Medical help for
the working classes
Medical advice for the home 1895
There were no help with medical
matters for the working classes in the "good old days" before th N.H.S and
certainly not in the 1800's. The best was probably a local, who had a medical
book like the one which supplied the following.
warning do not try any of the operations yourself
Medical leeches and their application
The leech used for medical purposes is called the hirudo medicinalis to distinguish it from other varieties, such as the horseleech and the Lisbon leech. It various from two to four inches in length, and is of a blackish brown colour, marked on the back with six yellow spots and edged with a yellow line on each side. Formally leeches were supplied by Lincolnshire, Yorkshire, and other fenny countries, but latterly most of the leeches are procured from France, where they are now becoming scarce.
Applying leeches
When applied to a
part it should be fully freed from down or hair by shaving, and all liniments,
&c., carefully and effectually cleaned away by washing. If the leech is hungry
it will soon bite, but sometimes, great difficulty is experienced in getting
them to fasten. When this is the case, roll the leech into a little porter, or
moisten the service with a little blood, or milk, or sugar and water. Leeches
may be applied by holding them over the part with a piece of linen cloth, or by
means of an inverted glass, under which they must be placed.
When applied to the gums care should be taken to use a leech glass, as
they are apt to creep down the patient’s throat, a large swans quill will answer
the purpose of a leech glass. When leeches are gorged they will drop off
themselves; never tear them off from a person, but just dip the point of a
moistened finger into some salt and touch them with it.
Leeches are supposed to abstract about two drachms of blood, or six leeches draw about an ounce; but this is independent of the bleeding after they have come off, more blood generally flows then than during the time they are sucking. The total amount of blood drawn and subsequently lost by each leech bite is nearly half an ounce.
After the leech come away encourage bleeding by flannels dipped in hot water and wrung out dry, and then apply a warm spongiopiline poultice. If the bleeding is not to be encouraged, cover the bites with a rag dipped in olive oil, or spread with spermaceti ointment, having previously sponged the parts clean.
When bleeding continues from leech bites, and it is desirable to stop it, apply pressure with the fingers over the part, or dip a rag in a strong solution of alum and lay over them, or use the tincture of sesquichloride of iron. Or apply a leaf of matico to them, placing the under surface of the leaf next to the skin, or touch each bite with finely pointed piece of lunar caustic. Alternatively, lay an extract of lead over the bites; pass a fine needle through a fold of skin so as to include the bite, and twist a piece of thread round it. Be sure never to allow anyone to go to sleep with leech bites bleeding, without watching them carefully; and never apply too many to children; or place them where their bites can be compressed if necessary. In other words, never apply leeches to children except over a bone.
After leeches have been used they should be placed in water containing 16% of salt, which facilitates the removal of the blood they contain. They should afterwards be placed one by one in warm water, and the blood forced out by gentle pressure. The leeches should then be thrown into fresh water, which is to be renewed every twenty-four hours. They may be re applied after an interval of eight to ten days and be disgorged a second time. The best plan, however is to empty the leech by drawing the thumb and forefinger of the right hand along it’s body from the tail to the mouth, the leech being firmly held at the sucker extremity by the fingers of the left hand. By this means, with a few minutes rest between each application, the same leech may be used four or five times in succession. If a leech be accidentally swallowed, or by any means should get into the body, employ an emetic, or enema of salt and water.
Minor Operations
Bleeding is sometimes necessary at once in certain accidents, such as concussion, and therefore it is well to know how to do this. First of all, bind up arm above the elbow with a piece of bandage or a handkerchief pretty firmly, then place your finger over one of the veins at the bend in the arm, and feel if there is any pulsation; if there is try another vein, and if it does not pulsate or beat, choose that one. Now rub the arm from the wrist towards the elbow, place the left thumb upon the vein, and hold the lancet as you would a pen, and nearly at right angles to the vein, taking care to prevent it going to far, by keeping the thumb near to the point, and resting the hand upon the little finger. Now place the point of the lancet on the vein, push it suddenly upwards, depress the elbow, and raise the hand upwards and outwards, so as to cut obliquely across the vein. When sufficient blood is drawn off, which is known by feeling the pulse at the wrist and near the thumb, bandage the arm. If the pulse fell like a piece of cord, more blood should be taken away, but if it soft, and can be easily pressed, the bleeding should be stopped. When you bandage the arm, place a piece of lint over the opening made by the lancet, and pass a bandage lightly but firmly around the arm, so as to cross it over the bend of the elbow, in the form of a figure 8.
When dry warmth is required
When dry warmth is required to be applied to any part of the body, fry a flour pancake and lay it over the part. On the other hand, warm some sand and place in the patient’s socks, and lay it to the part; salt in a paper bag does as well; or warm water put into a stone jar, and rolled up in a flannel.
Compression of the brain
In compression of
the brain from any cause such as apoplexy, or a piece of fractured bone pressing
on it, there is a loss of sensation. If you tickle the feet of the injured
person and he does not feel it, you cannot arouse him so as not to get any
answer. The pulse is slow and laboured; the breathing deep, laboured and
snorting; the pupil enlarged. Raise the head, loosen strings or tight things,
and send for a surgeon. If one cannot be got at once, apply mustard poultices to
the feet and thighs, leeches to the temples, and hot water to the feet.
Person found hanging
Loosen the cord or whatever it may be by which the person has been suspended. Open the temporal artery or jugular vein, or bleed the arm; employ electricity , if at hand, and proceed as for drowning, taking the additional precaution to apply eight or ten leeches to the temples.