_At the instant of letting go, the man at the head of the patient will
again draw the arms steadily upward to the sides of the patient's head
as before (the assistant holding the tongue again changing hands to
let the arms pass, if necessary), holding them there while he slowly
counts one, two, three, four (about five seconds)._
_Repeat these movements deliberately and perseveringly twelve or
fifteen times in every minute--thus imitating the natural motions of
breathing. Continue the artificial respiration from one to four hours,
or until the patient breathes; and for a while after the appearance of
returning life carefully aid the first short gasps until deepened into
full breaths._
_Keep body warm after this with warm-water bottles._
=FROSTBITE.=--The nose, chin, ears, fingers, and toes are the parts
usually frozen, although severe results ending in death of the frozen
part occur more often owing to low vitality of the patient than to the
cold itself. In the milder degree of frostbite there is stiffness,
numbness, and tingling of the frozen member; the skin is of a pale,
bluish hue and somewhat shrunken. Recovery ensues with burning pain,
tingling, redness, swelling and peeling of the epidermis, as after
slight burns. The skin is icy cold, white, and insensitive in severe
forms of frostbite, and, if not skillfully treated, becomes, later,
either swollen and discolored, or shriveled, dry, and black. In either
case the frozen part dies and is separated from the living tissue
after the establishment of a sharp line of inflammation which results
in ulceration and formation of pus, and thus the dead part sloughs
off. It is, however, possible for a part thoroughly frozen to regain
its vitality.
=Treatment.=--The essential element in the treatment is to secure a
very gradual return of blood to the frozen tissues, and so avoid
violent inflammation. To obtain this result the patient should be
cared for in a cold room, the frozen parts are rubbed gently with
snow, or cloth wet with ice water, until they resume their usual
warmth. Then it is well to rub them with a mixture of alcohol and
water, equal parts, for a time and expose them to the usual
temperature of a dwelling room. Warm drinks are now administered to
the patient. The frozen member, if hand or foot, is raised high in
the air on pillows and covered well with absorbent cotton and bandage.
If much redness, swelling, and pain result this dressing is removed
and the part is wrapped in a single thickness of cotton cloth kept
continually wet with alcohol and water.
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