follow this treatment up with very cold water. Then give a cold bath in an unheated room, rub the chest and the region of the heart thoroughly with fresh water, and finally put the patient into a cold bed, cover him with cold cloths, and give an enema of cold water.
Some blow fresh air into one of the nostrils by means of bellows, while the other nostril and the mouth are kept firmly closed. But, as far as my experience goes, by this treatment the air is much more likely to get into the stomach than into the lungs. If it is necessary to induce artificial respiration, it is better to alternately press the arms of the patient firmly to his chest and then to raise them above his body, or, what is even more simple, squeeze together every two or three seconds both chest and abdomen with the hands.
As soon as faint signs of life, such as a twitching of the eyes, a change in the color of the lips, or an attempt at breathing are noticed, the nose should be tickled with a feather, and a few drops of some stimulating fluid, either wine, brandy, or ammonia, should be poured into the mouth and throat. When the symptoms of returning life become more marked, pour a few teaspoonfuls of one of the above-mentioned liquids into the mouth and give an injection with a spoonful of wine or brandy, and also use one of the liquids to rub the skin; then put the patient into a warm bed. After this, some warm soup or a cup of coffee will be in place. Should the excitement become too great, it is advisable to give a lukewarm bath and some soothing potion.
In the every-day happenings of our life such accidents occur but rarely. However, complaints of frozen fingers, toes, ears, and noses, and chilblains, are frequent.
Many people think that fingers, toes, and noses are apt to be frozen because they are so distant from the heart, and are in consequence not so plentifully supplied with warm blood. Although I do not wish to dispute this entirely, the main reason seems to be that these parts are very thin and small and come more directly in contact with the air. When such small parts are exposed to intense cold, the veins contract and drive the blood toward the interior. The backs of the fingers and toes freeze first; they become pale and devoid of feeling, and the joints benumbed and stiff. After a while the blood in the veins congeals, all tissues grow brittle and break easily. But frozen joints are not dead. If gradually warmed they can be restored entirely; if, however, they have been exposed to intense cold and are then suddenly warmed, a strong inflammatory reaction sets in, the same as when normally warm parts are exposed to a temperature as high as that of boiling water. Cold alone can produce numbness and insensibility; but an inflammatory reaction is alone due to too rapid a warming. To such careless treatment only must the troubles which are known as frozen joints, chilblains, etc., be ascribed. Chilblains, where the skin and tissues are inflamed, cause a disagreeable itching in warm weather.
