Wounds, infection, and teeth

Wash, don’t sew

The dirt you leave in is what takes the leg. Irrigation beats iodine. Use the cleanest water you have — boiled and cooled is best — in a volume that feels wasteful. A squeeze bottle, a syringe without a needle, or a clean plastic bag with a pinhole, hard stream, several minutes.

Soap on the skin around the wound, not packed into deep holes. Pick out gravel and wood you can see, with boiled tweezers. Do not dig for what you cannot see.

1. Stop the bleeding first (see The first ten minutes).
2. Wash your own hands. Gloves if you have them.
3. Irrigate. Then irrigate again.
4. A thin film of honey (plain, not on an infant) or petroleum jelly on a shallow clean cut, then a dry dressing. Change daily, or when wet.
5. Watch. Pain that gets worse after day two, spreading red, fever, red streaks toward the heart, pus that smells sweet or rotten, a wound that opens itself — that is infection. See below.

Close it or leave it open

Warning. A sewn-up dirty wound is an abscess with a lid. Bites — dog, cat, hog, human — stay open. Cat bites go bad fastest.

Infection, the homestead killer

Before antibiotics, people died of a rose-thorn. Treat every wound like it wants to be that story.

Early: more washing, warm wet cloth 15 minutes a few times a day, rest the limb, elevate. If you have leftover antibiotics prescribed for this person for a skin infection, that is the moment — not ‘whatever is in the drawer.’ Wrong drug, wrong dose, and you breed something worse.

Red streaks, fever, confusion, a wound on the face or hand that is blowing up: they need a real drug and a real drain. If no clinic exists, keep irrigating, keep it open, keep them drinking, and lance only a clearly soft, pointing abscess you can see — small nick at the lowest point, after cleaning, and let it drain. Do not squeeze the face or the middle of the back.

Tip. Tetanus lives in dirt and manure. A puncture from a nail in the barn is the classic. If their tetanus shot is not current and a clinic still exists, go. In the field: wash deep, leave open, watch the jaw and muscle spasms. You cannot treat lockjaw at home.

Hooks, splinters, eyes

Fishhook with the barb in: push it through until the barb clears, snip the barb, back the shank out. Do not rip it backward. Wash. Watch for infection.

Splinter: sterilize a needle in flame, let it cool, lift the skin, slide it out the way it went in. If it is under a nail and you cannot get it, soak and wait — do not carve the nail off unless it is already lifting and full of pus.

Something in the eye: rinse a long time with clean water. Do not rub. A loose lash you can see, damp cloth at the corner. Lime, lye, or battery acid: rinse for 20 minutes and do not stop early. Cover both eyes if one is hurt — they move together.

Teeth, when there is no dentist

A knocked-out adult tooth: pick it up by the crown, not the root. If dirty, rinse one second in clean water. Push it back into the socket and have them bite a cloth. If you cannot, keep it in milk or in their own spit, not dry. A chance only in the first hour.

Broken tooth, screaming in the cold air: clean, then cover the nerve with temporary filling, melted candle wax, or sugar-free gum as a lid. Clove oil on a cotton pellet dulls the nerve — a drop, not a mouthful.

Abscess: swollen face, tooth that throbs, fever. Warm salt-water rinses. Ibuprofen. Do not put aspirin on the gum — it burns a hole. They need the tooth out or a drug. A neighbor who has pulled teeth is worth more than courage with pliers on the wrong day. If you must: good light, the right tooth, slow rock, not a yank upward on a lower molar like a fence post.

Warning. A spreading dental infection that closes the throat or makes the floor of the mouth board-hard is an airway emergency. Sit them up. That is how people died of a toothache.