A Practical Physiology Part 41

This is done usually as follows: Seize the lashes between the thumb and forefinger, and draw the edge of the lid away from the eyeball. Now, telling the patient to look down, press a slender lead-pencil or penholder against the lid, parallel to and above the edge, and then pull the edge up, and turn it over the pencil by means of the lashes.

The eye is now readily examined, and usually the foreign body is easily seen and removed. Do not increase the trouble by rubbing the eye after you fail, but get at once skilled help. After the substance has been removed, bathe the eye for a time with hot water.

If lime gets into the eye, it may do a great amount of mischief, and generally requires medical advice, or permanent injury will result. Until such advice can be had, bathe the injured parts freely with a weak solution of vinegar and hot water.

374. Broken Bones. Loss of power, pain, and swelling are symptoms of a broken bone that may be easily recognized. Broken limbs should always be handled with great care and tenderness. If the accident happens in the woods, the limb should be bound with handkerchiefs, suspenders, or strips of clothing, to a piece of board, pasteboard, or bark, padded with moss or gra.s.s, which will do well enough for a temporary splint. Always put a broken arm into a sling after the splints are on.

[Ill.u.s.tration: Fig. 162.--Showing how an Umbrella may be used as a Temporary Splint in Fracture of the Leg.]

Never move the injured person until the limb is made safe from further injuries by putting on temporary splints. If you do not need to move the person, keep the limb in a natural, easy position, until the doctor comes.

Remember that this treatment for broken bones is only to enable the patient to be moved without further injury. A surgeon is needed at once to set the broken bone.

[Ill.u.s.tration: Fig. 163.--Showing how a Pillow may be used as a Temporary Splint in Fracture of the Leg.]

375. Fainting. A fainting person should be laid flat at once. Give plenty of fresh air, and dash cold water, if necessary, on the head and neck. Loosen all tight clothing. Smelling-salts may be held to the nose, to excite the nerves of sensation.

376. Epileptic and Hysterical Fits, Convulsions of Children.

Sufferers from "fits" are more or less common. In _epilepsy_, the sufferer falls with a peculiar cry; a loss of consciousness, a moment of rigidity, and violent convulsions follow. There is foaming at the mouth, the eyes are rolled up, and the tongue or lips are often bitten. When the fit is over the patient remains in a dazed, stupid state for some time. It is a mistake to struggle with such patients, or to hold them down and keep them quiet. It does more harm than good.

See that the person does not injure himself; crowd a pad made from a folded handkerchief or towel between the teeth, to prevent biting of the lips or tongue. Do not try to make the sufferer swallow any drink.

Unfasten the clothes, especially about the neck and chest. Persons who are subject to such fits should rarely go out alone, and never into crowded or excited gatherings of any kind.

_Hysterical fits_ almost always occur in young women. Such patients never bite their tongue nor hurt themselves. Placing a towel wrung out in cold water across the face, or dashing a little cold water on the face or neck, will usually cut short the fit, speaking firmly to the patient at the same time. Never sympathize too much with such patients; it will only make them a great deal worse.

377. Asphyxia. Asphyxia is from the Greek, and means an "absence of pulse." This states a fact, but not the cause. The word is now commonly used to mean _suspended animation_. When for any reason the proper supply of oxygen is cut off, the tissues rapidly load up with carbon dioxid. The blood turns dark, and does not circulate. The healthy red or pink look of the lips and finger-nails becomes a dusky purple. The person is suffering from a lack of oxygen; that is, from asphyxia, or suffocation.

It is evident there can be several varieties of asphyxia, as in apparent drowning, strangulation and hanging, inhalation of gases, etc.

The first and essential thing to do is to give fresh air. Remove the person to the open air and place him on his back. Remove tight clothing about the throat and waist, dash on cold water, give a few drops of ammonia in hot water or hot ginger tea. Friction applied to the limbs should be kept up. If necessary, use artificial respiration by the Sylvester method (sec. 380).

The chief dangers from poisoning by noxious gases come from the fumes of burning coal in the furnace, stove, or range; from "blowing out" gas, turning it down, and having it blown out by a draught; from the foul air often found in old wells; from the fumes of charcoal and the foul air of mines.

378. Apparent Drowning. Remove all tight clothing from the neck, chest, and waist. Sweep the forefinger, covered with a handkerchief or towel, round the mouth, to free it from froth and mucus. Turn the body on the face, raising it a little, with the hands under the hips, to allow any water to run out from the air pa.s.sages. Take only a moment for this.

Lay the person flat upon the back, with a folded coat, or pad of any kind, to keep the shoulders raised a little. Remove all the wet, clinging clothing that is convenient. If in a room or sheltered place, strip the body, and wrap it in blankets, overcoats, etc. If at hand, use bottles of hot water, hot flats, or bags of hot sand round the limbs and feet. Watch the tongue: it generally tends to slip back, and to shut off the air from the glottis. Wrap a coa.r.s.e towel round the tip of the tongue, and keep it well pulled forward.

The main thing to do is to keep up artificial respiration until the natural breathing comes, or all hope is lost. This is the simplest way to do it: The person lies on the back; let some one kneel behind the head.

Grasp both arms near the elbows, and sweep them upward above the head until they nearly touch. Make a firm pull for a moment. This tends to fill the lungs with air by drawing the ribs up, and making the chest cavity larger. Now return the arms to the sides of the body until they press hard against the ribs. This tends to force out the air. This makes artificially a complete act of respiration. Repeat this act about fifteen times every minute.

[Ill.u.s.tration: Fig. 164.--The Sylvester Method. (First movement--inspiration.)]

All this may be kept up for several hours. The first sign of recovery is often seen in the slight pinkish tinge of the lips or finger-nails. That the pulse cannot be felt at the wrist is of little value in itself as a sign of death. Life may be present when only the most experienced ear can detect the faintest heart-beat.

When a person can breathe, even a little, he can swallow. Hold smelling-salts or hartshorn to the nose. Put one teaspoonful of the aromatic spirits of ammonia, or even of ammonia water, into a half-gla.s.s of hot water, and give a few teaspoonfuls of this mixture every few minutes. Meanwhile do not fail to keep up artificial warmth in the most vigorous manner.

379. Methods of Artificial Respiration. There are several well-established methods of artificial respiration. The two known as the Sylvester and the Marshall Hall methods are generally accepted as efficient and practical.

[Ill.u.s.tration: Fig. 165.--The Sylvester Method. (Second movement--expiration.)]

380. The Sylvester Method. The water and mucus are supposed to have been removed from the interior of the body by the means above described (sec. 378).

The patient is to be placed on his back, with a roll made of a coat or a shawl under the shoulders; the tongue should then be drawn forward and retained by a handkerchief which is placed across the extended organ and carried under the chin, then crossed and tied at the back of the neck. An elastic band or small rubber tube or a suspender may be used for the same purpose.

The attendant should kneel at the head and grasp the elbows of the patient and draw them upward until the hands are carried above the head and kept in this position until one, two, three, can be slowly counted.

This movement elevates the ribs, expands the chest, and creates a vacuum in the lungs into which the air rushes, or in other words, the movement produces _inspiration_. The elbows are then slowly carried downward, placed by the side, and pressed inward against the chest, thereby diminishing the size of the latter and producing _expiration_.

These movements should be repeated about fifteen times each minute for at least two hours, provided no signs of animation show themselves.

381. The Marshall Hall Method. The patient should be placed face downwards, the head resting on the forearm with a roll or pillow placed under the chest; he should then be turned on his side, an a.s.sistant supporting the head and keeping the mouth open; after an interval of two or three seconds, the patient should again be placed face downward and allowed to remain in this position the same length of time. This operation should be repeated fifteen or sixteen times each minute, and continued (unless the patient recovers) for at least two hours.

[Ill.u.s.tration: Fig. 166.--The Marshall Hall Method. (First position.)]

If, after using one of the above methods, evidence of recovery appears, such as an occasional gasp or muscular movement, the efforts to produce artificial respiration must not be discontinued, but kept up until respiration is fully established. All wet clothing should then be removed, the patient rubbed dry, and if possible placed in bed, where warmth and warm drinks can be properly administered. A small amount of nourishment, in the form of hot milk or beef tea, should be given, and the patient kept quiet for two or three days.

[Ill.u.s.tration: Fig. 167.--The Marshall Hall Method. (Second position.)]

382. Sunstroke or Heatstroke. This serious accident, so far-reaching oftentimes in its result, is due to an unnatural elevation of the bodily temperature by exposure to the direct rays of the sun, or from the extreme heat of close and confined rooms, as in the cook-rooms and laundries of hotel bas.e.m.e.nts, from overheated workshops, etc.

There is sudden loss of consciousness, with deep, labored breathing, an intense burning heat of the skin, and a marked absence of sweat. The main thing is to lower the temperature. Strip off the clothing; apply chopped ice, wrapped in flannel to the head. Rub ice over the chest, and place pieces under the armpits and at the sides. If there is no ice, use sheets or cloths wet with cold water. The body may be stripped, and sprinkled with ice-water from a common watering-pot.

If the skin is cold, moist, or clammy, the trouble is due to heat exhaustion. Give plenty of fresh air, but apply no cold to the body. Apply heat, and give hot drinks, like hot ginger tea. Sunstroke or heatstroke is a dangerous affliction. It is often followed by serious and permanent results. Persons who have once suffered in this way should carefully avoid any risk in the future.

Chapter XIV.

In Sickness and in Health.

383. Arrangement of the Sick-room. This room, if possible, should be on the quiet and sunny side of the house. Pure, fresh air, sunshine, and freedom from noise and odor are almost indispensable. A fireplace as a means of ventilation is invaluable. The bed should be so placed that the air may get to it on all sides and the nurse move easily around it.

Screens should be placed, if necessary, so as to exclude superfluous light and draughts.

The sick-room should be kept free from all odors which affect the sick unpleasantly, as perfumery, highly scented soaps, and certain flowers.

Remove all useless ornaments and articles likely to collect dust, as unnecessary pieces of furniture and heavy draperies. A clean floor, with a few rugs to deaden the footsteps, is much better than a woolen carpet.

Rocking-chairs should be banished from the sick-room, as they are almost sure to disturb the sick.

A daily supply of fresh flowers tends to brighten the room. Keep the medicines close at hand, but all poisonous drugs should be kept carefully by themselves and ordinarily under lock and key. A small table should be placed at the bedside, and on it the bell, food tray, flowers and other small things which promote the comfort of the patient.

The nurse should not sleep with the patient. Sofas and couches are not commonly comfortable enough to secure needed rest. A cot bed is at once convenient and inexpensive, and can be readily folded and put out of sight in the daytime. It can also be used by the patient occasionally, especially during convalescence.

384. Ventilation of the Sick-room. Proper ventilation is most essential to the sick-room, but little provision is ordinarily made for so important a matter. It is seldom that one of the windows cannot be let down an inch or more at the top, a screen being arranged to avoid any draught on the patient. Remove all odors by ventilation and not by spraying perfumery, or burning pastilles, which merely conceal offensive odors without purifying the air. During cold weather and in certain diseases, the patient may be covered entirely with blankets and the windows opened wide for a few minutes.

Avoid ventilation by means of doors, for the stale air of the house, kitchen smells, and noises made by the occupants of the house, are apt to reach the sick-room. The entire air of the room should be changed at least two or three times a day, in addition to the introduction of a constant supply of fresh air in small quant.i.ties.

385. Hints for the Sick-room. Always strive to look cheerful and pleasant before the patient. Whatever may happen, do not appear to be annoyed, discouraged, or despondent. Do your best to keep up the courage of sick persons under all circ.u.mstances. In all things keep in constant mind the comfort and ease of the patient.