WA B942w 1896 NLM QSlETfifil b NATIONAL LIBRARY OF MEOKINE SURGEON GENERAL'S OFFICE LIBRARY Section................................... Form 113c No. W.D..S.G.O. m \H\2 NLM051298816 ^ WHAT TO DO UNTIL THE DOCTOR COMES. A WL OF INSTRUCTIONS AS TO THE Proper Method of Managing Cases of Poisoning, Sudden Illness, Accidents, etc., While Awaiting the Arrival of the Physician, ALSO Notes on Sanitary Science and Invalid Cookery, the whole subject matter being so Tabulated and Indexed as to be instantly available, and -so Illustrated by Engravings (reproductions of photographs) as to be readily understood. W. S. BUNN, M. D., LAWRENCE, KANSAS. LAWRENCE, KANSAS : JOURNAL COMPANY, PRINTERS AND BINDERS. .100 T,'.'.._ »»^^ Uk J J WAr U° *>*> WA Ee>4'i. w COPYRIGHT. 1896, BY W. S. BUNN, M. D. PREFACE. For placing this little volume before the public the author offers no apology. The questions constantly asked during twelve years of active practice in city and country, have demonstrated to him its necessity. Some medical literature is found in almost every household, most of it practically useless, much of it positively pernicious. A treatise on "The Practice of Medicine" is not needed—for such, in the hands of persons not thoroughly skilled by reason of a long course of training and study, becomes dangerous. What is required, however, is a concise manual or hand-book containing plain instructions for the management of accidents, injuries, poison- ings, sudden illness, etc., during the anxious interval that elapses—often hours in country districts, between the summoning and the arrival of the physician. Prompt action by some sensible, cool headed person would often save life could he know just what course to pursue. This in our little manual we endeavor to teach, using plain language and so arranging and indexing the subject matter as to render it instantly available. Should the directions herein given suffice for the preservation of a single human life it would be to the author a sufficient recompense for the time spent upon the preparation. He believes, however, that it may be the means of saving many. iv The following suggestion is offered, viz.: each responsible member of the family should spend a few leisure hours in looking through this little manual and thoroughly familiarizing himself with the method of classification. Then a little evening drill may be occasionally practiced, some one suggesting the occurrence of a possible accident, or emergency, and another quickly finding the treatment therefor. You will by this plan become familiar with many bits of knowledge that cannot be otherwise than useful. Lawrence, Kan., January i, 1897. W- S> BUNN. INDEX A No. Acetic Acid, pois. by.................. 3 Acid—Acetic, pois. by.................. 3 " Carbolic, pois. by............... 4 burns by............... 70 Hydrochloric, pois. by........... 2 burns by.......... 70 Muriatic, burns by.............. 70 " pois. by............... 2 Nitric, pois. by..... ............ 2 " burns by................. 70 '' Oxalic, pois. by.................. 3 '' Prussic, pois. by................. 5 Sulphuric, pois, by......... ..... 2 burns by.............. 70 Tartaric, pois. by............... 3 Aconite, pois. by....................... 9 Alcohol, pois. by...............45 and 10 Alkali, pois. by........................ 7 Ammonia, pois. by.................... 7 Anthrax.............................. no Antimony, pois. by..................... 8 Apoplexy.............................. 42 Arsenic, pois. by...................... 6 Artificial Breathing.................... 32 No. Asthma............................... 51 Atropia............................. n Baked Milk.......................... 129 Battery Fluid, pois. by................. 2 Bed Bug Poison, pois. by............... 13 Bee Sting............................ 36 Beef Juice............................ 121 Beef Marrow......................... 143 '' Raw............................. 143 " Steak........................... 143 Belladonna, pois. by................... n Bite of Snake......................... 33 Tarantula...................... 34 Scorpion..................... 35 Centipede..................... 35 Cat, Rat, or other animal........ 37 Mad Dog or any rabid animal___ 38 Bitter Almonds, pois. by............... 5 Bitter Sweet, pois. by.................. 12 Black Antimony, pois. by............. 8 Bleeding from Nose.................. 74 " Lungs................... 75 No. '' Stomach................. 76 " Bowels................. 77 " Womb.................. 78 ' Cuts or Wounds.......... 79 Broken Bones......................... 86 Burns ................................ 6g with hot oil, fats, molten metal, or acids.......................... 70 with alkalies, concentrated lye, potash, etc................... 71 Buttermilk............................. 130 C Candy Toys, pois. by................... 6 Carbolic Acid, pois. by.................. 4 '' burns by................ 70 Care of Infants..............pages 94 to 113 Carrying Wounded Persons............. 85 Caustic Potash, pois by................ 7 burns.................. yi Caustic Soda, burns................... 71 pois. by.................. 7 Centipede Sting........................ 35 Charcoal Fumes, pois. by............... 27 Cherry Laurel Water, pois. by.......... 5 VI No. Chicken Broth......................... 117 " Broiled or Roasted............ 137 " Pox.......................... Ill Child Bed Fever....................... 108 Child Birth............................ 61 Chloral, pois. by....................... 14 Chloroform............................ 30 Choking, from something in mouth, throat or windpipe...................... 64 Choke Damps, pois. by................• 29 Cholera............................... 104 Cholera Morbus........................ 48 Cholera Infantum...................... 49 Cocoa............... .................. 141 Concentrated Lye, pois. by............. 7 " burns by. ........... 71 Convulsions........................... 46 Consumption......................... . . 101 Cookery for Invalids.................... 114 Corrosive Sublimate, pois. by........... 13 Corn Meal Gruel....................... 123 Cramp Colic.......................... 56 Cream of Celery...................... 120 Creosote, pois. by..................... 4 Croup................................ 50 Croton Oil, pois. by................... 15 Cuts of Head or Face.................. 80 Cuts of Neck.................. " " Arm or Hand........... " " Body, Chest or Abdomen . " " Legs or Feet........... Cyanide of Potash, pois. by...... D Digitalis, pois. by............... Diphtheria................... Dislocation of Bones............ Dog Bite....................... Drowning...................... Drunkenness................... Dysentery...................... B Ear, foreign bodies in ......... Egg Nog....................... Eggs, Solf Boiled............... Poached................. Scrambled................ Omelet................... '' Lemonade ............... Emergency Box, contents of..... Epilepsy....................... Ether, pois. by.................. Extract of Opium, pois. by...... Eye, foreign bodies in........... F No. Fainting............................. 40 Falling Sickness....................... 41 Farcy................................. 109 Fire Damp, pois .by................... 27 Fits................................... 41 Flooding.............................. 78 Fly Paper, pois. by................... 6 Flux,................................. 60 Foreign Bodies Swallowed.............. 65 in Nose................. 66 " Eye.................. 68 " " " Ear................. 67 " Flesh................. 93 Fowler's Solution, pois. by.............. 6 Fox Glove, pois. by.................... 16 Fracture of Bone...................... 86 Freezing.............................. 73 Frost Bite............................. 73 G German Measles....................... m Glanders.............................. iog Green Wall Paper, pois. by............. 6 H Hanging.............................. 63 Heat, Exhaustion...................... 44 No, Heat-stroke........................... 43 Hellebore, pois. by ................... 9 Hemlock, pois. by..................... 17 Henbane, pois. by..................... 17 Hernia.............................. 92 Hydrophobia.......................... 38 Hydrate of Chloral, pois. by............ 14 Hydrochloric Acid, pois. by............. 2 Hyoscyamus, pois. by.................. 17 I Illuminating Gas, pois. by............. 27 Indian Tobacco, pois. by............... 1S Infants, Care of........................ 112 Infant, Feeding........................ 112 Food Table..................... 113 Insect Powder, pois. by ...,............ g Insensibility........................... 39 Intoxication............................ 45 Invalid Cookery...................page 104 J Jamestown (Jimson) Weed, pois by...... 12 K Kidney, Acute Inflammation.......... 54 L Labor .............................. 61 Laudanum, pois. by.................... 20 Lemonade, Hot................ with Egg ........... Liniment of Belladonna, pois. by Lightning.................... Lobelia, pois. by............... London Purple, pois. by........ Lung Fever .................... Lumbago..................... Lye, Concentrated............. M Measles............,.......... Milk.......................... " Punch .................. Morphine, pois. by............ Mulled Wine ................. Beer................... " Ale.................... " Port................... Mumps....................... Muriatic Acid, pois. by......... " burns............ Mushrooms, pois. by........... N Neuralgia of Stomach.......... Neuralgia..................... Nightshade, pois. by........... Vll Xo. Nitric Acid, puis, by................... 2 burns by.................. 70 n I Nux Vomica, pois. by............. ... 25 7= O Oat Meal Gruel........................ 124 Oil of Hitter Almonds, pois. by.......... 5 " " Vitriol, pois. by.................. 2 " " " burns by................. 70 Omelet.............................. 135 Onion Gruel........................... 125 Opium, pois. by....................... 20 Oxalic Acid, pois by................... 3 Oysters................................ 136 " Steamed........................ 136 '' Stewed........................ 136 " Broiled........................ 136 P Pain in Loins.......................... 54 Paragoric, pois. by..................... 20 Paralytic Stroke....................... 42 Paris Green, pois. by.................. 6 Partridge.............................. 137 Plover................................ 137 Pheasant.............................. 137 Peptonized Milk....................... 131 Vlll No. Pleurisy............................... 53 Pneumonia............................ 52 Poison Chart..................pages i to 13 Poisoning by unknown poison........... 1 If unknown see alphabetical index. Poison Ivy.. ' '........................ 23 " Oak............................ 23 " Sumac......................... 23 Poke Berry, poss. by.................... 22 Potash Caustic, pois. by................ 7 Potato Vines, pois. by.................. I2 Potatoes, Baked, Roasted, Mashed, Ken- tucky............................. J44 Prairie Chicken........................ 137 Predigested Milk....................... 131 Puerperal Fever....................... 108 Pure Air ............................. 95 " Food............................ 96 " Water............................ 97 Q Quail................................. I3? Quick Beef Broth...................... Il8 " Chicken Broth................... 122 R Rat Paste, pois. by..................... 21 Rat Poison, pois. by............... 6 and 24 No. Rupture.............................. 92 S Salts of Lemon, pois. by................ 3 " " Sorrel, pois. by................. 3 Sanitation...................pages 66 to 94 Sewer Gas, pois. by.................... 29 Scheeles Green, pois. by................ 6 Scalds................................ 69 Scarlet Fever.................... 99 and 59 Scorpion Sting......................... 35 Slug Killer........................... 9 Small Pox............................. i°6 Snake Bite............................ 33 Snipe................................. J37 Soup................................. TI5 Soup Stock............................ 115 Spasms................................ 4^ Splenic Fever......................... no Spider Bite........................... 34 Sterilized Milk......................... 127 Stings, Bees, Wasps, and Hornets....... 36 Strychnine, pois. by.................... 25 Strangulated Hernia................... 92 Sugar of Lead, pois. by................ 26 Sunstroke............................. 43 Suffocation, from pressure about throat.. 63 T - No. Tarantula Bites....................... 34 Tartaric Acid, pois. by................. 3 Tartaric Emetic, pois. by............... 8 Thorns, Splinters, Nails, etc., in flesh--- 93 Tincture of Belladonna, pois. by........ 11 Toadstool, pois. by.................... *9 Tobacco, pois. by..................... *8 Tomato Vine, pois. by................. 12 Tuberculosis.......................... 101 Typhoid Fever........................ 102 Typhus Fever........................ io3 U Unconsciousness....................... 39 Urine, Suppression of.................. 55 V Vapor of Ammonia, pois. by............ 38 Veratrum, pois. by..................... 9 Vomiting Blood........................ 76 Simple....................... 47 W Whooping Cough...................... m White Arsenic, pois. by................. 6 Wine of Opium, pois. by................ 20 Woodcock............................. 137 Y Yellow Fever.......................... 105 PART ONE. POISON CHART. DIRECTIONS. Dispatch some one at once for the nearest Physician, stating, if possible, the poison taken and the princi- pal symptoms, that he may know at once how to act. If the poison taken is unknown, treat the patient immediately as directed under the heading No. i. un- known. If the poison is known, refer at once to the index or run over the columns of names along the left hand margin of each page, until found, the treatment will be given directly opposite. Remember that accidental poisoning seldom proves fatal. Keep cool and be able upon the arrival of the Physician to state just what you have done. 3---- No. 11 known I'oison. Endeavor to provoke vomiting by giving large draughts of warm water, and passing the finger into the throat. If not successful in this give a pint of warm water to which a tablespoonful of ground mustard has been added. Repeat this in a few minutes if neces- sary or if at hand give a teaspoonful of syrup of ipecac. After vomiting give bland liquids, such as milk, cream, whites of eggs, some kind of ale, flour and water or gruel. Then if there is much weakness give stimulants as whiskey, wine, strong coffee, or tea, or harts- horn, or ammonia, the dose of which is a half teaspoonful with an ounce of water. No. 2. Sulphuric Arid. Oil of Vitriol. \idir Arid. Muriatic or Hydrochloric Acid. Battery Fluid. Give as quickly as possible hartshorn or ammonia, one teaspoonful to an ounce of water and repeat every few minutes for several doses; or give ordinary cooking soda in half teaspoonful doses, or chalk, or magnesia, or plaster from the wall, or soap and water, as may be most readily obtained. Follow by a glass or two of milk or cream, or several eggs beaten, or some kind of oil, or lard. No. 3. Oxalic Acid. Malts of Lemon. Salts of Sorrel. Tartaric Acid. Acetic Acid. Give plaster from the wall, chalk or whiting with water. Repeat several doses at short intervals. Then give a large draught of warm water as emetic, and hasten its action by "tickling" the throat if necessary. Follow by a glass or two of cream, or a couple of beaten eggs. 4 No. 4. Carholic Acid, Creosote. No. 5. Prussie Acid. Cherry Laurel Water, Cyanide of Potash, Oil of Bitter Almonds. Give a pint of warm water with a tablespoonful of ground mustard to produce vomit- ing. Assist this action by passing the finger down the throat. If common epsom salts can be obtained give two full doses at short intervals. In a few moments give cream, milk or beaten eggs. The patient must be made to rest as quietly as possible and if very feeble, stimulants, as whiskey, hartshorn and water (a teaspoonful to the ounce), etc., may be given. Give mustard and warm water to provoke vomiting (a tablespoonful ground mustard to a pint of water). Douche the patient alternately with hot and cold water. Keep up artificial respiration. For instructions see No. 32. No. 6. Arsenic. White-Arsenic, Scheeles & Let the head rest on a moderately high pillow. Apply cold water to the head and warmth to the feet. Do not mistake this condition for intoxication (No. 45). Note.—Apoplexy or stroke is usually due to rupture of a blood-vessel in the brain or its envelopes. The attack may be sudden, the patient falling as if shot, or the unconsciousness and paralysis appear more gradually. Usually there are no warning symptoms. The face is flushed, the breathing snoring and heavy. The pulse slow, full and hard. Usually one side of the body is paralyzed. The sides of the face different in appearance, one wrinkled and drawn, the other flabby and puffing in and out with the breathing (see No. 39). 22 No. 43. Sunstroke or Heatstroke. Do not confound this with simple heat exhaustion. Sunstroke or heatstroke is a sudden attack occurring in very hot weather after prolonged exposure to the direct rays of the sun, or nearly as often to great artificial heat, as in shops, laundries, furnace rooms, etc., where in addition to the heat there is a heavy atmosphere. The circumstances under which it occurs will serve to distinguish it from apoplexy, alcoholic stupefaction, etc., but better read No. 39. The patient usually while about his labors is seized with a sudden pain in his head, a sense of fullness about the pit of the stomach, sickness, dizziness, blindness and loss of consciousness. There is then heavy breathing, often great heat and dryness of the skin. Until the physician comes you cannot do better than to place the patient in a cool airy place, remove all clothing possible, wrap him in a sheet and pour cold water over him at intervals. When the skin becomes cool, stop until it again feels hot to the hand. These cases are frequently fatal and no delay should be permitted in securing a competent physician. No. 44. Exhaustion from heat. After active exertion, or exposure to heat there is sometimes felt a condition of extreme weakness or depression, but with a cool clammy skin (not hot and dry as in sun- stroke, see 43) and a weak pulse. The patient can be placed where he can secure fresh air and absolute rest. Brandy or whiskey and water may be given in small doses every fifteen minutes until the system reacts. ■2 3" No. 45. Drunkenness or Intoxication. Note.—Other conditions may be mistaken for the "dead drunk " state, and the patient left to " sleep it off" may die. On the other hand active measures taken to arouse a person supposed to be drunk, would prove fatal were the case apoplexy. Read carefully No. 39. Unless the case is certainly one of intoxication do not give an emetic, but treat as though it ivcre apoplexy (No. 42) until the physician arrives. If knozvu to be drunk- enness give an emetic of warm water or mustard and warm water. Cold wet cloths may be applied to the head if the pulse is feeble and rapid. Give aromatic spirits of ammonia, if it can be obtained, a teaspoonful to an ounce of water. If the skin is cold and clammy and the patient is greatly prostrated apply dry heat to the body to prevent collapse. Leinon juice or vinegar is often useful to quiet the stomach. No. 46. Spasms or Convulsions. Spasms or convulsions of the infant or child may result from various causes. Some- times they are serious—as brain or kidney disease or the beginning of some acute illness, as scarlet-fever, or diphtheria. Other causes are fright, indigestion, teething, etc. No time should be lost in securing a physician. What shall you do meanwhile? As quickly as possible place the feet in hot water to which mustard has been added (a heaping teaspoonful to the gallon), or if it can be as quickly prepared a general warm bath may be given. At the same time cloths wet in cold water should be applied to the head until it feels cool. These proceedings should be continued according to the severity of the attack. 24- No.46. Continued. It is also proper to give a rectal injection of soap and water, to clear the bowels. A full dose of castor oil may also be given as soon as the child can swallow. This will be a sufficient effort until your physician comes and determines the cause. As there is usually more or less irritation of the stomach and bowels, the giving of everything the neighbors suggest will only increase the trouble. No. 47. Simple Vomiting Simple vomiting is usually due to indigestion or something irritating in the stomach. Encourage the emptying of the stomach by giving a large draught of warm water, or apply a mustard poultice to the pit of the stomach. If severe see No. 48. Dyspeptics should of course consult their physician. No. 48. Cholera morbus. This is characterized by violent vomiting and purging, with cramping pains, cool, clammy skin, pinched face and rapid pulse. Until the doctor comes you can do no better than to give the patient small pieces of ice to swallow if at hand and apply a mustard poultice to the pit .of the stomach, or cloths wrung from hot water and sprinkled with turpentine. If the pain is so severe as to demand relief at once, give a teaspoonful of whiskey or peppermint-water every few minutes and in desperate cases laudanum may be given, 30 drops to adult and for children one drop for each year of age. Avoid the laudanum if possible until the doctor comes as it masks the symptoms and renders an accurate diagnosis difficult. 2 5 No. 49, Cholera Infantum. This is the most severe form of infantile diarrhoea, simulating cholera in its intensity. If a babe has frequent watery stools and great thirst but rejects water or milk as soon as taken, face pinched, pulse rapid and feeble, lose no time in securing the doctor. It is a dangerous disease. Until the doctor arrives cloths may be dipped in hot water in which hops are steeping and placed over the abdomen, changing as fast as cool. As much common cooking soda as will lay on the large blade of a penknife may be dissolved in a teacupful of water and administered every half hour. If the collapse or weakness becomes extreme, from 5 to 1 5 drops of brandy or whiskey may be given in a little hot water every half hour. No. 50. Croup. This disease begins usually at night after the first sleep; is always distressing and alarming but rarely dangerous. In many cases it amounts to no more than a hoarse barking cough, with some difficulty of breathing. In this case quiet the child and give him a little melted sugar and butter. If the disease is more severe place cloths wrung from hot water about the neck, and retain the heat by a dry one outside. If syrup of ipecac can be obtained give from one-half to one teaspoonful every 10 to 20 minutes until vomiting is produced, or give a tablespoonful of a paste made by mixing powdered alum with molasses. Do not get excited and communicate your nervousness to the child as it invariably makes him worse. 26---- No. 51. For the relief of the paroxysms of asthma many measures have been tried, sometimes ",a- successful, often failing. General directions only can be given. The patient will do better sitting in a chair and where ventilation can be secured. In some cases where the direct cause of the attack can be traced to a disordered stomach, an emetic of hot water and mustard will cut it short. Stimulants can be tried as a couple of cups of strong black coffee or a generous glass of hot wJiiskey toddy. Smoking tobacco is sometimes of advantage. The most certain relief is obtained, however, from opium in doses of 30 drops to an adult, children one drop for each year of age. Do not use opium until the doctor comes unless the condition is desperate. No. 52. "Ve'ver. ^ is uncommon for Pneumonia to develop with such rapidity as to require any treatment pending the arrival of the physician. Some cases are however very severe from the beginning. There will occur a severe chill, followed by fever, a pain in the chest, located near the nipple, rapid and laborious breathing, a cough and often a rusty-colored expectoration. Commonly in the center of each cheek a red patch will be seen, and the patient exhibits great restlessness. What shall you do? Place your patient in bed in a moderately warm room and keep the temperature even. For the pain in the chest a large poultice of hops may be applied as hot as can be borne. Give no solid food. If the physician is long in coming and it is desirable a cup of broth or gruel may be given. 27 No. 53. A severe pain or stitch in the side may be Pleurisy or Neuralgia. This, only the Pleurisy. physician can determine. When the pain, however, is so great that the patient is unable to secure a deep inspiration (take a long breath), a piece of flannel may be dipped in hot water, wrung dry as possible, sprinkled with a few drops of turpentine and applied to the painful side. This may be repeated at intervals, or if turpentine is not at hand,, put a tablespoonful or two of mustard in the water from which you wring the flannel. No. 54. A pain in the loins may be from an acute inflammation of the kidneys or from muscular Pam in the loins, rheumatism. If so severe as to demand immediate relief, place your patient in bed and Lumbago, r J r Acute inflammation apply a hot-water bag, or if not handy, fill a selfsealer fruit jar with hot water, wrap it in a cloth and apply to painful part. Make it as hot as it can be tolerated. A cup of strong hop tea may be drank as an additional measure. These proceedings will be sufficient until the coming of the doctor whether the cause be either the one or the other mentioned above. 28- No.55. Suppression of urine. No. 56. Colic, Cramp Colic, Neuralgia of the stomach. The natural flow of the urinary secretion may be interfered with from various causes, operating anywhere from the kidneys to the external opening. While waiting for the physician, if the distress becomes great, try a hot sitzbath. Have a tub of water as hot as can be borne; sit down in it; then add boiling water from a pitcher to maintain the temperature. Try to pass the urine while in different positions. Wring a flannel cloth from very hot water, sprinkle it with turpentine and apply over the lower part of the abdomen. Do not make continuous and violent efforts to urinate, but try at intervals, keeping as quiet as possible between times. Abdominal pain occurs from such a variety of causes, that only general directions for relief can be given until the physician arrives. It may be anything from a simple indi- gestion to an appendicitis, or an intestinal obstruction, or the passage of a gall or kidney stone. Opiates should not be used as they mask the symptoms and interfere with an accurate diagnosis. The turpentine stupe, made by wringing a piece of flannel from very hot water and sprinkling it with turpentine, may be applied, being careful not to blister. Or a poultice of hops may be applied. Internally essence of peppermint in a little hot water may be given or a large dose of whiskey and hot water with an ounce or, two of glycerine (or if that is not at hand a little soap may be added) can also be used.^ff^rie^ agonizing pain still continues and the patient is not already vomiting, a pint of water containing a tablespoonful of mustard may be taken as an emetic. If it does not act promptly, "tickle" the throat with the finger to induce this action. 29---- No. 57. Neuralgia in general is a subject that can not be treated here. The author only Neuralgia. mentions it to decry the practice of using the so-called Headache Powders of the drug stores. They are in almost all instances compounds of the coal tar derivatives and their use is pernicious. A careful examination by a competent physician will often reveal the cause in " eye strain," constipation, or some constitutional vice that is amenable to treatment. If one must keep some remedial agent for the relief of pain let it be a prescription of your physician, who, knowing its composition can watch and control its effects from time to time. No. 58. The distinguishing mark of this disease is white patches on the tonsils or palate. Diphtheria. j^ a ^jjj or acjuit complains of sore throat and any patches can be seen (use a spoon to press down the tongue) at once send for your doctor, and place the patient in a room as far removed as possible from the rest of the family until he comes and the nature of the malady can be fully determined. Weak vinegar and water may be administered hot every few minutes until his arrival, or better, if at hand, diluted lemon juice. No. 59. The distinguishing features of this disease are vomiting, a sore throat and a scarlet scarlet Fever. rash. Never delay sending for a physician when the above symptoms are present, no matter in how mild a form. Place the patient in a room far removed from everyone. No treatment is necessary until the doctor comes. -3o- No. 60. This is a disease of the lower bowels, characterized by frequent discharges of bloody Flux' mucus, with great straining and prostration. This is contagious and the discharges should be burned until otherwise directed. While waiting the arrival of your doctor give the patient a full dose of epsom salts, and if food is desired, hot milk may be given. 3t PART FOUR. CHILDBIRTH. Note.—The assistance of an educated physician should never willingly be dispensed with, in any case of childbirth. It is true that this function is a natural one and in ninety per cent, of all cases will progress to its termination unaided. In American life, however, there are so many disturbing factors that what should be purely a physiological process often times becomes a dangerous condition, and when discovered, help may not always be available. In a very great number of cases, however, labor occurs so unexpectedly or pro- gresses so rapidly that there is not time to secure such assistance. I have deemed it therefore advisable to give a few directions in view of such an emergency. 32 No, 61. Remember that in a " lying in" chamber, and with everything about a "lying in" LDirth- woman '■'cleanliness is Godliness." A good bath for the patient, using xvarm water and soap, a clean gown, above all clean bedding. Do not think that as the bedding will naturally be soiled that you should use any old dirty blankets or quilts. If you do and the woman has fever do not call it a dispensation of Providence. If the bowels have not been recently emptied and there is time to do so, an injection of warm water (a quart) should be thrown into the rectum and allowed to return after a few minutes. During the earlier part of the labor, if so desired, the woman may be allowed to walk about or sit. After a time a phenomenon occurs known as " the breaking of the waters," marked by the flow, from the vagina of from one to several ounces of clear fluid. After this the patient should be confined to the bed, not even arising to get over the vessel though she may desire to do so. After the birth of the child's head (sudden labor not being apt to occur in any other position than head first), if the body does not follow in a few minutes, the head may be seized, and without twisting it in any way, a gentle pull given during a pain. Use but little force. In case the feet or breech should come first, the same process may be employed at once as the child is then in great danger from the after coming head pressing the cord. After the child is born a half minute or so may elapse and the child allowed to cry out before the cord is tied. To tie the cord use common grocer's wrapping string as it is sufficiently strong and not apt to slip. Tie in two places, about two and a half and four inches from the child, and cut between the knots with scissors. See that there is no bleeding from the child's cord after cutting. If there 33 No. 61. should be, another ligature must be used and drawn tighter. Do not now commit what "ued- I have found to be a common error among the inexperienced—that of pulling on the cord still attached to the mother. Let it alone. After a bit she will probably have some pains, and the "after-birth" or placenta will be expelled. If skilled assistance has not yet arrived it is better to wait for it than for any unprofessional person to attempt the removal of a retained placenta, as the gravest results may follow. After the completion of labor an appalling accident may occur—i. e., violent hemorrhage or bleeding from the uterus. This often requires the promptest action, to avoid a fatal result. Have someone immedi- ately elevate the foot of the bed, a foot or more, and remove the pillow from beneath the patient's head. Cast aside the covers and knead and press the abdomen over the womb vigorously. If the womb can be felt, after a number of efforts, to be hardening and growing smaller keep up your efforts as you will succeed. If not, and the alarming bleeding still continues, the patient's face growing pale and fainting about to occur, the hand must be dipped in water as near boiling as can be borne, and passed boldly clear into the womb as far as it will go. The womb will be found full of blood clots. Drag them out and move the hand about vigorously until the womb can be felt hardening and squeezing the hand, when it may be removed and the kneading of the abdomen continued for awhile. This latter should only be done as a last resort, but if necessary do it as it has no immediate danger and may save life. Such cases should always go into the hands of a physician afterward if one has not already arrived. The "lying in" period should always be superintended by a physician, and has no discussion Concluded -34— No. 61. here. Remember that the directions given here do not cover even a small per cent of mi, .1 , u r the accidents liable to occur at childbirth, but only skill and experience should assume the grave responsibility of managing such cases. Let me therefore once again insist strongly that every woman in labor should be attended by a physician. For instructions as to the care of the newly born infant see Index for number.' ----35 PART FIVE. ACCIDENTS AND INJURIES. In considering this subject the author has attempted to so arrange the index that immediate reference may be made to any particular case. This has proven somewhat difficult, but in case of failure to at once find what you wish, much assistance may be obtained in accomplishing this object from the plates, which here accompany the text. — -36- No. 62. Drowning, Remove the patient quickly to the nearest dry place on the bank. Tear the clothing from about the neck and chest. Sweep the finger about in the mouth to remove anything which may have entered. Turn the body first upon the face, and make once firm pressure upon the back and sides. Then turn upon the back and make artificial respira- tion if the patient is not already breathing (see No. 32). Do this at once and let some one else read the balance of these directions and follow them. While artificial breathing is kept quietly in action, remove the wet clothing (cut it away) and wrap the patient in warm dry clothes taken from bystanders or otherwise obtained. Warm stones, hotwater- jugs, anything warm may be placed about the patient. At the same time beneath the clothing rub the limbs briskly upward to start the sluggish circulation towards the heart. As soon as your patient can swallow give him a generous drink of whiskey and hot water. This will be sufficient until the doctor comes and accepts charge. No. 63. Hanging or Suffocation from pressure about the throat. Remove at once the obstruction to breathing and if natural breathing does not immediately ensue, practice artificial respiration until it does (see 32). If the body is cool wrap in warm cloths. Place hot wster-jugs, or warm stove lids, or warm stones, or anything warm about the body. Rub briskly toward the heart to start the circulation. When you send for the physician have him bring, if at hand, an electric batter}7. If the breathing becomes established and the patient can swallow, give a hot drink of some kind—if obtainable whiskey and hot water. ---37--- No. 64. Choking from some- thing in the mouth. throat or windpipe. In mouth or throat. If the offending body be within the mouth, or in sight in the upper throat, remove it with the finger, or a spoon handle, or piece of wire bent to a hook, or a pair of scissors, or pincers, or tweezers if at hand.' Use a spoon to press down the tongue. If it is a pin or fish bone, or anything sharp, and you cannot readily grasp it, quiet the patient's fears. Let him lie upon the face as efforts to swallow will not be so frequent, and quietly await the arrival of the doctor with proper instruments for its removal. If in the windpipe, as evidenced by coughing and great difficulty of breathing, invert the body (head down) and give a smart blow upon the back or chest. If not soon dislodged the surgeon's skill will be required. No. 65. Foreign bodies swallowed. When such things as pins, buttons, tin whistles, slatepencils, marbles, pieces of coal, etc., are swallowed by children or adults, do not give them a physic. On the other hand give plenty of vegetables as potatoes, beans, turnips, cabbage, etc., and mush and milk freely. This makes a large amount of refuse to pass the bowels and the offending object is carried harmlessly along with it until it is expelled. No. 66. Foreign bodies in the nose. If easily reached remove with a hairpin or anything convenient. Tickle the nose or inhale a very slight bit of pepper to produce sneezing. If unsuccessful, take the patient to a physician before any swelling ensues. 38 No. 67. Foreign bodies in the ear. Be very cautious and gentle in your efforts to remove foreign bodies from the ear. If in sight and loose, gentle efforts may be made to dislodge them. If bugs or insects of any kind are in the ear place the patient where a strong light will shine upon the opening; they will sometimes come out. If not, pour warm sweet oil in the ear. If still unsuc- cessful, syringe the ear with warm water. Do not use warm water where the object is one that will swell, as corn grains, beans, etc. On the whole it is better to let the physician manipulate such cases, and sometimes his skill is taxed. No. 68. Foreign bodies in the eye. Motes, cinders, and other foreign bodies in the eye can usually be removed by the aid of a soft handkerchief folded to a point, or a gentle stream of warm water used with a syringe, or squeezed from a sponge or cloth. If not readily removed by the above methods, hold the eye still by tying over it firmly a folded handkerchief wet with cold water and consult a doctor. ■39- No.69. Burns aud scalds. Remove all clothing rapidly, taking very especial care to not tear away the blisters which may have formed. To this end the clothing may be clipped away with scissors. The blisters should then be punctured on one side with a needle. If carron oil (a mixture of linseed oil and lime water in equal parts) is at hand wet strips of muslin in it, and cover injured surface leaving them unchanged until the physician arrives. If carron oil is not obtainable, cover burned surface with dry cooking soda, or with sweet oil or any fat containing no salt. If there is any great shock and threatened collapse, administer whiskey and water, in small doses. If pain is intense, laudanum may be administered, 20 drops to an adult, and one drop to children for each year of age. Place the patient in a cool, quiet place and avoid all excitement until the doctor comes. No. 70. Burns with hot oil or fats, molten metal or acids. No. 71. Burns with alkalies, concentrated lye, caustic, potash, etc. Plunge the parts quickly into cold water and treat as directed above in paragraph 69. If alkalies have been swallowed see No. 7, and for surface burns first wash with diluted vinegar and proceed as in No. 69. No. 72. In shocks from lightning there is nothing to be done except to secure rest and quiet Lightning. an(j moderate stimulation, with whiskey and water, strong tea or coffee, until the physician can be summoned and treat the case according to its symptoms. -4Q- No. 73. Freezing, Frost-bite. Attempt to restore the circulation in the frozen parts by flushing with water and active, vigorous rubbing. At first the water should be the ordinary temperature of well water, but it must be rapidly warmed by the addition every few seconds of hot water, until after a very few minutes you are using friction with hot water. Follow this direction and you will find it is better than the time honored custom of rubbing with ice or snow. Consult a physician as to subsequent management. No. 74. Bleeding from the Try compressing firmly the bleeding nostril for a few minutes and keep the arms extended above the head. If unsuccessful try cold wet cloths or ice upon the back of the neck, nose and forehead. If still unsuccessful snuff ice cold water slightly salty, or try alum water—a piece of alum the size of a nut in a cup of water. If these measures fai] the hemorrhage is probably from some constitutional cause and a physician should at once be summoned. If life seems in danger from loss of blood you can plug the nose as follows: Tear a number of pieces of soft, clean muslin about an inch square, take a stout thread and tie the squares upon it about three inches apart, like the tail of a kite; then take a small pencil and push the end square as far back in the nose as possible, follow with each one in succession, leaving the end of the string hanging from the nostril to facilitate removal. Let the patient he upon his face until the doctor comes and directs further proceedings. -41 No. 75. Bleeding from the lungs. People rarely die directly from a hemorrhage of the lungs. Have the patient lie down in a cool, dark room and keep absolutely quiet. Do not allow him to speak above a whisper, nor to be surrounded by anxious friends. If ice is at hand have him swallow small pieces at frequent intervals; if no ice, sip cold water. A small pinch of salt may be given every few minutes until bleeding ceases. Summon your physician at once as a hemorrhage of the lungs means a condition requiring active treatment for some time. No. 76. Bleeding from stomach , vomiting blood. Have the patient lie down in a cool, quiet place. If ice is at hand allow him to swallow small pieces, and place also ice at the pit of the stomach; or cold water com- presses. Do not give him anything to eat as particles in the stomach only aggravate vomiting. This is all you can do until your doctor comes. No. 77. Bleeding from the bowels. Have the patient lie down in a quiet place, secure rest, and apply cold cloths to abdomen. A few drops of turpentine sprinkled on the cloths will do no harm. A doctor should be consulted to determine the cause. 42---- No. 78. If with childbirth or miscarriage see latter part of No. 61. If not, have the patient iing from jje jown jn a cool quiet place, stop all conversation and excitement. Place beneath her mb. ' ^ r ' r head a very small pillow or none at all. Raise the foot of the bed eighteen or twenty inches. Place cloths wrung out of cold water over the lower part of the abdomen, thighs and vulva. Have her use a pan and pass urine without rising, until bleeding has been stopped some hours. Such conditions are unnatural and a physician should as soon as possible determine cause and treat it. 43— No. 79. If bleeding from cuts or wounds about the head or face, see No. 80. "IrSlr" °Ut8 If bleeding from cuts-or wounds about the neck, see No. 81. If bleeding from cuts or wounds about the arms or hands, see No. 82. If bleeding from cuts or wounds about the body, see No. 83. If bleeding from cuts or wounds about the legs or feet, see No. 84. -44- No. 80. Bleeding from cuts or wounds of scalp or face can be controlled until the doctor Bleeding from cuts comes by pressure with the fingers upon the bleeding point, or fold a clean white cloth and wounds about J r ... the head or face. of proper size to cover the wound, dip it in cold water and press firmly upon the wound until bleeding ceases. Then a strip of muslin may be torn into a bandage and the compress tied in place. Do not put on soot, and cobwebs, and flour, and salt, and dry dust, etc., as it poisons the wound. The cold compress as above described is all the treatment required until the surgeon arrives to permanently stitch or dress the injury. See Plate No. 4 immediately following. Fig. No. 4. COMPRESS, SCALP OK FACE. (See No. 80, page 44.) Fig. No. 5. THUMB PRESSURE IN NECK. (See No. 81, page 45.) No. 81. Grasp the neck above and below the injury and press firmly until you have caught Cuts, stabs, or ^g vessei an(j controlled it. Then keep steady and continuous pressure iust enough to wounds in the r J . . neck. control the hemorrhage until the surgeon arrives. If you cannot stop it by this method, put the finger in the wound and press firmly in different directions. Once controlled never relax your pressure until the surgeon arrives to direct proceedings and assume responsibility. See Plate No. 5, immediately preceding. ----46- No. 82. (a) In the arm pit.—Press firmly behind the collar bone. Sieze some hard, round cuts or wounds of object the size of an orange, wrap in a handkerchief and press firmly in the armpit. arm or hand. J o > r •■ Then bind or hold the arm against the side until the surgeon comes. See Plate A o. 6, immediately following: (b) If the wound is betivecn shoulders and elbow see next printed page. (c) If between elbow and hand see second next printed page. (d) If about the hand see third next printed page. \ Fio. No. 6. COMPRESS, IN ARM PIT. (See No. 82, page 46.) % Fk;. No. 7. TOURNIQUET TO ARM. (See No. 82, page 47.) ----47---- No. 82. (b) If the wound is between shoulder and elbow. If spouting freely press above and continued. below the wound. If this fail have someone make a roll of cloth the size of the fist, lay it over and above the wound, around it and the arm tie a handkerchief loosely; run a stick of any kind through the loop of the handkerchief and twist just tight enough to stop the bleeding—and no tighter. Have a surgeon quickly in these cases as there will be danger of gangrene. See Plate No. 7, immediately preceding. 48 (c) If between elbow and hand. Wring a clean cloth from cold water and bind firmly on the wound, but only just tight enough to stop bleeding. See Plate No. 8, immediately following. This plate illustrates the compress over the pulse or radial artery of the left arm. Fig. No. 8. COMPRESS, RADIAL ARTERY. (See No. 82, page 48.) ♦ Fig. No. 9. COMPRESS, HAND. (See No. 82, page 49.) ----49 No. 82. (d) Wounds of the hand. Bleeding from cuts in the palm of the hand may be continued. troublesome. Take a round, smooth object, as a china egg, a ball or stone, wrap it in a clean handkerchief, grasp in the bleeding hand and bind firmly. See Plate No. 9, immediately preceding. About the back of the hand or the fingers the compress and bandage will be sufficient. ----5c- No. 83. (a) About chest. Make a compress of clean cloth, dip in cold, clean water and 'hod"chest"? °f aPPty to wound, pressing it firmly with the hand or tying it tightly in position with a abdomen. bandage. If this fail, remove it and press the finger or thumb firmly upon the point from which the blood seems to well. In a stab wound which penetrates the chest, place the patient in the recumbent position and enforce rest and quiet, as the breathing will be embarrassed, and over the wound apply a clean compress. (b) About abdomen. Over cuts or wounds which do not open the abdominal cavity, place a clean, folded cloth wrung from clean, cold water, and await your surgeon. If the abdomen is penetrated, but the intestines do not protrude do the same as above. If intestines protrude from the wound and you know that it will require an hour or more to secure a surgeon, wash your hands quickly and thoroughly, removing every particle of dirt; and gently replace them. Over the wound place clean cloths wrung from clean hot water, and await your surgeon, giving your patient an ounce of whiskey and hot water if there is great prostration. If you cannot replace intestines with ease, and you know that the surgeon will soon arrive simply cover them with clean cloths wrung from clean water as hot as can be borne, until he comes. Missing image no. 10 5' No. 84. (a) If of the thigh close to the body. If a large vessel is opened nothing will stop wounds of legs and it but pressure with the thumb or finger. Press above and below the wound or thrust the finger boldly into the wound and press firmly upon the point from which the blood seems to well. See Plate No. 10, immediately preceding for course of large artery. (b) If betzvcen the body and knee see next printed page. (c) If in the hollow of the knee see second next printed page. (d) If betivecu the knee and foot see third next printed page. (e) If about the foot see fourth next printed page. 52 No. 84. (b) If between body and knee. Tie a handkerchief or piece of strong cloth about the limb above the wound; pass a stick through the loop and twist it tight enough to stop the bleeding. Have the surgeon quickly in these cases as the circulation is cut off from the limb below. See Plate No. 11, immediately following. If the larger vessels are not opened use only a clean cloth folded, wrung from clean, cold water and held upon the wound by a bandage or the hand until the surgeon comes. Fig. No. ii. TOURNIQUET, THIGH. (See No. 84, page 52.) • ^i&g.-.'** Fu;. No. 12. COMPRESS, HOLLOW OF THE KNEE. (See No. 84, page 53.) ----53 No. 84. (c) If in the hollow of the knee. Take a ball or roll of clean cloth and place it iuueH- upon the wound. Then bend the knee upon the thigh firmly enough to stop the hemor- rhage, and retain it there with a bandage. See Plate No. 12, immediately preceding. ----54---- No. 84. (d) If between the knee and foot. Place a clean cloth wrung from cold water ",ued- over the wound and tie firmly in place with a clean handkerchief or bandage and place the limb in an elevated position. If this fails, remove the dressing and with the finger washed perfectly clean, press firmly above and below the wound, or failing in this press firmly upon the point from which the blood wells, holding it steadily until the surgeon comes. See plate No. 13, immediately following. Fig. No. 13. COMPRESS, LEG. (See No. 84, page 54.) Fig. No. 14. COMPRESS, FOOT. (See No. 84, page 55.) No. 84. (e) About the foot. Make a compress of clean cloth and place it upon the wound; continued. tie it firmly with a bandage and elevate the limb. See Plate No. 14, immediately preceding. -56- No. 85. The following Plates, Nos. 15, 16, 17, 18, 19, explain themselves. The particular 'wounded *erson™/ method employed in each instance must be determined by the nature of the case, and the materials at hand. The stretcher in Plate No. 19, can be made of poles cut by the road- side, fork handles, etc., and gunny sacks, or a buggy blanket, or a coverlid or strong sheets, brought from the nearest house, or coats of bystanders. In carrying a wounded person the bearers should keep step and walk with a steady swinging pace to avoid jolting. Nos. 15 and 16, the Saddle. No. 17, the Tandem. No. 18, the Sling. No. 19, the Stretcher. H W > O 0 r w Fig. No. 16. THE SADDLE IN USE. (See No. 85, page 56.) C/i ^ Fig. No. 18. THE SLING. (See No. 85, page 56.) Fig. No. 19. THE STRETCHER, (See No. 85, page 56.) 57- No. 86. For treatment of fracture of skull see No. 87. Fracture of bones. For treatment of fracture of arms see No. 88. For treatment of fracture of legs see No. 89. For treatment of fracture of ribs see No. 90. No. 87. Fracture of the skull. In fracture of the skull but little can be done pending the arrival of the surgeon. Place the patient in a horizontal position. Loosen clothing from about the neck, and cover the wound with clean cloths wrung from clean, cold water. If there is great weak- ness and feet and hands are cold, hot-water-jugs, self-sealer fruit jars filled with hot water, or hot irons, may be placed around him. Blood and dirt may be washed from the face and head. All injuries about the head should be carefully inspected by a surgeon, as often an apparently slight injury will be followed by epilepsy or other symptoms of brain injury. 58---- No. 88. (a) If the fracture is between the elbow and the shoulder. Cut away the clothing Fracture of the arm, an(j tie the forearm to the chest with a bandage, placing a folded cloth between the arm and body; then cover the injured part with clean cloths wet with cold water and await your surgeon. Keep the cloths wet with frequent changing. See Plate No. 20, imme- diately following. If the elbow is crushed, allow the arm to hang perfectly straight and apply cold compresses until the surgeon comes. (b) If the fracture is between the elbow and hand, see next printed page. Fig. No. 20. FRACTURE, ARM. (See No. 88, page 58.) &wl Fig. No. 21. FRACTURE, THIGH. (See No. 89, page 59.) No. 88. Continued. ----59---- (b) Between the elbow and hand. In this fracture it is usually sufficient to fold a cloth into ten or a dozen thicknesses and tie about the arm as directed in Plate No. 22 for the leg. Keep cloths wrung from cold water over the injured parts until the surgeon comes. No. 89. Fracture of the legs. (a) Of the thigh. Lay the patient in a horizontal position. Arrange him as comfortable as possible and on either side of the injured limb and snugly against it, lay a couple of sand bags as long and nearly as large as the limb. These will act as a support and prevent twitching of the muscles and consequent pain until the surgeon comes. If sand cannot be quickly obtained use in lieu thereof a couple of sticks of heavy wood wrapped in cloth. Cold compresses should be kept applied to the injured parts. See Plate No. 21, immediately preceding. (b) If the fracture is below the knee, see next printed page •60---- No. 89. (b) If the fracture is below the knee. Either take a small pillow or a blanket folded lMued- many times. This is then bound about the limb as shown in Plate No. 22, immediately following. If necessary several pieces of shingle may be used outside as a reinforcement. In the trough thus made the limb can rest snugly and be covered with cold water com- presses until the doctor comes. ^fe^,.?^ Fig. No. 22. FRACTURE, LEG. (See No. 89, page 60.) -—6i No. 90. Where the ribs are fractured and breathing is painful partial comfort may be secured Fracture of ribs. while waiting for the physician by binding a towel or pillow-slip or muffler tightly about the chest over the seat of injury. No. 91. The inexperienced should never attempt the reduction of any dislocated bone, as dislocation of bones, permanent injury of the joint may follow such bungling efforts. Tear some strips of muslin and roll them into bandages, and bind the dislocated member in such a way as to prevent motion, and take the patient to a surgeon quickly as possible, or have the surgeon summoned if any of the large joints are involved. ----62 No. 92. A rupture often-times slips from beneath its truss or " comes down " from various hernia * *' causes and becomes "caught " so that it can not be returned. This condition places the ituuture. patient in pain, often intense, and likewise in great danger. If there is difficulty in reducing the hernia, proceed as follows: Place the patient in the position shown in Plate No. 23, immediately following, grasp the mass gently and make gentle pressure towards the abdomen in the direction from which the rupture seems to come. Don't be rough, work gently but persistently for some minutes. If your efforts fail make a large poultice of hops or bran and place over the part, or wring cloths from hot water and sprinkle them with laudanum and apply. In a few minutes try again. Repeat these proceedings several times and still failing have the surgeon quickly, keeping up the hot applications until he arrives. Fig. No. 23. REDUCTION OF HERNIA. (See No. 92, page 62.) -63 No. 93. If a large splinter or nail or any foreign body of any size should be driven into the 'oreign bodies, as flesh, you should not remove it but leave it for the doctor. The reason for this is that thorns, splinters, J nails, etc., in the many times the wound is poisoned from the object producing it being unclean and the wound should be thoroughly cleansed, kept open by drainage and made to heal from the bottom. Care as to this matter will absolutely prevent lockjaw and abscesses. Pack some cotton around the injured part to prevent the clothing rubbing it and see the doctor. ■64- No. 94. Note.:—Contents of an Emergency Box. The author suggests that the following rgcnc> Jox. articles be prepared and kept in any convenient box. They should be neatly packed and carefully labeled that they may be selected with celerity and certainty. You will be amply repaid for the slight trouble and expense necessary the first time an accident or emergency occurs in your household. i. ^ Six bandages rolled. These should be made from strips torn from an old but thoroughly clean sheet and should vary in width from one and one-half to three inches and should be the length of the sheet. They may then be very tightly and evenly rolled and kept wrapped in paper. 2. One dozen compresses. These may be made from both old muslin or linen and flannel (strictly clean). Tear into square pieces of different sizes and fold smoothly and neatly to several thicknesses. These should also be kept wrapped in clean paper to insure freedom from dust or dirt when needed. 3. An ounce of Borated Absorbent Cotton, from the drug store. 4. A package of Court or adhesive Plaster, from the drug store. This is always convenient for drawing together small superficial wounds. 5. Pins, common and safety. 6. A cake of Antiseptic Soap. 7. Four clean towels. 8. A good hot water bag with fouutain syringe attachments. (A substitute for the hot water bag may be secured by filling a quart self-sealer fruit jar with hot water and wrapping it in flannel). ----65 No. 94. 9. Mustard. Both in the form of the fllour and also the mustard leaves. These are the ready-made plasters requiring only wetting for instant use. Obtain at the drug store. 10. Two ounces of Turpentine. 11. Two ounces of Spirits of Camphor. 12. Two ounces of Syrup of Ipecac. 13. Two ounces of Carron Oil (equal parts of linseed oil and lime water) for burns and scalds. 14. One-half ounce of Laudanum, wrapped in red wrapper and labelled Laudanum, Poison, with dose. 15. Two ounces of Aromatic Spirits of Ammonia. 16. Eight ounces of best Whiskey. 17. Eight ounces of Epson Salts. 18. Two ounces of Castor Oil. 19. Four ounces of best Olive Oil. 20. Four ounces of best cider Vinegar (filtered). 21. Small bottle of common cooking Soda. 22. Package of Flax Seed Meal. 23. Package of Hops. To these may be added a good liniment, cough syrup, ointment, etc., procured of some physician. 66 PART SIX. SANITARY NOTES. To be brief, a large proportion of the "ills and natural shocks that flesh is heir to," are not an inherit- ance of the past, nor a natural necessity of the present. They are born of the conditions with which we surround ourselves. Pure air, pure food, pure water, and the avoidance of contamination by contact with foci of infection—these, with regular habits, comprise the laws of health. 67- Pure A.ir. It is obvious that in a little manual of this kind one cannot enter into details. The No. 95. author designs, however, calling your attention to the more common sources of a,r" impurities in the air. Each time a person of average size breathes there is taken into and exhaled from the lungs about twenty cubic inches of air. This is accomplished ordinarily about eighteen times to the minute, using three hundred and sixty cubic inches or about fifteen cubic feet of air per hour. This air when respired undergoes the following changes: It loses about one-twentieth its volume of oxygen gas, and gains carbon dioxide gas. It also gains vapor of water and ammonia and a small quantity of organic matter. As the organic matter rapidly decomposes and as carbon dioxide gas will not support life, the necessity of a careful scientific ventilation of living apartments is self- evident. Sunlight and fresh air should be freely admitted and the atmosphere in a sitting-room or bed-room should be at all times as pure and sweet as it is outside The slightest odor to a sensitive nostril is indicative of the presence of poisonous pro- ducts which will sooner or later sap the vitality of those long exposed to their noxious influ- ences. Another common source of impure air in living apartments is the poisonous gases— carbon monoxide and coal gas escaping from imperfect heaters. If stoves or hot air furnaces are used it must be required that the draught is perfect and the connections are tightly fitted. If the air in your sitting-room becomes oppressive, if you have a feeling of ----68---- No. 95. restlessness or lassitude, if you have a "stuffy" headache, raise all the windows, throw back your shoulders and fill your lungs five or six times with the pure cool air and note how quickly those symptoms will disappear. " Evil things love the dark " and from the putrid recesses of a foul vault, a defective kitchen sink, a choked or leaking drain, or an imperfect sewer trap, or from decom- posing vegetables or other organic matter in the cellar, or from heaps of refuse in alleys, or about the house, where perhaps a heavy flood of rain has deposited it, carried from a distant source, in short from anywhere where there is a deposit of organic matter, and God's free sun and air cannot penetrate, there are bred the demons of disease; and Divine Providence is asked to bear the blame resulting from the criminal carelessness of man. You will remember the story of the occupancy of New Orleans by Gen. Butler's army. The southrons said to him, " You are all right now but just wait until ' Yellow Jack' pays his annual visit." But while they were waiting for the fatal germs to awake to activity and smite the invading army, as the silent, swift, invisible arrows of Apollo smote with death the Grecian hosts before the walls of Troy, Gen. Butler cleaned up the city and there was no yellow fever that year. It was the triumph of science over super- stition; the science of cleanliness, which is the subject of my story: Secure from your physician or druggist such antiseptic solutions as they recommend and keep these sinks and drains and cesspools clean. Again, the germs producing the class of diseases known as malaria, of which inter- ----69---- No. 95. mittent fever is the type, thrive in damp soil. A pond of water is not dangerous if the e",um1, banks are steep, nor a stream of running water under similar conditions, but if there are sloping, muddy shores the miasm of malaria is there produced. Where there are many shade trees about a house the soil is kept damp and there germs will thrive and exercise their pernicious influence upon the dwellers therein. The best surroundings for a residence are well drained blue grass sward.s, and shade trees should not be planted so closely as to exclude the sunlight, and should be trimmed high enough to allow the "gentle zephyrs " to play hide and seek beneath their lower branches. You should request your physician as a part of his professional duty to assist in locating and removing all such possible sources of contamination as enumerated above. Pure Food. No. 96. The subject of pure food should be considered from two points of view, viz. : The t(*0lX- selection of an untainted or unadulterated article and the methods of its preparation. Both are equally important as the most expert cook could not make a palatable sample of coffee from chicory or clay-berries, and the finest of Mocha or Java may be spoiled. Again, while there are without question some joints of meat which are not fit for use, and no cook could make tender or palatable, the richest, juiciest cut from a mature animal ----70---- may be rendered indigestible and robbed of a great portion of its nutritive qualities by unscientific cooking. For instance for hundreds of years and possibly thousands invalids have been given beef tea made by chopping the meat and placing the fragments in a bottle, sealing the bottle presumably to retain the escaping strength, and placing the apparatus in a kettle of boiling water to simmer for some hours. The albumen of the meat is coagulated, the fibrous portion contracted, and the watery portions holding the salts in solution are expressed. This liquid, slightly stimulating but possessing no food value whatever, is then administered, and many a loved one has died of inanition and starvation while the anxious attendants fondly supposed they were administering the " ne plus ultra" of nutriments. The proper cooking of food is not only a health preserving measure but it is also a matter of pleasure and economy. The author would "therefore insist that a good cook- book is an absolutely indispensable article in the kitchen. For convenience of reference a few recipes are appended. See " Invalid Cookery." In the matter of food selection we cannot enter into discussion of specific adultera- tions. In many of the states "food commissions" are now publishing reports from which much information can be derived, and a suspicious article can be referred to your physician for examination. A few points, however, must be mentioned. From "measly'' beef or pork, eaten raw or imperfectly cooked, or more rarely from dried or uncooked fish from which the intestines have not been removed, are obtained the various forms of tape- worms. 7> No. 96. From pork imperfectly cooked is obtained the trichina spiralis. inued. From the meat of tubucular or lump-jawed cattle (consumptives) are contracted tubercular or consumptive diseases. Such meat is unfit for use, cooked or uncooked, and any person found dispensing such should be prosecuted to the fullest extent of the law. The same is true of animals with splenic fever, pleuro pneumonia, cow or sheep pox, in fact almost every disease to which animals are subject may be transmitted to man. Canned goods, whether meat or vegetable, sometimes have developed poisonous products, and should be discarded unless absolutely sweet and clean. Meats also soon become unfit for use after cooking, and should never be eaten if there can be detected the slightest stale taste or odor. Again, all fruits or vegetables eaten raw should be very thoroughly washed in pure water. The practice of green grocers or fruiters exposing their stock in open stalls allows them to become covered with the street dust, containing as it does, filth of almost every description, and loaded with the germs of any prevailing epidemic. Such articles as figs or dates are absolutely unfit for use after such exposure, unless after thorough washing and cooking. Another possible source of contamination of food with disease germs is through the interposition of the "green" or "blue-bottle" fly, which may divide his friendly attentions between any convenient mass of filth and your dinner roast. Perhaps no food product is responsible for as many ills as milk. Owing to its composition it is an almost perfect vehicle for the growth and development of a number No. 96. of the so-called pathological bacteria or disease germs. Milk from a hcaltJiy animal is aseptic or free from germs when drawn; but in a short time, a very few minutes in fact, under favorable conditions,it has caught from the air the spores of such infection as may be present, or has received contamination from dirty vessels in which it may have been placed. Diphtheria, scarlet fever, etc., have indubitably been so transmitted, and an epidemic started in the milkman's route. From a consumptive cow, the milk when drawn is already loaded with the bacilli of consumption, and liable to produce this dread disease. It is sometimes insiduous in its development and may exist a long time in a latent form before the health of the animal perceptibly deteriorates. The health of the family cow is so intimately associated with the general welfare of the family that no pains should be spared to feed her upon clean food and give her pure water and keep accurate observation as to her general condition. Dairy herds should be regularly inspected by one competent to discern latent disease and deal with it scientific- ally, while the utmost care should be taken to keep milk in a pure atmosphere, and in the very sweetest and cleanest containers. In doubt as to the successful accomplishment of these precautionary measures, the proper proceeding is to always bring the milk just before using to a temperature of 160 degrees, keeping it so for five minutes. Under certain conditions, not as yet exactly determined, milk and also cheese develops a very active poison called Tyrotoxicon. This is the fatal element in wholesale poisoning by ice cream sometimes reported. This is also the principal factor in the ----73 No. 96. causation of cholera infantum. When we come to consider the immense fatality among ,nu