Use of the Tourniquet
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.