The Home Medical Library Volume I Part 13

=Treatment.=--The hair should be cut short when permissible. Any crusts on the head should be softened by the application of sweet oil, and then removed by washing in soap and warm water. Petroleum or kerosene is a good remedy. It must be rubbed on the head two successive nights, the head being covered by a cap, and washed off each morning with hot water and soap. The patient must be cautioned not to approach an open flame after kerosene has been put on his head.

The eggs or "nits" are next to be attacked with vinegar, which is sponged on the hair and the fine-tooth comb plied daily for a week.

The remaining irritation of the scalp can be cured by washing the head daily and applying sweet oil.

A simpler plan consists of drenching hair and scalp twice with cold infusion of (poisonous) larkspur seed, made by steeping for an hour an ounce of the seed in six ounces of hot water.

This treatment will destroy both insects and eggs. After twenty-four hours the hair and scalp must be shampooed with warm water thoroughly.

=CLOTHES LICE.=--These insects are a trifle larger than the head lice, being one-twelfth to one-eighth inch long, of a dirty, yellowish-gray color, and only infesting the most filthy people. The lice are generally only seen on the clothes, where they live, coming out on the body only to feed. The visible signs on the body are varying degrees of irritation from redness to ulceration, due to scratching. The treatment is simply cleanliness of the body and clothes.

=CRAB LICE.=--The crab louse or "crab" inhabits the skin covered by hair about and above the s.e.xual organs most frequently, and from thence spreads to the hairy region on the abdomen, chest, armpits, beard, and eye lashes. Itching and scratching first call attention to the presence of the parasites, which are even more troublesome than the other species.

Application of kerosene to the part is sufficient to kill the lice, but this treatment must be repeated several times at intervals of a week, in order to kill the parasites subsequently hatched.

=FLEA.=--Flea bites are recognized by the itching caused by the poison introduced by the insect, and by points of dried blood surrounded for a little while by a red zone. In the case of children and people with delicate skins, red or white lumps appear resembling nettlerash.

Generally the skin is simply covered with minute, red points, perhaps raised a little by swelling above the surface, and when very numerous may remotely resemble the rash of measles. Fleas, unlike lice, do not breed on the body, but as soon as they are satiated leave their host.

Their eggs are laid in cracks in floors, on dirty clothes and similar spots, and it is only the mature flea which preys upon man. The human flea may infest the dog and return to man, but the dog flea is a distinct species, and never remains permanently on the human host. For these reasons it is not difficult to get rid of fleas after they have attacked the body, unless continually surrounded by them.

=JIGGER OR SAND FLEA.=--Also called chique, chigo, and nigua. It is common in Cuba, Porto Rico, and Brazil. About one-half the size of the ordinary flea, it is of a brownish-red color with a white spot on the back. The female lives in the sand and attacks man, on whom she lives, boring into the skin about the toe nail, usually, and laying her eggs under the skin, which gives rise to itching at first and then violent pain. The insect sucks blood and grows as it gorges itself, producing a white swelling of the skin in the center of which is seen a black spot, the front part of the flea. The flea after expelling its eggs drops off and dies. People with habitually sweaty feet are exempt from attacks of the pest.

Unless the flea is unattached, one must either wait until the insect comes away of its own free will, or remove it with a red-hot needle in order to destroy the eggs. The negroes peel the skin from the swelling with a needle and squeeze out the eggs. Ordinarily the bites do no permanent injury, but occasionally if numerous, or if the insect is pressed into the skin in the efforts to remove it, or if sores resulting from bites are neglected, then violent inflammation, great pain, and even death of the part may result. Sound shoes and a night and morning inspection of the feet will protect against the inroads of the sand fleas.

=FLIES.=--The common housefly does not bite, but is constantly inimical to human health by conveying disease germs of typhoid fever, cholera, and other disorders from bowel discharges of patients suffering from these diseases to articles of food on which the insects light. Flies have been a fruitful source of sickness in military camps, as evidenced in the recent Spanish-American and Anglo-African campaigns. The bites of the sandfly, gadfly, and horsefly may be both relieved and prevented by the same means recommended in the case of mosquitoes for these purposes.

=SCORPION OR CENTIPEDE STING.=

_First Aid Rule.--Squeeze lemon juice on wound._

=SPIDER OR TARANTULA BITE.=

_First Aid Rule.--Pour water of ammonia on bite. If patient is depressed, give strong coffee._

=SCORPIONS AND CENTIPEDES.=--These both inhabit the tropics and semitropical regions, and lurk in dark corners and out-of-the-way places, crawling into the boots and clothing during the night.

Scorpions sting with their tails, which are brought over the head and back for the purpose, while holding on to the victim with their lobsterlike claws. The poisonous centipede has a flattened brownish-yellow body, with a single pair of short legs for each body segment, and long, many-jointed antennae.

The wounds made by either of these pests are rarely dangerous, except in young children and those in feeble health. The stings are usually relieved by bathing with a two per cent solution of carbolic acid, with rum, or with lemon juice.

=SPIDERS.=--Many of the tropical spiders bite the human being.

Trapdoor spiders are among the commonest of these pests. Their bodies grow to great size, two to two and a half inches long, and are covered with hair giving them a horrid appearance. They live in holes bored in the ground, and provided with a trapdoor contrivance which is closed when the insect is at home.

The trapdoor spider resembles the tarantula, by which name it is usually known in Cuba and Jamaica, but is somewhat smaller and commoner. Neither the stings of the trapdoor spider nor true tarantula are usually dangerous although the wounds caused by the bites may heal slowly.

Application of water of ammonia and of the other remedies recommended for mosquito bites (p. 158) are indicated here, and if the patient is generally depressed by the poison, strong coffee forms a good antidote.

=SNAKE BITE.=

_First Aid Rule 1.--Make the wound bleed. Cut slit through the wound, lengthwise of limb, two inches long and half an inch deep. Squeeze tissues._ DO NOT SUCK THE WOUND.

_Rule 2.--Keep poison out of general circulation. Tie large cord or bandage tightly about part between wound and heart. Loosen in fifteen minutes._

_Rule 3.--Use antidote. Wash wound and cut with fresh solution of chloride of lime (one part to sixty parts of water). Inject anti-venene with hypodermic syringe, ten cubic centimeters, as on label. Or, inject with hypodermic syringe thirty minims of solution of permanganate of potash (five grains to two ounces of water), three times in different places. If no syringe at hand, pour permanganate solution into wound._

_Rule 4.--Support heart if weak. Inject with hypodermic syringe one-thirtieth grain of sulphate of strychnine into leg. Repeat as needed every thirty minutes with caution._

_Rule 5.--Give no whisky or other liquor. Do not burn the wound._

=SNAKE BITE.=--There are many different species of poisonous snakes in the United States. The more common are the rattlesnake, the moccasin, the copperhead, and the common viper.

All the venomous snakes have certain characteristics by which they may be distinguished from their harmless brethren. The head is generally broad and flat and of a triangular shape, the wide, heavy jaws tapering to a point at the lips. There is a depression or pit between the nostril and eye on the upper lip, hence the name "pit vipers"

given to poisonous snakes. The pupil of the eye is long and vertical, of an oval or elliptical shape.

Venomous snakes are thicker in proportion to their length than harmless snakes, the surface of their bodies is rougher, and their tails are blunt or club-shaped. Conversely, harmless snakes possess long narrow heads, the pupils of their eyes are round, not vertical slits, and their bodies are not thick for their length, but long and slim with pointed tails. The bite of vipers of all kinds is much more poisonous in tropical regions, and in the North fatal snake bite is a rare occurrence.

If there is a doubt whether a snake is poisonous, the neck may be pressed down against the ground between the jaws of a forked stick, and the poison fangs looked for without danger. These hang directly down from the front part of the upper jaw, or are thrust horizontally forward just in front of the upper lip, and may drip saliva and venom.

In Cuba and Porto Rico there is a viper called Juba, or Boaquira, which is a counterpart of the Northern rattlesnake, and the most poisonous of the many species in that region. Among venomous species of the Philippines are two boas and also a viper from nine to ten feet long, which exceptionally pursues and attacks man. This snake is easily killed by a blow on the neck. Another small viper with a club-shaped tail, inhabiting these islands, is nocturnal in its habits, and may get into boots at night. Boots, therefore, should always be inspected before one puts them on in the morning.

Usually it is only the young, old, and weak who succ.u.mb to snake bite.

=Symptoms.=--The symptoms of snake bite of all poisonous species are similar. At first there is some pain in the wound, which rapidly increases together with swelling and discoloration until death of the part may ensue. The vital centers in the brain controlling the heart and breathing apparatus, are paralyzed by the poison. There is often drowsiness and stupor, and the breathing is labored and the pulse weak and irregular, with faintness and cold sweats.

=Treatment.=--The treatment consists first in keeping the poison out of the general blood stream. With this purpose in view a handkerchief, piece of cotton clothing, string, or strap should be immediately wound about the bitten limb above the wound, between it and the heart. This will r.e.t.a.r.d absorption of the poison only for a time; it is said twenty-five minutes. The knife is the most effective means of removing the poison by making an oval cut on each side of the wound so that the two incisions meet and remove all the flesh below and around the wound. Bleeding should be encouraged to drain out the poison. The skin containing the wound may be lifted up, and the whole wound cut out by one snip of the scissors where this is practicable.

Some advocate burning out the wound with a red-hot wire, or darning needle, instead of cutting, but the treatment is less effective and more painful. Rambaud forbids burning. As to the general condition: if stupor is a prominent symptom the patient must be made to move about and exercise to keep alive his nerve centers. Otherwise one tablespoonful of whisky may be given in half a cup of hot water hourly, to sustain the weakened heart and respiration until recovery ensues.

The most effective treatment, according to Dr. George Rambaud, Director of the Pasteur Inst.i.tute of New York City, is thorough washing of the wound (after it has been opened with the knife) with freshly prepared solution of chloride of lime, in the proportion of one part of lime to sixty of water. The burning of a wound is bad practice. If necessary, chloride-of-lime solution should be injected into the tissues around the wound. One about to go into a place where the most venomous snakes are found should inject into himself a dose of Calmette's antivenomous serum every two or three weeks as a means of prevention. If the serum is used, whisky should not be given in the treatment of one who has been bitten, for the anti-venene is a powerful cell stimulator.

Calmette, the Director of the Pasteur Inst.i.tute in Lille, France, several years ago discovered antivenomous serum. That serum is efficient for the bites of most of the venomous snakes of different countries, including the rattlesnake, cobra, python, etc.

It is prepared in the dry form so that it can be carried easily, and will keep almost indefinitely. The proper course to be followed by persons going into countries infested by venomous snakes is always to have on hand a few doses of it. Its value has been positively demonstrated within the last few years in India, where it is used in the British Army, as well as in other countries.

In the fluid form it should be used hypodermically, a dose of ten cubic centimeters being injected within eighty or ninety minutes of the reception of the poison.

=DOG BITE OR CAT BITE.= (See Hydrophobia, Vol. V, p. 264.)

_First Aid Rule 1.--Make sure animal is mad. Send patient to Pasteur inst.i.tute if one is within reach._