BURNS and SCALDS are injuries to the surface of the living body arising from exces sive heat—a scald implying that the heat proceeded from a fluid medium, as boiling water; a burn, from a solid. The injury is much the same in both cases; therefore the directions for the treatment of burns will be applicable also to scalds. These injuries may be divided into three classes: 1. Burns resulting in simple redness of the skin; 2. Burns resulting in vesication or blistering; 3. Burns resulting in sloughing, or death of the part. The first object, after the accident has occurred, is to relieve the suffering; and cold applied either in the form of ice or water seems in most cases to have almost a specific power in allaying pain and checking the advance of inflammation. In other cases, moderate warmth is found more efficacious, and we must be guided mainly by the sensations of the sufferer as to which of these remedies we make use of. In very severe cases, opium or chloroform may be employed. But if the injury the body has received be very serious, the patient complains less of pain than of cold; he shivers, is much depressed, and must be well supplied with stimulants, to prevent his dying from the shock.
The best local application is the Carron-oil, which derives its name from the famous ironworks, where it has been used for many years. It consists of equal parts of olive oil and lime-water, and should be applied on linen rags or cotton-wool. Blisters may be pricked, and the contained serum allowed to trickle away, but on no account is the raised skin to be removed. The dressings should not be changed oftener than cleanli
ness requires; and as each portion of the old dressing is removed, it must at once be re placed with fresh, so that as little exposure as possible of the burnt surface may take place. The main principle of treatment is exclusion of the air from the injured part; and so long as this is effected, it matters but little what remedial agent is employed. Great care must be taken in the treatment of a sore resulting from a burn, that the con traction of the scar does not cause distortion of the neighboring parts.
When the clothes catch fire, the person should lie down on the floor, and roll herself, or be rolled, in the rug, table-cover, or anything sufficiently voluminous to stifle the flames; and afterwards the clothes, especially stockings, should be removed with great care, lest the cuticle should separate with them, which would materially increase the sufferings of the patient.
Extensive scalds or burns are very fatal to young children; and it must be remem bered that their skin is more susceptible to external impressions, and will suffer from a degree of heat innocuous to an adult. Infants have frequently been scalded to death in too hot baths, or by too hot fomentations. The principles of treatment for burns pro duced by the contact of chemical agents to the skin, are the same as those for burns by fire.