How do you treat a burn? Almost everyone, if you ask them for the first response required in the treatment of a burn, will tell you, "Put it in cold water…".

However…

In my first year of homoeopathic training a general discussion led the lecturer to describe a treatment for burns. He explained that he had been dining with a friend who had burnt herself and had immediately, to his horror, held the burnt area of her hand in the heat of a candle for a little while. The friend had then explained to him that the normal treatment of using cold water was ineffective, but that the application of heat to a burn meant that it would not blister, and although it did hurt more on the initial application it healed far more quickly and painlessly thereafter. This she demonstrated a little while later when he saw to his amazement that the burned area was not even red and she was experiencing no pain.

His explanation was that left alone a burn, ‘burnt’, as in the vital force would produce heat. By applying cold water this burning effect was reduced and the vital force had to summon even more heat. If instead we assist the vital force by applying heat the job would be done more quickly.

This is really nothing more than elementary homoeopathy… like cures like… similar similibus curentur….  And yet some in the group were surprised, and some argued that this would be dangerous with anything other than a very slight burn…

Some of us tried this out when the opportunity arose, and I personally discovered that holding an accidentally scalded part in hot water for a little while did indeed improve things to a remarkable degree. The theory was tested more thoroughly when, about year later, whilst working in a fish and chip shop, I slipped and my left hand plunged into the chip fryer up past the wrist. I ran (screaming!) into the kitchen and turned on the hot tap. The plug was in the sink and the sink began to fill. At the same time a couple of concerned customers had run into the kitchen to see if they could help. One of them noticed that I was running the hot tap and tried to ‘help’ by explaining that I had turned on the wrong tap and attempted to turn off the hot and on the cold. In my pain I had to prevent them and also explain what I was doing. This meant that my hand remained in the water for a longer period than it would perhaps, had I been left alone (this is relevant later…).

The next day, my hand had no evidence of the burn whatsoever! The customers who had witnessed the incident were amazed!

Last year (Sept 2007) I received a phone call from one of my daughter’s friends. In the background I could hear my daughter crying and obviously distressed. She had apparently scalded her hand with double boiled water. The drive to the friends’ house took about half an hour. On my arrival I gave her Canth 200c. She explained that she had ‘done the hot water thing’ but that it hadn’t worked. She was in a lot of pain and was obviously distressed.

I took her home, but was concerned as she seemed in so much pain. She was also very angry. The accident had been caused by the friends’ dog, who had become amorous with her leg as she was pouring the water into a cup. She was angry with the dog and was saying that, ‘dogs like that shouldn’t be kept as pets!’ this was a ridiculous thing to say, there was nothing wrong with the dog really, and it was also extremely unusual for her. I gave her Caust 200c, which did ease the pain and she seemed to settle, was no longer angry with the dog and was able to laugh about its antics, but I was still concerned. Her hand had produced a sizable blister and she was still in pain. I was also confused as to why the hot water had not relieved the pain as it had with my own, perhaps more serious, burn.

I remembered seeing Hahnemann’s article ‘On the Treatment of Burns’ in the book ‘The Lesser Writings’. I re-read the article and realised the mistake we had made. I also understood why my burn had had a different result.

The problem was, it seemed, the time that the hand had been exposed to the heat. My hand had been immersed for a considerable amount of time whilst I engaged in discussions with the concerned customers, whilst my daughter had merely put it in and taken it out.

Hahnemann’s advice is that the heating should continue until there is no more pain. He recommends the use of alcohol and/or oil of turpentine, neither of which I had at my disposal, but I deduced that it was the ‘heat’ that was the important ingredient.

I explained this to my daughter and we spent the next three hours with her hand in hot water. At this point I should explain that I do not mean scalding hot! The temperature is what I would describe as ‘hand hot’, the temperature that a normal hand understands as ‘hot’ but not unbearable. Because of the time delay I didn’t ask her to simply plunge her hand into water of this temperature. We began with tepid water and by removing some and adding some we increased the temperature over a period of half and hour. She then kept her hand in the water until the pain stopped. This took several hours.

Over the next few days I suggested to her than she often return her hand to the warm water, particularly if she felt any pain, but also in order to prevent it from drying.  

I was concerned as the blister was ‘impressive’, although after the initial hot water treatment she was in very little pain. She described the sensation as a ‘discomfort’ rather than ‘pain’. There had been criticisms of my treatment of it, with various people suggesting that she should have taken it to hospital to have it ‘treated properly’. I sought support or advice from ‘Homoeopathy’ but could only find instructions to ‘immerse the part in cold water and seek medical attention’, in addition to the obvious remedies.

She heroically and carefully kept the blister whole and continued to ensure that it did not become dry.

In addition to the hot water I gave her a bottle of Canth 30c, in medicinal solution, from which she took a teaspoonful daily for a few days, after succussing the bottle 6 times.

After 6 days the blister seeped of its own accord and I instructed her not to remove the covering it had left. I gave her a couple of doses of Calen 30c, again in medicinal solution and succussed prior to repetition, and a couple of days later the layer of dead skin came free on its own. Eleven days after the scalding there was just a little pink discoloration of the new skin and this was the only evidence that the event had occurred.

Just for the record, one the first night I did offer to take her to the local hospital, Homoeopathy is my choice and I do not force my opinion on my children, but she is 19 and her response was ‘why would I want to go there? You and Hahnemann can fix it!’ I’m just very glad that I took notice of my lecturer and also had the article to hand to work out what we had done wrong.

Today there is no evidence that her hand had ever been injured in this way. There are no blemishes and no sensation changes. She is a little more careful when handling hot water though!

The article, ‘On the Treatment of Burns’, written by Dr. Hahnemann in 1816, is a poignant reminder that our work as homoeopaths extends beyond the search for the correct remedy. It is in the basic understanding of the maxim ‘similar similibus curentur’ and the application of treatment that consistently responds to the needs of the vital force. I have reproduced the article here and whilst I hope than none of you will ever need to employ it, I hope it serves you as well as it did me should you have to.

Sadly, I feel pressed to add, due to today’s climate of legislative suppression, that I am not personally advocating, nor instructing anyone to adopt these methods in the treatment of serious burns. I am of the mind that the current suffering of burns victims could be greatly reduced, and also am wondering if there is anyone who would take up Dr. Hahnemann’s challenge today?

ON THE TREATMENT OF BURNS

Dr. Samuel Hahnemann, 1816.

(From the Allg. Anz.d. D., No. 156, 1816. In reply to Professor Dzondi’s recommendation of cold water in the same journal, No 104).

It is to be regretted that Professor Dzondi, of Halle, should have recommended as the only sure, efficacious and best remedy for burns, a means of the injurious nature of which all who have much to do with fire are perfectly convinced. Has he then instituted comparative experiments with all remedies recommended for this purpose, that he can now with any degree of truth vaunt his cold water as being the only sure, the best remedy? In such injuries the question is, not what shall give relief for the first few moments, but what shall most speedily render the burnt skin entirely destitute of pain and heal it. This can only be determined by comparative experiments, not by speculation. But it has already been settled by observation, which may easily be repeated, that it is exactly the opposite of cold water that heals burns most rapidly. For with the true physician the object should be to heal, not to relieve for a few moments.

Slight burns – for example, when a hand has been scalded with hot water of from 180^o to 190^o fahr. - heal without any application, in the course of from twenty-four to forty-eight hours; but they take a somewhat longer time to do so if we employ cold water in order to give relief at first. For such slight injuries hardly any remedy is requisite, least of all one like cold water, which delays the cure. But for large severe burns, the best remedies are not so generally known, and the public requires some instruction on that subject; it is in these that cold water is specially shews itself to be the most wretched palliative and in some cases the most dangerous remedy that can be conceived. Comparative experiments and observations will, I repeat, convince everyone most conclusively, that the exact opposite of cold water is the best remedy for severe burns. Thus the experienced cook, who from the nature of his occupation must so often happen to burn himself, and must consequently have learned by experience the remedy for burns, never puts his hand that he has burned with boiling soup or grease into a jug of cold water (he knows from experience the bad consequences of so doing), no, he holds the burned spot so near to the hot glow of the incandescent coals, that the burning pain is thereby at first increased, and he holds it for some time in this situation, until, namely, the burning pain becomes considerably diminished and almost entirely removed in this high temperature. He knows, if he does so, that the epidermis will not even raise and form a blister, not to speak of the skin suppurating, but that, on the contrary, after thus bringing his hand near the fire, the redness of the burned spot, together with the pain, will often disappear in a quarter of an hour; it is healed all at once, quickly and without any after-sufferings, though the remedy was at first disagreeable. To this method he gives decidedly the preference, because he knows form experience that the use of cold water, which at first procures for him a delusive alleviation, will be followed by blisters and suppuration of the part, lasting for days and weeks.

The maker of lacquered ware and other workmen who use in their business alcohol and ethereal oils, and who have to do with boiling linseed oil, know from experience that the most rapid and permanent way to cure the most severe burns and to get rid of the pain, is to apply to them the best alcohol and oil of turpentine, substances which on a sensitive skin (as that of the mouth, the nose , the eyes) cause a pain of burning like fire, but in cases of burning of the skin (the slightest, more severe, and even the most serious ones) act as a most incomparable[1] remedy. True, they know not the rationale of this cure - they only say, “one bad thing must drive out another”; but this they know from multiplied experience, - that nothing will make the burned spot painless and cause it to heal without suppurating, except rectified alcohol and oil of turpentine.

Does Professor Dzondi imagine that it would never have occurred to these workmen to use cold water as a palliative remedy immediately after burning themselves? Any child who had burned itself would in its alarm would fly to cold water; it would not require any advise to do so; but the workman has repeatedly tried it to his own injury, and experience, which in such cases is always purchased at the expense of ones own suffering, has taught and convinced him that the very opposite of cold water is the surest, quickest and truest remedy for even the worst burns: he has been rendered wise by experience, and in all cases he greatly prefers the remedy which at first causes pain (alcohol, oil of turpentine) to that which deludes by instantaneous relief to the pain (cold water).

Let professor Dzondi only makes upon himself as he offers to do one pure comparative experiment, and he will be convinced that he has made a grievous mistake in recommending cold water as the only sure an best remedy for burns.

Let him plunge both his healthy hands at the same instant full of boiling water and retain them there for from 2 to 3 seconds only, and withdraw them both at the same time: they will, as may easily be imagined, be both equally severely scalded, and as the hands belong to one and the same body, if one hand be treated with cold water and the with alcohol or oil of turpentine, the experiment will furnish a pure comparison and convincing result. This case will not admit of the excuse offered in that of the burns of two different individuals, where the bad consequences that always result when the hand is treated with cold water are sought to be ascribed to impure humours, bad constitution, or some other difference in the one so treated to the one that has been much more easily cured by alcohol. No, let one and the same individual (best of all the professor himself, in order to convince him), scald both his hands in the most equal manner before competent witnesses, and then plunge one hand (which we shall call A) into his cold water as often and as long as he pleases, but let him hold the other hand (which we shall call B) uninterruptedly in a vessel of warmed alcohol, keeping the (covered) vessel constantly warm. In this the burning pain of the hand B rises in a few seconds to double its intensity, but thereafter it will go on diminishing, and in three, six, twelve, or at the most twenty-four hours (according to the degree of the burn) it will be completely and for ever removed, but the hand, without the production of any blister, far less of suppuration, will become covered with a brown, hard, painless epidermis, which peels off after a few days, and appears fresh and healthy, clad in its new skin.

But the hand A, which the professor plunges into cold water, as often and as long as he pleases, does not experience the primary increase of pain felt by hand B; on the contrary, the first instant it is as if in heaven; all the pain of the burn is as if vanished, but – after a few minutes it recommences and increases, and soon becomes intolerably severe, if cold water be not again used for it, when the pains likewise in the first instants as if extinguished; this amelioration, however, also lasts but a few minutes; they then return, even in this colder water, and in a short time increased to greater and greater intensity. If he now puts his severely burned hand into the coldest snow water, he runs the risk of sphacelus, and yet after a few hours he can find no relief from the pains in the water that is less cold. If he now withdraws his ill-treated hand from the water, the pain, instead of being less than it was immediately after the scald, is four and six times greater than it was at first; the hand becomes excessively inflamed, and swells up to a great extent with blisters, and he may now apply cold water, or saturnine lotion, lead ointment, hemp-seed oil, or any other of the ordinary remedies he likes; the hand A, treated in this manner, inevitably turns into a suppurating ulcer, which, treated with these ordinary so-called cooling and smoothing remedies, at length heals up after many weeks or even months. (solely by the natural powers of his body), with hideously deformed cicatrices and tedious, agonizing pains.

This is what experience teaches us with respect to burns of any severity.

If Professor Dzondi imagines he knows better than is here stated, if he believes he is certain of the sole curative power of cold water, which he lauds so much, in all degrees of burns, then he may confidently undertake to institute the above decisive, purely comparative experiment before competent witnesses. It is only by such an experiment that truth will be brought to light. What risk does he run if his cold water will procure as rapid relief for the hand A as the warm alcohol will for the hand B?

But no! I pity the poor hand; I know very well how it would be! Let the Professor, if he is not quite so sure of the efficacy of cold water in severe burns, perform but a small portion of the experiment, let him dip only two fingers of each hand into boiling water for two or three seconds, and let him treat the fingers of hand A and those of hand B in the way above described, and this little comparative experiment will teach him how wrong he was to recommend to the public as the only, best and efficacious remedy in all degrees of burns, cold water, an agent which although it is uncommonly soothing in the commencement, is subsequently so treacherous, so extremely noxious. For severe burns he could not advise anything more injurious than cold water (except perhaps the ointments and oils ordinarily used for burns), and in slighter cases where no blister would rise if left alone, blisters come on when they are treated with the palliative cold water.

In the meantime, before professor Dzondi can make known the result of this decisive experiment upon himself, it may be useful for the public to know, that one of the greatest surgeons of our time, Benjamin Bell[2] of England, instituted a similar experiment for the instruction of the world, which was almost as pure as the one I have proposed. He made a lady who had scalded both arms, apply to the one oil of turpentine, and plunge the other into cold water. The first arm was well in an hour – but the other continued [to be] painful for six hours; if she withdrew it an instant from the water she experienced more intense pain, and it required a much longer time for its cure than the first[3]. He therefore recommends, as A. H. Richter[4] had already done, the application of brandy,[5] he also advises that the part be kept constantly moistened with it.[6] Kentish[7] also greatly prefers, and that very properly, the spirituous remedies to all others. I shall not adduce the experience confirmatory to this I have myself had.

From all this it appears that Professor Dzondi has made a mistake, and that cold water, far from being a curative agent, is, on the contrary, an obstacle to the cure of slight burns, and occasions a great aggravation of more serious ones, that in the highest degree of such lesions, it even exposes the part to the risk of sphacelus, if the temperature of the water applied be very low (just as warm applications are apt to cause mortification of frost-bitten limbs), and that on the other hand, warm alcohol and oil of turpentine are inestimable, wonderfully rapid, perfectly efficacious, and genuine remedies for burns, just as snow is for frost-bitten limbs.

The adherents of the old system of medicine ought not longer to strive against the irresistible efforts towards improvement and perfection that characterises the spirit of the age. They must see that it is of no use doing so. The accumulated lumber of their eternal palliatives, with their bad results, stands revealed in its nothingness before the light of truth and pure experience.

I know very well that the doctor insinuates himself uncommonly into the affections of his patient, if he procures him a momentary heavenly relief by plunging the seriously burnt part into cold water, unmindful of the evil consequences  resulting therefrom, but his conscience would give him a much higher reward than such a deluded patient ever can, if he would give the preference to the treatment with heated alcohol (or oil of turpentine), which is only painful in the first moments, over all traditional pernicious palliatives (cold water, saturnine lotions, burn slaves, oils, &c.); if he could be taught by experience and pure comparative experiments, that by the former means alone is all danger of mortification guarded against, and that the patient is thereby cured and relieved of all his sufferings, often in less than a hundredth part of the time required for the cure by cold water, saturnine lotions, slaves and oils.

So, also the girl heated by dancing to the highest degree of fever, and tormented by uncontrollable thirst, finds the greater, refreshment for the first few moments from exposure to draft of air, and from drinking a glass of ice cold water, until she is taught by the speedy occurrence of a dangerous or even fatal illness, that it is not what affords us the greatest gratification for the first few moments that is for our real welfare, but that, like the pleasant cup of sin, it is fraught with evil, often with ruin and death.

ADDITION TO THE FOREGOING ARTICLE.

From the Allgem. Anzeiger der Deutschen. No.204. 1816.

When ancient errors that should justly sink into oblivion are attempted to be palmed off upon the world anew, he who knows better ought not to neglect to publish his convictions, and thereby to consign the pernicious error to its proper ignominious place, and to exalt the true and the salutary to its right position for the welfare of mankind. It was this idea that guided me in No.156 of this journal,[8] where I first displayed the inestimable advantages of warm spirituous fluids for the rapid and permanent healing of extensive burns, over cold water, which only alleviates for an instant, but whose results are extremely pernicious.

The most convincing tests of the relative value of these two opposite methods, viz., the curative (the really healing) methods, (the employment of warm spirituous fluids, such as alcohol or oil of turpentine), and the palliative (alleviating) method, (the use of cold water, &c.), are furnished firstly, by pure comparative experiments, where burns of two limbs of the same body are simultaneously treated, the one by the one method, the other by the other; secondly, by the expressed convictions of the most unprejudiced and honourable physicians. One single such authority, who, knowing the worthlessness as facts of the favourite pre-conceived notions of the age, dispossesses his mind of them, and, rejecting the old pernicious errors from genuine conviction, is not afraid to claim for truth its merited station, is worth thousands of prejudiced upholders and combatants for the opposite.

Thousands of over hasty advocates of the pernicious employment of cold water in serious burns, must hold their peace before the expressed convictions of that most upright of practical physicians Thomas Sydenham, who despising the prejudiced opinion that has prevailed universally from Galen’s time till now, morbi contrariis curentur (therefore cold water for burns), and influenced by his convictions and by truth alone, thus expresses himself:[9] “As an application in burns, alcohol bears the bell from all other remedies that have ever been discovered, for it effects a most rapid cure. Lint dipped in alcohol and applied, immediately after the injury, to any part of the body that shall have been scalded with hot water or singed with gunpowder, will do this, provided that as long as the pain lasts the spirit be renewed; after that, only twice a-day will suffice.” Let him who can prove this to be false come forward!

Or, who can contradict one of the best and most enlightened practical surgeons of our time, Benjamin Bell, when from his extensive experience he alleges:[10] “One of the best applications to every burn of this kind is strong brandy, or any other ardent spirit; it seems to induce a momentary additional pain, but this soon subsides and is succeeded by an agreeable soothing sensation. It proves most effectual when the parts can be kept immersed in it; but where this cannot be done, they should be kept constantly moist with pieces of old linen soaked in spirits”.

Kentish, who, as a practitioner in Newcastle, had to treat the workmen who were often fearfully burnt in the coal pits, considers very carefully in his book[11] all the claims preferred in favour of cold water and all other cooling remedies for burns, and he finds as the result of all his experience, contrary to the great prejudice he felt in favour of these long used things, that under their use no single person who had got a severe burn on a great part of his body ever recovered, but that all were cured who were treated by the speediest possible application and frequent renewal of hot turpentine.

But no proof for the truth of this can be so strong as that which is afforded by comparative experiments performed simultaneously on one and the same body. In my former paper I cited the case of a lady who got both her arms burnt, one of which was treated by Bell with cold water, but the other was kept covered with oil of turpentine; in the first the pains persisted for a much longer time and a much greater period was required for the cure than in the last, which was treated with the volatile oil.

Another experiment of not less convincing character is related by John Anderson.[12] “A lady scalded her face and right arm with boiling grease; the face was very red, very much scalded, and the seat of violent pains; the arm she had plunged into a jug full of cold water. In the course of a few minutes oil of turpentine was applied to the face. For her arm she desired to continue the use of cold water for some hours, because it had formerly been of service to her in burns (she could not say whether those had been more severe or less so than the present one). In the course of seven hours her face looked much better and was relieved. In the meantime she had often renewed the cold water for the arm, but whenever she withdrew it she complained of much pain, and in truth the inflammation in it had increased. The following morning I found that she had suffered great pain in the arm during the night; the inflammation had extended above the elbow, several large blisters had risen, and thick eschars had formed on the arm and hand.  The face on the contrary was completely free from pain, had no blisters, and only a little of the epidermis had become detached. The arm had to be dressed for a fortnight with emollient remedies before it was cured.”

Who can read these honest observations of illustrious men without being satisfied of the much superior healing power of the application of spirituous fluids to that of cold water, which affords a delusive alleviation, but delays cure?

I shall not, therefore, adduce my own very extensive experience to the same effect. Were I even to add a hundred such comparative observations, could they prove more plainly, strongly, and convincingly than is done by these two cases, that (warm) spirituous fluids possess  an inestimable advantage over the transiently alleviating cold water in the case of severe burns?

How instructing and consoling, then, for mankind is the truth that is to be deduced from these facts: that for serious and for the most severe injuries from burning, though cold water is very hurtful for them, spirituous applications (warm alcohol or oil of turpentine) are highly beneficial and capable if saving many lives.

These proofs will serve to guide the great numbers of mankind who require help, to the only effectual method, to the only health bringing (sanative) remedy, without which, in the case of extensive burns (that is where the greater part of the surface of the body has been scalded or burnt), delivery from death and recovery is perfectly impossible, and has never been witnessed.

This one single, and, as I have imagined, not unworthy object of my essay, was evidently not perceived by Professor Dzondi, as is proved by his violent letters to me; he only perceives in my remarks an attack upon his opinion. It is a matter of very little interest to me to find that cold water which has already been recommended ninety-nine times by others for burns, from a predilection in favour of this palliative whose effects are so injurious, is now served up to us again for the hundredth time, and I should feel ashamed to make use of a Journal so useful in promoting the happiness of the people as this is, for the purposes of merely personal recrimination and discussion. Moreover, as in the article I allude to I advised him to convince himself of the truth of my assertions by an experiment upon himself, my object was thereby to inform everyone of the conditions necessary to be observed in order to constitute a really convincing pure experiment of this kind.

I avail myself of this opportunity to expose the disadvantage of cold water (and other ordinary palliatives) in the treatment of serious burns, and call the attention of the public to the only effectual remedies, warm spirituous fluids, in order that they may avail themselves of them in the hour of need. This is not any mere idea of my own, but it has been clearly proved and irrefragably demonstrated by the observations of the most honourable and illustrious men of our profession (Sydenham, Heister, B. Bell, J. Hunter, Kentish), and especially by the convincing comparative experiments of Bell and Anderson.

I shall only observe further, that the burnt parts must be kept moistened uninterruptedly with the warm spirituous fluid, e.g. warm alcohol, for which end the linen rags soaked in it should first be simply laid upon the injured parts, and then, in order to prevent evaporation, and to keep all warm, covered with pieces of woollen cloth or sheepskin. If a very large portion of the surface of the body is burnt, then some one will be obliged to devote himself entirely and constantly to the external care of the patient, removing the pieces of cloth or skin one by one and pouring with a spoon warm alcohol (or oil of turpentine) over the linen rags upon the skin (without removing them), then as soon as they are dry, covering up the part and going on to the others, so that when the last part has been moistened and covered up, it is time to commence again with the first part, which, in the case of such a volatile fluid as warm alcohol, has in the meantime generally become dry. This process must be continued day and night unremittingly, for which purpose the person engaged in the performing it must be changed every two hours for a fresh one. The chief benefit, especially in severe and very serious injuries from burns, depends on what is done within the first twenty-four hours, or in the worst cases, the first forty-eight hours, that is, until all trace of the pain of the burn is permanently removed. A basin should be at hand containing very hot water, which should be frequently renewed, in which some vessels full of alcohol should stand, of which the attendant takes out the warmest for the purpose of wetting the rags, whilst the rest stand in the basin in order to remain sufficiently warm so that there never shall be a want of warm alcohol for the purpose of pouring on the rags. If the parts of the body on which the patient is obliged to lie are also burnt, the rags, dipped in warm alcohol, should be applied to them on the commencement, and a layer of water-proof cloth spread underneath; these parts can subsequently be wetted from above without being removed. If the greater part of the body is burnt, the first application must only consist of warm brandy, in order to spare the first shock to the patient which is the worst, the second wetting should be preformed with stronger alcohol, and afterwards the very strongest alcohol may be used. And as this operation must be continued uninterruptedly during the night, the precaution must be used of keeping the candle (or lantern) at a good distance, otherwise the warm spirituous vapour rising from the skin might readily catch fire, and prove destructive to the patient.

If the burn has been effected with gun powder, the small black particles should not be picked out of the skin before all traces of the pain of the burn are permanently removed.