|
No matter how nimble of foot, arm or body, how alert of mind, how superbly healthy one may be, one may easily make a false step, or repeat some unwise action once too often. Like the driver who secured the stage driving job over a mountain¬ous route in preference to others who boasted their ability to drive dangerously close to the edge of a precipice, you may be able to drive close to danger, but at the same time you should have sense enough to stay as fat away from it as possible. Your vitality may be at low ebb at the time you take yourunnecessary risk, so even though you may not be sent on your final long journey with speed and dispatch, you may not “pull through” so easily as you thought possible.
Even with the greatest of precaution and the best of health, accidents and disease may come upon one. Therefore, while avoiding worry, always be careful. It pays in the long run. The ex¬pression “It is better to be safe than sorry” has underlying it a great deal of wisdom.
FINAL WORD.—Health is one of the best safeguards against accidents and their consequences when incurred. A physically fit person possesses an alertness of mind and strength of muscle which often enables him to remove himself promptly from sources of danger; also, if he meet with an accident the processes of repair are so rapid that no great inconvenience may result from an injury that might other¬wise prove serious. Nevertheless, it is wise for everyone to keep out of danger. Some people may, in fact, tempt Fate in about every possible manner. Many escape injury, maim¬ing, sickness and death, sometimes miraculously, perhaps many times. This may so embolden them that they still more flagrantly disregard all rules of common sense and all laws of Nature and physics.
Human bites sometimes result seriously. There is no specific treatment for these wounds. They should be thor¬oughly cleansed, as should any other wounds, then a suitable dressing applied. A dressing wet with baking-soda solution is excellent.
A tourniquet should be applied immediately between the wound and the body (the hand or lower extremity being the part usually bitten). Any strap or stout cord, or a handker¬chief, may be used for the purpose. If the person bitten is alone the tourniquet may be tightened with a stick, which can then be tied with another hand (see Spanish Windlass Tourni¬quet under Hemorrhage). As with a dog-bite, the patient should suck the wound if possible, expectorating the blood, though if there is an open wound in the mouth this treatment should be avoided.
The bite should be incised (lanced) or cut out entirely before the sucking. The more bleeding the better, though the tourniquet will prevent free bleeding. The wound may be saturated with a mild solution of acetic acid, or equal parts of white vinegar and water (lemon juice will do); or it may be cauterized with the point of a white-hot iron; or gunpowder grains may be rubbed into it. The use of the white-hot iron is not so dreadful as might be imagined, for it is done instantly and may not hurt as much as an ordinary pinch. After the above local treatment the tourniquet may be loosened momentarily and again tightened, loosened again after a few moments and this releasing and tightening re¬peated. If the patient shows no symptoms of absorption, such as nausea, dizziness or faintness, the ligature may be loosened for gradually increasing periods until it can be removed entirely.
As soon as possible after these steps have been taken rapidly eliminative measures should be adopted. Alcohol is not the specific it was formerly considered, so should not be used, for it sometimes does much more harm than good. Hot water may be drunk copiously and hot enemas repeated several times. Fresh air and deep breathing are essential, and it is especially important that skin activity should be greatly accel¬erated by means of the full hot bath, hot-blanket pack, wet-sheet pack, or similar measures. If the patient becomes drowsy and the heart-action is appreciably decreased, fomen¬tations over the heart may be employed. If heart-failure seems likely the roots of the nerves governing the heart’s action may be stimulated by fomentations to the spine.
Snake-bites are not so invariably serious as a great manypeople believe. But there are several varieties of snakes whose bites are poisonous, and if neglected are likely to cause serious symptoms or prove fatal—sometimes, also, in spite of care. The bite of the Texas reptile called the gila monster is classed by some as fatally poisonous, yet by others is said not to be. While it may not be fatally poisonous, its bite is certainly as serious as that of the venomous snakes. The bite of a poi¬sonous snake shows the imprint of the teeth, outside of which appear fang punctures. The fang punctures are absent in bites from non-venomous snakes—but such snakes rarely bite, instinctively knowing that their defense does not lie in such a weapon as their teeth. The amount of poison injected and the kind of snake govern to a great extent the symptoms; but some patients have all the symptoms and yet recover.
Dog-bites occasionally result in hydrophobia, but this con¬dition is rare. Many dogs are killed because they have bitten humans without any proof that they have rabies (or lyssa). However, there is the possibility of the dog having the disease and transmitting it to any human or animal bitten by it. If the claws are contaminated from the animal’s saliva, scratches may produce the disease, as may the tongue, if it comes in contact with a break in the skin. If the bite or the scratch is received through clothing, infection is less likely than if direct, because the clothing wipes off most of the virus. It is doubtful if any case called hydrophobia in man that develops “months or years” after exposure is actual rabies due to the previous bite or scratch. Wrong living, or worry and imagi¬nation of the symptoms, may lead to the development of a con¬dition wrongly diagnosed as rabies.
The wound should be treated like any other penetrating or lacerated wound, which is by cleansing with antiseptic solu¬tion and sterile dressing. Lemon juice is said to be an excel¬lent antidote, hence may be used if there is any suspicion of rabies, or as a safe precautionary measure in any case. The wound may be swabbed with tincture of iodine if desired, and before this the patient himself, or someone else, may suck fairly vigorously on the wound, spitting out all blood ex¬tracted and then rinsing the mouth well with boracic-acid solution or lemon juice. A tourniquet may be used on an ex¬tremity, placed between the wound and the heart. Vigorous eliminative treatment, together with proper care of the wound, will practically always prevent further trouble. \
Those who are inclined to worry about the possibility of the gravest trouble and who still cling to a fairly firm belief in the efficacy of strange or powerful drugs or medicaments may consider the use of anti-rabies serum if they wish. But in our opinion it should be avoided. Some patients, however, who have been treated by this method have died, while others bitten by the same animals but not treated have continued to / live.
Poisoned wounds, as meant here, are those produced by the bites of animals, humans or snakes. Insect bites are con¬sidered under Stings and Insect Bites.
In treating gunshot wounds never probe for the missiles. Merely swab the entrance and exit wounds with an antiseptic solution, such as iodine tincture, and apply sterile dressing, Lockjaw sometimes results from these wounds. All cases should be cared for by a physician or a surgeon. The tend¬ency of doctors, however, is to give anti-tetanus serum for all gunshot wounds, as well as for all other wounds with any likelihood of becoming infected. If one maintains a clean blood-stream by good elimination, eats moderately and cor¬rectly and drinks copiously of plain water, and as soon as practicable exposes wounds to sunlight or artificial sunlight, it is not likely that there usually will be any serious con¬sequences from them.
In punctured wounds of the chest the wound should becleansed with an antiseptic solution, then covered with a fairly thick pad of gauze and the chest strapped with overlapping layers of adhesive tape extending around the injured side from the center of the back to the center of the chest. The patient most likely will lie on his injured side, but the head and shoulders should be slightly raised. In punctured wounds involving the heart there is grave danger of immediate death, though some patients survive the injury. If the knife or other instrument is still in the wound, leave it there, as it may be serving the purpose of a plug, preventing fatal or grave hemorrhage. Elevate the head and shoulders and see that the patient is comfortable, then await the doctor. (For wounds of the abdomen, the reader is referred to Abdomen, Wounds of.)
Gunshot wounds may be due to shetgrin, rifle, pistol (re¬volver) , or shrapnel. As the missile enters the body it is likely to carry with it foreign bodies, in the form of pieces of cloth¬ing or dirt, causing infection. The injuries produced within the body are the chief danger in these wounds, though often the missiles penetrate to considerable depth, or even perforate the body, without causing destruction of any vital structure. This accounts for the fact that the initial hemorrhage is rarely of any importance. The wound of exit should be looked for. If found it will be seen to be much greater in extent than the entrance wound, and an ugly laceration. Wounds caused by blank cartridges are burned contusions, deep within which is the wad from the cartridge.
In case of punctured wounds, including stab wounds, it is important that, when possible, the object causing the wound be inspected to determine if part of it has remained in the wound, as frequently happens in case of splinter and needle wounds (see Splinters). In this case the object is likely to work in further, or to migrate through the tissues. If the foreign body is such as to require surgical assistance antiseptic precautions are advisable pending skilled treatment. Many small punctured wounds are of little importance. After re¬moving the foreign body assist the wound to bleed for a while, then touch it with tincture of iodine, mercurochrome, or alco¬hol, or bathe in a boracic-acid solution and dress or not accord¬ing to its nature, severity and location.
If these simple wounds have evidently been contaminated, as by a rusty nail, an unclean sliver of wood or a stable fork, a doctor should give expert care; but if he cannot’be secured, the wound should be treated with a strong germicidal anti¬septic, applied on a cotton swab made by twisting a tuft of cotton around the end of a toothpick or similar small object that is not smooth, after which a wet alcohol dressing should be applied. In applying strong carbolic acid solutions all ex¬cess of the acid should first be pressed out from the swab em¬ployed against the neck of the bottle, and it should not be used unless alcohol is available for use immediately afterward.
— Next Page »
|
|