THE UP-(X)UNTRY MEDICINE CHEST AND HOW TO USE IT. 221 



Gunshot Wounds. — Any foreign body, manifestly on the surface or sticking in the 

 entrance of a gunshot wound, should of course be removed ; but on the whole the less 

 the amateur meddles with such wounds the better. He should on no account open or 

 probe wounds of the kind in attempts to remove fragments of lead or to ascertain the 

 presence of these below the surface. The wound should as soon as possible be 

 washed and dressed as directed under "Cuts and Wounds." 



Drowning. — The various methods of performing artificial respiration in case of drowning 

 when natural breathing has ceased are always fully described in "first aid" books, 

 but I think the preliminary emptying of the lungs, &c., of water is in some of these 

 not sufficiently insisted on. To imitate those movements of the chest walls by which 

 air is drawn in while water still occupies the windpipe and bronchial tubes, is I am 

 convinced the cause of not a few failures to save life in these cases. Always remember 

 then in dealing with a case of drowning, to begin by emptying as far as possible the 

 patient's air passages of the water he has inhaled and swallowed. This is best done 

 by laying him face downwards, the head dependent, and the body resting on a roll of 

 cloth in such a way that the pit of the stomach is the highest point: the patient lying in 

 this position, the operator compresses the chest walls from behind, with his outspread 

 hands aided by his own weight ; if much water has been swallowed it will now flow 

 from the mouth and nose : — then, and not till then, the patient may be turned on his 

 back and " artificial respiration," as it is termed, begun. 



Sunstroke. — The morning sun is dangerous in Shanghai during the summer months, and 

 should not be encountered before food has been taken. White is the colour which 

 most effectually protects from the sun, and should be preferred in the body clothes 

 and head coverings. When sun-hats cannot be procured, folds of thin white cloth 

 should be used to protect the head and neck ; by wetting these from time additional 

 coolness may be obtained. A wet handkerchief worn beneath the hat is useful when 

 exposure is long-continued and severe. A sense of fullness in the head and tightness 

 across the chest, with partial or total suppression of the perspiration, are symptoms 

 of impending danger, and should warn those who experience them to desist from active 

 exertion and to seek further protection from the sun. In the treatment of cases of 

 sunstroke cold water poured freely over the head, chest and neck is the remedy most 

 likely to prove of service in the first instance. Should death from failure of the heart's 

 action appear impending — evidenced by failure of the pulse and feeble irregular 

 breathing — stimulants must be given, as wine, brandy, &c. Nothing more surely 

 predisposes to sunstroke than the abuse of alcoholic stimulants, and nothing renders 

 the treatment of such cases so hopeless as the fact that the patient has been indulging 

 in these to excess before his seizure. 



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