It is important to understand that the basic principles of Hygiene should not be violated in cases of emergency. The body’s needs must be met and its capacity recognized. Obviously, there are conditions which result from injury and accidents that require some immediate and skilled mechanical attention.
In cases where such first aid is necessary, we should still avoid violating the fundamental principles employed in the Hygienic system. We should avoid employing procedures which are likely to be damaging in the long term, even if a short-term end is gained.
In certain situations, such as fracturing a bone, dislocating a joint, or severing an artery, which represent mechanical injuries, then mechanical techniques of correction are necessary and justified. However, these mechanical techniques are only justifiable so far as they go. They have no relation whatsoever to actual healing, nor do they remove causes except in the immediate sense.
Healing is a fundamental biological process and we employ some of these techniques—like the reduction of dislocations, the setting of broken bones, and minor surgery— in order to facilitate healing, not to perform it.
Artificial respiration certainly may prevent a person from dying and in no way could it be considered as harmful, nor does it attempt to usurp the normal and orderly processes of the organism. It is a temporary mechanical procedure that enables the body to perform the functions of life more satisfactorily under the prevailing conditions. Strictly speaking, the “respiration” is anything but artificial.
You may have heard of the millionaire who came running on to the beach to see his wife who had just been dragged from the water and artificial respiration was being administered. The gentlemen screamed at the man, “That’s my wife! What are you doing?” “Well,” said the young man, “Your wife almost drowned. We’re giving her artificial respiration.” “Artificial, be damned,” was the reply. “Give her the real thing—I can afford it!”
When we have to resort to surgical or mechanical techniques as may be required, and where tissues are severely damaged after serious injury, it is sometimes necessary to relieve pain and consequently the age-old question of the use of anesthetics arises.
I think we have to make a distinction between caring for the sick and facilitating surgical intervention. For example, a victim of a motor accident who requires a limb amputation—it would be unthinkable to approach this surgical onslaught without providing, so far as we are able, freedom from pain.
In the case of accident or injury, we are not dealing directly with a problem of health and disease. We are not trying to modify symptoms at the expense of the injured person’s future health. We are simply trying to restore a certain mechanical facility to the body. We are attempting to mechanically adjust the body.
Constructive surgery does not in any way violate Hygiene and the use of anesthetics may be justified under these conditions. At the same time, we must realize that, having spent the last two or three thousand years discovering the fact that there is no virtue in remedies, drugs do not change their character with circumstances.
The fact that wounds heal when ointments are put on them does not mean that the wound would not have healed if an ointment had not been administered. At best, the use of salves and ointments alike can only fall into the dubious category of, perhaps, affording a little protection for the wound. Certainly, they have no power to heal. The power to heal must always be related to the living body itself as an inherent biological function.
It is so easy to think that when we take a remedy or apply an ointment to a wound and it heals, that the extraneous substance has performed the healing. Finally, the cold disappears and the last thing we took before we got well is thought to have “cured” the cold. It is surprising how many people expect wounds to heal when they continually interfere with them, and this particularly applies to the numerous mechanical problems that people have from injuries they suffer. Continuous interference will often delay and, in some cases, actually prevent healing.
I recall a number of years ago when I had an office practice in England, a gentleman who owned a restaurant on the lower floor of the same building consulted me about his stomach problem. Sometimes in the evenings when I closed my office, we used to walk to the station together. At these times, we used to discuss various things and inevitably his stomach problems would always arise (no pun intended).
Never having taken my advice of course, he always had his stomach problems. He used to complain of these severe pains and quite commonly he would stop at the local chemist and get something to relieve the pain in his stomach. He was constantly swallowing antacids and pain relievers.
One day, I put it to him this way, “I don’t think your stomach will ever recover. Supposing I were to put my finger on the table and hit it with a hammer and it were to become mangled, bruised, and bleeding, and then were to rub all sorts of ointments over it and bandage it, and then put it back on the table and keep on hitting it with a hammer. How long do you think it would take to heal?” He said, “It would never heal.” “Right,” I said, “Now, let’s take another situation.
A man who has a pain in his stomach all the time and continually takes hot, fiery, spicy foods, incompatible combinations, and constantly smothers the various discomforts with powders, antacids, and other drugs that have no business in the stomach whatsoever. How long do you think it would take for that stomach to heal?” My friend did not answer the question and, as far as I know, he continued to take his palliatives.
But I think I made my point that by continual interference, no matter whether the lesion is the evolution of a disease process or whether it is the result of accident or injury, healing cannot be effected. Healing, we must contend, is a fundamental biological process and is directly related to the soundness and general functional vigor of the individual. Certain external factors are required but it must be emphasized that these external factors are secondary to the internal factors. The internal factors are related to our general level of health, our functional efficiency, our basic vitality.
I am sure we all know those people who are in vigorous health and if they suffer an injury, they recover quickly and regain normality. We also know other people who suffer the most serious consequences from what seem trivial wounds and, of course, this is directly related to their degree of health. The fact that we can damage ourselves and recover quickly does not mean that we can violate the laws of life.
The basic principle of cause and effect is always in operation. There are consequences to every action.
Now, there are certain objects in first aid. First, to prevent a person from dying and I consider that this is a better way of expressing the fundamental rather than the mendacious euphemism “to save the person’s life.” Philosophically, I do not believe it is possible to save a person’s life. But it is possible to prevent people under certain circumstances from killing themselves.
This, then, is the first requisite of applying first aid techniques. We have to try to prevent death from occurring. Secondly, we have to attempt to minimize the suffering. Thirdly, to prepare the sufferer for subsequent care, i.e., to avoid the possibility of complications later.
Some years ago, an acquaintance of mine was involved in a motorcycle accident and dispatched to the hospital. He was discharged some hours later when the initial examinations revealed no serious injury. However, the following day, he collapsed and was returned to the hospital where it was discovered that he had a ruptured spleen. This was not immediately evident but the precaution should have been taken.
When we speak of an emergency, this implies an absolute need for immediate attention. Quite commonly, this is not the case; but an emergency is certainly a time when something actually has to be done.
In Hygiene, we are, I suppose, notorious for our belief in the philosophy of doing nothing intelligently or intelligently leaving things alone; but there are certain conditions, and we are well aware of these, where it is intelligent to do something and that doing something is imperative if we are to prevent deterioration and possible death. However, we must acknowledge that before anything is done, we must be fully aware of what it is that we are doing and what the reasons are for doing it. It is always possible to do something but in many instances whatever we are doing is merely interfering.
We are placing obstacles in the path of the body’s processes and this is the very thing we must always attempt to avoid. Nevertheless, there are cases where something actually must be done. I recall a few years ago being at the bedside of a young child whose parents were keen Hygienists. This child had been taken rather sick two or three days before, and the parents had placed him on a fast with absolute rest, and yet he was apparently deteriorating. They called me for advice and I discovered that the young child had a strangulated hernia. Obviously, surgical intervention was necessary.
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Here we had a mechanical problem that, required a mechanical procedure provide the body with favorable conditions for recovery. Doing nothing in this situation was certainly not intelligent. The use of mechanical procedures and surgical techniques in an attempt to remove immediate causes of trouble does not in any way invalidate the fundamental premises on which the Hygienic system is based.
Following accidents and injury, we are dealing with mechanical problems which require mechanical solutions rather than a pathological evolution which has disturbed the body’s chemistry and physiological activity. This requires understanding and the removal of cause. Philosophically, I agree there is a fine line of demarcation, and it is easy for the type of remedy-mentality that is common to extend the therapeutic approach to the vast array of illness or symptom complexes that evolve in the sick as a result of their unhealthy lifestyle.
First aid represents immediate and temporary care. It is not designed to restore health but merely to avert the possibility of further damage or even death. Many of the techniques commonly employed provide nothing but interference. Somebody once remarked that experience is something you get from making mistakes. I have always thought that it is much better if we can learn from other people’s mistakes.
Of course, this is sometimes difficult as we are not prone to learning from other people’s mistakes. We always, like to make them for ourselves, and then we know for sure. But gradually, one by one, many of the stimulants such as alcohol, strong tea, sugary drinks, which were employed as a means of dealing with shock, have been abandoned and no doubt as time passes many other measures which are essentially interference will be abandoned as well.