Mutual Life Insurance Company of New York.

Accidents, emergencies and illnesses, a manual for reference online

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DROWNING — HANGING. 19

effort ought to be made, and persisted in until the
arrival of a physician, or for at least a couple of hours.
As soon as returning vitality permits, some brandy in
a little water may be given; and, as the strength of
the person is usually completely exhausted by mus-
cular efforts of the most violent and continued charac-
ter to save himself from drowning, some beef-tea or
other easily digested nourishment should be given.
He should be kept in bed, very quiet and comfortably
warm for some hours at least.

HANGING.

Here death results from asphyxia induced by pres-
sure applied to the trachea (windpipe) from the out- Asphyxia
side, as in strangling, or hanging. The body, if hang- ^■■°'"
ing, should be at once cut down, care being taken not ^"S"ig-
to let it fall. Remove by the finger, as in the
directions in drowning, any accumulation of mucus
at the base of the tongue, and place the body on
the back, just as directed for a person taken from the
water. If the body is still warm, after removal of the
clothing, the face, head, neck and chest should be
dashed freely with cold water. To do this success-
full)', a person should stand six feet or more away
with a bowl of cold water, and then throw its contents
with as much force as possible against the person.
This having been repeated a number of times, the
water should be rapidly wiped oflf with a towel. There
is little essential difference in the condition of a per-
son who has been hanged and one who has been Treatment,
drowned. In both it is asphyxia ; in one case, the air
has been kept from the lungs by a ligature ; in the other
by a liquid. Artificial respiration in both of them

G^lnBun In Thb Motual Life Issurancb Co. op New Yokx.)



aU HANGING — SUFFOCATIOK

must be used, assisted for the same reason and in the
same manner by like auxiliaries.

There is an impression, quite prevalent among the
ignorant, that a penalty is incurred at law for cutting
down the body of a person found hanging, unless the
sanction of the coroner is obtained. Such delay is un-
necessary and unjustifiable; and an effort should at
once be made to restore suspended animation by the
methods given.



Asphyxia

from

suffocation.



SUFFOCATION.

There are several gases which, when inhaled, are
followed by symptoms of asphyxia. The little valve
(epiglottis) over the entrance of the trachea (wind-
pipe) is so extremely sensitive that it will not even
permit a drop of water to pass without a spasmodic
closure of the opening, followed by coughing. It is
not only sensitive to solids and liquids, but also to
the presence of most gases. At one time it was
thought that all gases were taken past it into the lungs,
and thence absorbed into the blood. The prevailing
opinion now is that most of them irritate the valve at
the entrance of the trachea, and closure of the entrance
follows. The breathing is thus interrupted much as
it is in drowning, where the liquid cuts off the passage
of air to the lungs ; or as in hanging, where the ligature
prevents the entrance of air. In such cases death
results from asphyxia.



Carbonic-
acid gas.



CARBONIC-ACID GAS.



Asphyxia by this gas takes place as soon as the per-
son inhales it. A sudden sense of suffocation is felt,
with dizziness and inability to stand. If the individual

((X^lnsure in Tub Mutual Lipb Insukancb Co. op Kkw Tobz.)



SUFFOCATION. 81

is standing at the time the air is taken into the lungs,
and falls, he is in a position while down to inhale still
more of the carbonic-acid gas, for it is heavier than
the air.

This gas, sometimes known under the name of
"choke damp," is produced in the ordinary process
of fermentation, in burning and slacking lime; it is Where
also found in mines, particularly coal mines, and in °"" '
wells, cellars or caves which have long been closed.
It is considerably heavier than the atmosphere, and
is consequently found lying on the floor of the cavity
where confined.

No well, vat, old cellar, or cavern of any kind, should
ever be entered without first lowering a lighted candle
into the deepest point. If the flame is extinguished,
or burns dimly, this indicates the presence of this tg^ted and
gas, and no one, under any circumstances, should dislodged.
be permitted to enter until this foul air has been re-
moved. It lies at the bottom, because it is too heavy
to ascend. It is not so heavy, however, but that a
strong current of common air will dislodge it. Buckets
of water dashed down into the well, or masses of
lighted shavings or blazing paper, give enough
movement to the carbonic-acid gas to dislodge it from
its resting place. Freshly slacked lime also rapidly
absorbs it. After testing the success of the efforts
by again introducing the lighted candle, it can soon
be known whether a person may enter with impunity.

Sometimes there may be no carbonic-acid gas in
the cavity, but the efforts of the workmen will dislodge
it from an adjacent space into the one in which they
are breathing. This possibility should never be lost
sight of.



(I^ Inaare in Thb Uutual Lifb Iksdkascb Co. of Nbw Tobk.)



SUFFOCATION.



How to re-
move a per-
son over-
come by
carbonic-
acid gas.



Treatment.



When a person appears overcome by this carbonic-
acid gas, he is, of course, wholly unable to help
himself, and must at once be removed. Sometimes
a grapnel-hook can be used with advantage, but
often the better way is to rapidly lower some bold,
clear-headed person, with a rope securely fastened
around his middle, who can seize and bring to the sur-
face the unfortunate individual. No time should be
lost in descending or arising, as the person lowered
depends upon doing everything during the interval
that he can hold his breath; for, of course, should
he inhale the gas, his position, in this respect, would
be but little better than the man he attempts to suc-
cor. A large sack is sometimes thrown over the head
and shoulders of the person who descends. It contains
enough air to serve for several inhalations, while the
texture of the material prevents the admission of the
deleterious gas in a hurtful degree.

The person suffering from asphyxia, immediately
after being brought out from the gas, should be
placed on his back, the neck and throat bared, and
any other obstacles to breathing quickly removed. His
body should then be quickly stripped, and if he has
not fallen into water on being overpowered by the
gas, his head, neck and shoulders should be freely
dashed with cold water.

Remember, this is not "sprinkling,"' as commonly
practiced, but, as said before, a person should stand
ofif some distance, with a bowl of cold water, and
throw its contents, with as much force as jjossible,
against the parts. Other bowlfulls should follow with-
out an interval for half a minute, while one can count
thirty slowly, then the dripping water be wiped away
by a towel. This procedure should be repeated from



(1^ Insure In Thb Uotual Li7b Imshbanos Co. of Nev Tobk.)



SUFFOCATION. 23

time to time, as required. Sometimes, if a brook of
water is near, the stripped person might be repeatedly
dipped into it, care being taken, of course, not to dip
his face. Artificial respiration should be used as soon
as possible.

If the person has fallen into water and become
chilled, the use of the cold water, in this manner, should
be avoided, as the evaporation of the moisture ab-
sorbs more heat than can be manufactured by the
exhausted and overpowered system. In such a case,
the body of the person should be put into a warmed
bed, with hot applications, and artificial respiration
(p. i6) at once established, as in the asphyxia from
drowning and hanging.

While artificial respiration is being used, friction ap-
plied to the limbs should be kept up.

BURNING CHARCOAL.

Carbonic-oxide, a very poisonous gas, is given
off during the burning of charcoal, and when ^^ ^^'^
inhaled for a sufficient length of time, rapidly proves bonic-oxide
fatal. The person quickly drops insensible, and dies gas.
of asphyxia, very similarly to one who succumbs to
carbonic-acid gas. The treatment there advised under
the previous heading should at once be carried out.



ANTHRACITE AND BITUMINOUS COAL.

These also, when burned in a close room, as a
kitchen shut up for the night with an open stove of
burning coals, give off, to a degree, the peculiar Asphyxia
poisonous gas alluded to as coming from burning char- ^^°^ burn-
coal, carbonic-oxide gas, as well as other noxious '"^ ^°^ '
gases. Persons sleeping in such a room, unless awak-
ened as the air becomes fouled, will soon be found

(^^ Insure In The Uunrjo. Lxrs Insuramje Go. of New Tosx.)



24



SUFFOCATION.



senseless or dead. The treatment should be as de-
scribed in the preceding pages, under asphyxia from
inhaling carbonic-acid gas.



Asphyxia
from
ordinary
gas.



Asphyxia
from foul air
in drains
and privies.



COMMON BURNING GAS.

Persons retiring at night often leave the gas "turned
down," and the flame becomes extinguished. Enough
gas may then escape to give trouble to the sleeper un-
less the room is well ventilated. Persons have been
known to "blow it out" as they would a candle, and
suffocation more or less complete has followed.

Treat as in the asphyxia from carbonic-acid gas
just described.

FOUL AIR IN DRAINS AND PRIVIES.

This usually consists of sulphuretted hydrogen, and
arises from the decomposition of the residual matters
found in these situations. Great caution, on this ac-
count, should always be observed on opening and
entering such places, or places in possible communica-
tion with them, especially if they have been long closed.
A small quantity of pure sulphuretted hydrogen, if in-
haled, is usually fatal; but, in the cases referred to,
the gas usually exists diluted with common air. The
breathing becomes difficult, the person loses his
strength, falls, becomes insensible and cold, lips and
face are blue, and the mouth is covered with bloody
mucus.

The person should be removed as quickly as pos-
sible beyond the influence of the foul air, and the
treatment under the head of "Carbonic-Acid Gas"
pursued.

The possibility of such a disaster should always
be borne in mind in opening long-closed drains or

B^" Insure in The Mutual Lips Insubancb Go. of Nsw Tobx.)



throat.



SUFFOCATION — LIGHTNING. 25

privy-vaults, and the danger lessened by taking a few
pounds of chloride of lime (bleaching powder), dis-
solving it in a pailful of water, and dashing it into the
cavity. In the absence of this, lime and water in the
form of the common "whitewash" may be employed.
This gas readily combines with lime, to that extent
freeing the air of the poisonous compound.

FOREIGN BODTES IN THE THROAT.

A piece of food or some other body often gets back
into the mouth, and cannot be swallowed. In such a
case, the finger will often be able to thrust it down- Foreign
ward, should that be thought best. A hairpin, body in the
straightened and bent at the extremity, will often
drag it out. If the body is firm in character, a pair
of scissors, separated at the rivet, and one blade held
by the point, will furnish a loop, which often can be
made to extract it.

ACCIDENTS FROM LIGHTNING.

A person struck by lightning is usually rendered
more or less unconscious, the unconsciousness struck by
lasting for a longer or shorter time. Cases are on lightning.
record where a person struck exhibited no sign of
life for an hour, and then recovered. Temporary par-
alysis of a portion of the body may remain for a while,
or a disturbance of some special function, such as the
sight, smell, taste, or hearing. When death takes
place, it is from shock to the brain and nervous system.

When the person exhibits little or no signs of life. Treatment,
the clothing should be rapidly removed and the
body exposed to a dashing of cold water ; then dried,
placed in bed, and warmth applied, particularly to the

iSSF" Insure in Ths M utcal Lin Ihsobuicb Go. ov New Tobx.



26 LIGHTNING — BURNS.

"pit of the stomach," by means of glass or rubber
bottles filled with hot water.

Artificial respiration should be kept up until the
parts of the brain and nervous system in charge of this
duty shall have recovered enough to attend to it. As
said before, recoveries after an hour of supposed death
are on record.

Some stimulant, as brandy (teaspoonful) or the
aromatic spirits of ammonia (twenty drops in a table-
spoonful of water), repeated in a few minutes, may be
given.

Burns caused by lightning should receive the same
attention as a burn from any other cause. Some-
times an injury observed is not directly due to the
electricity, but to a fragment detached by that agent
from a neighboring substance.

BURNS AND SCALDS.

When the clothing catches fire, throw the person
Put the fire down on the ground, so that the flames will not
out. rise toward the mouth and nostrils. Then with-

out a moment's delay, roll the person on the
carpet, or, if possible, in a hearth-rug, so as to
stifle the flames. If no rug can be had, use your coat.
Keep the flame as much as possible from the face, so
as to prevent the entrance of the hot air into the lungs.
This can be done by beginning at the neck and
shoulders with the wrapping.

If the burn or scald involves considerable surface,
symptoms of shock from the extreme of mere weak-
ness to that of utter prostration appear. This at once
requires prompt attention, and a few drops of aromatic
spirits of ammonia in water, or a little brandy, should

e^~ Insure in Thb Mutdai Lipb Insdbahcb Co. ob New Tobk.)



BURNS. 27

be given and repeated in a few moments until a return
of the strength is apparent. A burn, superficial as far
as depth is concerned, but covering a large surface, shock from
especially in the case of small children and aged burns.
people, is usually considered more serious than a
burn smaller in extent, but deeper and more com-
plete. If there is reason to suppose that hot air or
steam has been inhaled, no time should be lost in ob-
taining the opinion of a physician as to the result of
the injury to the throat and lungs.

Treatment. — The burnt surface should be cleansed
carefully by allowing water to trickle over it.
The skin over a blister should not be cut off, but
should be snipped with scissors near the edge, and Treatment,
the water gently squeezed out. This allows the skin
to remain as a protective. If the blister re-forms it
may be necessary to repeat this operation.

If the burn or scald is slight in character, one of the
best applications is the cold water dressing, p. 32,
keeping the linens used constantly wet.

In more severe cases a very good application is
carron oil, which is a mixture of linseed oil and lime-
water in equal parts. Sweet-oil alone is very good.
Vaseline, with a little boric acid rubbed up with it, is
also very soothing. Lard and baking soda mixed will
relieve pain.

Wheaten flour is often dusted over the burn; but
this, with the discharges, hardens, and is of as little Flour or
comfort as an application of small crusts of bread cotton-wool
would be to the injured part. Cotton wool (carded not to be
cotton, cotton batting) is often used, but the fibers be- "^^'^•
come imbedded in the discharges, and then cannot be
detached without pain and disturbance of the wound.

Talcum powder, or Fuller's Earth, is very useful as

(t^ Insure In Ths Mutdal Lips Ih-simAXCx Co. of New Tobk.)



28



BURNS.



Very simple
measures.



If shock or
pain is
present.



Scalds.



drying powders after the blister has been cut, or
any of the skin becomes detached.

If the burn or scald, particularly the latter, is super-
ficial in character, a simple and useful dressing is the
application by brush or a soft wisp of old muslin,
of the white of egg to the injury. As soon as the first
layer dries, another should be used. A lather of soap
from the shaving-cup, applied by the brush in the same
way, is often followed by immediate relief. These
substances protect from the action of the air the ir-
ritated nerves beneath.

If a physician has been sent for, it is better not to
make any domestic applications to the burned parts.
Such things frequently prevent him from using those
better adapted, and keep him from forming a cor-
rect estimate of the real extent of the injuries.

If there is much shock and depression, stimulants
will be needed, such as aromatic spirits of ammonia,
brandy or whisky. If there is much pain, laudanum
can be given, five drops every two or three hours, until
four or five doses have been administered.

Burns and scalds practically differ but little from
each other. Scalds are usually more confined to the
outer cuticle, unless the substance containing the heat
is viscid in character, as oil, pitch, etc., and does not
rapidly run off the part with which it came in contact.
As far as popular assistance is concerned, the two may
be regarded as presenting no essential difference.



Burns by
lime, caustic
potash and
other
alkalies.



BURNS BY LIME, CAUSTIC POTASH, AND OTHER ALKALIES.

As a rule, these are troublesome, since there is not
only removal of the cuticle (superficial skin), but de-
struction of the soft parts below. Lime is a powerful
alkali, and rapidly destroys the parts with which it

(t^ iDBDre ID Thb Mutual Lifk Insurancb Co. op NzTr Yobs.)



BURNS— CONTUSIONS. 29

comes in contact. As it is useless to attempt to pick
it off, an application should at once be made of some-
thing to unite with the alkali, so as to form a compara-
tively harmless preparation. \'^inegar diluted with
water, lemon juice or any other dilute acid will
answer. These things do not undo what has been
done ; they only prevent further mischief. The subse-
quent treatment is the same as for bums. And what
has been said about the alkali known as lime, may be
said about other alkalies, potash, soda, ammonia, etc.

BURNS BY ACIDS — SULPHURIC ACID (oiL OF VITRIOL),
NITRIC ACID (^AQUA FORTIs), ETC.

As alkalies destroy the living tissue they come in
contact with, so will acids of sufficient concentration.
In such cases, applications of water will dilute
them beyond their capacity to injure. Alkalies neu- ^1™^ ^y
tralize acids into harmless preparations, and cooking
soda, washing-soda or saleratus can be used for
this purpose. Common earth, gathered almost any-
where, applied in handfuls, contains alkali enough of
one kind or another to entitle it to the consideration of
being one of the best (and at the same time most easily
secured) applications in cases of bums by acids.



CONTUSIONS.

These common injuries are termed "bruises" by
most people, and are the only injuries, besides Contusions
wounds and fractures, produced by blows or pressure, or bruises.
The injury may be of the simple form; only a slight
shaking or jarring of the texture, with no visible
change, except what results from the rupture of the

(fy Insure in The Mctitai. Lifb Ihsubascs Co. op Nsw Tobx.)



acids.



30



CONTUSIONS.



Symptoms.



Treatment,



blood-vessels. This is the most frequent. In the
more severe but less frequent form, the contusion
means broken blood-vessels, muscles, and tissues be-
tween and around them; the parts are thoroughly
crushed, sometimes to a pulp, damaged beyond re-
covery, and ready to perish in the gangrene resulting
from the extreme form of such an injury.

In contusions, the first conspicuous symptom is that
of shock, which generally, but not always, bears a
relation to the extent of the injury. Thus a crushed
finger is attended, as a rule, with much less shock
than a crushed hand or foot. Contusion of certain
parts, as the larger joints, breasts, and other portions
of the body, are followed by most severe symptoms
of shock. The pain is not always as severe as might
at first be thought, for the nerves are so much injured
as to be deprived of their ability to receive and trans-
mit the necessary impression.

The quantity of blood escaping from the ruptured
vessels depends, in a large degree, upon the size and
number of the vessels injured, but in some degree
upon the space in which the blood can accumulate.
A single divided vessel in the scalp, owing to the loose-
ness of the tissue in which the vessels are distributed,
may permit a swelling, the result of the escape of
blood, extending in area over a half of one side of the
head.

Discoloration is due to the color of the escaped
blood, seen through the cuticle, and varies from black-
ness usually indicating intense injury, through dark
blue, purple, crimson, down to delicate pink, indi-
cating only a blood-stained fluid.

Treatment. — In the milder contusions, there is but
little shock. Should there be more, place the patient



(1^ Insure In Trb Mutual Lipb Inbitbancb Co. op Nbw Yokk/^



CONTUSIONS. 81

on the back, head not elevated, and give stimulants as
directed. (See shock, p. 13). The next thing is to
limit the consequences likely to ensue from the rup-
tured blood vessel. This is best done by lessening the
supply of blood to the part by elevating this, if pos-
sible, above the heart, and applying cold in the shape
of powdered ice, tied up in towels, to the part, and
along the course of the larger vessels going to the
injury.

A large piece of ice secured in a towel, so that the
pieces cannot escape, can be reduced to fine fragments
by a blow or two against the wall. After it has
been on for a time, water may be substituted in
the shape of a drip;* or several thicknesses of wet
towel may be applied, only they must be dipped in
cold water, squeezed out, and changed every minute
or two. If not chariged, the wet towels really act as
poultices to the part, inviting what we should try to
prevent. When the surgeon appears, special meas-
ures will be directed by him. Recollect it takes a
great deal of heat to convert ice into water, and water
into vapor, and if the patient has not got this heat,
symptoms of chilliness will be observed. When this
happens the application must be stopped, and the
moisture must be taken up by a towel ; particular at-
tention always being paid to keep the bed-clothing
and everything else perfectly dry and neat.

A common accident is a "mashed finger" from the
member getting caught in a closing window, or want



* A pitcher, or some other vessel of water, placed higher
than the injured parts, with a moistened string or strip of linen.
One end of the string is placed in the water, while the other
hangs down on the outside, so that the water will drip along
the string from the vessel to the point of contusion.

(t^ lasnre in Thb MuTUAt Lifb Insuranch Co. op New Tork.)



32



CONTUSIONS — FRACTURES.



Mashed fin-
ger and its
treatment.



of precision in using a hammer. Tlie firm bone be-
neath and the blow above usually contuse (bruise) the
tissues (veins, vessels, muscles, etc.), between, and
often the pain and other symptoms last some days.

Wrap up in a bandage of old muslin, and keep con-
stantly wet with cold water, or some mild astringent
like Pond's Extract. If there is much pain add laud-
anum. The discoloration and swelling may remain
some days after the pain subsides. Stimulating lini-
ments can now be used to encourage an extra flow of
pure blood to the part and the washing away of the
injured blood.



FRACTURES.



Fractures,
varieties of.



These may be divided for our purposes into two
varieties — the simple and the compound. In a simple
fracture the bone is broken and there is some lacera-
tion of the soft parts around it, but no break in the
skin. In a compound fracture the skin over the seat
of the fracture is also broken, and sometimes the bone
protrudes.

There is always some shock, and great pain in the
broken bone, especially if it is stirred. If surgical
assistance can be obtained without removing the pa-
tient, he should be left lying quietly. All that need
be done is to cut the clothing over the afifected part
and put on it cloths wet with cold water, which will
allay the pain to some de^ee. If he has to be re-
moved, it will be necessary to make some kind of a
splint which will hold the limb immovable. The best
thing for this is two pieces of board, each long
enough to extend beyond the joints above and below
the broken bone and a little wider than the thickness



CX^ Insure In Thb Mutual Life Insueancb Oo. op New roRK.)



FRACTURES — DISLOCATIONS. 33

of the limb. These boards should be well padded
with cotton batting, or several layers of cloth, or


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