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HEMORRHAGE.

Hamorrhage, or bleeding, is the result of the opening of a blood vessel by a wound or otherwise. It may be external or internal.

Hæmorrhage is divided into-1. Arterial, where the blood flows in jets in great force, and is of a bright red colour. 2. Venous, where it flows slowly-wells out-and is of a dark, purple hue. 3. Capillary, where there is a general oozing of red blood from

surface.

Treatment-If the blood is dark coloured, lift the wounded limb to a level higher than the rest of the body after removing all bandages. If the blood is bright scarlet and flows out in jerks, press one or more fingers firmly over the place from whence the blood flows.

INCISED WOUNDS.

WOUNDS.

Treatment-1. Wash the part carefully with water.
2. Arrest the hæmorrhage.

3. Adjust the edges and fix in a natural position.
4. Place patient in an easy position, so as to
avoid straining the parts. In wounds of
throat, sand-bags are good supports for fixing
head and neck.

5. Apply cold water dressing, or strips of adhesive plaster.

INCISED WOUNDS, WITH PROTRUSION OF INTERNAL ORGANS. Treatment-Wash the parts carefully with warm water, and return, unless they are much injured, and place patient in a thorough state of rest.

In incised wounds about the face it is very important to replace the wounded portions with as little delay as possible.

CONTUSED AND LACERATED WOUNDS are more dangerous and troublesome to heal, besides being liable to erysipelas, gangrene, &c.

Treatment-Wash.

Arrest hæmorrhage.

Replace parts in their natural position.

Apply cold water dressings, and never allow them to get dry.

VII. TREATMENT OF CASES OF DROWNING,
HANGING, &c. (a).

I.-DROWNING.-Send immediately for medical assistance, blankets, and dry clothing, but proceed to treat the patient instantly, securing as much fresh air as possible.

The points to be aimed at are- -first, and immediately, the restoration of breathing; and secondly, after breathing is restored, the promotion of warmth and circulation.

The efforts to restore life must be persevered in until the arrival of medical assistance, or until the pulse and breathing have ceased for at least an hour.

TREATMENT TO RESTORE Natural Breathing.

Rule 1. To maintain a Free Entrance of Air into the WindpipeCleanse the mouth and nostrils; open the mouth; draw forward the patient's tongue, and keep it forward; an elastic band over the tongue and under the chin will answer this purpose. Remove all tight clothing from about the neck and chest.

Rule 2. To adjust the Patient's Position-Place the patient on his back on a flat surface, inclined a little from the feet upwards; raise and support the head and shoulders on a small firm cushion or folded article of dress placed under the shoulder-blades. Rule 3.-To imitate the Movements of Breathing-Grasp the patient's arm just above the elbow, and draw the arms gently and steadily upwards, until they meet above the head (this is for the purpose of drawing air into the lungs); and keep the arms in that position for two seconds. Then turn down the patient's arms, and press them gently and firmly for two seconds against the sides of the chest (this is with the object of pressing air out of the lungs. Pressure on the breast-bone will aid this).

Repeat these measures alternately, deliberately, and perseveringly, fifteen times in a minute, until a spontaneous effort to respire is perceived, immediately upon which cease to imitate the movements of breathing, and proceed to induce circulation and warmth. Should a warm bath be procurable, the body may be placed in it up to the neck, continuing to imitate the movements of breathing. Raise the body for 20 seconds in a sitting position, dash cold water against the chest and face, and pass ammonia under the nose. The patient should not be kept in the warm bath longer than five or six minutes.

(a) The above directions are chiefly Dr. H. R. Silvester's method of restoring the apparently dead or drowned, and have been approved by the Royal Medical and Chirurgical Society.

Rule 4.-To excite Inspiration-During the employment of the above method excite the nostrils with snuff or smelling salts, or tickle the throat with a feather. Rub the chest and face briskly, and dash cold and hot water alternately on them.

TREATMENT AFTER NATURAL BREATHING HAS BEEN RESTORED.

Rule 5.-To induce Circulation and Warmth-Wrap the patient in dry blankets and commence rubbing the limbs upwards, firmly and energetically. The friction must be continued under the blankets or over the dry clothing.

Promote the warmth of the body by the application of hot flannels, bottles or bladders of hot water, heated bricks, &c., to the pit of the stomach, the armpits, between the thighs, and to the soles of the feet. Warm clothing may generally be obtained from bystanders. On the restoration of life, when the power of swallowing has returned, a teaspoonful of warm water, small quantities of wine, warm brandy and water, or coffee should be given. The patient should be kept in bed, and a disposition to sleep encouraged. During reaction large mustard plasters to the chest and below the shoulders will greatly relieve the distressed breathing.

VIII. POISONS AND ANTIDOTES.

POISONS are substances capable of destroying life.

ACIDS AND ALKALIES form antidotes to each other.

The acids suitable for the purpose are vinegar, lime juice, and orange juice mixed with water.

The alkalies are soda, potash, lime, and magnesia diluted with

water.

ALBUMEN AND OILS will protect the gullet and walls of the stomach in poisoning by irritants. White of egg, milk, flour and water, salad oil, and castor oil may be used.

EMETICS are remedies used for the purpose of causing vomiting. The safest and readiest are-irritating back of throat with the finger or a feather, a tablespoonful or less of made mustard in a tumblerful of tepid water, salt half-ounce to one ounce in water, or two tablespoons of ipecacuanha wine in water.

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Antidotes.

Emetic of mustard at once, unless vomiting is
already present. Sickness must be promoted by
administering white of egg, barley water, milk,
gruel, or give equal parts of oil and lime water.
Two to four tablespoonfuls of castor oil may be
given to carry off poison from intestines.
Give a tablespoonful of made mustard in a tumblerful
of warm water; then dash cold water in face and
give sal volatile, strong coffee. Afterwards pro-
mote warmth.

Excite vomiting. Give gruel, linseed tea freely, and
warm bath. Avoid oil.

Common salt.

Remove at once to pure air. Dash cold water on head and neck. Rub chest with stimulating applications. Artificial respiration.

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Give emetics promptly; then castor oil, and then brandy.

Epsom salts and vinegar mixed.

Vinegar and water, followed by orange or lemon juice in water.

See Deadly Nightshade, &c.

Chalk, whiting, soap and water, or the plaster of the apartment beaten up with water. Olive oil, linseed tea, barley water, milk gruel, may be given freely, either alone, or with the above.

Poisons.

Antidotes.

LEAD, SUGAR OF

LEAD, WHITE...

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See Goulard's Extract.

See Goulard's Extract.

Prompt emetic; then dose of castor oil; then brandy.

Give a mustard emetic. Keep patient awake by walking him quickly about. Beat legs with wet towels, &c. Give strong coffee.

See Hydrochloric Acid.

See Morphia.

Chalk, whiting, or magnesia in water. If necessary, vomiting should be excited.

No antidote can be relied on. Dash cold water at once over head and neck; repeat at intervals. After recovery, excite vomiting, and then give strong coffee with brandy.

Treatment at once. Oil of turpentine, dose up to

one ounce.

Give an emetic at once.

Emetics at once, and repeat till'free vomiting. If spasms have not begun, give oil (olive, melted lard, &c.) freely. Keep every one around as quiet as possible, as even a breath of cold air may bring

on a spasm.

See Hartshorn and Oil.

See Hartshorn and Oil.

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