There are few medical emergencies that can rival a burn in production of pain, potential complications, and disability. Burns may be thermal (produced by heat), chemical, or electrical in origin; there is little practical difference in either sequelae or in treatment. They are classified in severity as first, second, and third degree.
First-degree burns involve the deeper layers of skin and produce blistering, with subsequent loss of tissue fluids into the blister and a denuded area with the potential for infection.
Third-degree burns cause charring and destruction of skin and underlying tissues, and are of course the most serious of the three. In an emergency situation, the untrained person will not be concerned with classifying the burn. Fortunately, the initial treatment is the same for all burns, and good immediate relief of pain can usually be obtained by simple methods.
If there is any question about the severity of a burn, call a physician immediately. Then following treatment, which has been found effective in relief or reduction of pain in first- and second-degree burns, involving 10 percent or less of the body surface, may be initiated. Clinical impressions, as well as some animal experimentation, suggest that this method results in less tissue injury as well as more rapid healing. A more detailed treatment of how to deal with various kinds of burns is covered in "House Call" in the February, 1973, issue of Life and Health. But the following simple procedure can be used:
1. Immediately plunge the burned area into ice water; seconds may count in easing injury and disability. If on the trunk, or covering an extensive area, use ice-water compresses.
2. The cold treatment MUST be continued until it is possible to discontinue treatment without the return of pain. The time required may be from 30 minutes to as long as five hours.
3. Do not use butter or grease. If one of these has already been applied, or if a bandage is in place, remove them in the ice-water bath.
4. If only a small area is involved, or there is little or no blistering, no other treatment may be required.
5. More extensive burns require medical evaluation and treatment as soon as possible.
II. Chronic Bronchitis
"Tobacco is a slow, insidious, but most malignant poison."— The Ministry of Healing, p. 327.
Perhaps nowhere is the insidious nature of tobacco more exemplified than in chronic bronchitis. By the time the smoker is willing to admit that he has more than "a little smoker's cough," irreversible changes have often taken place that may make the victim a respiratory cripple or even lead to death.
Pathological changes owing to smoking may take place rapidly at first, with paralysis, then loss of protective cilia lining the respiratory tubes. Then come irritative and inflammatory changes in the lining cells, an increase in mucous production, spasm of the bronchial muscles, and swelling of bronchial membranes, and an increased susceptibility to infection, allergies, and other noxious agents. These changes produce the typical clinical picture of a chronic hacking cough, mucous production, wheezing, and shortness of breath, at times with low-grade fever.
Occasionally chronic bronchitis is seen in the nonsmoker, caused by recurrent acute infections, allergies, or environmental pollution. It is estimated, however, that about 90 percent of patients are smokers, and usually the last-named factors are merely aggravating conditions.
Although both patients and physicians tend to become discouraged with the treatment of bronchitis and its fellow traveler, emphysema, improvement may be remarkable if only the patient can be induced to stop smoking. I have seen patients who were almost bedridden, with constant wheezes, cough, sputum production, and recurrent infection, become almost asymptomatic after finally ceasing their "internal pollution"! (For a more detailed description of the causes and pathology of bronchitis, see "This, Too, Can Kill!" in the February, 1973, issue of Life and Health.)
Before undertaking any remedial measures, an accurate diagnosis should be made by a physician, as chronic cough may be caused by many things, such as cancer of the lung, tuberculosis, or other diseases.
1. Stop smoking! Unless this is done, treatment is doomed to failure.
2. Hydrotherapy (once or twice a week—more frequently with acute flare-ups).
a. Alternate hot and cold to the chest.
b. Fomentations to the chest, front and back; cold mitten friction; hot foot bath.
c. Heating (moist) compress to chest overnight, especially for acute flare-ups.
3. Use of a steam vaporizer and direct steam inhalations may be helpful.
4. Honey-eucalyptus cough syrup (few drops of eucalyptus oil to a cup of honey) as needed.
5. Measures to promote thinning of secretions.
a. High fluid intake.
b. Saturated solution of potassium iodide, 8 to 15 drops in 6 ounces of water, 3 or 4 times daily. (Caution: Some people are allergic to iodides and may develop a skin rash or swelling of the salivary glands.)
6. Program to build up general resistance:
a. Simple, nourishing, well-balanced diet.
b. Avoid exposure to wet or cold.
c. Keep extremities well-clothed.
d. Avoid loss of sleep.
e. Sunbaths, ultraviolet, and/or heat treatments.
f. Moderate exercise in the open air.
g. Trial on a diet free of dairy products, to which many persons are allergic.
h. Deep-breathing exercises.
i. Avoid dry, over-heated air.
j. Avoid dust, smog, other air pollutants as much as possible.