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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. Isinglass Plaster. Lint. A pair of small Scales with Weights. An ounce and a drachm Measure-glass. A Lancet. A Probe. A pair of Forceps, and some curved Needles.
    2580. The following PRESCRIPTIONS may be made up for a few shillings; 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 quantity 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, scraped 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 quantity, 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 quantity 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 quantity 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 coarsely-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 quantity 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 institutions, 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 accumulation 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 quantity, 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 passes 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, passing 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. When sufficient blood has been taken away, remove the bandage from above the elbow, and place the thumb of the left hand firmly over the cut, until all the bleeding ceases. A small pad of lint is then to be put over the cut, with a larger pad over it, and the two kept in their places by means of a handkerchief or linen roller bound pretty tightly over them and round the arm.
    2606. When a person is bled, he should always be in the standing, or at any rate in the sitting, position; for if, as is often the case, he should happen to faint, he can, in, most eases at least, easily be brought to again by the operator placing him flat on his back, and stopping the bleeding. This is of the greatest importance. It has been recommended, for what supposed advantages we don't know, to bleed people when they are lying down. Should a person, under these circumstances, faint, what could be done to bring him to again? The great treatment of lowering the body of the patient to the flat position cannot be followed here. It is in that position already, and cannot be placed lower than it at present is--except, as is most likely to be the case, under the ground.

    2607. BLEEDING FROM THE NOSE.--Many children, especially those of a sanguineous temperament, are subject to sudden discharges of blood from some part of the body; and as all such fluxes are in general the result of an effort of nature to relieve the system from some overload or pressure, such discharges, unless in excess, and when likely to produce debility, should not be rashly or too abruptly checked. In general, these discharges are confined to the summer or spring months of the year, and follow pains in the head, a sense of drowsiness, languor, or oppression; and, as such symptoms are relieved by the loss of blood, the hemorrhage should, to a certain extent, be encouraged. When, however, the bleeding is excessive, or returns too frequently, it becomes necessary to apply means to subdue or mitigate the amount. For this purpose the sudden and unexpected application of cold is itself sufficient, in most cases, to arrest the most active hemorrhage. A wet towel laid suddenly on the back, between the shoulders, and placing the child in a recumbent posture, is often sufficient to effect the object; where, however, the effusion resists such simple means, napkins wrung out of cold water must be laid across the forehead and nose, the hands dipped in cold water, and a bottle of hot water applied to the feet. If, in spite of these means, the bleeding continues, a little fine wool or a few folds of lint, tied together by a piece of thread, must be pushed up the nostril from which the blood flows, to act as a plug and pressure on the bleeding vessel. When the discharge has entirely ceased, the plug is to be pulled out by means of the thread. To prevent a repetition of the hemorrhage, the body should be sponged every morning with cold water, and the child put under a course of steel wine, have open-air exercise, and, if possible, salt-water bathing. For children, a key suddenly dropped down the back between the skin and clothes, will often immediately arrest a copious bleeding.

    2608. SPITTING OF BLOOD, or hemorrhage from the lungs, is generally known from blood from the stomach by its being of a brighter colour, and in less quantities than that, which is always grumous and mixed with the half-digested food. In either case, rest should be immediately enjoined, total abstinence from stimulants, and a low, poor diet, accompanied with the horizontal position, and bottles of boiling water to the feet. At the same time the patient should suck through a quill, every hour, half a wine-glass of water in which 10 or 15 drops of the elixir of vitriol has been mixed, and, till further advice has been procured, keep a towel wrung out of cold water on the chest or stomach, according to the seat of the hemorrhage.

     Bites and Stings.

    2609. BITES AND STINGS may be divided into three kinds:--1. Those of Insects. 2. Those of Snakes. 3. Those of Dogs and other Animals.
    2610. 1. The Bites or Stings of Insects, such as gnats, bees, wasps, &c., need cause very little alarm, and are, generally speaking, easily cured. They are very serious, however, when they take place on some delicate part of the body, such as near the eye, or in the throat. The treatment is very simple in most cases; and consists in taking out the sting, if it is left behind, with a needle, and applying to the part a liniment made of finely-scraped chalk and olive-oil, mixed together to about the thickness of cream.
    2611. Bathing the part bitten with warm turpentine or warm vinegar is also of great use. If the person feels faint, he should lie quietly on his back, and take a little brandy-and-water, or sal-volatile and water. When the inside of the throat is the part stung, there is great danger of violent inflammation taking place. In this case, from eight to twelve leeches should be immediately put to the outside of the throat, and when they drop off, the part to which they had been applied should be well fomented with warm water. The inside of the throat is to be constantly gargled with salt and water. Bits of ice are to be sucked. Rubbing the face and hands well over with plain olive-oil, before going to bed, will often keep gnats and musquitoes from biting during the night. Strong scent, such as eau-de-Cologne, will have the same effect.
    2612. 2. Bites of Snakes.--These are much more dangerous than the preceding, and require more powerful remedies. The bites of the different kinds of snakes do not all act alike, but affect people in different ways.--Treatment of the part bitten. The great thing is to prevent the poison getting into the blood; and, if possible, to remove the whole of it at once from the body. A pocket-handkerchief, a piece of tape or cord, or, in fact, of anything that is at hand, should be tied tightly round the part of the body bitten; if it be the leg or arm, immediately above the bite, and between it and the heart. The bite should then be sucked several times by any one who is near. There is no danger in this, provided the person who does it has not got the skin taken off any part of his mouth. What has been sucked into the mouth should be immediately spit out again. But if those who are near have sufficient nerve for the operation, and a suitable instrument, they should cut out the central part bitten, and then bathe the wound for some time with warm water, to make it bleed freely. The wound should afterwards be rubbed with a stick of lunar caustic, or, what is better, a solution of this--60 grains of lunar caustic dissolved in an ounce of water--should be dropped into it. The band should be kept on the part during the whole of the time that these means are being adopted. The wound should afterwards be covered with lint dipped in cold water. The best plan, however, to be adopted, if it can be managed, is the following:--take a common wine-glass, and, holding it upside down, put a lighted candle or a spirit-lamp into it for a minute or two. This will take out the air. Then clap the glass suddenly over the bitten part, and it will become attached, and hold on to the flesh. The glass being nearly empty, the blood containing the poison will, in consequence, flow into it from the wound of its own accord. This process should be repeated three or four times, and the wound sucked, or washed with warm water, before each application of the glass. As a matter of course, when the glass is removed, all the blood should be washed out of it before it is applied again.--Constitutional Treatment. There is mostly at first great depression of strength in these cases, and it is therefore requisite to give some stimulant; a glass of hot brandy-and-water, or twenty drops of sal-volatile, is the best that can be given. When the strength has returned, and if the patient has not already been sick, a little mustard in hot water should be given, to make him so. If, on the other hand, as is often the case, the vomiting is excessive, a large mustard poultice should be placed over the stomach, and a grain of solid opium swallowed in the form of a pill, for the purpose of stopping it. Only one of these pills should be given by a non-professional person. In all cases of bites from snakes, send for a surgeon as quickly as possible, and act according to the above directions until he arrives. If he is within any reasonable distance, content yourself by putting on the band, sucking the wound, applying the glass, and, if necessary, giving a little brandy-and-water.
    2613. 3. Bites of Dogs.--For obvious reasons, these kinds of bites are more frequently met with than those of snakes. The treatment is the same as that for snake-bites, more especially that of the bitten part. The majority of writers on the subject are in favour of keeping the wound open as long as possible. This may be done by putting a few beans on it, and then by applying a large linseed-meal poultice over them.
     Injuries and Accidents to Bones.
    2614. Dislocation of Bones.--When the end of a bone is pushed out of its natural position, it is said to be dislocated. This may be caused by violence, disease, or natural weakness of the parts about a joint.--Symptoms. Deformity about the joint, with unnatural prominence at one part, and depression at another. The limb may be shorter or longer than usual, and is stiff and unable to be moved, differing in these last two respects from a broken limb, which is mostly shorter, never longer, than usual, and which is always more movable.--Treatment. So much practical science and tact are requisite in order to bring a dislocated bone into its proper position again, that we strongly advise the reader never to interfere in these cases; unless, indeed, it is altogether impossible to obtain the services of a surgeon. But because any one of us may very possibly be placed in that emergency, we give a few rough rules for the reader's guidance. In the first place make the joint, from which the bone has been displaced, perfectly steady, either by fixing it to some firm object or else by holding it with the hands; then pull the dislocated bone in a direction towards the place from which it has been thrust, so that, if it moves at all from its unnatural position, it may have the best chance of returning to its proper place. Do not, however, pull or press against the parts too violently, as you may, perhaps, by doing so, rupture blood-vessels, and produce most serious consequences. When you do attempt to reduce a dislocated bone, do it as quickly as possible after the accident has taken place, every hour making the operation more difficult. When the patient is very strong, he may be put into a warm bath until he feels faint, or have sixty drops of antimonial wine given him every ten minutes until he feels sickish. These two means are of great use in relaxing the muscles. If the bone has been brought back again to its proper place, keep it there by means of bandages; and if there is much pain about the joint, apply a cold lotion to it, and keep it perfectly at rest. The lotion should be, a dessert-spoonful of Goulard's extract, and two tablespoonfuls of vinegar, mixed in a pint of water. Leeches are sometimes necessary. Unless the local pain, or general feverish symptoms, are great, the patient's diet should be the same as usual. Dislocations may be reduced a week, or even a fortnight, after they have taken place. As, therefore, although the sooner a bone is reduced the better, there is no very great emergency, and as the most serious consequences may follow improper or too violent treatment, it is always better for people in these cases to do too little than too much; inasmuch as the good which has not yet may still be done, whereas the evil that has been done cannot so easily be undone.

    2615. FRACTURES OF BONES.--Symptoms. 1. Deformity of the part. 2. Unnatural looseness. 3. A grating sound when the two ends of the broken bone are rubbed together. 4. Loss of natural motion and power. In some cases there is also shortening of the limb.--Fracture takes place from several causes, as a fall, a blow, a squeeze, and sometimes from the violent action of muscles.--Treatment. In cases where a surgeon cannot be procured immediately after the accident, the following general rules are offered for the reader's guidance:--The broken limb should be placed and kept as nearly as possible in its natural position. This is to be done by first pulling the two portions of the bone in opposite directions, until the limb becomes as long as the opposite one, and then by applying a splint, and binding it to the part by means of a roller. When there is no deformity, the pulling is of course unnecessary. If there is much swelling about the broken part, a cold lotion is to be applied. This lotion (which we will call Lotion No. 1) may be thus made:--Mix a dessert-spoonful of Goulard's extract and two tablespoonfuls of vinegar in a pint of water. When the leg or arm is broken, always, if possible, get it to the same length and form as the opposite limb. The broken part should be kept perfectly quiet. When a broken limb is deformed, and a particular muscle is on the stretch, place the limb in such a position as will relax it. This will in most cases cure the deformity. Brandy-and-water, or sal-volatile and water, are to be given when the patient is faint. Surgical aid should, of course, be procured as soon as possible.

    2616. JOINTS, INJURIES TO.--All kinds of injuries to joints, of whatever description, require particular attention, in consequence of the violent inflammations which are so liable to take place in these parts of the body, and which do so much mischief in a little time. The joint injured should always be kept perfectly at rest; and when it is very painful, and the skin about it red, swollen, hot, and shining, at the same time that the patient has general feverish symptoms, such as great thirst and headache--leeches, and when they drop off, warm poppy fomentations, are to be applied; the No. 1 pills above-mentioned are to be given (two are a dose for a grown person) with a black draught three hours afterwards. Give also two tablespoonfuls of the fever-mixture every four hours, and keep the patient on low diet. When the injury and swelling are not very great, warm applications, with rest, low diet, and a dose of aperient medicine, will be sufficient. When a joint has received a penetrating wound, it will require the most powerful treatment, and can only be properly attended to by a surgeon. The patient's friends will have to use their own judgment to a great extent in these and in many other cases, as to when leeches, fever-mixture, &c., are necessary. A universal rule, however, without a single exception, is always to rest a joint well after it has been injured in any way whatever, to purge the patient, and to keep him on low diet, without beer, unless he has been a very great drinker indeed, in which case he may still be allowed to take a little; for if the stimulant that a person has been accustomed to in excess be all taken away at once, he is very likely to have an attack of delirium tremens. The quantity given should not, however, be much--say a pint, or, at the most, a pint and a half a day. Rubbing the joint with opodeldoc, or the application of a blister to it, is of great service in taking away the thickenings, which often remain after all heat, pain, and redness have left an injured joint. Great care should be observed in not using a joint too quickly after it has been injured. When the shoulder-joint is the one injured, the arm should be bound tightly to the body by means of a linen or flannel roller, and the elbow raised; when the elbow, it should be kept raised in the straight position, on a pillow; when the wrist, it should be raised on the chest, and suspended in a sling; when the knee, it should be kept in the straight position; and, lastly, when the ankle, it should be a little raised on a pillow.

    2617. BRUISES, LACERATIONS, AND CUTS.--Wherever the bruise may be, or however swollen or discoloured the skin may become, two or three applications of the extract of lead, kept to the part by means of lint, will, in an hour or little more, remove all pain, swelling, and tenderness. Simple or clean cuts only require the edges of the wound to be placed in their exact situation, drawn close together, and secured there by one or two slips of adhesive plaster. When the wound, however, is jagged, or the flesh or cuticle lacerated, the parts are to be laid as smooth and regular as possible, and a piece of lint, wetted in the extract of lead, laid upon the wound, and a piece of greased lint placed above it to prevent the dressing sticking; the whole covered over to protect from injury, and the part dressed in the same manner once a day till the cure is effected.

    2618. BRUISES AND THEIR TREATMENT.--The best application for a bruise, be it large or small, is moist warmth; therefore, a warm bread-and-water poultice in hot moist flannels should be put on, as they supple the skin. If the bruise be very severe, and in the neighbourhood of a joint, it will be well to apply ten or a dozen leeches over the whole bruised part, and afterwards a poultice. But leeches should not be put on young children. If the bruised part be the knee or the ankle, walking should not be attempted till it can be performed without pain. Inattention to this point often lays the foundation for serious mischief in these joints, especially in the case of scrofulous persons. In all conditions of bruises occurring in children, whether swellings or abrasions, no remedy is so quick or certain of effecting a cure as the pure extract of lead applied to the part.

    Burns and Scalds.

    2619. BURNS AND SCALDS being essentially the same in all particulars, and differing only in the manner of their production, may be spoken of together. As a general rule, scalds are less severe than burns, because the heat of water, by which scalds are mostly produced, is not, even when it is boiling, so intense as that of flame; oil, however, and other liquids, whose boiling-point is high, produce scalds of a very severe nature. Burns and scalds have been divided into three classes. The first class comprises those where the burn is altogether superficial, and merely reddens the skin; the second, where the injury is greater, and we get little bladders containing a fluid (called serum) dotted over the affected part; in the third class we get, in the case of burns, a charring, and in that of scalds, a softening or pulpiness, perhaps a complete and immediate separation of the part. This may occur at once, or in the course of a little time. The pain from the second kind of burns is much more severe than that in the other two, although the danger, as a general rule, is less than it is in the third class. These injuries are much more dangerous when they take place on the trunk than when they happen on the arms or legs. The danger arises more from the extent of surface that is burnt than from the depth to which the burn goes. This rule, of course, has certain exceptions; because a small burn on the chest or belly penetrating deeply is more dangerous than a more extensive but superficial one on the arm or leg. When a person's clothes are in flames, the best way of extinguishing them is to wind a rug, or some thick material, tightly round the whole of the body.
    2620. Treatment of the First Class of Burns and Scalds.--Of the part affected.--Cover it immediately with a good coating of common flour, or cotton-wool with flour dredged well into it. The great thing is to keep the affected surface of the skin from the contact of the air. The part will shortly get well, and the skin may or may not peel off.--Constitutional Treatment. If the burn or scald is not extensive, and there is no prostration of strength, this is very simple, and consists in simply giving a little aperient medicine--pills (No. 2), as follows:--Mix 5 grains of blue pill and the same quantity of compound extract of colocynth, and make into two pills--the dose for a full-grown person. Three hours after the pills give a black draught. If there are general symptoms of fever, such as hot skin, thirst, headache, &c. &c., two tablespoonfuls of fever-mixture are to be given every four hours. The fever-mixture, we remind our readers, is made thus:-Mix a drachm of powdered nitro, 2 drachms of carbonate of potash, 2 teaspoonfuls of antimonial wine, and a tablespoonful of sweet spirits of nitro, in half a pint of water.
    2621. Second Class. Local Treatment.--As the symptoms of these kinds of burns are more severe than those of the first class, so the remedies appropriate to them are more powerful. Having, as carefully as possible, removed the clothes from the burnt surface, and taking care not to break the bladders, spread the following liniment (No. 1) on a piece of linen or lint--not the fluffy side--and apply it to the part: the liniment should be equal parts of lime-water and linseed-oil, well mixed. If the burn is on the trunk of the body, it is better to use a warm linseed-meal poultice. After a few days dress the wound with Turner's cerate. If the burn is at the bend of the elbow, place the arm in the straight position; for if it is bent, the skin, when healed, will be contracted, and the arm, in all probability, always remain in the same un natural position. This, indeed, applies to all parts of the body; therefore, always place the part affected in the most stretched position possible.--Constitutional Treatment. The same kind of treatment is to be used as for the first class, only it must be more powerful. Stimulants are move often necessary, but must be given with great caution. If, as is often the case, there is great irritability and restlessness, a dose of opium (paregoric, in doses of from sixty to a hundred drops, according to age, is best) is of great service. The feverish symptoms will require aperient medicines and the fever mixture. A drink made of about a tablespoonful of cream of tartar and a little lemon-juice, in a quart of warm water, allowed to cool, is a very nice one in these cases. The diet throughout should not be too low, especially if there is much discharge from the wound. After a few days it is often necessary to give wine, ammonia, and strong beef-tea. These should be had recourse to when the tongue gets dry and dark, and the pulse weak and frequent. If there should be, after the lapse of a week or two, pain over one particular part of the belly, a blister should be put on it, and a powder of mercury and chalk-grey powder, and Dover's powder (two grains of the former and five of the latter) given three times a day. Affections of the head and chest also frequently occur as a consequence of these kinds of burns, but no one who is not a medical man can treat them.
    2622. Third Class.--These are so severe as to make it impossible for a non-professional person to be of much service in attending to them. When they occur, a surgeon should always be sent for. Until he arrives, however, the following treatment should be adopted:--Place the patient full-length on his back, and keep him warm. Apply fomentations of flannels wrung out of boiling water and sprinkled with spirits of turpentine to the part, and give wine and sal-volatile in such quantities as the prostration of strength requires; always bearing in mind the great fact that you have to steer between two quicksands--death from present prostration and death from future excitement, which will always be increased in proportion to the amount of stimulants given. Give, therefore, only just as much as is absolutely necessary to keep life in the body.

    2623. CONCUSSION OF BRAIN--STUNNING.--This may be caused by a blow or a fall.--Symptoms. Cold skin; weak pulse; almost total insensibility; slow, weak breathing; pupil of eye sometimes bigger, sometimes smaller, than natural; inability to move; unwillingness to answer when spoken to. These symptoms come on directly after the accident.--Treatment. Place the patient quietly on a warm bed, send for a surgeon, and do nothing else for the first four or six hours. After this time the skin will become hot, the pulse full, and the patient feverish altogether. If the surgeon has not arrived by the time these symptoms have set in, shave the patient's head, and apply the following lotion (No. 2): Mix half an ounce of sal-ammoniac, two tablespoonfuls of vinegar, and the same quantity of gin or whisky, in half a pint of water. Then give this pill (No. 1); Mix five grains of calomel and the same quantity of antimonial powder with a little bread-crumb, and make into two pills. Give a black draught three hours after the pill, and two tablespoonfuls of the above-mentioned fever-mixture every four hours. Keep on low diet. Leeches are sometimes to be applied to the head. These cases are often followed by violent inflammation of the brain. They can, therefore, only be attended to properly throughout by a surgeon. The great thing for people to do in these cases is--nothing; contenting themselves with putting the patient to bed, and waiting the arrival of a surgeon.

    2624. THE CHOLERA AND AUTUMNAL COMPLAINTS.--To oppose cholera, there seems no surer or better means than cleanliness, sobriety, and judicious ventilation. Where there is dirt, that is the place for cholera; where windows and doors are kept most jealously shut, there cholera will find easiest entrance; and people who indulge in intemperate diet during the hot days of autumn are actually courting death. To repeat it, cleanliness, sobriety, and free ventilation almost always defy the pestilence; but, in case of attack, immediate recourse should be had to a physician. The faculty say that a large number of lives have been lost, in many seasons, solely from delay in seeking medical assistance. They even assert that, taken early, the cholera is by no means a fatal disorder. The copious use of salt is recommended on very excellent authority. Other autumnal complaints there are, of which diarrhoea is the worst example. They come on with pain, flatulence, sickness, with or without vomiting, followed by loss of appetite, general lassitude, and weakness. If attended to at the first appearance, they may soon be conquered; for which purpose it is necessary to assist nature in throwing off the contents of the bowels, which may be one by means of the following prescription:--Take of calomel 3 grains, rhubarb 8 grains; mix and take it in a little honey or jelly, and repeat the dose three times, at the intervals of four or five hours. The next purpose to be answered is the defence of the lining membrane of the intestines from their acrid contents, which will be best effected by drinking copiously of linseed tea, or of a drink made by pouring boiling water on quince-seeds, which are of a very mucilaginous nature; or, what is still better, full draughts of whey. If the complaint continue after these means have been employed, some astringent or binding medicine will be required, as the subjoined:--Take of prepared chalk 2 drachms, cinnamon-water 7 oz., syrup of poppies 1 oz.; mix, and take 3 tablespoonfuls every four hours. Should this fail to complete the cure, 1/2 oz. of tincture of catechu, or of kino, may be added to it, and then it will seldom fail; or a teaspoonful of the tincture of kino alone, with a little water, every three hours, till the diarrhoea is checked. While any symptoms of derangement are present, particular attention must be paid to the diet, which should be of a soothing, lubricating, and light nature, as instanced in veal or chicken broth, which should contain but little salt. Rice, batter, and bread puddings will be generally relished, and be eaten with advantage; but the stomach is too much impaired to digest food of a more solid nature. Indeed, we should give that organ, together with the bowels, as little trouble as possible, while they are so incapable of acting in their accustomed manner. Much mischief is frequently produced by the absurd practice of taking tincture of rhubarb, which is almost certain of aggravating that species of disorder of which we have now treated; for it is a spirit as strong as brandy, and cannot fail of producing harm upon a surface which is rendered tender by the formation and contact of vitiated bile. But our last advice is, upon the first appearance of such symptoms as are above detailed, have immediate recourse to a doctor, where possible.

    2625. TO CURE A COLD.--Put a large teacupful of linseed, with 1/4 lb. of sun raisins and 2 oz. of stick liquorice, into 2 quarts of soft water, and let it simmer over a slow fire till reduced to one quart; add to it 1/4 lb. of pounded sugar-candy, a tablespoonful of old rum, and a tablespoonful of the best white-wine vinegar, or lemon-juice. The rum and vinegar should be added as the decoction is taken; for, if they are put in at first, the whole soon becomes flat and less efficacious. The dose is half a pint, made warm, on going to bed; and a little may be taken whenever the cough is troublesome. The worst cold is generally cured by this remedy in two or three days; and, if taken in time, is considered infallible.

    2626. COLD ON THE CHEST.--A flannel dipped in boiling water, and sprinkled with turpentine, laid on the chest as quickly as possible, will relieve the most severe cold or hoarseness.

    2627. SUBSTANCES IN THE EYE.--To remove fine particles of gravel, lime, &c., the eye should be syringed with lukewarm water till free from them. Be particular not to worry the eye, under the impression that the substance is still there, which the enlargement of some of the minute vessels makes the patient believe is actually the case.

    2628. SORE EYES.--Incorporate thoroughly, in a glass mortar or vessel, one part of strong citron ointment with three parts of spermaceti ointment. Use the mixture night and morning, by placing a piece of the size of a pea in the corner of the eye affected, only to be used in cases of chronic or long-standing inflammation of the organ, or its lids.

    2629. LIME IN THE EYE.--Bathe the eye with a little weak vinegar-and-water, and carefully remove any little piece of lime which may be seen, with a feather. If any lime has got entangled in the eyelashes, carefully clear it away with a bit of soft linen soaked in vinegar-and-water. Violent inflammation is sure to follow; a smart purge must be therefore administered, and in all probability a blister must be applied on the temple, behind the ear, or nape of the neck.

     2630. STYE IN THE EYE.--Styes are little abscesses which form between the roots of the eyelashes, and are rarely larger than a small pea. The best way to manage them is to bathe them frequently with warm water, or in warm poppy-water, if very painful. When they have burst, use an ointment composed of one part of citron ointment and four of spermaceti, well rubbed together, and smear along the edge of the eyelid. Give a grain or two of calomel with 5 or 8 grains of rhubarb, according to the age of the child, twice a week. The old-fashioned and apparently absurd practice of rubbing the stye with a ring, is as good and speedy a cure as that by any process of medicinal application; though the number of times it is rubbed, or the quality of the ring and direction of the strokes, has nothing to do with its success. The pressure and the friction excite the vessels of the part, and cause an absorption of the effused matter under the eyelash. The edge of the nail will answer as well as a ring.

    2631. INFLAMMATION OF THE EYELIDS.--The following ointment has been found very beneficial in inflammations of the eyeball and edges of the eyelids:--Take of prepared calomel, 1 scruple; spermaceti ointment, 1/2 oz. Mix them well together in a glass mortar; apply a small quantity to each corner of the eye every night and morning, and also to the edges of the lids, if they are affected. If this should not eventually remove the inflammation, elder-flower water may be applied three or four times a day, by means of an eye-cup. The bowels should be kept in a laxative state, by taking occasionally a quarter of an ounce of the Cheltenham or Epsom salts.
    2632. FASTING.--It is said by many able physicians that fasting is a means of removing incipient disease, and of restoring the body to its customary healthy sensations. Howard, the celebrated philanthropist (says a writer), used to fast one day in every week. Napoleon, when he felt his system unstrung, suspended his wonted repast, and took his exercise on horseback.

     Fits.

    2633. Fits come on so suddenly, often without even the slightest warning, and may prove fatal so quickly, that all people should be acquainted at least with their leading symptoms and treatment, as a few moments, more or less, will often decide the question between life and death. The treatment, in very many cases at least, to be of the slightest use, should be immediate, as a person in a fit (of apoplexy for instance) may die while a surgeon is being fetched from only the next street. We shall give, as far as the fact of our editing a work for non-professional readers will permit, the peculiar and distinctive symptoms of all kind of fits, and the immediate treatment to be adopted in each case.

    2634. APOPLEXY.--These fits may be divided into two kinds--the strong and the weak.
    2635. 1. The strong kind.--These cases mostly occur in stout, strong, short-necked, bloated-faced people, who are in the habit of living well.--Symptoms. The patient may or may not have had headache, sparks before his eyes, with confusion of ideas and giddiness, for a day or two before the attack. When it takes place, he falls down insensible; the body becomes paralyzed, generally more so on one side than the other; the face and head are hot, and the blood-vessels about them swollen; the pupils of the eyes are larger than natural, and the eyes themselves are fixed; the mouth is mostly drawn down at one corner; the breathing is like loud snoring; the pulse full and hard.--Treatment. Place the patient immediately in bed, with his head well raised; take off everything that he has round his neck, and bleed freely and at once from the arm. If you have not got a lancet, use a penknife or anything suitable that may be at hand. Apply warm mustard poultices to the soles of the feet and the insides of the thighs and legs; put two drops of castor oil, mixed up with eight grains of calomel, on the top of the tongue, as far back as possible; a most important part of the treatment being to open the bowels as quickly and freely as possible. The patient cannot swallow; but these medicines, especially the oil, will be absorbed into the stomach altogether independent of any voluntary action. If possible, throw up a warm turpentine clyster (two tablespoonfuls of oil of turpentine in a pint of warm gruel), or, if this cannot be obtained, one composed of about a quart of warm salt-and-water and soap. Cut off the hair, and apply rags dipped in weak vinegar-and-water, or weak gin-and-water, or even simple cold water, to the head. If the blood-vessels about the head and neck are much swollen, put from eight to ten leeches on the temple opposite to the paralyzed side of the body. Always send for a surgeon immediately, and act according to the above rules, doing more or less, according to the means at hand, and the length of time that must necessarily elapse until he arrives. A pint, or even a quart of blood in a very strong person, may be taken away. When the patient is able to swallow, give him the No. 1 pills, and the No. 1 mixture directly. [The No. 1 pills are made as follows:--Mix 5 grains of calomel and the same quantity of antimonial powder with a little bread-crumb: make into two pills, the dose for a full-grown person. For the No. 1 mixture, dissolve on ounce of Epsom salts in half a pint of senna tea: take a quarter of the mixture as a dose] Repeat these remedies if the bowels are not well opened. Keep the patient's head well raised, and cool as above. Give very low diet indeed: gruel, arrowroot, and the like. When a person is recovering, he should have blisters applied to the nape of the neck, his bowels should be kept well open, light diet given, and fatigue, worry, and excess of all kinds avoided.
    2636. 2. The weak kind.--Symptoms. These attacks are more frequently preceded by warning symptoms than the first kind. The face is pale, the pulse weak, and the body, especially the hands and legs, cold. After a little while, these symptoms sometimes alter to those of the first class in a mild degree.--Treatment. At first, if the pulse is very feeble indeed, a little brandy-and-water or sal-volatile must be given. Mustard poultices are to be put, as before, to the soles of the foot and the insides of the thighs and legs. Warm bricks, or bottles filled with warm water, are also to be placed under the armpits. When the strength has returned, the body become warmer, and the pulse fuller and harder, the head should be shaved, and wet rags applied to it, as before described. Leeches should be put, as before, to the temple opposite the side paralyzed; and the bowels should be opened as freely and as quickly as possible. Bleeding from the arm is often necessary in these cases, but a non-professional person should never have recourse to it. Blisters may be applied to the nape of the neck at once. The diet in those cases should not be so low as in the former--indeed, it is often necessary, in a day or so after one of these attacks, to give wine, strong beef-tea, &c., according to the condition of the patient's strength.
    2637. Distinctions between Apoplexy and Epilepsy.--1. Apoplexy mostly happens in people over thirty, whereas epilepsy generally occurs under that ago; at any rate for the first time. A person who has epileptic fits over thirty, has generally suffered from them for some years. 2. Again, in apoplexy, the body is paralyzed; and, therefore, has not the convulsions which take place in epilepsy. 3. The peculiar snoring will also distinguish apoplexy from epilepsy.
    2638. Distinctions between Apoplexy and Drunkeness.--1. The known habits of the person. 2. The fact of a person who was perfectly sober and sensible a little time before, being found in a state of insensibility. 3. The absence, in apoplexy, of the smell of drink on applying the nose to the mouth. 4. A person in a fit of apoplexy cannot be roused at all; in drunkenness he mostly can, to a certain extent.
    2639. Distinction between Apoplexy and Hysteria.--Hysterics mostly happen in young, nervous, unmarried women; and are attended with convulsions, sobbing, laughter, throwing about of the body, &c. &c.
    2640. Distinction between Apoplexy and Poisoning by Opium.--It is exceedingly difficult to distinguish between these two cases. In poisoning by opium, however, we find the particular smell of the drug in the patient's breath. We should also, in forming our opinion, take into consideration the person's previous conduct--whether he has been low and desponding for some time before, or has ever talked about committing suicide.

    2641. EPILEPSY.--Falling Sickness.--Those fits mostly happen, at any rate for the first time, to young people, and are more common in boys than girls. They are produced by numerous causes.--Symptoms. The fit may be preceded by pains in the head, palpitations, &c. &c.; but it mostly happens that the person falls down insensible suddenly, and without any warning whatever. The eyes are distorted, so that only their whites can be seen; there is mostly foaming from the mouth; the fingers are clinched; and the body, especially on one side, is much agitated; the tongue is often thrust out of the mouth. When the fit goes off, the patient feels drowsy and faint, and often sleeps soundly for some time.--Treatment. During the fit, keep the patient flat on his back, with his head slightly raised, and prevent him from doing any harm to himself; dash cold water into his face, and apply smelling-salts to his nose; loosen his shirt collar, &c.; hold a piece of wood about as thick as a finger--the handle of a tooth-brush or knife will do as well--between the two rows of teeth, at the back part of the mouth. This will prevent the tongue from being injured. A teaspoonful of common salt thrust into the patient's mouth, during the fit, is of much service. The after-treatment of these fits is various, and depends entirely upon their causes. A good general rule, however, is always to keep the bowels well open, and the patient quiet, and free from fatigue, worry, and excess of all kinds.
    2642. Fainting Fits are sometimes very dangerous, and at others perfectly harmless; the question of danger depending altogether upon the causes which have produced them, and which are exceedingly various. For instance, fainting produced by disease of the heart is a very serious symptom indeed; whereas, that arising from some slight cause, such as the sight of blood, &c., need cause no alarm whatever. The symptoms of simple fainting are so well known that it would be quite superfluous to enumerate them here. The treatment consists in laying the patient at full length upon his back, with his head upon a level with the rest of his body, loosening everything about the neck, dashing cold water into the face, and sprinkling vinegar and water about the mouth; applying smelling-salts to the nose; and, when the patient is able to swallow, in giving a little warm brandy-and-water, or about 20 drops of sal-volatile in water.
    2643. Hysterics.--These fits take place, for the most part, in young, nervous, unmarried women. They happen much less often in married women; and even (in some rare cases indeed) in men. Young women, who are subject to these fits, are apt to think that they are suffering from "all the ills that flesh is heir to;" and the false symptoms of disease which they show are so like the true ones, that it is often exceedingly difficult to detect the difference. The fits themselves are mostly preceded by great depression of spirits, shedding of tears, sickness, palpitation of the heart, &c. A pain, as if a nail were being driven in, is also often felt at one particular part of the head. In almost all cases, when a fit is coming on, pain is felt on the left side. This pain rises gradually until it reaches the throat, and then gives the patient a sensation as if she had a pellet there, which prevents her from breathing properly, and, in fact, seems to threaten actual suffocation. The patient now generally becomes insensible, and faints; the body is thrown about in all directions, froth issues from the mouth, incoherent expressions are uttered, and fits of laughter, crying, or screaming, take place. When the fit is going off, the patient mostly cries bitterly, sometimes knowing all, and at others nothing, of what has taken place, and feeling general soreness all over the body. Treatment during the fit. Place the body in the same position as for simple fainting, and treat, in other respects, as directed in the article on Epilepsy. Always well loosen the patient's stays; and, when she is recovering, and able to swallow, give 20 drops of sal volatile in a little water. The after-treatment of these cases is very various. If the patient is of a strong constitution, she should live on plain diet, take plenty of exercise, and take occasional doses of castor oil, or an aperient mixture, such as that described as "No. 1," in previous numbers. If, as is mostly the case, the patient is weak and delicate, she will require a different mode of treatment altogether. Good nourishing diet, gentle exercise, cold baths, occasionally a dose of No. 3 myrrh and aloes pills at night, and a dose of compound iron pills twice a day. [As to the myrrh and aloes pills (No. 3), 10 grains made into two pills are a dose for a full-grown person. Of the compound iron pills (No. 4), the dose for a full grown person is also 10 grains, made into two pills.] In every case, amusing the mind, and avoiding all causes of over-excitement, are of great service in bringing about a permanent cure.
    2644. LIVER COMPLAINT AND SPASMS.--A very obliging correspondent recommends the following, from personal experience:--Take 4 oz. of dried dandelion root, 1 oz. of the best ginger, 1/4 oz. of Columba root; braise and boil all together in 3 pints of water till it is reduced to a quart: strain, and take a wine-glassful every four hours. Our correspondent says it is a "safe and simple medicine for both liver complaint and spasms."
    2645. LUMBAGO.--A "new and successful mode" of treating lumbago, advocated by Dr. Day, is a form of counter-irritation, said to have been introduced into this country by the late Sir Anthony Carlisle, and which consists in the instantaneous application of a flat iron button, gently heated in a spirit-lamp, to the skin. Dr. Corrigan published, about three years ago, an account of some cases very successfully treated by nearly similar means. Dr. Corrigan's plan was, however, to touch the surface of the part affected, at intervals of half an inch, as lightly and rapidly as possible. Dr. Day has found greater advantages to result from drawing the flat surface of the heated button lightly over the affected part, so as to act on a greater extent of surface. The doctor speaks so enthusiastically of the benefit to be derived from this practice, that it is evidently highly deserving attention.
    2646. PALPITATION OF THE HEART.--Where palpitation occurs as symptomatic of indigestion, the treatment must be directed to remedy that disorder; when it is consequent on a plethoric state, purgatives will be effectual. In this case the patient should abstain from every kind of diet likely to produce a plethoric condition of body. Animal food and fermented liquor must be particularly avoided. Too much indulgence in sleep will also prove injurious. When the attacks arise from nervous irritability, the excitement must be allayed by change of air and a tonic diet. Should the palpitation originate from organic derangement, it must be, of course, beyond domestic management. Luxurious living, indolence, and tight-lacing often produce this affection: such cases are to be conquered with a little resolution.

     2647. Poisons shall be the next subject for remark; and we anticipate more detailed instructions for the treatment of persons poisoned, by giving a simple LIST OF THE PRINCIPAL POISONS, with their ANTIDOTES OR REMEDIES.

     Oil of Vitriol, Aquafortis, Spirit of Salt  = Magnesia, Chalk, Soap-and-Water
     Emetic Tartar = Oily Drinks, Solution of Oak-bark.
     Salt of Lemons, or Acid of Sugar. =  Chalk, Whiting, Lime or Magnesia and Water. Sometimes an Emetic Draught.
     Prussic Acid. =  Pump on back, Smelling-Salts to nose, Artificial Breathing, Chloride of Lime to nose.
     Pearlash. Soap-Lees.  Smelling-Salts. Nitre, Hartshorn, Sal-Volatile = Lemon-Juice and Vinegar-and-Water 
     Arsenic, Fly-Powder, or White Arsenic, Kings Yellow, or Yellow Arsenic. =  Emetics, Lime-Water, Soap-and-Water, Sugar and Water, Oily Drinks. 
     Mercury, Corrosive Sublimate, Calomel =  Whites of Eggs, Soap-and-Water.
     Opium, Laudanum = Emetic Draught, Vinegar-and-Water, dashing Cold Water on chest and face, walking up and down two or three hours.
     Lead, White Lead, Sugar of Lead, Goulard's Extract = Epsom Salts, Castor Oil, Emetics.
     Copper, Blue-stone, Verdigris = Whites of Eggs, Sugar-and-Water, Castor Oil, Gruel.
     Zinc = Lime-Water, Chalk-and-Water, Soap-and-Water.
     Iron = Magnesia, Warm Water.
     Henbane, Hemlock, Nightshade, Foxlgove = Emetics and Castor Oil; Brandy-and-Water, if necessary.
     Poisonous Food = Emetics and Castor Oil.

    2648. The symptoms of poisoning may be known for the most part from those of some diseases, which they are very like, from the fact of their coming on immediately after eating or drinking something; whereas those of disease come on, in most cases at least, by degrees, and with warnings. In most cases where poison is known, or suspected, to have been taken, the first thing to be done is to empty the stomach, well and immediately, by means of mustard mixed in warm water, or plain warm salt-and-water, or, better, this draught, which we call No. 1:--Twenty grains of sulphate of zinc in an ounce and a half of water. This draught to be repeated in a quarter of an hour if vomiting does not ensue. The back part of the throat should be well tickled with a feather, or two of the fingers thrust down it, to induce vomiting. The cases where vomiting must not be used are those where the skin has been taken off, and the parts touched irritated and inflamed by the poison taken, and where the action of vomiting would increase the evil. Full instructions are given in the article on each particular poison as to where emetics are or are not to be given. The best and safest way of emptying the stomach is by means of the stomach-pump, as in certain cases the action of vomiting is likely to increase the danger arising from the swollen and congested condition of the blood-vessels of the head, which often takes place. In the hands, however, of any one else than a surgeon, it would be not only useless, but harmful, as a great deal of dexterity, caution, and experience are required to use it properly. After having made these brief introductory remarks, we shall now proceed to particulars.
    2649. Sulphuric Acid, or Oil of Vitriol (a clear, colourless liquid, of an oily appearance).--Symptoms in those who have swallowed it. When much is taken, these come on immediately. There is great burning pain, extending from the mouth to the stomach; vomiting of a liquid of a dark coffee-colour, often mixed with shreds of flesh and streaks of blood; the skin inside the mouth is taken off; and the exposed surface is at first white, and after a time becomes brownish. There are sometimes spots of a brown colour round the lips and on the neck, caused by drops of the acid falling on these parts. There is great difficulty of breathing, owing to the swelling at the back part of the mouth. After a time there is much depression of strength, with a quick, weak pulse, and cold, clammy skin. The face is pale, and has a very anxious look. When the acid swallowed has been greatly diluted in water, the same kind of symptoms occur, only in a milder degree.--Treatment. Give a mixture of magnesia in milk-and-water, or, if this cannot be obtained, of finely powdered chalk, or whiting, or even of the plaster torn down from the walls or ceiling, in milk-and-water. The mixture should be nearly as thick as cream, and plenty of it given. As well as this, simple gruel, milk, or thick flour-and-water, are very useful, and should be given in large quantities. Violent inflammation of the parts touched by the acid is most likely to take place in the coarse of a little time, and can only be properly attended to by a surgeon; but if one cannot be obtained, leeches, the fever-mixtures (the recipe for which appears repeatedly in previous paragraphs), thick drinks, such as barley-water, gruel, arrowroot, &c., must be had recourse to, according to the symptoms of each particular case and the means at hand. The inflamed condition of the back part of the mouth requires particular attention. When the breathing is very laboured and difficult in consequence, from fifteen to twenty leeches are to be immediately applied to the outside of the throat, and when they drop off, warm poppy fomentations constantly kept to the part. When the pain over the stomach is very great, the same local treatment is necessary; but if it is only slight, a good mustard poultice will be sufficient without the leeches. In all these cases, two tablespoonfuls of the fever-mixture should be given every four hours, and only gruel or arrowroot allowed to be eaten for some days.
    2650. Nitric Acid, commonly known as Aqua Fortis, or Red Spirit of Nitre (a straw-coloured fluid, of the consistence of water, and which gives off dense white fumes on exposure to the air).--Symptoms produced in those who have swallowed it. Much the same as in the case of sulphuric acid. In this case, however, the surface touched by the acid becomes yellowish. The tongue is mostly much swollen.--Treatment. The same as for sulphuric acid.
    2651. Muriatic Acid, Spirit of Salt (a thin yellow fluid, emitting dense white fumes on exposure to the air).--This is not often taken as a poison. The symptoms and treatment are much the same as those of nitric acid.
    N.B.--In no case of poisoning by these three acids should emetics ever be given.
    2652. Oxalic Acid, commonly called Salt of Lemons.--This poison may be taken by mistake for Epsom salts, which it is a good deal like. It may be distinguished from them by its very acid taste and its shape, which is that of needle-formed crystals, each of which, if put into a drop of ink, will turn it to a reddish brown, whereas Epsom salts will not change its colour at all. When a large dose of this poison has been taken, death takes place very quickly indeed.--Symptoms produced in those who have swallowed it. A hot, burning, acid taste is felt in the act of swallowing, and vomiting of a greenish-brown fluid is produced, sooner or later, according to the quantity and strength of the poison taken. There is great tenderness felt over the stomach, followed by clammy perspirations and convulsions; the legs are often drawn up, and there is generally stupor, from which the patient, however, can easily be roused, and always great prostration of strength. The pulse is small and weak, and the breathing faint.--Treatment. Chalk or magnesia, made into a cream with water, should be given in large quantities, and afterwards the emetic draught above prescribed, or some mustard-and-water, if the draught cannot be got. The back part of the throat to be tickled with a feather, to induce vomiting. Arrowroot, gruel, and the like drinks, are to be taken. When the prostration of strength is very great and the body cold, warmth is to be applied to it, and a little brandy-and-water, or sal-volatile and water, given.
    2653. Prussic Acid (a thin, transparent, and colourless liquid, with a peculiar smell, which greatly resembles that of bitter almonds).--Symptoms produced in those who have swallowed it. These come on immediately after the poison has been taken, and may be produced by merely smelling it. The patient becomes perfectly insensible, and falls down in convulsions--his eyes are fixed and staring, the pupils being bigger than natural, the skin is cold and clammy, the pulse scarcely perceptible, and the breathing slow and gasping.--Treatment. Very little can be done in these cases, as death takes place so quickly after the poison has been swallowed, when it takes place at all. The best treatment--which should always be adopted in all cases, even though the patient appears quite dead-is to dash quantities of cold water on the back, from the top of the neck downwards. Placing the patient under a pump, and pumping on him, is the best way of doing this. Smelling-salts are also to be applied to the nose, and the chest well rubbed with a camphor liniment.
    2654. ALKALIS: Potash, Soda, and Ammonia, or common Smelling-Salts, with their principal preparations--Pearlash, Soap Lees, Liquor Potassae, Nitre, Sal Prunella, Hartshorn, and Sal--Volatile.--Alkalis are seldom taken or given with the view of destroying life. They may, however, be swallowed by mistake.--Symptoms produced in those who have swallowed them. There is at first a burning, acrid taste in, and a sensation of tightness round, the throat, like that of strangling; the skin touched is destroyed; retching mostly followed by actual vomiting, then sets in; the vomited matters often containing blood of a dark brown colour, with little shreds of flesh here and there, and always changing vegetable blue colours green. There is now great tenderness over the whole of the belly. After a little while, great weakness, with cold, clammy sweats, a quick weak pulse, and purging of bloody matters, takes place. The brain, too, mostly becomes affected.--Treatment. Give two tablespoonfuls of vinegar or lemon-juice in a glassful of water every few minutes until the burning sensation is relieved. Any kind of oil or milk may also be given, and will form soap when mixed with the poison in the stomach. Barley-water, gruel, arrowroot, linseed-tea, &c., are also very useful, and should be taken constantly, and in large quantities. If inflammation should take place, it is to be treated by applying leeches and warm poppy fomentations to the part where the pain is most felt, and giving two tablespoonfuls of the fever mixture every four hours. The diet in all these cases should only consist of arrowroot or gruel for the first few days, and then of weak broth or beef-tea for some time after.
    2655. When very strong fumes of smelling-salts have in any way been inhaled, there is great difficulty of breathing, and alarming pain in the mouth and nostrils. In this case let the patient inhale the steam of warm vinegar, and treat the feverish symptoms as before.
    2656. Arsenic.--Mostly seen under the form of white arsenic, or fly-powder, and yellow arsenic, or king's yellow.--Symptoms produced in those who have swallowed it. These vary very much, according to the form and dose in which the poison has been taken. There is faintness, depression, and sickness, with an intense burning pain in the region of the stomach, which gets worse and worse, and is increased by pressure. There is also vomiting of dark brown matter, sometimes mixed with blood; and mostly great thirst, with a feeling of tightness round, and of burning in, the throat. Purging also takes place, the matters brought away being mixed with blood. The pulse is small and irregular, and the skin sometimes cold and clammy, and at others hot. The breathing is painful. Convulsions and spasms often occur.--Treatment. Give a couple of teaspoonfuls of mustard in a glass of water, to bring on or assist vomiting, and also use the other means elsewhere recommended for the purpose. A solution, half of lime-water and half of linseed-oil, well mixed, may be given, as well as plenty of arrowroot, gruel, or linseed-tea. Simple milk is also useful. A little castor-oil should be given, to cleanse the intestines of all the poison, and the after-symptoms treated on general principles.
    2657. Corrosive Sublimate.--Mostly seen in the form of little heavy crystalline masses, which melt in water, and have a metallic taste. It is sometimes seen in powder. This is a most powerful poison.--Symptoms. These mostly come on immediately after the poison has been taken. There is a coppery taste experienced in the act of swallowing, with a burning heat, extending from the top of the throat down to the stomach; and also a feeling of great tightness round the throat. In a few minutes great pain is felt over the region of the stomach, and frequent vomiting of long, stringy white masses, mixed with blood, takes place. There is also mostly great purging. The countenance is generally pale and anxious; the pulse always small and frequent; the skin cold and clammy, and the breathing difficult. Convulsions and insensibility often occur, and are very bad symptoms indeed. The inside of the mouth is more or less swollen.--Treatment. Mix the whites of a dozen eggs in two pints of cold water, and give a glassful of the mixture every three or four minutes, until the stomach can contain no more. If vomiting does not now come on naturally, and supposing the mouth is not very sore or much swollen, an emetic draught, No. 1, may be given, and vomiting induced. (The No. 1 draught, we remind our readers, is thus made:--Twenty grains of sulphate of zinc in an ounce and a half of water; the draught to be repeated if vomiting does not take place in a quarter of an hour.) After the stomach has been well cleaned out, milk, flour-and-water, linseed-tea, or barley-water, should be taken in large quantities. If eggs cannot be obtained, milk, or flour-and-water, should be given as a substitute for them at once. When the depression of strength is very great indeed, a little warm brandy-and-water must be given. In the course of an hour or two the patient should take two tablespoonfuls of castor-oil, and if inflammation comes on, it is to be treated as directed in the article on acids and alkalis. The diet should also be the same. If the patient recovers, great soreness of the gums is almost certain to take place. The simplest, and at the same time one of the best modes of treatment, is to wash them well three or four times a day with brandy-and-water.
    2658. Calomel.--A heavy white powder, without taste, and insoluble in water. It has been occasionally known to destroy life.--Symptoms. Much the same as in the case of corrosive sublimate.--Treatment. The same as for corrosive sublimate. If the gums are sore, wash them, as recommended in the case of corrosive sublimate, with brandy-and-water three or four times a day, and keep the patient on fluids, such as arrowroot, gruel, broth, or beef-tea, according to the other symptoms. Eating hard substances would make the gums more sore and tender.
    2659. Copper.--The preparations of this metal which are most likely to be the ones producing poisonous symptoms, are blue-stone and verdigris. People are often taken ill after eating food that has been cooked in copper saucepans. When anything has been cooked in one of these vessels, it should never be allowed to cool in it.--Symptoms. Headache, pain in the stomach, and purging; vomiting of green or blue matters, convulsions, and spasms.--Treatment. Give whites of eggs, sugar-and-water, castor-oil, and drinks, such as arrowroot and gruel.
    2660. Emetic Tartar.--Seen in the form of a white powder, or crystals, with a slightly metallic taste. It has not often been known to destroy life.--Symptoms. A strong metallic taste in the act of swallowing, followed by a burning pain in the region of the stomach, vomiting, and great purging. The pulse is small and rapid, the skin cold and clammy, the breathing difficult and painful, and the limbs often much cramped. There is also great prostration of strength.--Treatment. Promote the vomiting by giving plenty of warm water, or warm arrowroot and water. Strong tea, in large quantities, should be drunk; or, if it can be obtained, a decoction of oak bark. The after-treatment is the same as that for acids and alkalis; the principal object in all these cases being to keep down the inflammation of the parts touched by the poison by means of leeches, warm poppy fomentations, fever-mixtures, and very low diet.
    2661. Lead, and its preparations, Sugar of Lead, Goulard's Extract, White Lead.--Lead is by no means an active poison, although it is popularly considered to be so. It mostly affects people by being taken into the system slowly, as in the case of painters and glaziers. A newly-painted house, too, often affects those living in it.--Symptoms produced when taken in a large dose. There is at first a burning, pricking sensation in the throat, to which thirst, giddiness, and vomiting follow. The belly is tight, swollen, and painful; the pain being relieved by pressure. The bowels are mostly bound. There is great depression of strength, and a cold skin.--Treatment. Give an emetic draught (No. 1, see above) at once, and shortly afterwards a solution of Epsom salts in large quantities. A little brandy-and-water must be taken if the depression of strength is very great indeed. Milk, whites of eggs, and arrowroot are also useful. After two or three hours, cleanse the stomach and intestines well out with two tablespoonfuls of castor-oil, and treat the symptoms which follow according to the rules laid down in other parts of these articles.--Symptoms when it is taken into the body slowly. Headache, pain about the navel, loss of appetite and flesh, offensive breath, a blueness of the edges of the gums; the belly is tight, hard, and knotty, and the pulse slow and languid. There is also sometimes a difficulty in swallowing.--Treatment. Give five grains of calomel and half a grain of opium directly, in the form of a pill, and half an ounce of Epsom salts in two hours, and repeat this treatment until the bowels are well opened. Put the patient into a warm bath, and throw up a clyster of warmish water when he is in it. Fomentations of warm oil of turpentine, if they can be obtained, should be put over the whole of the belly. The great object is to open the bowels as freely and as quickly as possible. When this has been done, a grain of pure opium may be given. Arrowroot or gruel should be taken in good large quantities. The after-treatment must depend altogether upon the symptoms of each particular case.
    2662. Opium, and its preparations, Laudanum, &c.--Solid opium is mostly seen in the form of rich brown flattish cakes, with little pieces of leaves sticking on them here and there, and a bitter and slightly warm taste. The most common form in which it is taken as a poison, is that of laudanum.--Symptoms. These consist at first in giddiness and stupor, followed by insensibility, the patient, however, being roused to consciousness by a great noise, so as to be able to answer a question, but becoming insensible again almost immediately. The pulse is now quick and small, the breathing hurried, and the skin warm and covered with perspiration. After a little time, these symptoms change; the person becomes perfectly insensible, the breathing slow and snoring, as in apoplexy, the skin cold, and the pulse slow and full. The pupil of the eye is mostly smaller than natural. On applying his nose to the patient's mouth, a person may smell the poison very distinctly.--Treatment. Give an emetic draught (No. 1, see above) directly, with large quantities of warm mustard-and-water, warm salt-and-water, or simple warm water. Tickle the top of the throat with a feather, or put two fingers down it to bring on vomiting, which rarely takes place of itself. Dash cold water on the head, chest, and spine, and flap these parts well with the ends of wet towels. Give strong coffee or tea. Walk the patient up and down in the open air for two or three hours; the great thing being to keep him from sleeping. Electricity is of much service. When the patient is recovering, mustard poultices should be applied to the soles of the feet and the insides of the thighs and legs. The head should be kept cool and raised.
    2663. The following preparations, which are constantly given to children by their nurses and mothers, for the purpose of making them sleep, often prove fatal:--Syrup of Poppies, and Godfrey's Cordial. The author would most earnestly urge all people caring for their children's lives, never to allow any of these preparations to be given, unless ordered by a surgeon.
    2664. The treatment in the case of poisoning by Henbane, Hemlock, Nightshade, and Foxglove, is much the same as that for opium. Vomiting should be brought on in all of them.
    2665. Poisonous Food.--It sometimes happens that things which are in daily use, and mostly perfectly harmless, give rise, under certain unknown circumstances, and in certain individuals, to the symptoms of poisoning. The most common articles of food of this description are Mussels, Salmon, and certain kinds of Cheese and Bacon. The general symptoms are thirst, weight about the stomach, difficulty of breathing, vomiting, purging, spasms, prostration of strength, and, in the case of mussels more particularly, an eruption on the body, like that of nettle-rash.--Treatment. Empty the stomach well with No. 1 draught and warm water, and give two tablespoonfuls of castor-oil immediately after. Let the patient take plenty of arrowroot, gruel, and the like drinks, and if there is much depression of strength, give a little warm brandy-and-water. Should symptoms of fever or inflammation follow, they must be treated as directed in the articles on other kinds of poisoning.
    2666. Mushrooms, and similar kinds of vegetables, often produce poisonous effects. The symptoms are various, sometimes giddiness and stupor, and at others pain in and swelling of the belly, with vomiting and purging, being the leading ones. When the symptoms come on quickly after taking the poison, it is generally the head that is affected.--The treatment consists in bringing on vomiting in the usual manner, as quickly and as freely as possible. The other symptoms are to be treated on general principles; if they are those of depression, by brandy-and-water or sal-volatile; if those of inflammation, by leeches, fomentations, fever-mixtures, &c. &c.

    2667. FOR CURE OF RINGWORM.--Take of subcarbonate of soda 1 drachm, which dissolve in 1/2 pint of vinegar. Wash the head every morning with soft soap, and apply the lotion night and morning. One teaspoonful of sulphur and treacle should also be given occasionally night and morning. The hair should be cut close, and round the spot it should be shaved off, and the part, night and morning, bathed with a lotion made by dissolving a drachm of white vitriol in 8 oz. of water. A small piece of either of the two subjoined ointments rubbed into the part when the lotion has dried in. No, 1.--Take of citron ointment 1 drachm; sulphur and tar ointment, of each 1/2 oz.: mix thoroughly, and apply twice a day. No. 2.--Take of simple cerate 1 oz.; creosote 1 drachm; calomel 30 grains: mix and use in the same manner as the first. Concurrent with these external remedies, the child should take an alterative powder every morning, or, if they act too much on the bowels, only every second day. The following will be found to answer all the intentions desired.
    2668. Alterative Powders for Ringworm.--Take of
     Sulphuret of antimony, precipitated . 24 grains. Grey powder . . . . . 12 grains. Calomel . . . . . . 6 grains. Jalap powder . . . . . 36 grains.
    Mix carefully, and divide into 12 powders for a child from 1 to 2 years old; into 9 powders for a child from 2 to 4 years; and into 6 powders for a child from 4 to 6 years. Where the patient is older, the strength may be increased by enlarging the quantities of the drugs ordered, or by giving one and a half or two powders for one dose. The ointment is to be well washed off every morning with soap-and-water, and the part bathed with the lotion before re-applying the ointment. An imperative fact must be remembered by mother or nurse,--never to use the same comb employed for the child with ringworm, for the healthy children, or let the affected little one sleep with those free from the disease; and, for fear of any contact by hands or otherwise, to keep the child's head enveloped in a nightcap, till this eruption is completely cured.

    2669. SCRATCHES.--Trifling as scratches often seem, they ought never to be neglected, but should be covered and protected, and kept clean and dry until they have completely healed. If there is the least appearance of inflammation, no time should be lost in applying a large bread-and-water poultice, or hot flannels repeatedly applied, or even leeches in good numbers may be put on at some distance from each other.

    2670. FOR SHORTNESS OF BREATH, OR DIFFICULT BREATHING.--Vitriolated spirits of ether 1 oz., camphor 12 grains: make a solution, of which take a teaspoonful during the paroxysm. This is found to afford instantaneous relief in difficulty of breathing, depending on internal diseases and other causes, where the patient, from a very quick and laborious breathing, is obliged to be in an erect posture.

    2671. SPRAINS.--A sprain is a stretching of the leaders or ligaments of a part through some violence, such as slipping, falling on the hands, pulling a limb, &c. &c. The most common are those of the ankle and wrist. These accidents are more serious than people generally suppose, and often more difficult to cure than a broken log or arm. The first thing to be done is to place the sprained part in the straight position, and to raise it a little as well. Some recommend the application of cold lotions at first. The editress, however, is quite convinced that warm applications are, in most cases, the best for for the first three or four days. These fomentations are to be applied in the following manner:--Dip a good-sized piece of flannel into a pail or basin full of hot water or hot poppy fomentation,--six poppy heads boiled in one quart of water for about a quarter of an hour; wring it almost dry, and apply it, as hot as the patient can bear, right round the sprained part. Then place another piece of flannel, quite dry, over it, in order that the steam and warmth may not escape. This process should be repeated as often as the patient feels that the flannel next to his skin is getting cold--the oftener the better. The bowels should be opened with a black draught, and the patient kept on low diet. If he has been a great drinker, he may be allowed to take a little beer; but it is better not to do so. A little of the cream of tartar drink, ordered in the case of burns, may be taken occasionally if there is much thirst. When the swelling and tenderness about the joint are very great, from eight to twelve leeches may be applied. When the knee is the joint affected, the greatest pain is felt at the inside, and therefore the greater quantity of the leeches should be applied to that part. When the shoulder is sprained, the arm should be kept close to the body by means of a linen roller, which is to be taken four or five times round the whole of the chest. It should also be brought two or three times underneath the elbow, in order to raise the shoulder. This is the best treatment for these accidents during the first three or four days. After that time, supposing that no unfavourable symptoms have taken place, a cold lotion, composed of a tablespoonful of sal-ammoniac to a quart of water, or vinegar-and-water, should be constantly applied. This lotion will strengthen the part, and also help in taking away any thickening that may have formed about the joint. In the course of two or three weeks, according to circumstances, the joint is to be rubbed twice a day with flannel dipped in opodeldoc, a flannel bandage rolled tightly round the joint, the pressure being greatest at the lowest part, and the patient allowed to walk about with the assistance of a crutch or stick. He should also occasionally, when sitting or lying down, quietly bend the joint backwards and forwards, to cause its natural motion to return, and to prevent stiffness from taking place. When the swelling is very great immediately after the accident has occurred, from the breaking of the blood-vessels, it is best to apply cold applications at first. If it can be procured, oil-silk may be put over the warm-fomentation flannel, instead of the dry piece of flannel. Old flannel is better than new.

    2672. CURE FOR STAMMERING.--Where there is no malformation of the organs of articulation, stammering may be remedied by reading aloud with the teeth closed. This should be practised for two hours a day, for three or four months. The advocate of this simple remedy says, "I can speak with certainty of its utility."
    2673. STAMMERING.--At a recent meeting of the Boston Society of Natural History, Dr. Warren stated, "A simple, easy, and effectual cure of stammering." It is, simply, at every syllable pronounced, to tap at the same time with the finger; by so doing, "the most inveterate stammerer will be surprised to find that he can pronounce quite fluently, and, by long and constant practice, he will pronounce perfectly well."

    2674. SUFFOCATION, APPARENT.--Suffocation may arise from many different causes. Anything which prevents the air getting into the lungs will produce it. We shall give the principal causes, and the treatment to be followed in each case.
    2675. 1. Carbonic Acid Gas. Choke-Damp of Mines.--This poisonous gas is met with in rooms where charcoal is burnt, and where there is not sufficient draught to allow it to escape; in coalpits, near limekilns, in breweries, and in rooms and houses where a great many people live huddled together in wretchedness and filth, and where the air in consequence becomes poisoned. This gas gives out no smell, so that we cannot know of its presence. A candle will not burn in a room which contains much of it.--Effects. At first there is giddiness, and a great wish to sleep; after a little time, or where there is much of it present, a person feels great weight in the head, and stupid; gets by degrees quite unable to move, and snores as if in a deep sleep. The limbs may or may not be stiff. The heat of the body remains much the same at first.--Treatment. Remove the person affected into the open air, and, even though it is cold weather, take off his clothes. Then lay him on his back, with his head slightly raised. Having done this, dash vinegar-and-water over the whole of the body, and rub it hard, especially the face and chest, with towels dipped in the same mixture. The hands and feet also should be rubbed with a hard brush. Apply smelling-salts to the nose, which may be tickled with a feather. Dashing cold water down the middle of the back is of great service. If the person can swallow, give him a little lemon-water, or vinegar-and-water to drink. The principal means, however, to be employed in this, as, in fact, in most cases of apparent suffocation, is what is called artificial breathing. This operation should be performed by three persons, and in the following manner:--The first person should put the nozzle of a common pair of bellows into one of the patient's nostrils; the second should push down, and then thrust back, that part of the throat called "Adam's apple;" and the third should first raise and then depress the chest, one hand being placed over each side of the ribs. These three actions should be performed in the following order:--First of all, the throat should be drawn down and thrust back; then the chest should be raised, and the bellows gently blown into the nostril. Directly this is done, the chest should be depressed, so as to imitate common breathing. This process should be repeated about eighteen times a minute. The mouth and the other nostril should be closed while the bellows are being blown. Persevere, if necessary, with this treatment for seven or eight hours--in fact, till absolute signs of death are visible. Many lives are lost by giving it up too quickly. When the patient becomes roused, he is to be put into a warm bed, and a little brandy-and-water, or twenty drops of sal-volatile, given cautiously now and then. This treatment is to be adopted in all cases where people are affected from breathing bad air, smells, &c. &c.
    2676. 2. Drowning.--This is one of the most frequent causes of death by suffocation.--Treatment. Many methods have been adopted, and as some of them are not only useless, but hurtful, we will mention them here, merely in order that they may be avoided. In the first place, then, never hang a person up by his heels, as it is an error to suppose that water gets into the lungs. Hanging a person up by his heels would be quite as bad as hanging him up by his neck. It is also a mistake to suppose that rubbing the body with salt and water is of service.--Proper Treatment. Directly a person has been taken out of the water, he should be wiped dry and wrapped in blankets; but if these cannot be obtained, the clothes of the bystanders must be used for the purpose. His head being slightly raised, and any water, weeds, or froth that may happen to be in his mouth, having been removed, he should be carried as quickly as possible to the nearest house. He should now be put into a warm bath, about as hot as the hand can pleasantly bear, and kept there for about ten minutes, artificial breathing being had recourse to while he is in it. Having been taken out of the bath, he should be placed flat on his back, with his head slightly raised, upon a warm bed in a warm room, wiped perfectly dry, and then rubbed constantly all over the body with warm flannels. At the same time, mustard poultices should be put to the soles of the feet, the palms of the hands, and the inner surface of the thighs and legs. Warm bricks, or bottles filled with warm water, should be placed under the armpits. The nose should be tickled with a feather, and smelling-salts applied to it. This treatment should be adopted while the bath is being got ready, as well as when the body has been taken out of it. The bath is not absolutely necessary; constantly rubbing the body with flannels in a warm room having been found sufficient for resuscitation. Sir B. Brodie says that warm air is quite as good as warm water. When symptoms of returning consciousness begin to show themselves, give a little wine, brandy, or twenty drops of sal-volatile and water. In some cases it is necessary, in about twelve or twenty-four hours after the patient has revived, to bleed him, for peculiar head-symptoms which now and then occur. Bleeding, however, even in the hands of professional men themselves, should be very cautiously used--non-professional ones should never think of it. The best thing to do in these cases is to keep the head well raised, and cool with a lotion such as that recommended above for sprains; to administer an aperient draught, and to abstain from giving anything that stimulates, such as wine, brandy, sal-volatile, &c. &c. As a general rule, a person dies in three minutes and a half after he has been under water. It is difficult, however, to tell how long he has actually been under it, although we may know well exactly how long he has been in it. This being the case, always persevere in your attempts at resuscitation until actual signs of death have shown themselves, even for six, eight, or ten hours. Dr. Douglas, of Glasgow, resuscitated a person who had been under water for fourteen minutes, by simply rubbing the whole of his body with warm flannels, in a warm room, for eight hours and a half, at the end of which time the person began to show the first symptoms of returning animation. Should the accident occur at a great distance from any house, this treatment should be adopted as closely as the circumstances will permit of. Breathing through any tube, such as a piece of card or paper rolled into the form of a pipe, will do as a substitute for the bellows. To recapitulate: Rub the body dry; take matters out of mouth; cover with blankets or clothes; slightly raise the head, and place the body in a warm bath, or on a bed in a warm room; apply smelling-salts to nose; employ artificial breathing; rub well with warm flannels; put mustard poultices to feet, hands, and insides of thighs and legs, with warm bricks or bottles to armpits. Don't bleed. Give wine, brandy, or sal-volatile when recovering, and persevere till actual signs of death are seen.
    2677. Briefly to conclude what we have to say of suffocation, let us treat of Lightning. When a person has been struck by lightning, there is a general paleness of the whole body, with the exception of the part struck, which is often blackened, or even scorched.--Treatment. Same as for drowning. It is not, however, of much use; for when death takes place at all, it is generally instantaneous.

    2678. CURE FOR THE TOOTHACHE.--Take a piece of sheet zinc, about the size of a sixpence, and a piece of silver, say a shilling; place them together, and hold the defective tooth between them or contiguous to them; in a few minutes the pain will be gone, as if by magic. The zinc and silver, acting as a galvanic battery, will produce on the nerves of the tooth sufficient electricity to establish a current, and consequently to relieve the pain. Or smoke a pipe of tobacco and caraway-seeds. Again--
    2679. A small piece of the pellitory root will, by the flow of saliva it causes, afford relief. Creosote, or a few drops of tincture of myrrh, or friar's balsam, on cotton, put on the tooth, will often subdue the pain. A small piece of camphor, however, retained in the mouth, is the most reliable and likely means of conquering the paroxysms of this dreaded enemy.

    2680. WARTS.--Eisenberg says, in his "Advice on the Hand," that the hydrochlorate of lime is the most certain means of destroying warts; the process, however, is very slow, and demands perseverance, for, if discontinued before the proper time, no advantage is gained. The following is a simple cure:--On breaking the stalk of the crowfoot plant in two, a drop of milky juice will be observed to hang on the upper part of the stem; if this be allowed to drop on a wart, so that it be well saturated with the juice, in about three or four dressings the warts will die, and may be taken off with the fingers. They may be removed by the above means from the teats of cows, where they are sometimes very troublesome, and prevent them standing quiet to be milked. The wart touched lightly every second day with lunar caustic, or rubbed every night with blue-stone, for a few weeks, will destroy the largest wart, wherever situated.
    2681. To CURE A WHITLOW.--As soon as the whitlow has risen distinctly, a pretty large piece should be snipped out, so that the watery matter may readily escape, and continue to flow out as fast as produced. A bread-and-water poultice should be put on for a few days, when the wound should be bound up lightly with some mild ointment, when a cure will be speedily completed. Constant poulticing both before and after the opening of the whitlow, is the only practice needed; but as the matter lies deep, when it is necessary to open the abscess, the incision must be made deep to reach the suppuration.

    2682. WOUNDS.--There are several kinds of wounds, which are called by different names, according to their appearance, or the manner in which they are produced. As, however, it would be useless, and even hurtful, to bother the reader's head with too many nice professional distinctions, we shall content ourselves with dividing wounds into three classes.
    2683. 1. Incised wounds or cuts--those produced by a knife, or some sharp instrument.
    2684. 2. Lacerated, or torn wounds--those produced by the claws of an animal, the bite of a dog, running quickly against some projecting blunt object, such as a nail, &c.
    2685. 3. Punctured or penetrating wounds--those produced by anything running deeply into the flesh; such as a sword, a sharp nail, a spike, the point of a bayonet, &c.
    2686. Class 1. Incised wounds or cuts.--The danger arising from these accidents is owing more to their position than to their extent. Thus, a cut of half an inch long, which goes through an artery, is more serious than a cut of two inches long, which is not near one. Again, a small cut on the head is more often followed by dangerous symptoms than a much larger one on the legs.--Treatment. If the cut is not a very large one, and no artery or vein is wounded, this is very simple. If there are any foreign substances left in the wound, they must be taken out, and the bleeding must be quite stopped before the wound is strapped up. If the bleeding is not very great, it may easily be stopped by raising the cut part, and applying rags dipped in cold water to it. All clots of blood must be carefully removed; for, if they are left behind, they prevent the wound from healing. When the bleeding has been stopped, and the wound perfectly cleaned, its two edges are to be brought closely together by thin straps of common adhesive plaster, which should remain on, if there is not great pain or heat about the part, for two or three days, without being removed. The cut part should be kept raised and cool. When the strips of plaster are to be taken off, they should first be well bathed with lukewarm water. This will cause them to come away easily, and without opening the lips of the wound; which accident is very likely to take place, if they are pulled off without having been first moistened with the warm water. If the wound is not healed when the strips of plaster are taken off, fresh ones must be applied. Great care is required in treating cuts of the head, as they are often followed by erysipelas taking place round them. They should be strapped with isinglass plaster, which is much less irritating than the ordinary adhesive plaster. Only use as many strips as are actually requisite to keep the two edges of the wound together; keep the patient quite quiet, on low diet, for a week or so, according to his symptoms. Purge him well with the No. 2 pills (five grains of blue pill mixed with the same quantity of compound extract of colocynth; make into two pills, the dose for an adult). If the patient is feverish, give him two tablespoonfuls of the fever-mixture three times a day. (The fever-mixture, we remind our readers, is thus made: 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.) A person should be very careful of himself for a month or two after having had a bad cut on the head. His bowels should be kept constantly open, and all excitement and excess avoided. When a vein or artery is wounded, the danger is, of course, much greater. Those accidents, therefore, should always be attended to by a surgeon, if he can possibly be procured. Before he arrives, however, or in case his assistance cannot be obtained at all, the following treatment should be adopted:--Raise the cut part, and press rags dipped in cold water firmly against it. This will often be sufficient to stop the bleeding, if the divided artery or vein is not dangerous. When an artery is divided, the blood is of a bright red colour, and comes away in jets. In this case, and supposing the leg or arm to be the cut part, a handkerchief is to be tied tightly round the limb above the cut; and, if possible, the two bleeding ends of the artery should each be tied with a piece of silk. If the bleeding is from a vein, the blood is much darker, and does not come away in jets. In this case, the handkerchief is to be tied below the cut, and a pad of lint or linen pressed firmly against the divided ends of the vein. Let every bad cut, especially where there is much bleeding, and even although it may to all appearance have been stopped, be attended to by a surgeon, if one can by any means be obtained.
    2687. Class 2. Lacerated or torn wounds.--There is not so much bleeding in these cases as in clean cuts, because the blood-vessels are torn across in a zigzag manner, and not divided straight across. In other respects, however, they are more serious than ordinary cuts, being often followed by inflammation, mortification, fever, and in some cases by locked-jaw. Foreign substances are also more likely to remain in them.--Treatment. Stop the bleeding, if there is any, in the manner directed for cuts; remove all substances that may be in the wound; keep the patient quite quiet, and on low diet--gruel, arrowroot, and the like; purge with the No. 1 pills and the No. 1 mixture. (The No. 1 pill: Mix 5 grains of calomel and the same quantity of antimonial powder, with a little bread-crumb, and make into two pills, which is the dose for an adult. The No. 1 mixture: Dissolve an ounce of Epsom salts in half a pint of senna tea. A quarter of the mixture is a dose.) If there are feverish symptoms, give two tablespoonfuls of fever-mixture (see above) every four hours. If possible, bring the two edges of the wound together, but do not strain the parts to do this. If they cannot be brought together, on account of a piece of flesh being taken clean out, or the raggedness of their edges, put lint dipped in cold water over the wound, and cover it with oiled silk. It will then fill up from the bottom. If the wound, after being well washed, should still contain any sand, or grit of any kind, or if it should get red and hot from inflammation, a large warm bread poultice will be the best thing to apply until it becomes quite clean, or the inflammation goes down. When the wound is a very large one, the application of warm poppy fomentations is better than that of the lint dipped in cold water. If the redness and pain about the part, and the general feverish symptoms, are great, from eight to twelve leeches are to be applied round the wound, and a warm poppy fomentation or warm bread poultice applied after they drop off.
    2688. Class 3. Punctured or penetrating wounds.--These, for many reasons, are the most serious of all kinds of wounds.--Treatment. The same as that for lacerated wounds. Pus (matter) often forms at the bottom of these wounds, which should, therefore, be kept open at the top, by separating their edges every morning with a bodkin, and applying a warm bread poultice immediately afterwards. They will then, in all probability, heal up from the bottom, and any matter which may form will find its own way out into the poultice. Sometimes, however, in spite of all precautions, collections of matter (abscesses) will form at the bottom or sides of the wound. Those are to be opened with a lancet, and the matter thus let out. When matter is forming, the patient has cold shiverings, throbbing pain in the part, and flushes on the face, which come and go. A swelling of the part is also often seen. The matter in the abscesses may be felt to move backwards and forwards, when pressure is made from one side of the swelling to the other with the first and second fingers (the middle and that next the thumb) of each hand.

    MEDICAL MEMORANDA.

    2689. ADVANTAGES OF CLEANLINESS.--Health and strength cannot be long continued unless the skin--all the skin--is washed frequently with a sponge or other means. Every morning is best; after which the skin should be rubbed very well with a rough cloth. This is the most certain way of preventing cold, and a little substitute for exercise, as it brings blood to the surface, and causes it to circulate well through the fine capillary vessels. Labour produces this circulation naturally. The insensible perspiration cannot escape well if the skin is not clean, as the pores get choked up. It is said that in health about half the aliment we take passes out through the skin.
    2690. THE TOMATO MEDICINAL.--To many persons there is something unpleasant, not to say offensive, in the flavour of this excellent fruit. It has, however, long been used for culinary purposes in various countries of Europe. Dr. Bennett, a professor of some celebrity, considers it an invaluable article of diet, and ascribes to it very important medicinal properties. He declares:--1. That the tomato is one of the most powerful deobstruents of the materia medica; and that, in all those affections of the liver and other organs where calomel is indicated, it is probably the most effective and least harmful remedial agent known in the profession. 2. That a chemical extract can be obtained from it, which will altogether supersede the use of calomel in the cure of diseases. 3. That he has successfully treated diarrhoea with this article alone. 4. That when used as an article of diet, it is almost a sovereign remedy for dyspepsia and indigestion.
    2691. WARM WATER.--Warm water is preferable to cold water, as a drink, to persons who are subject to dyspeptic and bilious complaints, and it may be taken more freely than cold water, and consequently answers better as a diluent for carrying off bile, and removing obstructions in the urinary secretion, in cases of stone and gravel. When water of a temperature equal to that of the human body is used for drink, it proves considerably stimulant, and is particularly suited to dyspeptic, bilious, gouty, and chlorotic subjects.
    2692. CAUTIONS IN VISITING SICK-ROOMS.--Never venture into a sick-room if you are in a violent perspiration (if circumstances require your continuance there), for the moment your body becomes cold, it is in a state likely to absorb the infection, and give you the disease. Nor visit a sick person (especially if the complaint be of a contagious nature) with an empty stomach; as this disposes the system more readily to receive the contagion. In attending a sick person, place yourself where the air passes from the door or window to the bed of the diseased, not betwixt the diseased person and any fire that is in the room, as the heat of the fire will draw the infectious vapour in that direction, and you would run much danger from breathing it.
    2693. NECESSITY OF GOOD VENTILATION IN ROOMS LIGHTED WITH GAS.--In dwelling-houses lighted by gas, the frequent renewal of the air is of great importance. A single gas-burner will consume more oxygen, and produce more carbonic acid to deteriorate the atmosphere of a room, than six or eight candles. If, therefore, when several burners are used, no provision is made for the escape of the corrupted air and for the introduction of pure air from without, the health will necessarily suffer.