Popular surgery: being plain directions offered to the public at large, but particularly to heads of families, captains of ships ... for affording relief in all cases of accident, dangerous disease, poisoning, etc. in the absence of a regular practitioner. From the French

Front matter

I i

POPULAR SURGERY.

London:

Chapter II. On The First Assistance To Be Rendered In Cases Of Accident

Page

Many Persons assembled round the Sufferer highly censurable — Reasons - - _ - 1 7

Precautions to be observed at the Spot where the Accident has occurred, as to the Propriety of Removal - ift.

Position of Patient to be attended to - -id.

Cleansing him if greatly soiled _ _ _ jd.

Precautions as regards his Dress - - - 1 8

Examination necessary in order to detect Hemorrhage - id. Directions as to whether it would be prudent to suspend it or let it proceed - - - -id.

One Surgeon at least should be instantly sent for - id.

Better send for two, if the Case be dangerous - - id.

Directions for Nurses, Attendants, &c. in the interim - 19

Remarks on Bleeding, Leeches, Fomentations, &c. - id.

Application of Rags dipped in Cold Water strongly recommended _ _ . _ jf).

Remarks on the Prejudices of the Public against Simplicity generally - - - « 20

Temperature of Chamber - _ _ if,.

Visits of Friends - - - - ■ id.

Abstinence insisted on - - - -id.

Hints to Nurses - - - - 21

The Warm Bath - - - id.

Its Substitutes _ _ _ _ if,.

Observations upon the Application of Warmth to Persons Frost-bitten - - - - 22

Means recommendable in such Cases - - - 23

Methods of combating Exhaustion and Debility in dangerous Accidents - - • - -id.

Use of Boiling Water explained and recommended - 24

Proved to be a valuable Agent in such Cases - 25

Blisters, Mustard Poultices, and Moxas - - id.

The Moxa explained - - - -id.

TABLE OF CONTENTS.

IX

Chapter III. Of The First Attentions Generally Required By Wounds

Page

Recapitulation of Means recommended in the two preceding Chapters - - - - 27

Remarks on Wounds from Slugs and Balls - ib.

from Burns - - ih.

from Cutting Instruments in general ib. Rules for uniting the Edges of incised Wounds - 28

Applied to parts of the Body in Particular - - ib.

General Rules as regards Position in such Cases - ib.

Remarks on Wounds in the Neighbourhood of Joints 29 Translator’s Remarks - - ib.

Adhesive Plaster recommended to be kept in every Family, in case of Accident _ _ _ H.

Minute Directions for the first Dressing of Wounds - 30

Bandages - - - - - ib.

May always be constructed of Handkerchiefs, or Pieces of Linen of that Form, variously folded to suit the Nature of the Accident - - - - 31

Minute Directions for the subsequent Dressings of Wounds 32 Means of combating Inflammation, should it supervene ib.

Chapter IV

OF THE IMMEDIATE AID TO BE AFFORDED TO AN INDIVIDUAL WHO HAS HAD A LIMB BROKEN, IN AWAITING THE ARRIVAL OF A SURGEON.

Means of recognising a Fracture - - - - 34

Remarks on setting it - - - - 35

Means of assuring its Maintenance in the proper Position when set - . _ _ ib.

Varieties of same pointed out . _ _ ib.

Precautions to be observed in such Circumstances - 37

Other Methods - - - ib.

X

TABLE OF CONTENTS.

Page

Applied in Fractures of the Hand or Fore-arm - 40

of the Arm - - - ib.

of the Thigh or Leg - - ii.

Precautions to be observed in shifting the Patient - 42

Local Applications where there is Inflammation - ib.

Fractures of the Head and Face - - - 43

Observations thereupon - - . . Hf,

Means of Assistance - - - - ib.

Fractures of the Collar-bone - - ~ ib.

Means of Assistance - - - ib.

Fractures of the Ribs - - . . ib.

Means of detecting them - - - 44

of Assistance - - . . ib.

Fractures complicated with Wounds or Hemorrhage - ib. Precautions as regards the undressing Persons who have met with Fractures - - - - 45

Remarks on Fractures complicated with Wounds, Splinters, exposed Bone, Points of Bone, Slugs, and Bullets - - i... , ^ - - - ib.

General Measures to be adopted - - - ib.

Precautionary Measures - - - ib.

Fractures may be mistaken for Dislocations - - ib.

Signs by which the two may be distinguished 46

How Dislocations happen - ~ ib.

Proceeding for reducing them - - - ib.

Measures to be employed when they are reduced - ib.

Chapter V

PRECAUTIONS AS REGARDS THE TRANSPORT OF THE SICK, AND PARTICULARLY THOSE WHO HAVE SUFFERED EXTERNAL IN-

JURIES.

Carrying on Shoulders - - - - 48

On a Door or Shutter - - - - ib.

Litters of various Kinds - - - - 49

Precautions to be observed as regards State of Patient before setting out - - - - 50

Precautions during the Journey - - - ib.

TABLE OF CONTENTS. xi

Page

Bearers should keep step - - - - 51

Utility of the Sedan Chair, wheeled Vehicles, &c. - ib.

Hints to Bearers - - - - - 52

Chapter VI. Eoptures

Common to both Sexes - - - - 53

More frequent in Males' ... . ib.

Causes explained - . . ~ ib.

Predisposing Causes - - - - 54

Danger of not attending to Ruptures - - ib.

Strangulated Rupture - - . - ib.

Use of the Truss - - . 55

Means of recognising Ruptures - - - ib.

Method of reducing them - - - 56

The Warm Bath, Bloodletting - - - ib.

There should be no Delay in sending for a Surgeon when the Rupture is strangulated - - - 57

Precautions to be observed in the Attempts at Reduction - - - - 58

Chapter VII. Asphyxia, Or Suspended Anijiation

1. From Drowning - - - - 59

Means of Resuscitation - - - - ib.

General Remarks - ... ib.

Artificial Respiration - - - 60

Friction - - - - ib.

Stimulants - - - - - ib.

2. From Hanging - - . . 65

Means of Resuscitation - ... ib.

General Treatment - ... ib.

Xll

TABLE OF CONTENTS.

Page

3. From Effluvia - _ _ - 65

Theory of Asphyxia explained - - ~ ib.

' Remedies for same . _ _ - 67

4. From Smothering - _ _ _ gg

Rules for Treatment . - ib.

5. In new-born Children _ _ - 69

Means of restoring Animation - _ - ib.

Apoplexy in new-born Children - - 71

Means of distinguishing same from Asphyxia - ib.

Treatment - - _ . . ib.

Lightning - - _ . .72

Precautions to be observed in a Thunder-storm - ib. Treatment of Persons struck by Lightning - - 73

Apparent Death from the Effects of Cold - - 74

Treatment - _ - - ib.

Convulsions in Children - . - 75

Kinds of Convulsion - - _ - ib.

Treatment of each Kind - - _ ib.

Chapter VIII. Poisoning

Observations - - _ ' _ 7g

Arrangement of Poisons into Classes - - 80

1st Class, Concentrated Mineral Acids.

Vitriol - - - _ - ib.

Aqua Fortis - - - - - ib.

Spirits of Salts . - _ _ ib.

Symptoms _ _ _ _ ib.

The distinctive Characters of each of these Poisons - 81 Treatment - - - - - - ib.

After Treatment - - - - - ib.

2d Class, Alkalies.

Soda _ . _ ~ ib.

TABLE OF CONTENTS,

Ammonia

3d Class, Metallic Poisons.

Preparations of Arsenic Copper Lead Antimony Silver

Mercury - Iron, Zinc, and Tin

Treatment in general in particular After-treatment

4th Class, Vegetable Poisons.

1. Opium, or Laudanum Prussic Acid Laurel Water Henbane

Meadow Saffron - Hemlock

Deadly Nightshade Symptoms - Treatment

3. Nux Vomica, or Ratsbane Symptoms xiii

Page - 82

- ii.

- ib.

- ib.

- ib.

- ib.

- ib.

- ib.

- ib.

- ib.

- ib.

- ib.

- ib.

- ib.

- ib.

- ib.

- ib.

- ib.

- ib.

- ib.

- ib.

- ib.

- ib.

- ib.

- ib.

- ib.

- ib.

XIV

TABLE OF CONTENTS.

Poisonous Mushrooms

Page - 87

Symptoms _ _ .

- ib.

Treatment _ - .

Ergot of Rye (Spurred Rye, Blighted Rye)

- ib.

Remarks on same ...

- ib.

Symptoms ...

- ib.

Treatment - . .

- ib.

5th Class, Poisonous Animals.

Poisonous Muscles - -

Symptoms ....

- ib.

- ib.

Spanish Flies - . _

Symptoms ...

- ib.

Treatment ...

- ib.

Chapter IX. Common Operations

- ib.

Materials for Operation

Position of Patient

Application of Ligature

- ib.

Operation in general

Practical Remarks

Quantity of Blood to be withdrawn

Closing of the orifice

- ib.

A. Bleeding at the Arm

- ib.

Choice of Veins

- ib.

Operation ...

Bandage . - -

TABLE OF CONTENTS.

XV

Page

B. Bleeding at the Wrist

-

-

Choice of Vein

-

-

ib.

-

-

ib.

Bandage

-

-

C. Bleeding at the Ankle

.

_

ib.

Choice of Vein

-

-

ib.

Materials for Operation

-

-

ib.

-

-

Bandage

-

-

D. Bleeding at the Neck

-

_

ib.

Choice of Spot for Operation

— Remarks

Materials for same

-

-

ib.

-

m

ib.

Bandage

-

-

Cupping

-

-

-

-

ib.

Materials for Operation, as Substitutes for profes-

sional ones

-

-

ib.

-

-

Vaccination

-

-

ib.

-

-

Precautions

-

-

•

-

-

Choice of Leeches

-

•

ib.

Precautions with respect to Application -

-

ib.

Preliminary Measures

-

-

Application

-

-

ib.

Means of encouraging Bleeding

-

-

Precautions to avoid soiling Patient’s Dress and

Bed-linen

-

ib.

Method of stopping Bleeding

-

-

ib.

XVI

TABLE OF CONTENTS.

Appendix

SOME USEFUL DOMESTIC BANDAGES IN ADDITION TO THOSE DE- SCttlBED IN THE BODY OF THE WORK.

Page

1. For retaining Applications upon one of the Eyes - 118

2. upon both Eyes - - ib-

S. at the Armpit - - 1 1 9

4. For severe Cuts on the Lip (from Blows for example),

when no Medical Assistance is likely to be obtained 120

5. For Wounds at the Sides of the Neck - - ib.

6. For Wounds at the Fore Part of the Neck - - 121

7. For Wounds at the Back Part of the Neck - - ib.

8. For Fractures of the Collar-bone - - 122

9. For Wounds of the Limbs which run crosswise - ib.

10. For Wounds of the Limbs which run longwise - 123

1 1 . For Rupture of the Tendon inserted into the Heel,

called Tendon of Achilles - - - ib.

12. For Wounds across the Back of the Hand or Wrist 124

IS. For Wounds across the Fore Part of do. - - ib.

1 4. For supporting the Purse, if the Testes are swelled in

consequence of a Fall, a Blow, or any other Cause- 125

Since the impression of this work, an oversight has been discovered in the article of Poisons, namely, the subject of Oxalic Acid.

This poison, although possessing claims to rank among the vegetable poisons, resembles, in the common characters of the symptoms it induces, the mineral acids, and exacts precisely the same treatment as these.

Introduction

A POPULAR Work on Surgery will startle many by the name. What can the people have to do with Surgery, will be their first question — an Art which not only pre-supposes a profound knowledge of anatomy, but the wielding of those fearful instruments, the very sight of which makes the flesh crawl ? — Who could bear to think of treating a surgical accident, when a cut finger, if it bleed a little freely, will throw a whole house into consternation, and create a general helterskelter in running for the doctor ? Nothing ! certainly nothing ! The thing is too ridiculous to entertain a moment’s thought ! Such will be the premises — such the inference. But, in return, were it asked, — Wliat have the people to do with Medicine ? These same persons would gravely and unhesitatingly reply, — Every thing ! Has not Buchan, and every succeeding family physician down to the Penny Doctor, mentioned

B

INTRODUCTION.

all the ills which to the human frame is liable? Traced in a clear and manifest style the symptom of each particular malady ? And laid down for one and all a comprehensible and rational plan of cure, from which mankind has greatly profited? — That mankind has sometimes profited from their instructions, cannot be denied ; that it has greatly profited from them, and that too in the unqualified sense of the expression, must be denied by persons of reflection, and more especially when they view the subject in the following manner.

Medicine does presuppose a knowledge of anatomy, and that not a superficial one; for that knowledge extends to the structure of one and every tissue of which the body is composed, and, beyond all things else, to those nervous communications, by means of which, when one part or organ of the human frame is diseased, the malady is obvious in the disordered functions of another situated far away. If, therefore, the rational treatment of disease exacts on the part of the practitioner that he should explore the seat, and direct his remedies to that alone, — a thing so important, but so difficult, that, to do justice to his patient, and honour to his profession, he must have profoundly studied

INTRODUCTION.

3'

the one just named, and a number of accessor}'- sciences; — how, let it be asked, are they, to whom such necessary knowledge is as a hidden treasure, — how are they to unveil at once the mystery, or expect to have their unaided search crowned with success ? Nor would that be all, were it even thus ; the remedies require many, very many fields of science to be explored, in order to know, and administer them advantageously. Their action on the animal economy is so complex, so difficult of conceiving and of rightly valuing, that this second part of the affair is in all respects as truly important as the first. There are diseases, of which if the nature be not accurately known, the remedies employed in their treatment, even though empirically administered, do occasionally succeed ; and such diseases may sometimes, especially as they are not of a dangerous character, be treated fearlessly and with a saving of a certain expense, which the calling in of a practitioner would necessarily occasion: but these are very few in number; and as it can only be economy which would or ought to actuate the public to treat their maladies, it cannot be put too much upon its guard against the abuse of a superficial knowledge of this science. Moreover, in the

INTRODUCTION.

vast majority of complaints, the patient is not endangered by the delay attending the arrival of the medical practitioner.

But let us examine the sister science, Surgery, and see how far the public is in a fit state to help itself in diseases or accidents peculiar to its province. There is no question in the following pages of scalpels, amputating knives, actual or other cauteries ; of little else, in short, than a grain or two of common sense, a bundle of rags, and a few handkerchiefs. Quid rides ? It is even thus. We will explain: — The object of this little volume is not to induce the public to usurp the province of the regular surgeon, — to plunge it into a labyrinth of doubts, difficulties, and dangers ; but merely to put it in possession of a few broad principles, and a certain portion of the modus operandi, by which it can calmly face the danger of an accident that involves the question of life or death in a fellow being, grapple with it until the arrival of a surgeon, and, when life can be preserved, preserve it ! — What family is proof against accidents ? May you not, patient reader ! be called on, almost at this instant, to listen to the painful intelligence that a calamity of a threatening nature has happened to a mem-

INTRODUCTION.

ber of your own household? Suppose such an one to have been engaged in drawing the cork from a bottle ; this has broken, cutting through the main artery of the thigh ; an accident entailing certain death, unless aid be immediately rendered ; and no surgeon within some miles ! The blood is gushing out in torrents from the wound, or he is already at the point of exhaustion ! Well, if this fearful accident should have occurred subsequently to your reading Chapter I. You would go calmly and scientifically to his relief, [loithout instruments !) quiet the tumultuous grief of his surrounding friends, while dexterously applying a bandage which you would instantly construct of your pocket-handkerchief, and coolly put aside the arm of death ! ~ -

There are accidents of a very common character, which require surgical assistance, but which do not threaten life : such, for example, are fractures and dislocations. But even here assistance cannot be obtained too soon ; for after the utmost and permanent contraction of the surrounding muscles, which generally takes place in about three quarters or even half an hour, the reduction is effected with the extremest difl&culty, and with inconceivable suffer-

B 3

INTRODUCTION.

ing to the patient ; while, accomplished in the first moments after the accident, the adjustment of the displaced parts is comparatively easy, and is accompanied with very little pain. In short, the surgical cases of which the present volume treats, are those in which relief may be administered in the first moments, which are the most precious ; and that, too, with as much facility, and with as much efficacy in almost every instance, as if a surgeon were actually present.

Can the utility, then, of such a work be any longer doubted ? Or rather, ought not every one to be in a position to afford instant relief to a fellow-being the victim of an accident? So different in the hands of the public is this department of Surgery, from Medicine; that while in the latter, the nature of this disease is, to say the least, obscure, and the treatment empirical ; in the former, every thing is palpable to the senses, and the means of relief not only always at hand, but capable of being effectually employed by persons of the meanest intellect, and the commonest dexterity. So much in the way of introduction to M. Mayor’s work. There remains but little for the translator to say in addition to what he has already done, upon the remaining parts of the volume ; these he has

INTRODUCTION.

prepared himself, in the sole view of carrying out the usehil design of M. Mayor. They are not all strictly surgical, but they are still cases of accident, consequently they require prompt relief; and here also are the means, within the reach of ordinary persons. These superadded kinds of accident are of very common occurrence, and in them all is life imminently in danger.

At the end of the volume will be found directions for vaccination, bleeding, cupping, and the application of leeches ; and a description, taken from a most able work by the same author, addressed to the profession, of a number of bandages of the utmost simplicity, constructed of pocket-handkerchiefs or pieces of linen of the same form ; a species of bandage which, it is hoped, will ere long be universally employed in preference to the common, and for the most part objectionable, bandages, of the present and bygone days.

POPULAR SURGERY.

Chapter I. Of The Means Of Arresting A Flow Of

BLOOD.

W^henever an accident occurs, wherein the loss of blood is liable to expose the wounded person more or less immediately to danger, the hemorrhage * may be always suspended by applying one or more fingers, according to the extent of the injury, upon the place from whence the blood issues ; precisely in the same manner as the flowing of a liquid would be arrested from a hole in the vessel in which it is contained ; the fingers forming the best plug that can be made use of in the first moments of an accident, and while the other more important means are being got ready.

These consist of any soft substances which are capable of being rolled up or moulded into the form of a plug, and are to be applied di-

* From the Greek Aima, blood, B.eo, I flow. — A flow of blood.

POPULAR SURGERY.

rectly upon the open vessel, so as completely to fill up and cover the wound : for this purpose recourse may be had to sponge, German tinder, puff-ball, spiders’ web, moistened paper, tow, lint, old and soft linen, wool, or, if in the country and at a distance from any habitation, even fine moss. But whenever it can be obtained, the preference should be given to sponge, as it can be more easily insinuated into the wound, the interstices of which it fills completely up, by reason of its peculiar structure and its elasticity.

But in order to impart the greatest efficacy to the means just recommended, the clots of blood, if there are any, should be removed, and the wound washed with cold water, in order that the place from which the blood issues may be exposed as completely as possible ; the point of the plug ought then to be placed directly upon the vessel, and not upon the clot. The cleansing of the wound alone will often cause the flowing of the blood to cease. The substances thus wedged in should be maintained in their situation by a neck-kerchief or a pocket-handkerchief folded in the form of a cravat, a common band, or even a garter. If the means already pointed out should be in-

ARRESTING FLOW OF BLOOD.

II sufficient to suspend the flow of blood, the whole application should be removed, and the pressure of the finger alone relied upon, until the surgeon, or a person acquainted with the nature and treatment of such accidents, can be called in : the wounded person could manage this himself, in case of need.

The pressure of the fingers upon the same place during several hours, would suffice to arrest the most considerable hemorrhage ; but as this continued pressing, if confided to one person, would become too painful to be long endured, two or three persons should be employed to aid alternately.

If, however, it should be found necessary, from the great depth or extent of the wound, to have the powers of restraining the hemorrhage under still more complete control, a tourniquet should be applied to the limb : when this instrument (which is most likely to be the case) cannot be obtained, it may be readily and efficaciously replaced by the following means ; namely, a handkerchief folded in the form of a cravat, to each end of which is to be fastened a band or garter, should be bound tightly round the upper part of the thigh or arm, care being taken to apply previously along the inner side

POPULAR SURGERY.

of the limb *, immediately beneath the bandage, a handkerchief folded several times over, or a piece of linen doubled backwards and forwards of sufficient thickness to flatten, in compressing it, the principal vessel which runs along this part and which may be easily felt by its pulsation or beats.

In the majority of cases, and particularly when the wounded person is not very fleshy, the above method of exerting compression upon the main artery would alone suffice; but otherwise a substitute for the tourniquet, not less simple, more expeditive, and on the whole much better, may be formed from a cravat, in the middle of which is to be made a double knot. This knot is then to be applied upon the course of the main vessel which it is necessary to compress, while the ends of the cravat are carried, one

* There will be no difficulty in finding out the place where the compression of the tourniquet, or its substitute, is to be effected, when it is known that the main artery passes downwards along the inside of the limb, going from the centre of one joint to the centre of the one next beneath it, as, for example, from the centre of the armpit or groin to the centre of the bend of the elbow or knee. It is in the two first mentioned places, where the pulsations of the artery are distinctly felt, that the pressure of the vessel against the bone, either by means of the thumb alone, or with a tight pledget of linen rag beneath it, can arrest the most violent hemorrhage in a limb. — Note of Tr.

ARRESTING FLOW OF BLOOD.

before and the other behind the limb, to its outer side, from whence, after crossing, they are to be returned over the knot and effectually secured, either upon the front or back part of the limb by means of pins, or on the opposite side by a knot or bow. A powerful compression may be also effected by applying the ends of the fingers upon the part where the pulsation of the main artery is felt.

The best means, without doubt, is to tie or twist the bleeding vessel itself just above the part which is open, — the course which is in general pursued by surgeons, and which is not a very difficult thing to perform ; but if, from timidity or otherwise, this be not practicable, nothing more can be done than to employ the means just pointed out, which will effectually suspend the flow of blood, until a surgeon can be procured. It may not be altogether useless to observe, before proceeding farther, that when, after the common operation of bleeding in the arm, and the surgeon has left the patient, the blood should gush out afresh, — which not unusually happens from either the pledget or the ligature becoming displaced, or from the latter pressing more tightly above than below the

POPULAR SURGERY.

opening in the vein which it ought not to do, — the bandage should be removed from the arm, the wound washed, a fresh pledget placed upon the orifice, and the ligature re-applied in a similar manner, — that is to say, in the form of a figure of eight, the in ter- crossing of it being of course made to correspond to the pledget ; the patient should then be told to keep the arm quite still and in a half-bent position. Sometimes a completely bent position will of itself suffice to arrest the flow of blood.

Leech f bites, especially in children and very delicate individuals, will often give rise to a loss of blood difficult to suppress. If the means ordinarily employed, fail to effect the desired end, recourse may be had to the following methods : — The skin is to be gently pinched up, about the spot where the blood is flowing freely, and the part itself covered with finely powdered charcoal or powdered alum, or, better still, a morsel of sponge or lint soaked with a

* The blood of the veins, unlike that of the arteries, flows from the extremities of the body to the centre, the heart; so that the streams of blood in the vessels of a limb are running in contrary directions : pressure, therefore, of a wounded vein, as after bleeding, should be made below or upon the opening, but never above it. — Note of Tr. For the operation of bleeding, see last Chapter.

f For the methods of applying leeches, see last Chapter.

ARRESTING FLOW OF BLOOD.

spirituous liquor. Surgeons are occasionally obliged to employ a cupping glass, or lunar caustic, or even the end of a wire heated to whiteness in order to burn the leech bite : sometimes they employ — (and a very excellent method it is) — a small needle, which is run through the cuticle or outer skin immediately above the orifice ; this is instantly and effectually closed, and the flow of blood quickly suspended.

A most essential thing to be observed is, to keep the wounded person perfectly quiet, in order that whatever may have been applied, may not become displaced : he should never be lost sight of, in order that if the hemorrhage return, instant assistance may be afforded him ; but unless such a circumstance take place, nothing should be touched, for fear of the slightest alteration occasioning the closed vessel to re-open. Attention, however, should be paid to the bandage, so that if it should be found at all loose it may be gently tightened, or on the contrary too tight, so as to occasion pain or swelling of the parts, it may be relaxed. In no case should any exciting food or drink be given to the -patient ; he should he allowed hut little aliment, and the use for drink of nothing hut pure v'ater.