The Book of Household Management Part 268

2569. _Symptoms_.--Languor and restlessness, hoa.r.s.eness, wheezing, and short, dry cough, with occasional rattling in the throat during sleep, the child often plucking at its throat with its fingers; difficulty of breathing, which quickly becomes hard and laboured, causing great anxiety of the countenance, and the veins of the neck to swell and become knotted; the voice in speaking acquires a sharp, crowing, or croupy sound, while the inspirations have a harsh, metallic intonation.

After a few hours, a quant.i.ty of thick, ropy mucus is thrown out, hanging about the mouth, and causing suffocating fits of coughing to expel.

2570. Treatment.--Place the child immediately in a hot bath up to the throat; and, on removal from the water, give an emetic of the antimonial or ipecacuanha wine, and, when the vomiting has subsided, lay a long blister down the front of the throat, and administer one of the following powders every twenty minutes to a child from three to six years of age.

2571. Take of calomel, 12 grains; tartar emetic, 2 grains; lump sugar, 30 grains. Mix accurately, and divide into 12 powders. For a child from six to twelve years, divide into 6 powders, and give one every half-hour.

2572. Should the symptoms remain unabated after a few hours, apply one or two leeches to the throat, and put mustard poultices to the foot and thighs, retaining them about eight minutes; and, in extreme cases, a mustard poultice to the spine between the shoulders, and at the same time rub mercurial ointment into the armpits and the angles of the jaws.

2573. Such is a vigorous and reliable system of treatment in severe cases of croup; but, in the milder and more general form, the following abridgment will, in all probability, be all that will be required:--First, the hot bath; second, the emetic; third, a mustard plaster round the throat for five minutes; fourth, the powders; fifth, another emetic in six hours, if needed, and the powders continued without intermission while the urgency of the symptoms continues. When relief has been obtained, these are to be discontinued, and a dose of senna tea given to act on the bowels.

Diarrhoea.

2574. The diarrhoea with which children are so frequently affected, especially in infancy, should demand the nurse's immediate attention, and when the secretion, from its clayey colour, indicates an absence of bile, a powder composed of 3 grains of grey powder and 1 grain of rhubarb, should be given twice, with an interval of four hours between each dose, to a child from one to two years, and, a day or two afterwards, an aperient powder containing the same ingredients and quant.i.ties, with the addition of 2 or 3 grains of scammony. For the relaxation consequent on an overloaded stomach, or acidity in the bowels, a little magnesia dissolved in milk should be employed two or three times a day.

2575. When much griping and pain attend the diarrhoea, half a teaspoonful of Dalby's Carminative (the best of all patent medicines) should be given, either with or without a small quant.i.ty of castor oil to carry off the exciting cause.

2576. For any form of diarrhoea that, by excessive action, demands a speedy correction, the most efficacious remedy that can be employed in all ages and conditions of childhood is the tincture of Kino, of which from 10 to 30 drops, mixed with a little sugar and water in a spoon, are to be given every two or three hours till the undue action has been checked. Often the change of diet to rice, milk, eggs, or the subst.i.tution of animal for vegetable food, or _vice versa_, will correct an unpleasant and almost chronic state of diarrhoea.

2577. A very excellent carminative powder for flatulent infants may be kept in the house, and employed with advantage, whenever the child is in pain or griped, by dropping 5 grains of oil of aniseed and 2 of peppermint on half an ounce of lump sugar, and rubbing it in a mortar, with a drachm of magnesia, into a fine powder. A small quant.i.ty of this may be given in a little water at any time, and always with benefit.

THE DOCTOR.

CHAPTER XLIII.

2578. "Time," according to the old proverb, "is money;" and it may also, in many cases, and with equal truthfulness, be said to be life; for a few moments, in great emergencies, often turn the balance between recovery and death. This applies more especially to all kinds of poisoning, fits, submersion in water, or exposure to noxious gases; and many accidents. If people knew how to act during the interval that must necessarily elapse from the moment that a medical man is sent for until he arrives, many lives might be saved, which now, unhappily, are lost.

Generally speaking, however, nothing is done--all is confusion and fright; and the surgeon, on his arrival, finds that death has already seized its victim, who, had his friends but known a few rough rules for their guidance, might have been rescued. We shall, therefore, in a series of papers, give such information as to the means to be employed in event of accidents, injuries, &c., as, by the aid of a gentleman of large professional experience, we are warranted in recommending.

List of Drugs, &c., necessary to carry out all Instructions.

2579. We append at once A LIST OF DRUGS, &c., and a few PRESCRIPTIONS necessary to carry out all the instructions given in this series of articles. It will be seen that they are few--they are not expensive; and by laying in a little stock of them, our instructions will be of instant value in all cases of accident, &c.--The drugs are--Antimonial Wine.

Antimonial Powder. Blister Compound. Blue Pill. Calomel. Carbonate of Potash. Compound Iron Pills. Compound Extract of Colocynth. Compound Tincture of Camphor. Epsom Salts. Goulard's Extract. Jalap in Powder.

Linseed Oil. Myrrh and Aloes Pills. Nitre. Oil of Turpentine. Opium, powdered, and Laudanum. Sal Ammoniac. Senna Leaves. Soap Liniment, Opodeldoc. Sweet Spirits of Nitre. Turner's Cerate.--To which should be added: Common Adhesive Plaster. Isingla.s.s Plaster. Lint. A pair of small Scales with Weights. An ounce and a drachm Measure-gla.s.s. A Lancet. A Probe. A pair of Forceps, and some curved Needles.

2580. The following PRESCRIPTIONS may be made up for a few s.h.i.+llings; and, by keeping them properly labelled, and by referring to the remarks on the treatment of any particular case, much suffering, and, perhaps, some lives, may be saved.

2581. _Draught_.--Twenty grains of sulphate of zinc in an ounce and a half of water. This draught is to be repeated in a quarter of an hour if vomiting does not take place.

2582. _Clyster_.--Two tablespoonfuls of oil of turpentine in a pint of warm gruel.

2583. _Liniments_.--1. Equal parts of lime-water and linseed-oil well mixed together. [Lime-water is made thus: Pour 6 pints of boiling water upon 1/4 lb. of lime; mix well together, and when cool, strain the liquid from off the lime which has fallen to the bottom, taking care to get it as clear as possible.] 2. Compound camphor liniment.

2584. _Lotions_.--1. Mix a dessert-spoonful of Goulard's extract and 2 tablespoonfuls of vinegar in a pint of water.--2. Mix 1/2 oz. of sal-ammoniac, 2 tablespoonfuls of vinegar, and the same quant.i.ty of gin or whisky, in half a pint of water.

2585. _Goulard Lotion_.--1 drachm of sugar of lead, 2 pints of rain-water, 2 teaspoonfuls of spirits of wine. For inflammation of the eyes or elsewhere:--The better way of making Goulard Lotion, if for the eyes, is to add to 6 oz. of distilled water, or water that has been well boiled, 1 drachm of the extract of lead.

2586. _Opodeldoc_.--This lotion being a valuable application for sprains, lumbago, weakness of joints, &c., and it being difficult to procure either pure or freshly made, we give a recipe for its preparation. Dissolve 1 oz. of camphor in a pint of rectified spirits of wine; then dissolve 4 oz. of hard white Spanish soap, sc.r.a.ped thin, in 4 oz. of oil of rosemary, and mix them together.

2587. _The Common Black Draught_.--Infusion of senna 10 drachms; Epsom salts 10 drachms; tincture of senna, compound tincture of cardamums, compound spirit of lavender, of each 1 drachm. Families who make black draught in quant.i.ty, and wish to preserve it for some time without spoiling, should add about 2 drachms of spirits of hartshorn to each pint of the strained mixture, the use of this drug being to prevent its becoming mouldy or decomposed. A simpler and equally efficacious form of black draught is made by infusing 1/2 oz. of Alexandrian senna, 3 oz. of Epsom salts, and 2 drachms of bruised ginger and coriander-seeds, for several hours in a pint of boiling water, straining the liquor, and adding either 2 drachms of sal-volatile or spirits of hartshorn to the whole, and giving 3 tablespoonfuls for a dose to an adult.

2588. _Mixtures_--1. _Aperient_.--Dissolve an ounce of Epsom salts in half a pint of senna tea: take a quarter of the mixture as a dose, and repeat it in three or four hours if necessary.

2589. 2. _Fever Mixture_.--Mix a drachm of powdered nitre, 2 drachms of carbonate of potash, 2 teaspoonfuls of antimonial wine, and a tablespoonful of sweet spirits of nitre, in half a pint of water.

2590. 3. _Myrrh and Aloes Pills_.--Ten grains made into two pills are the dose for a full-grown person.

2591. 4. _Compound Iron Pills_.--Dose for a full-grown person: 10 grains made into two pills.

2592. _Pills_.--1. Mix 5 grains of calomel and the same quant.i.ty of antimonial powder with a little bread-crumb, and make into two pills.

Dose for a full-grown person: two pills.--2. Mix 5 grains of blue pill and the same quant.i.ty of compound extract of colocynth together, and make into two pills, the dose for a full-grown person.

2593. _Powders_.--Mix a grain of calomel and 4 grains of powdered jalap together.

2594. In all cases, the dose of medicines given is to be regulated by the age of the patient.

2595. _Abernethy's Plan for making a Bread-and-Water Poultice_.--First scald out a basin; then having put in some boiling water, throw in coa.r.s.ely-crumbled bread, and cover it with a plate. When the bread has soaked up as much water as it will imbibe, drain off the remaining water, and there will be left a light pulp. Spread it a third of an inch thick on folded linen, and apply it when of the temperature of a warm bath. To preserve it moist, occasionally drop warm water on it.

2596. _Linseed-Meal Poultice_.--"Scald your basin, by pouring a little hot water into it; then put a small quant.i.ty of finely-ground linseed-meal into the basin, pour a little hot water on it, and stir it round briskly until you have well incorporated them; add a little more meal and a little more water; then stir it again. Do not let any lumps remain in the basin, but stir the poultice well, and do not be sparing of your trouble. What you do next, is to take as much of it out of the basin as you may require, lay it on a piece of soft linen, and let it be about a quarter of an inch thick."--_Abernethy_.

2597. _Mustard Poultice_.--Mix equal parts of dry mustard and linseed-meal in warm vinegar. When the poultice is wanted weak, warm water may be used for the vinegar; and when it is required very strong, mustard alone, without any linseed-meal, is to be mixed with warm vinegar.

2598. _An ordinary Blister_.--Spread a little blister compound on a piece of common adhesive plaster with the right thumb. It should be put on just thickly enough to conceal the appearance of the plaster beneath.

The part from which a blister has been taken should be covered till it heals over with soft linen rags smeared with lard.

Baths and Fomentations.

2599. All fluid applications to the body are exhibited either in a hot or cold form; and the object for which they are administered is to produce a stimulating effect over the entire, or a part, of the system; for the effect, though differently obtained, and varying in degree, is the same in principle, whether procured by hot or cold water.

2600. _Heat_.--There are three forms in which heat is universally applied to the body,--that of the tepid, warm, and vapour bath; but as the first is too inert to be worth notice, and the last dangerous and inapplicable, except in public inst.i.tutions, we shall confine our remarks to the really efficacious and always attainable one--the

2601. _Warm and Hot Bath_.--These baths are used whenever there is congestion, or acc.u.mulation of blood in the internal organs, causing pain, difficulty of breathing, or stupor, and are employed, by their stimulating property, to cause a rush of blood to the surface, and, by unloading the great organs, produce a temporary inflammation in the skin, and so equalize the circulation. The effect of the hot bath is to increase the fulness of the pulse, accelerate respiration, and excite perspiration. In all inflammations of the stomach and bowels, the hot bath is of the utmost consequence; the temperature of the warm bath varies from 92 to 100, and may be obtained by those who have no thermometer to test the exact heat, by mixing one measure of boiling with two of cold water.

2602. _Fomentations_ are generally used to effect, in a part, the benefit produced on the whole body by the bath; to which a sedative action is occasionally given by the use of roots, herbs, or other ingredients; the object being to relieve the internal organ, as the throat, or muscles round a joint, by exciting a greater flow of blood to the skin _over_ the affected part. As the real agent of relief is heat, the fomentation should always be as hot as it can comfortably be borne, and, to insure effect, should be repeated every half-hour. Warm fluids are applied in order to render the swelling which accompanies inflammation less painful, by the greater readiness with which the skin yields, than when it is harsh and dry. They are of various kinds; but the most simple, and oftentimes the most useful, that can be employed, is "Warm Water." Another kind of fomentation is composed of dried poppyheads, 4 oz. Break them to pieces, empty out the seeds, put them into 4 pints of water, boil for a quarter of an hour, then strain through a cloth or sieve, and keep the water for use. Or, chamomile flowers, hemlock, and many other plants, may be boiled, and the part fomented with the hot liquor, by means of flannels wetted with the decoction.

2603. _Cold_, when applied in excess to the body, drives the blood from the surface to the centre, reduces the pulse, makes the breathing hard and difficult, produces coma, and, if long continued, death. But when medicinally used, it excites a reaction on the surface equivalent to a stimulating effect; as in some cases of fever, when the body has been sponged with cold water, it excites, by reaction, increased circulation on the skin. Cold is sometimes used to keep up a repellent action, as, when local inflammation takes place, a remedy is applied, which, by its benumbing and astringent effect, causes the blood, or the excess of it in the part, to recede, and, by contracting the vessels, prevents the return of any undue quant.i.ty, till the affected part recovers its tone.

Such remedies are called _Lotions_, and should, when used, be applied with the same persistency as the fomentation; for, as the latter should be renewed as often as the heat pa.s.ses off, so the former should be applied as often as the heat from the skin deprives the application of its cold.

2604. _Poultices_ are only another form of fomentation, though chiefly used for abscesses. The ingredient best suited for a poultice is that which retains heat the longest; of these ingredients, the best are linseed--meal, bran, and bread. Bran sewed into a bag, as it can be reheated, will be found the cleanest and most useful; especially for sore throats.

How to Bleed.

2605. In cases of great emergency, such as the strong kind of apoplexy, and when a surgeon cannot possibly be obtained for some considerable time, the life of the patient depends almost entirely upon the fact of his being bled or not. We therefore give instructions how the operation of bleeding is to be performed, but caution the reader only to attempt it in cases of the greatest emergency. Place a handkerchief or piece of tape rather but not too tightly round the arm, about three or four inches above the elbow. This will cause the veins below to swell and become very evident. If this is not sufficient, the hand should be constantly and quickly opened and shut for the same purpose. There will now be seen, pa.s.sing up the middle of the fore-arm, a vein which, just below the bend of the elbow, sends a branch inwards and outwards, each branch shortly joining another large vein. It is from the _outer_ branch--that the person is to be bled. The right arm is the one mostly operated on. The operator should take the lancet in his right hand, between the thumb and first finger, place the thumb of his left hand on the vein below the part where he is going to bleed from, and then gently thrust the tip of the lancet into the vein, and, taking care not to push it too deeply, cut in a gently curved direction, thus and bring it out, point upwards, at about half an inch from the part of the vein into which he had thrust it. The vein must be cut lengthways, and not across.