Archive for June, 2008
Foriegn Sustances in Ear
When an insect has found its way into the ear, place the patient upon the opposite side, and pour sweet-oil into the ear, until the insect becomes visible; then take it out with a small roll of paper or a pair of delicate forceps.
Extraneous bodies, such as gravel, shot, beads, cherry-stones, pieces of wood, peas, pins, etc., are often put into the ear by children. If attended to before they excite inflammation and swelling, they can generally be removed by very slender forceps or buy a hair-pin, the curved end of which has been bent so as to form an obtuse angle, like the heel of a spoon, and to which a handle has been made by sticking the points of the pin into a cork.
Place yourself behind the ear, draw it upwards and backwards with one hand, and at the same time away from the head, that you may look into it as far as possible; dip the instrument into sweet-oil, and pressing the bent part against the back part of the internal ear, push it in till it passes behind and around the object; then lift a little, and the end of the pin will take hold of it from behind, like a spoon, and bring it out. If you cannot succeed in passing the hair-pin behind the object, you may sometimes be able to remove it by means of a small syringe, with a slender nozzle; fill it with warm water, pass the point of the nozzle alongside the object and inject the fluid with moderate force.
If with children, particularly if there is a round object in the ear, it is better to push the hair-pin along the back part of the internal ear; with grown persons it is generally better along the upper surface. When the object is visible it can be seen where best to insert the instrument; but if not visible carefully feel for it. If anything has been wedged into the ear, it may sometimes be removed by a second hair-pin, prepared as above, inserted opposite to the first and both drawn out together. In all the manipulations great gentleness and care must be used, lest the object be pushed further into the canal.
If pain and inflammation of the ear remain, give Arnica, and after a few hours, Pulsatilla. If the inflammation is already very considerable, and the ear-canal so much swelled that nothing can be got out, Pulsatilla is also of service. In some cases, when the children are in great pain, have much fever, speak incoherently, or are delirious, give, if Pulsatilla does not suffice, Belladonna, and afterwards if there is still some pain left, Sulphur
Foreign Bodies into the Throat
If a foreign substance lodges in the throat, endeavor to make the patient throw it up, by beating him between the shoulders; let him open his mouth, press down his tongue with a spoon and look into the throat, in order to ascertain whether there be anything that can be seized and brought out with the fingers. Blowing into the ears is said to produce reflex action in the throat or gullet, and so the foreign object is forced out.
If, after the object has been removed, the sensation as if it were still there remains, particularly after pointed substances, it shows that a wound has been made, and all acrid or highly seasoned things must be avoided in food and drink.
If a large piece of food remains fast in the throat on account of its size and hardness, it is advisable to excite vomiting, particularly if upon retching, you perceive the obstruction move upward. Tickling the throat will sometimes affect this, if not, put snuff on the tongue, or give an injection of tobacco. When it can be felt on the outside of the throat, a gentle pressure upward may force it out. At first you ought to endeavor to make the sufferer throw up again whatever has been swallowed, but do not proceed with too much violence. If the substance has already descended so far that it cannot be felt in the throat, and it seems as if it were sticking fast in the chest, it must be forced down into the stomach, particularly if it is soft, smooth and soluble, and is only arrested on account of its size. If the sufferer feels that at times it slips down, it should be allowed to glide of itself into the stomach, or be assisted by occasionally swallowing a little water, provided it is a substance which will not swell; otherwise a little melted butter or sweet-oil. If the symptoms, however, become too troublesome, endeavor to push it down. For this purpose take a smooth, twig and tie to the end of it a bit of sponge. To be able to fasten it on well, cut a few notches in the stick, and use waxed thread or silk. Rub some sweet-oil on this instrument, and introduce it cautiously into the throat, pushing gently against the back of the throat.
If a contraction of the gullet takes place, which prevents the substance from being moved, or if pains, difficulty of breathing, and other symptoms make their appearance, give Ignatia; and if this fails to relieve, Chamomilla; then sweet-oil or butter; and after this, try again to push the substance down; if the face is pale, if there is nausea, worse after speaking, give Cocculus; if the face is red and if there is a constant inclination to swallow, Belladonna.
Dislocations, Fractures & its treatment
Dislocations, Luxations. The removal of the head of a bone from its corresponding articular cavity is termed a dislocation or luxation.
It is characterized by violent pain, loss of motion, swelling and alteration in the shape, length and direction of the limb. An unnatural depression or prominence can generally be felt in the vicinity of the injured joint; and there will be also a peculiar rigidity of the limb, and fever. By comparing the injured with the sound limb, the deformity with at “once be apparent. The first thing to be done is to give Arnica; or, if there is already redness and inflammation, Aconitum, and to apply cold water. By these means some relief may be obtained unit a surgeon can be called, which should be done at once. It is not necessary to do anything more after the dislocation has been reduced • all poultices, salves, bleeding, etc., are injurious. A proper bandage must be applied, and as soon as the inflammation abates, which, after taking Arnica and perhaps, Aconite, will soon take place, the limb should be moved often, but carefully, lest it grow stiff.
Fractures. The most certain sign of fracture is crepitation, a peculiar grating noise or sensation, produced by the rubbing together of two broken surfaces of bone. When on moving an injured limb, you can perceive this sensation; it is a pretty sure indication that it is fractured. In addition to this, there is usually increased mobility, which is the reverse of the peculiar rigidity of a limb in case of dislocation, some deformity, pain, swelling, inability to move or use the limb, and sometimes it is shortened.
In all cases of suspected fracture, send for a surgeon and for a skillful one too, and not for “the first best;” for mistakes committed under these circumstances can hardly ever be remedied. When children are the sufferers, more dispatch is required. But in ordinary cases, a day or two may elapse without incurring any risk, for a broken bone does not unite so very readily. Before the arrival of the surgeon, the broken limb should be moved as little as possible; on the painful part put linen bandages dipped frequently into cold water, or diluted Arnica tincture if the soft tissues have been bruised; internally give Aconite, if the patient is very weak or faint, and some hours after, Arnica. Only when the pains are insufferable, and occasion convulsions, give Chamomilla, then Hypericum. In very rare cases only, when the pains are excruciating, and other bad symptoms appear, stretching of the limbs will afford any relief. To do this wrap towels firmly above and below the part of the fracture; then fasten to them long pieces of cloth and tie one of these, say the upper, to the head-board of the bed; then pull slowly on the lower, and when extension enough to relieve the pain has been gained, fasten this piece to the lower bed-post or foot-board, and so retain the limb in a painless position till the surgeon comes. After the bone has been set, give Symphytum.