As a Community First Responder and first aid trained member of the NSW State Emergency Service, I put my skills into practice most times I go on a call out. So, reading about the forerunner techniques of what's employed today makes for amazing reading!
Take it away, Sharon!
I love old books - especially old medical texts!
On my book shelf, I have two first aid manuals – a silverfish-nibbled 1928 edition and a 1939 one. They are, more precisely, “The Authorised Textbook of the St John Ambulance Association being the Ambulance Department of The Grand Priory in the British Realm of the Venerable Order of the Hospital of St. John of Jerusalem” and they’re fascinating reading!
There are clues about the times in the framing of the sentences and the formality of the clothes worn in the drawings to demonstrate different techniques. Even a hint about acceptable mores of the day with the 1928 “Syllabus of Instruction” which comes with the warning, “It is contrary to the Regulations to hold Mixed Classes of men and women.” – an injunction that has disappeared in the 1937 edition.
I turn the slightly yellowed pages and wonder about the original owners. Did they learn their lessons well? Did they apply the techniques successfully? Were they nervous with their newly-learned skills or were they confident, eager to get out and practise the lessons on bandaging and resuscitation? What has changed over the years? What’s stayed the same?
I feel a bit like a sleuth as I comb the pages and give into my greatest temptation – procrastination by research! So...
A PEEK AT SOME OF THE TECHNIQUES AND TREATMENTS THAT CAUGHT MY FANCY...
On page 131 of the 1928 textbook is a heading:
“WOUNDS BY POISONED WEAPONS, AND BITES OF SNAKES AND RABID ANIMALS”
Among other measures, the treatment was
· Give alcohol, such as brandy (in the case of an adult two tablespoonfuls in a wineglass of water)
Perhaps quite pleasant for the victim though probably not nearly enough preparation for one of the suggestions which followed...
· If it is quite impossible to obtain the services of a doctor, apply a fluid caustic, such as pure carbolic acid or nitric acid, on a piece of wood, such as a match, cut to a point to ensure the caustic reaching the bottom of the wound.
By 1939, the heading was merely:
WOUNDS CAUSED BY A VENOMOUS SNAKE OR RABID ANIMAL.
Apparently “poisoned weapons” had become less of a threat in the intervening eleven years. The treatment had become more specific for each injury.
For snake bite, “alcohol should be avoided” – though if your patient could swallow you could “give hot drinks such as strong coffee, tea or milk.”
For the bite by a rabid animal, alcohol could still be given in the moderate quantity recommended in the 1928 edition and again the fluid caustic was suggested if a doctor wasn’t available. But now with added instructions – to prove effective every tooth mark must be probed and cauterised separately, as only by so doing can the virus be destroyed.
I can only imagine the desperation of the aid-giver and patient to try to avert this awful disease with its shocking mortality rate.
I was fascinated by a note near the beginning of both books in the Principles of First Aid... some first aiders must have been enthusiastic with application of medicinal alcohol because there’s this caution:
Stimulants. It is incorrect to suppose that alcohol is the only form of stimulant. Far too frequent use of spirits is made to restore a patient after an accident, often with serious results. The administration of alcohol must therefore be withheld until ordered by the doctor.
The introduction to this section on page 167 of the 1928 edition says: “the patient, usually a young girl, in consequence of mental excitement suddenly loses command of her feelings and actions.”
In the section for Special Treatment we’re advised -
1. - Avoid sympathy with the patient, and speak firmly to her.
2. - Threaten her with a cold water douche, and if she persists in her "fit", sprinkle her with cold water.
3. - Apply a mustard leaf at the back of the neck.
(As far as I’ve been able to determine, the “mustard leaf” would have been a “ready-made mustard plaster”. Mustard plasters needed to be used with care least they cause painful blistering of the skin.)
These days, we all have at least a passing familiarity with the mouth-to-mouth method of artificial respiration but that technique didn’t come into vogue until the middle of the twentieth century.
The 1928 and 1939 first aid manuals give both the Schafer and Silvester methods.
In the 1939 edition, we learn that the revising committee has “discussed with the Royal Life Saving Society the subject of artificial respiration and are in agreement with that Society that no method is so effective as Schafer’s”
In the appendices at the back of the 1939 edition, there is additional information for the more advanced first aider. The introduction says “They will be of special value to members of the Technical Reserves for the medical Services of the Forces of the Crown”.
The first - APPENDIX 1 – states:
"Carbon-dioxide is recognised as a powerful stimulant to respiration and where available should be applied at the earliest possible moment to the mouth and nose, preferably through a mask. The gas is applied for three minutes and left off for three minutes until respiration begins. It may be used with air alone or in conjunction with oxygen, according to the apparatus available. It must be realised that the gas can be drawn into the lungs only while artificial respiration is being performed.”
Well, I had to research further, didn’t I? From the abstract of a 1994 article in the medical journal, Anaesthesia, I learned that “the use of carbon dioxide in resuscitation was advocated in the 1920s and 1930s” And to administer? You could use the portable Sparklet Carbon Dioxide Resuscitator.
As I read these techniques, I can’t help but be glad for the advances in medical knowledge. Though on the heels of that thought, I wonder how today’s first aid manuals will be viewed in another fifty or a hundred years. What clever techniques will the first aiders of the future take for granted?
For first aid advice, including information on the current manual, visit the St John Ambulance websites. You can even get first aid advice as an iPhone app!
In the UK - www.sja.org.uk
In Australia - www.stjohn.org.au
In New Zealand - www.stjohn.org.nz
So with these book treasures in my possession, I’m ready to pounce as soon as there’s a Medical Historical Romance sub-genre!
In the meantime, I’d love to give away a copy of my last release to one of the commenters. So tell me, do you have any older books on your shelf? Perhaps a passion for a particular area of history?
A give-away, folks! Thanks, Sharon.
The winner will be announced on Monday, Jan.25th 2011. (open to local & international visitors)
If you'd like to find out more about Sharon, please visit her website. You can read her bio here.