common, as an emetic, 91. 
Scalds, 135. 
Scalp-wounds, 39, 54. 
Scarlet fever, 110. 
Seidlitz powders, 26, 27, 28. 
Shaving the face, cuts, what to do, 49. 
Shell-fish, poisonous, 95. 
Shock or collapse, fainting, 22, 23, 24, 25, 26 ; in burns and scalds, 
27 ; in contusions, 32 ; what to do, 24, 25 ; confounded with 
fainting, 25 ; death from, 23 ; in age and infancy compared, 
24 ; from bathing in or drinking cold water, 25. 
Signs of real death, 116-121. 
Silver, salts of, as poisons, 91. 
Small-pox, 83. 
Soap and water, object in using for wounds, 52. 
Soda, as a poison, 103. 
Spigelia, 114. 
Spitting of blood, 68. 
Splinters ; in hand, 51 ; under the nail, 51 ; how to remove. 52. 
Sprains, 36. 144 
INDEX, 
Squill, compound syrup of, 133. 
Stimulants ; ammonia and brandy (note), 20 ; effects of toomucli, 44. 
Stings of insects, 55. 
Stomach pump, 90. 
Stramonium, 115. 
Stretcher, how used, 7. 
Strychnia, 100. 
Suffocation, 12. 
Sugar of lead, 138. 
Sulphate of magnesia, 136 ; of soda, 137 ; of zinc, 135 ; of zinc, as an 
emetic, 92 ; of zinc, poisoning by, 103. 
Sulphureted hydrogen, 16. 
Sulphuric acid, “ oil of vitriol,” burns by, 31 ; poisoning by, 96. 
Sunstroke, 17-19; general observations on, 21; symptoms, 17; 
treatment, 18 ; prevention, 20. 
Suppuration, effects of on strength, 28, 29. 
Sutures, 47. 
Sweet-oil, 131. 
Sweet spirits of nitre, 133. 
Syrups, how to preserve, 124. 
Syrup of ipecacuanha, 133 ; of squill, 117. 
Tartrate of soda and potassa, 137. 
Tarrant’s seltzer aperient, 136. 
Tea-spoonful and table-spoonful, how to measure, 126, 127. 
Temperature in sunstroke, 19. 
Tetanus, “ lockjaw,” 52. 
Thigh, wounds of, 41, 42. 
Tin, salts of, as poisons, 103. 
Tincture of aconite, 105 ; of arnica, 129 ; cf camphor, 130 ; of capsi- 
cum, 130 ; of ginger, 131 ; lavender, 133 ; of myrrh, 130 ; of 
opium, “ laudanum,” 130 ; camphorated tincture of opium, 
“ paregoric,” 130 ; of rhubarb and senna, 130 ; of soap, camphor- 
ated, “ soap liniment,” 131. 
Tissue, meaning of, 61. 
Tobacco, as a poison, 116. 
Toothache, 63. 
Tourniquet, temporary, how to prepare, 43. 
Union of wounded surfaces, 49. 
Vaccination, 84. 
Valerianate of ammonia, elixir, Ilubbell’s, 132. 
Varioloid, 84. 
Vegetable poisons, 104. 
Vomiting, 79. 
Warner’s gout cordial, tinct. rhubarb and senna, 130. 
Water dressing, 32, 47 ; in burns and scalds, 28, 47 ; to wounds, 47 ; 
chilliness arising during its use, 33, 48. 
Water, warm, as an emetic, 91 ; cold, when it should not be used, 
21, 26. 
Wells, old, precautions on entering, 16. 
White of egg to burns, 28 ; antidote to poisons, 101. 
Whitlow, 61. 
“ Wolfsbane,” Aconite, 105. 
Wounds, varieties of, 36, 37 ; of hand, 38 ; of foot, 38 ; of scalp, 39, 
54 ; how to dress, 44, 45. 
Zinc, salts of, as poisons, 103