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101 Algorithms Questions
You Must Know

by

Amrinder Arora
Department of Computer Science,
The George Washington University
101 Algorithms Questions You Must Know
Copyright© 2018, Amrinder Arora

All rights reserved. No part of this book may be reproduced or transmitted in any
form or by any means, electronic or mechanical, including photocopying, recording,
or by an information storage and retrieval system - except by a reviewer who may
quote brief passages in a review to be printed in a magazine or newspaper - without
permission in writing from the publisher.
Table of Contents
Acknowledgments
Section 1: Warm Up Questions
Section 2: Asymptotic Analysis

Section 3: Data Structures, Sorting & Searching

Section 4: Divide and Conquer
Section 5: Greedy Algorithms
Section 6: Dynamic Programming
Section 7: Graph Traversal and Backtracking
Section 8: Branch and Bound
Section 9: NP-Completeness
Section 10: Theory of Lower Bounds
Section 11: Graph Theory
Bibliography
About the Autho r

Which Sections to Skip?

Which Ones to Read?

If you are looking for only challenging questions, jump straight to

Section 4.
If you need a primer on asymptotic notation, review Section 2.
If you need a primer in basic set theory and series concepts, review
Section 1.
If you need to review your data structures knowledge, review Section
3 as well.
Table of Figures

Figure 1: Reduction from the vertex cover to the dominating set

problem.
Figure 2: A graph that has a Hamiltonian Path, but has no
Articulation Points and no Hamiltonian Cycle.
Figure 3: Augmenting Path <a,f,c,d,e,b> can be used to extend the
exist matching {{c,f}, {e,d}}
Figure 4: A graph where minimum vertex cover is of size 2, and is
strictly larger than the size of maximum matching, which is 1.
 An Accompaniment to

Analysis and Design of Algorithms

(Third Edition)
Amrinder Arora
Cognella Academic Publisher
ISBN: 978-1-5165-1310-9
 Acknowledgments
This book would never have been possible if not for the constant
prodding by numerous students who simply wanted to get an
“official style guide” for the answers to the questions in their
algorithms textbook! Many answers now officially collected here in
this book have been exchanged with the students and have received
their critiques and suggestions.
A special thanks is also due to my former classmates and friends
Piyush Gupta, Fanchun Jin and Misam Abbas for helpful discussions
in shaping this book. Also, thanks to Justo Correas and Jesus
Correas, for constantly checking on me about the book, which kept
the project going!
Thanks are also due to my humble and patient wife and kids –
Roman, Jessica and Nayan – for their patience in dealing with me
while I worked (or at least pretended to work!) on this book.
 Section 1: Warm Up Questions
Question 1. Sets Basics
Consider A and B are two sets, such that |A| = 50 , and |A – B| = 20 ,
and |B| = 85 . Find the value of |B – A| .
Solution
We observe that elements of a set A can be place into two disjoint
categories – those that are also in B , and those that are not in B .
That is,
A = (A∩B) ∪ (A-B)
Further, since these two categories are disjoint, we also have:
|A| = |A∩B| + |A-B|
Since we are given that |A| = 50 , and |A – B| = 20 , we have that |A
∩ B| = 30
Similarly, we can conclude that:
|B| = |B ∩ A| + |B – A|
Therefore, |B – A| = 85 – 30 = 55 .

Question 2. Log Basics

Given that log 10 2 = 0.3010 and log 10 3 = 0.4771 , find the value of
log 6 10 .

Solution
We recollect that log (xy) = log x + log y .
Therefore, using log 10 2 = 0.3010 and log 10 3 = 0.4771 , we can
calculate log 10 6 = 0.3010 + 0.4771 = 0.7781

Further, we note that log b a log a b = 1 .

Therefore, log 6 10 = 1/0.7781 = 1.2851 .

Question 3. Recurrence Relation and Induction

Basics
Given the series T(n) = T(n-1) + n 2 and T(1) = 1 , find a closed-
form expression for T(n) using principle of mathematical induction.
Solution
We can get a closed form expression by using principle of
mathematical induction. Our claim is that T(n) = n (n+1) (2n + 1) /
6.
Base Case
The claim is true for the base case T(1) , as T(1) = 1 = (1 x 2 x 3)/6.
Induction Hypothesis
Let us suppose our induction hypothesis is true for all values of n up
to m .
That is, T(n) = n (n+1) (2n + 1)/6 for all values of n ≤ m .
Induction Step
From the given series, we have that T(m+1) = T(m) + (m+1) 2
That is, T(m+1) = m (m+1) (2m + 1)/6 + (m+1)
= (m+1) [ m(2m + 1)/6 + (m+1)]
= (m+1) [ 2m^2 + m + 6m + 6] / 6
= (m+1) [2m^2 + 7m + 6] /6
= (m+1) (m+2) (2m + 3)/6
= (m+1) (m+2) (2(m + 1) + 1)/6

Therefore, by principle of mathematical induction, we conclude that

T(n) = n (n+1) (2n + 1)/ 6 for all values of n ≥ 1 .

Question 4. Series Sum Basics

Compute the sum of the following series:
∑ i=1 to n i 2 i

Solution
Suppose S = ∑ i=1 to n i 2 i

Then S can be written as: 1 × 2 1 + 2 × 2 2 + 3 ×2 3 + ⋯ + n ×2 n

Such summations can often be simplified and solved using “term
sliding”.

S = 1×2+2×22+3×23+
… +n×2n
That is, 2S = 1×22+ 2 × 23 + 3 × 2 4 +
…. + (n-1) × 2 n + n × 2 n+1
Subtract the second equation from the first, and we obtain:
 –S = 1 × 2 + 1 × 2 2 + 1 × 2 3 + ... + 1 × 2 n – n 2 n+1
= 2 + 2 2 + 2 3 + ... + 2 n – n 2 n+1
= 2(1 + 2 1 + 2 2 + ... + 2 n-1 ) – n 2 n+1
By using geometric progression, we obtain :
–S = 2 (2 n – 1) – n 2 n+1

Therefore, S = (n-1) 2 n+1 + 2

Question 5. Series Sum Basics – II

What is the sum of the following series:
∑ i=1 to n i 2 2 i

Solution
While we can always use principle of mathematical induction (PMI)
to solve these kinds of problems, that requires us to know or guess
the solution. If we do not have a good guess, we may need to solve
it directly. The good news is that although it is a bit more
complicated, like the previous question, this question can also be
solved using term sliding.
S=122+22 22+32 23+… +n22n
=> 2S = 1 2 2 2 + 2 2 2 3 + 3 2 2 4 + …. + (n-1 2 ) 2 n + n 2 2 n+1

Subtracting the second term from the first one, we obtain that:
– S = 1 2 2 + (2 2 – 1 2 ) 2 2 + (3 2 – 2 2 ) 2 3 + … + (n 2 – (n-
1) 2 ) 2 n – n 2 2 n+ 1
Since i 2 – (i-1) 2 can be written as 2i-1 , we can now write the
previous equation as:
–S = ∑ i=1 to n (2i-1) 2 i – n 2 2 n+1

= 2 ∑ i=1 to n i 2 i – ∑ i=1 to n 2 i – n 2 2 n+1

From the previous question, we obtained that ∑ i=1 to n i 2 i = (n-1) 2

n+1 +2
By using the result of the previous question and simplifying, we
obtain that:
S = n 2 2 n+1 + 2 n+1 – 2 – (2n-2) 2 n+1 – 4
That is,

∑i=1 to n i22i = (n 2 – 2n + 3) 2 n+1 – 6

It is always prudent to validate the series for a few different of n .
For example, we can confirm that for n=1, both sides evaluate to 2 ,
and for n=3, both sides evaluate to 90 .

Question 6. Series Sums Basics – III

Which of the following two terms is larger:
∑ 1 to n i 2 or ∑ 1 to n*n i

Solutio n
Both of these terms can be independently solved and compared.
We can observe that: ∑ 1 to n i 2 = n (n+1) (2n+1)/6 , while ∑ 1 to n*n
= n 2 (n 2 +1)/2 .
Thus, the second term is significantly larger for larger values of n.

Question 7. Probability Basics – Dice, Thrice

What is the probability of rolling three six-sided dice, and getting a
different number on each die?
Solution
Many such problems can be solved using counting principles. This
specific problem can be restated as follows: when rolling three six-
sided dice, what is the total number of combinations, and what is the
number of “favorable” combinations, that is, combinations in which
there is a different number on each die.
The total number of combinations is 6 × 6 × 6 .
To count the total number of combinations in which there is a
different number on each die, we can take the number of
combinations for first die ( 6 ), multiply it by number of
combinations on second die (5, excluding the number obtained on
the first die), and multiplying it by the number on third die (4 ,
excluding the numbers obtained on first and second dies). Therefore,
the probability is (6 × 5 × 4) / (6 × 6 × 6) , that is, 5/9 .

Question 8. Probability Basics – Rain and

Soccer in Desert
Antonio has an exciting soccer game coming up. In recent years, it
has rained only 5 days each year in the city where they live.
Unfortunately, the weatherwoman has predicted rain for that day.
When it actually rains, she correctly forecasts rain 90% of the time.
When it doesn't rain, she incorrectly forecasts rain 10% of the time.
What is the probability that it will rain on the day of Antonio’s
soccer game?
Solution
Many such questions can be solved using Bayes theorem. A key
trick in many such problems to start by writing a notation for
different events. Suppose A represents the events that it rains, and
suppose B represents the event that the weather woman predicts
rain. For convenience, let us use A’ to denote the event that it does
not rain. Therefore p(A) + p(A’) = 1 .
The question requires us to find p(A/B) , that is, the probability that it
rains, given that the weatherwoman has predicted rain.
Using Bayes theorem, p(A/B) = p(B/A) p(A)/p(B).
We are given that p(B/A) = 0.9, and further that p(A) = 5/365
To calculate p(B) , we observe that
p(B) = p(B/A) p(A) + p(B/A’) p(A’)
= 0.9 * 5 / 365 + 0.1 * 360/365
= 0.111
Therefore, we can obtain that:
p(B/A) = 0.9 * (5/365) / 0.1111
= 0.111
So, we observe that the probability that it actually rains on Antonio’s
soccer match is relatively small. This seems counter-intuitive given
that the weatherwoman has high accuracy (correctly predicts rain
90% of time and incorrectly predicts rain only 10% of the time), but
this apparent anomaly is due to the low base rate – it only rains 5
days on average in Antonio’s city anyway. [1]
Question 9. Probability Basics – 1000 in a Sum
of Dic e
You roll a standard six faced unbiased dice unlimited times, and
keep your running sum. What is the probability you will hit 1000 (at
some point of time)?
Solution
Suppose p(n) represents the probability that we hit n at some point of
time. Further, the probability that the unbiased dice lands on any
number (1..6) is presented by q = 1/6.
We can articulate this solution by using a recurrence relation:
p(n) = p(n-6) q + p(n-5) q + p(n-4) q + … + p(n-1) q
Since initially we start with a sum of 0 , we have that p(0) = 1 . The
starting values of this recurrence relation can also be easily
calculated as follows:
p(1) = q
p(2) = p(1) q + q
p(3) = p(1) q + p(2) q + q
p(4) = p(1) q + p(2) q + p(3) q + q
p(5) = p(1) q + p(2) q + p(3) q + p(4) q + q
p(6) = p(1) q + p(2) q + p(3) q + p(4) q + p(5) q + q
Therefore, we can calculate empirically (using a program, or by
using Excel), the value of p(n) for any value of n . We observe that
the series stabilizes to p(n) = 0.2857 for large values of n .
We can also observe that the average of numbers on the dice is 3.5 ,
and that p(n) stabilizes to 1/3.5 .
 Section 2: Asymptotic Analysis
Preliminary Definitions
We use the following definitions, that are from the text.
1. We define O(g(n)) to be the set of all functions f(n)
such that there exist constants n 0 and c such that 0 ≤
f(n) ≤ c g(n) for all n ≥ n 0 . (Asymptotic analysis is
usually used for positive functions only, so we
assume that f(n) ≥ 0 .)
2. We define f(n) = Ω(g(n)) if there exist constants n 0
and c such that f(n) ≥ c g(n) for all n ≥ n 0 . We
observe that big omega notation is the inverse of the
Big O notation. That is, f(n) = O(g(n)) if and only if
g(n) = Ω(f(n)) .
3. We define f(n) = thet a (g(n)) if and only if f(n) =
O(g(n)) and g(n) = O(f(n)).

Question 10. Time complexity of Repeated

Squaring
What is the time complexity of the following program?

Solution
We observe that the outer loop (on counter j ) just increments one by
one. So, that loop runs in O(n) time.
The inner loop runs on counter k , and the value of k gets squared
every time, starting with 2 .
Therefore, the value of k jumps from 2 , to 4 , to 16 to 256 . We
j=1 observe that after m iterations of the loop, the value of
while (j < n) {
k=2 k becomes 2 2^m . The loop terminates when the value
while (k < n) { of k becomes larger or equal to n , that is, 2 2^m ≥ n ,
Sum +=
a[j]*b[k] that is, m ≥ log log (n) . Therefore the inner loop runs
k=k*k in O(log log n) time .
}
j++ Since the two loops are nested, the entire program runs
}
in O(n log log n) time.

Question 11. Time Complexity with Alternating

Big Jumps
What is the time complexity of the following program?
j=1
Solution
while (j < n) {
k=j
while (k < n) We observe that the outer loop (on counter j )
{
If (k is odd) increments by 0.1*n . So, that loop can only run a
k++ constant number of times (at most 10 times) before j
else exceeds n .
k += 0.01 * n
} The inner loop runs on counter k , and the value of k gets
j += 0.1 * n
} incremented by 1 if it is odd. After that, it becomes
even, and then it increments by 0.01*n.
Therefore, the value of k increments one time and then jumps by
0.01*n next time. Therefore, the inner loop can also run only a
constant number of times.
Therefore, the entire program runs in constant, that is, O(1) time.

Question 12. Time Complexity with Repeated

Squaring and Half Increment
What is the time complexity of the following program?
j=2
while (j < n) {
Solution
k=2
while (k < n) { As observed in one of the previous questions, the
Sum += inner loop runs on counter k , and the value of k gets
a[k]*b[k] squared every time, starting with 2 .
k=k*k
} Therefore, the value of k jumps from 2 , to 4 , to 16 to
j += j/2
} 256 . We observe that after m iterations of the loop,
the value of k becomes 2 2^m . The loop terminates
when the value of k becomes larger or equal to n , that is, 2 2^m ≥ n ,
that is, m ≥ log log (n) . Therefore the inner loop runs in O(log log
n) time.
We observe that the outer loop (on counter j ) increments by j/2 . In
other words, after every iteration, the value of j becomes equal to
3j/2. Therefore, after m steps, the value of loop counter will become
j*1.5 m . When that value exceeds n , therefore, we have that m ≥ log
1.5 (n). That is, the outer loop runs O(log n) times.

Since the loops are nested, the entire program runs in constant, that
is, O(log n log log n) time.

Question 13. Time Complexity with Log Addition

What is the time complexity of the following program?
j = 10
Solution
while (j < n) {
j += log (j)
} Weobserve that j has to increase from a constant value
to n , and in each iteration of the while loop, the value of
j increases by at least 1 and by at most log(n) . Therefore, clearly, the
time complexity of this algorithm has to be between O(n) and
O(n/log n) .
We can solve this breaking the loop into two parts: from 10 to sqrt(n)
and from sqrt(n) to n . The first part of the loop cannot take more
than O(sqrt(n)) time. The second part of the loop does not take more
than O(n/log (sqrt(n)) time. We observe that log(sqrt(n)) = ½ log(n).
Therefore, the total time taken by the algorithm is O(sqrt(n) + n/log
n) , that is, O(n/log n).

Question 14. Time Complexity with Square Root

Addition
What is the time complexity of the following program?
j = 10
Solution
while (j < n) {
j += sqrt (j)
} Weobserve that j has to increase from a constant value
to n , and in each iteration of the while loop, the value of
j increases by at least 1 and by at most sqrt(n) . Therefore, clearly,
the time complexity of this algorithm has to be between O(n) and
O(sqrt(n)) .
We claim that the time complexity is O(sqrt(n)). We can analyze
separate phases of the while loop in terms of the value of j .
For the value of j to go from n/4 to n, we require at most n/sqrt(n/4))
, that is 2 sqrt(n) steps. For the value of j to go from n/16 to n/4 , we
require at most n/4 sqrt(n/16) , that is, sqrt(n) steps. Similarly, for
the value of j to go from n/64 to n/16 , we require at most
n/16(sqrt(n/64)) , that is sqrt(n)/2 steps.
Therefore, overall, for the value of j to go from 1 to n , we require at
most sqrt(n) (2 + 1 + ½ + ¼ + … ) = 4 sqrt(n) steps.
Therefore, the total time taken by the algorithm is O(sqrt(n)).

Question 15. Sum of Functions

Given f 1 (n) = O(g 1 (n)) and f 2 (n) = O(g 2 (n)) , prove that f 1 (n)
+ f 2 (n) = O(g 1 (n) + g 2 (n)).

Solution
Since f 1 (n) = O(g 1 (n)) , therefore there exist constants c 1 and n 1 ,
such that f 1 (n) ≤ c 1 g 1 (n)) for all values of n ≥ n 1 .

Similarly, since f 2 (n) = O(g 2 (n)) , therefore there exist constants c

2 and n 2 , such that f 2 (n) ≤ c 2 g 2 (n)) for all values of n ≥ n 2 .

From the two choices of n 1 and n 2, we select the larger value, let us
call it n 3 . Similarly, we select the larger value from c 1 and c 2 , let
us call it c 3 . Therefore, we have:
f 1 (n) ≤ c 3 g 1 (n)) for all values of n ≥ n 3

f 2 (n) ≤ c 3 g 2 (n)) for all values of n ≥ n 3

Therefore, f 1 (n) + f 2 (n) ≤ c 3 (g 1 (n) + g 2 (n)) for all values of n ≥
n3.
Therefore, using the definition of O notation, f 1 (n) + f 2 (n) = O(g 1
(n) + g 2 (n)) .

Question 16. Product of Functions

Given f 1 (n) = O(g 1 (n)) and f 2 (n) = O(g 2 (n)) , prove that f 1 (n) f
2 (n) = O(g 1 (n) g 2 (n)) .

Solution
Since f 1 (n) = O(g 1 (n)) , therefore there exist constants c 1 and n 1 ,
such that f 1 (n) ≤ c 1 g 1 (n)) for all values of n ≥ n 1 .
Similarly, since f 2 (n) = O(g 2 (n)) , therefore there exist constants c
2 and n 2 , such that f 2 (n) ≤ c 2 g 2 (n)) for all values of n ≥ n 2 .

From the two choices of n 1 and n 2, we select the larger value, let us
call it n 3 . We define a new constant c 3 = c 1 c 2 . Therefore, we
have:
f 1 (n) ≤ c 1 g 1 (n)) for all values of n ≥ n 3

f 2 (n) ≤ c 2 g 2 (n)) for all values of n ≥ n 3

Therefore, f 1 (n) f 2 (n) ≤ c 3 (g 1 (n) g 2 (n)) for all values of n ≥ n 3 .

Therefore, using the definition of O notation, f 1 (n) f 2 (n) = O(g 1
(n) g 2 (n)) .

Question 17. Trichotomy in Context of

Asymptotic Notation
Given two functions f(n) and g(n) , both strictly increasing with n , is
it possible that f(n) and g(n) cannot be compared asymptotically?
Either prove that such two functions can always be compared
asymptotically, or give a counter example, such that neither f(n) is in
O(g(n)) nor is g(n) in O(f(n)) .
Solutio n
We can create two functions f and g that use each other in their
definitions. We initialize them to 2, that is, f(0)=2 and g(0)=2 .
For n > 0 :
f(n) = g(n-1)^2 // if n is odd
f(n) = f(n-1) + 1 // if n is even
g(n) = g(n-1) + 1 // if n is odd
g(n) = f(n-1)^2 // if n is even
Here are some sample values:
f(1) = 4 , g(1) = 3
f(2) = 5 , g(2) = 16
f(3) = 256 , g(3) = 17
f(4) = 257 , g(4) = 65536
From their construction, it is clear that both of them are increasing
functions. Also, due to their oscillating nature, neither function can
be written as O of the other function.

Question 18. Log of n!

Prove that log(n!) = theta(n log n)
Solutio n
We note that in order to prove that f(n) = theta(g(n)) , we need to
prove that that f(n) = O(g(n)) and g(n) = O(f(n)).
log(n!) = log (1 . 2 . 3 . … n) ≤ log (1) + log(2) + log(3) + …
+ log(n)
Therefore, log(n!) ≤ n log n
Therefore, clearly log(n!) = O(n log n), by using values of 1 for both
c and n 0 in the standard definition.
Further, we observe that
log(n!) = log (1 . 2 . 3 . … n) ≥ log (n/2) + log(n/2+1) + log(n/2+2)
+ … + log(n)
That is, log(n!) ≥ n/2 log n/2 , since each
term on the right is at least log(n/2)
That is, log(n!) ≥ n/2 log n – n/2 , since
log(n/2) = log(n) – 1
≥ n/4 log n + n/4 log n – n/2
≥ n/4 log n + n/2 – n/2 // for all values of
n≥4,sn≥2
≥ n/4 log n // for all values of n
≥4
Therefore, we have that using values of c=1/4 and n 0 =4 , n log n =
O(log n! )
Therefore, log(n!) = theta (n log n) .

Question 19. Polynomial vs. Exponential

Functions
How do these two functions compare asymptotically: n 17 and 2 n
Solution
We would like to evaluate lim f(n)/g(n) as n tends to infinity. One
very helpful tool in evaluating limits is L’Hopital’s rule, which states
that assuming certain conditions apply, lim n->infinity f(n)/g(n) = lim n-
>infinity f’(n)/g’(n) , where f’(n) and g’(n) represent the first
derivatives of functions f(n) and g(n) respectively.
Applying this to our case, we obtain that:
f’(n) = 17 n 16 and g’(n) = 2^n ln (2) .
We can repeat this process a few more times (16 to be precise!), and
at that point, we have that:
lim n-> infinity 17! /(2 n (ln 2) 17 ) which is obviously 0 .

Since lim n->infinity n 17 / 2 n = 0 , we conclude that n 17 = o( 2n ) . As

a corollary, we can also derive similar results for other polynomials.
For example, the following results are also correct:
(n+3) 6 = o(1.05) n
n 62 = o(5) n
n 62 + 5 n 21 = o(1.0001) n

Question 20. Polynomial vs. Log Functions

Asymptotically
How do these two functions compare asymptotically: n 2 and (log n)
80

Solution
We would like to evaluate lim n->infinity f(n)/g(n) , and we again use
the helpful L’Hopital’s rule, which states that assuming certain
conditions apply, lim n->infinity f(n)/g(n) = lim n->infinity f’(n)/g’(n) ,
where f’(n) and g’(n) represent the first derivatives of functions f(n)
and g(n) respectively.
Applying this to our case, we obtain that:
f’(n) = 2n and g’(n) = 80 (log n) 79 / n
Therefore, we have that:
lim n->infinity f(n)/g(n) = lim n->infinity 2n 2 /80(log n) 79
We can repeat this process a few more times (79 to be precise!), and
at that point, we have that:
lim n->infinity f(n)/g(n) = 2 80 n 2 /80! which obviously approaches
infinity as n tends to infinity .
Since lim n->infinity f(n)/g(n) = infinity , we conclude that n 2 = ω ((log
n) 80 ), or equivalently stated, (log n) 80 = o(n 2 ) . This relationship
between log functions and polynomial functions is very standard,
and all the following results are also correct and can be proved using
the same methodology.
(log (n+1)) 6 = o(n 2 )
(log (n)) 63 = o(n 1.1 )
log 63 (n) = o(n 1.1 ) // log k (n) is the short hand
notation for writing (log(n)) k
(log (n + n 2 + n 3 )) 2300 + (log (n+n 2 )) 613 = o(n
1.0001 )

Question 21. Tale of Two Exponents

How do these two functions compare asymptotically: (1.05) n and
(1.06) n
Solution
While both the functions are exponential, we can easily evaluate lim
n which is
n->infinity f(n)/g(n) , which is lim n->infinity (1.05/1.06)
obviously 0 , because 1.05 < 1.06. Therefore, (1.05) n = o(1.06) n .
The following results are also correct:
(sqrt(3)) n = o(2 n )
 2 n = o(2.1 n )
2 n = o(4 n )
2 n = o(2 2n ) // This is because 2 2n = 4 n

Question 22. An Exponent and Its Square

How do these two functions compare asymptotically: 2 n^2 and 10 n
Solution
These two functions appear to be difficult to compare, since 2 < 10 ,
and n 2 > n. So, which effect dominates? One way is to simply try a
large value of n , such as 100 to obtain a clue. 210000 appears to be
much larger than 10100 , especially if we consider that 2 400 is
already larger than 10 100 (since 2 4 > 10 ). So, the clue is quite clear
that 2 n^2 is larger than 10 n , but how do we prove the asymptotic
omega relationship? Once again, we use the limit method.
lim n->infinity 10 n /2 n^2 = lim n->infinity 10 n /2 nn

= lim n->infinity (10/2 n ) n

=0
Therefore, we conclude that 10 n = o(2 n^2 ) .

Question 23. Polynomial vs. Square Root of

Exponent
How do these two functions compare asymptotically: n 100 and 2 s
qrt(n)
Solution
All polynomials are smaller than exponents, even when exponent is a
square root (or a smaller fraction). Let us prove this using the limit
method.
lim n->infinity n 100 /2 sqrt(n)

Using L’Hopital’s rule, we have that

lim n->infinity n 100 /2 sqrt(n) = lim n->infinity 100 n 99 /((ln 2)/2
sqrt(n))2 sqrt(n)
= lim n->infinity 100 n 99.5 /a 2 sqrt(n)
// define constant a = (ln 2)/2
= lim n->infinity 100 * 99.5 n 99 /a 2 2 sqrt(n)

We can see that after a finite number of steps, this limit can be
evaluated to be 0 .
Therefore, as expected, we have that n 100 = o(2 sqrt(n) ).

Question 24. A Bit Bigger and a Bit Smalle r

How do these two functions compare asymptotically: n log n and n 1.1
log log log n
Solution
These two functions appear to be hard to compare due to the
following observation: while the first term n = o(n 1.1 ) , the other
term is log n = ω ( log log log n). Therefore, when we multiply these
two terms, we cannot reach a conclusion directly.
We can reach a conclusion however, if we simplify the question as
follows.
Firstly, we observe that, log n = o(n^0.1). [Hint: We can observe
this simply by applying L’Hopital’s rule and then taking the limit.]
Therefore, from this, if we multiple by n on both sides, we derive
that:
n log n = o(n 1.1 )
And of course, we know that n 1.1 = o(n 1.1 log log log n).
Therefore, by using transitivity, we reach the conclusion that:
n log n = o(n 1.1 )
an d
n 1.1 = o(n 1.1 log log log n).
That is,
n log n = o(n 1.1 log log log n).
This is a simple yet illustrative example of the value of rule of
transitivity, and how it can help us derive asymptotic relationships
that may otherwise appear to be challenging. The trick in these cases
is to find a convenient “intermediate” term to apply transitivity.

Question 25. Comparing Polynomial with Sum of

Logs
How do these functions compare asymptotically: n and (log n) 3 +
(log log n) 4
Solution
 Another Random Document on
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a few minutes, then the pain returns severer than ever, and the baby
cries louder than ever. I have seen very nervous children thrown into
convulsions from severe colicky pains.
My rule has been for years to nurse infants for the first two
months not oftener than once in two hours; after that until they are
six months old, every three hours, and from six to twelve months
every four hours; between times the babies cry, of course, not
because they are hungry, but because they have either pain or are
thirsty. The old German household remedy for this is fennel seed
tea; there is nothing as useful; it expels the gas and it quenches the
thirst from which colicky children suffer, at least while they have the
colic. This tea should be given regularly between times, and until
they are twelve or fifteen months old; it is soothing, and what is of
equal importance, it prevents overfeeding, which is the bane of
artificially-fed children. The latter, bottle-fed babies, are all more or
less colicky, and for these the fennel seed tea, between bottle time is
indeed a balm. If the fennel seed tea does not relieve the child at
once, or if the pain seems severe, then add a few drops of paregoric
to the fennel seed tea, and give an injection of German chamomile
tea, rubbing the bowels at the same time with a mixture of
turpentine and sweet oil, and I believe that every case will be
relieved. Permanent relief must be sought in ferreting out the cause
and removing it. This may be due to improper food, or feeding, to
indigestible contents in the stomach or bowels, and indeed, very
often to constipation. When the stomach is overloaded, a dose of
syrup of ipecac may give relief, and if due to constipation, the
Femina laxative syrup is the most appropriate remedy.
(e) Convulsions, or spasms in children have long been well
known to the laity, and from their frequent occurrence they make an
important class of children’s diseases. If there is one thing more
frightful to behold than another, to the young and inexperienced
mother, it is to see her baby’s eyes unsteadily rolling, or turned up
so as to show only the white of the eyeballs, or may be the eyes
steadily fixed in a stare while the child becomes completely
unconscious. A painful smile may play over its face, or an expression
of fear or anger may distort the facial expression, while the muscles
of the face twitch convulsively. The jaws are sometimes set, then
again there is gnashing of the teeth, alternating with relaxation of
muscles and ligaments. The child cannot swallow, and fluids poured
into the mouth flow out again. The other muscles of the body also
participate in the spasmodic contractions; those of the back contract
and relax, and those of the extremities are involved in lively
twitchings, or perform acts of thrashing, striking or twisting. The
breathing becomes very irregular, and from the spasms of the
muscles of the larynx or throat it may become entirely suspended,
and if the spasm does not subside in two or three minutes the child
may die. The skin becomes livid or congested and loses its sensibility
so that blisters or irritants make no painful impression. Sometimes
the child bleeds from the nose or mouth; the latter is generally due
to the tongue having been caught between the teeth during the
paroxysm. Frothy saliva wells up from the mouth and the urine and
stools are involuntarily discharged.
All convulsive attacks have not every symptom above
enumerated, some of them are usually absent and an attack may be
quite mild, and last only a few moments; if convulsions last longer
they are not only dangerous, but indicate serious disease, either of
the brain or in which the brain or spinal cord is seriously
complicated.
The period of the child’s life at which convulsions are most
frequent is from the time they are born up to the completion of the
first dentition. Nervous children who had convulsions while they
were teething are susceptible to violent attacks at the
commencement of various diseases or during the developmental
stage of the eruptive fevers. Perhaps the most frequent cause of
convulsions in children is the eruption of teeth. The irritation which a
growing tooth causes in the gums also irritates its nerve and this
irritability is reflected on the brain, and this causes the spasm. An
overloaded stomach, worms and digestive disturbances that
accompany teething irritate the bowels and from this too convulsions
ensue. The treatment for convulsions naturally resolves itself into
first giving instant relief during the paroxysm, and secondly, finding
out the cause of the attack. The latter is not always easy at first
sight, and as the cause may be serious a competent physician
should be sent for. But instructions that are serviceable while the
convulsion is on are of the greatest importance to mother and child.
The old and familiar remedy of giving the child a hot bath as soon as
possible is certainly the best thing that can be done. The child
should be undressed as quickly as possible so as to relieve it from all
constriction and so that nothing can interfere with the respiration
and circulation.
A towel wrung out of cold water should be placed over the child’s
head and its body immersed in hot water that is not so hot as to
scald; the hands on which the child is supported while in the water
must be well able to stand the heat. When the spasm has subsided,
the child should be transferred to a previously warmed woolen
blanket in which it is to be wrapped with its head softly elevated. If
the bowels are constipated an enema of warm water and a little
castile soap should be administered.
(f) Worms of different species infest the human organism; they
get into the system from the outside world, with the food we eat
and drink. Their abiding place seems to be the mucous membrane of
the intestinal canal with the exception of the trichinæ which
penetrate the mucous membrane and make their way to the
different muscles throughout the body; the voluntary muscles seem
to be their permanent dwelling place. These parasites are peculiar to
the meat of the hog and as very young children do not eat this
meat, they are so far totally exempt from them.
Tapeworms are rarely found in children under one year of age; it
is when they get older and especially when they eat hog’s meat, for
this too is the home of the embryo tapeworm, that they become
infected.
The roundworm, however, is peculiar to childhood. It is a
yellowish or whitish worm resembling the earthworm, from one to
twelve inches in length. The body is round, tapering toward each
extremity. This worm inhabits the small intestine, but by acts of
vomiting they are frequently ejected from the mouth or they may
find their way into other cavities. On the Pacific slope these worms
are not as frequently met with as on the other side of the Rockies. It
is propagated by ova and taken into the system by means of
drinking water containing them. The number varies greatly in
different cases; sometimes there are only a few and again there may
be dozens or hundreds coiled together so as to form balls or masses.
They are most common between the ages of three and ten years. I
do not believe that they ever exist in early infancy.
The symptoms denoting the presence of these parasites are on
the whole obscure and depend somewhat on the temperament of
the individual. A nervous child may be thrown into fits or convulsions
from them. My first case of these worms in a child seven years old
was rather exceptional and remarkable. The child was suddenly
taken with a severe attack of spasmodic croup, for which I
prescribed remedies without much relief. After the second day the
child passed five large roundworms, the croup subsided, and while I
claimed no credit that my remedies did not cure the croup it was
generally conceded that they killed the worms.
The usual symptoms are colic pains, impaired appetite, diarrhœa,
itching of the nose, swollen abdomen, puffy features, offensive odor
of breath, dreaming sleep and grinding the teeth during sleep or
twitching of the muscles.
The expulsion of the parasite is generally effected with simple
remedies. Five to ten drops of spirits of turpentine in half to one
tablespoonful of castor oil is a reliable remedy. The oil of wormseed
is another convenient remedy in the same dose on a lump of sugar
or mixed with oil; a cupful of tansy tea early three or four mornings
on an empty stomach serves a useful purpose; pinkroot and senna
administered as a tea has also a well-deserved popularity.
The thread, pin, spring or mawworm inhabits the large intestine
and chiefly the rectum. It is a thin yellowish-white parasite from
one-twelfth to one-third inch in length; the female has a straight,
awl-like, pointed tail, the male has a strongly curved tail. It rarely, if
ever, enters the small intestines. The worms occur chiefly in young
children, but there is no period of life that is exempt from them.
They cause pain and an itching sensation at the anus. This is
particularly troublesome when the children lie in warm beds. The
sexual organs are apt to become excited from the irritation and the
habit of masturbation be thus formed. In girls the worms may travel
into the vagina and leucorrhœa in children is often accounted for in
this way; around the anus there may be pimply redness.
From the loss of appetite and sleep the general health of the
child may become impaired; but the only possible evidence of the
presence of worms is to examine the stools. If worms of the above
description cannot be seen, yet the symptoms make their existence
suspected, a dose of some of the remedies above suggested should
be given and afterwards the stools again examined. Some children
have a peculiar predisposition to pinworms, and although you seem
to give them relief for the time being, in a short time afterwards the
same symptoms return and the worms are as numerous as ever. In
these cases a course of continual treatment becomes necessary to
eradicate the morbid habit; for this course I recommend:

Take: Powdered wormseed,

Powdered chocolate,
Milk of sulphur, of each equal parts.

Mix and give half to one teaspoonful every night at bedtime.

(g) Constipation is the bane of artificially reared children and if
the sagacity of mother or nurse does not correct the evil it often
causes serious complications. Sometimes those who are nursed on
the breast suffer from constipation, especially when the mothers or
wet nurses are troubled with similar derangements. Children under
one year of age should have two evacuations, and those from one to
three years should have at least one passage a day; when this does
not occur the feces become solid and constipation is the result. In
most febrile affections constipation is caused by a loss of moisture
through the skin and an increased urinary secretion. Certain foods
constipate, especially the starchy or farinaceous variety, as soups
containing corn starch, rice, sago, etc., and in older children certain
dishes consisting of peas, beans, and wheaten bread. A great many
medicines are constipating, for instance, most cough mixtures, for
they contain opium in some form, also preparations of iron, lead,
alum, bismuth, chalk, and vegetable remedies that contain
astringents or tannin.
It must be laid down as a RULE never to be violated, that every
child must have at least one passage a day from the day it is born,
and it is the imperative duty of mother or nurse to see that it is
accomplished. The infant of only a few days or weeks old may
require only a few drops of olive oil, but if that delays in its effect it
may become necessary to give relief at once, and for this purpose
we have in a small warm water enema a most decided and effectual
remedy. Soapsuds should never be used, except in very urgent
cases, for I have known a diarrhoea to ensue from the irritation it
caused which was very hard to control. If the feces are not very
hard a soap suppository may be used with good advantage, and in
the following manner: Take a piece of soap and pare it to a point the
thickness of a lead pencil and about an inch long, moisten this and
introduce carefully into the rectum; if the straining bring only the
soap away it may be well to use the water enema afterward. If the
constipation continues to be habitual a slight modification of the diet
becomes necessary; starchy foods must not be given as often, and
thinner than formerly; the milk too should be more diluted; broth or
beef tea substituted once or twice each day will often have a good
effect. When children are old enough to eat mixed food the diet can
often be so regulated as to materially contribute towards opening
the bowels. The children should be encouraged to drink a great deal
of water; from the lack of that alone some children become
constipated. Graham bread and boiled German prunes are especially
to be recommended; so are ripe raw fruits, grapes, strawberries,
apples, pears, etc. Children require fresh air and outdoor exercise to
be well and robust; they run and jump more when in the open air, all
of which gives tone and strength to the general system. If diet and
outdoor exercise alone does not remedy the evil, then the Femina
laxative syrup should be administered; it is efficient in its action, and
pleasant to take, and unlike most laxative or aperient remedies,
there is no danger of forming a habit of using purgatives.
(h) Whooping cough is the name of an affection deriving its
significance from a characteristic which is peculiar to this cough. It
commences like an ordinary bronchitis such as is the result of taking
cold; there is the usual hoarseness, tickling in the throat, dry cough,
sneezing, running from the nose; the eyes are red and watery, and
there is more or less fever. Sometimes the cough is ordinary, but at
other times it has a sharp metallic clang from the beginning. Owing
to certain marked periods in the course of the affection it has been
found convenient to divide it into three stages which may usually be
distinguished, although in a certain proportion of cases the first
stage (comprising some of the symptoms that have been
enumerated above) may be submerged into the second or whooping
stage. The first stage may last from four to five days to as many
weeks. The second stage is when the peculiar sound or whoop
begins; it consists of a great number of violent paroxysms, rapidly-
recurring spasmodic coughs, until most of the air in the lungs is
expired; there is then a sense of suffocation and the child becomes
bluish red over the entire head and face, from which the German
designation blue cough has originated. During this spell the face
swells and the eyeballs become congested and bulge from their
orbits and the nose often begins to bleed, while the urine and feces
are often involuntarily ejected and the contents of the stomach
thrown up from the violent contraction of the diaphragm. In a few
moments the spell is broken by a protracted, whistling croupy
inspiration, and this constitutes the whoop.
The whooping generally grows worse the first two or three
weeks, after which time in favorable cases the cough gradually
becomes milder, but this is not the rule by any means. I have had it
in my own family to last, in two instances, six months, and in
another eight months before the children had fully recovered.
Laughing or crying, swallowing dry, irritating morsels of food or
cold and impure air will bring on a paroxysm of cough. When several
children are affected together, the coughing of one will make the
others cough.
The third stage is when the cough is wearing off and has lost its
severity. The expectoration consists now of a yellowish or green-
colored mucus; in otherwise healthy children this lasts only a few
weeks, but in weakly or scrofulous ones it may last for several
months. This disease is not as yet thoroughly understood. It is an
epidemic, contagious bronchial catarrh, involving the nerves of
respiration and attacks an individual but once. When complications
arise the affection becomes exceedingly dangerous and the most
common of these is pneumonia.
There is no specific cure for whooping cough; it has got to run its
course, which may be either short or long. I have tried every agent
so far known to scientific medicine, and there is none that will give
prompt relief in every instance. Whooping cough being a bronchitis
plus something else, it seems rational that the same precautions that
are observed in a case of bronchitis should be followed here.
Children with this affection must not be exposed to drafts or rough
winds lest they get cold, which might seriously complicate matters.
In summer when the weather is warm, outdoor life is beneficial in
hastening recovery. Some children have the cough so light, that no
extra precautions seem to be necessary; they have no fever, eat, feel
and sleep well. But those who are feverish, who vomit freely, and
whose appetite is capricious, require every attention. Their diet
should be especially guarded, so that all dry, irritating nutriments are
prohibited, and so that the diet consists principally of liquid
nourishment. Warm drinks have a favorable influence on the
disease; a plentiful supply of warm milk, first thoroughly beaten with
an egg beater is the most suitable and convenient. The milk punch is
often borne well, and the little whisky that enters into its
composition is a needed stimulant to the sufferer; broths may be
given for a change, and to these the yolk of an egg can be added
with advantage. A great many remedies might be suggested, but the
one which has served my purpose the best, is the following:
 Take: Deodorized tincture, of opium ½ dram
Fluid extract, of belladonna 4 drops
Fluid extract, of ipecac. 10 drops
Simple syrup 2 ounces

For a child five years old, give a teaspoonful three or four times a
day; older or younger children in proportion. If the cough is hard
and dry, ten to twenty drops of syrup of ipecac alone should be
given instead of the mixture, and when the cough is loosened, the
mixture can be again administered. When in the course of the
affection the breathing suddenly becomes labored, and the fever
increases, it is fair to presume that the case is complicated with
pneumonia.
(i) Eruptive fevers, as their name implies, are characterized by an
eruption or exanthema. The most virulent of this class is smallpox.
The eruption of this disease is of the nature of vesicles, or pustules,
while that of measles, scarlatina, and rose rash is dry, and is
properly called a rash. Chickenpox, however, has also vesicles and
pustules, and for this reason it is very liable in times of an epidemic
of smallpox to be mistaken for a mild form of the latter disease. For
obvious reasons it is not proper to consider smallpox in this
connection; its gravity and its management require experience, and
further, it generally comes under special quarantine regulations of
the proper constituted authorities.
The eruptive fevers are all divided into three stages, namely: a
stage of invasion or development; a second stage when the eruption
appears, and while it lasts; and a third stage, that of desquamation,
when the eruption begins to fade or exfoliate in branny scales.
(j) Measles is generally a mild and not serious disease, and only
attacks the individual but once in a lifetime; only through gross
carelessness the disease becomes complicated, and then it may
become a very dangerous affection. It begins with all the symptoms
of a common cold. There is frequent sneezing, and an acrid muco-
serous discharge from the nostrils. The eyes are irritable, reddened
and watery, and there is more or less intolerance of light. The voice
becomes hoarse and there is always a bronchitis present which is
characterized by a dry, harsh cough. The patient is generally
feverish, alternating with chilly sensations or shivering; the appetite
is poor or absent and in some cases there is nausea and vomiting.
The children feel drowsy; they complain of pain in the head and
limbs and want to lounge around. The bowels may be constipated,
but diarrhœa supervenes in a certain proportion of cases. In nervous
children convulsions may occur; bleeding from the nose and false
croup are not infrequently met with in the development of this
disease. The duration of the first stage varies greatly in different
individuals, and comprises a period extending from one to seven
days. The eruption begins generally on the temples and forehead,
whence it extends over the head and neck, thence down the back
and over the entire body, occupying in its development from thirty-
six to forty-eight hours. The eruption bears a resemblance to flea
bites at first; it appears as minute red specks which gradually
enlarge and become slightly elevated and arrange themselves in
circular clusters. The portions of the skin that are free from the
eruption retain their white appearance; the face is more or less
swollen and the eyelids puffed. In some patients there is
considerable annoyance from itching in the skin. The cough and
bronchitis continue to be prominent symptoms, and the
expectoration, consisting of yellowish sputa becomes abundant. In
some children the fever runs very high in this stage and they
become delirious and restless, but this is only temporary, for it
generally diminishes with the eruption on the third or fourth day.
When the eruption begins to fade the third stage of the affection
is inaugurated, and when there exist no complications, the patient
may now be considered on the way to recovery which takes from
four to eight days longer.
The treatment in measles should consist in good nursing, rather
than in medication. Owing to the inflammation of the membranes of
the eyes, the patient should be kept in a darkened chamber, and the
eyes occasionally bathed with a solution of borax, by dissolving half
a teaspoonful in a tumblerful of water. Good judgment forbids that
the patient should be sweltered, but that he should be kept
comfortably warm and never allowed to cool off suddenly is also
very important. When the eruption is slow to develop a good sweat
will often bring it out; so will undue exposure, to cold drafts and the
transportation out of a warm bed into a cold one or drinking
immoderately of cold drinks either delay the development of the
eruption or drive it back, and from this undoubtedly dangerous
complications arise, like pneumonia, diphtheritic croup, and
convulsions. A mouthful of cold water now and then is harmless, but
on the whole the drinks should be quite warm; the cough and
bronchitis alone would require that.
Warm milk thoroughly beaten is the most suitable form of diet;
broths and soups may be given for a change, so can a mixture of
equal parts of weak hot tea and milk. The bowels should be moved
with a mild laxative and if the fever runs very high, ten to fifteen
drops of the sweet spirits of nitre, for a child five years old, in half
wineglass of water every few hours will generally reduce the
temperature. For the itching, the skin should be rubbed with equal
parts of glycerine and warm water. The cough is generally the most
troublesome feature, and the only symptom requiring regular
medication; for this a good general cough mixture will serve every
purpose, such as:

Take: Compound mixture of liquorice,

Syrup of wild cherry, of each 2 ounces

Mix and give to a child four years old a teaspoonful every four
hours; older or younger children in proportion.
(k) Rose rash, sometimes called false or German measles is a
comparatively trivial affection and of very little importance, for it
never has any serious complications and lasts only twenty-four or
forty-eight hours in the majority of cases. It is often mistaken for
measles, and one attack affords no protection against recurrences.
The eruption appears in small rose-colored spots or patches which
are not elevated. It does not commence on the head, but appears
on different parts of the body. The eruption may be preceded by
headache, loss of appetite, occasionally vomiting, and more or less
fever or chilly sensations.
The affection of the eyes and air passages, especially the
bronchitis which is characteristic of measles, are wanting in rose
rash, and when we hear of children having had measles several
times it is reasonable to presume that it was rose rash instead. This
eruption hardly calls for treatment, but a mild laxative and a
regulated diet would fulfill all requirements.
(l) Scarlet fever or scarlatina has received its name from the color
of its eruption. This affection presents itself differently in different
cases. It may be so mild in its attack that it constitutes a trifling
ailment and again it may be so severe that life is seriously
threatened, and destroyed in a few days. This has formed the basis
of dividing scarlatina into three varieties, namely: simple scarlatina,
diphtheritic scarlatina and malignant scarlatina.
The fever, as a rule, is notably higher than in other eruptive
fevers. The attack may begin with a chill, nausea and vomiting and
headache. There is also bleeding from the nose in a certain
proportion of cases. The most constant sign is redness and more or
less swelling of the throat, either with or without a sense of soreness
and pain in the act of swallowing. The stage of development lasts in
the average twenty-four hours, although exceptionally it may appear
in a few hours after the first symptoms of the disease have
appeared. The eruption often begins on the back first, and from
there rapidly spreads over the entire body in twenty-four hours. It
greatly differs from the eruption in measles in not allowing any
healthy or white skin to intervene between the red specks, but the
entire skin has a reddish blush. This has given rise to the expression
boiled lobster appearance in scarlatina, and indeed nothing could
illustrate the color of the skin better than by comparing the one with
the other. The eruption is sometimes accompanied with a great deal
of itching and burning and reaches its fullest development on the
third day after its first appearance; it lasts from four to six days.
 The extent and redness of the eruption varies greatly in different
individuals, in some it is very slight and transient while in others
there is not a spot as large as a dime which is not covered. Yet a
very light attack in one patient when communicated to another
individual may develop in that one a most malignant form. One
attack secures against a recurrence.
The throat affection seems to modify the eruption of the skin for
in some instances in which the throat is very bad, the skin eruption
is comparatively slight. There may be simply a little redness over the
tonsils, extending more or less over the soft palate, or on the other
hand, the disease in the throat may become in every respect equal
to if not identical with the worst type of diphtheria. Some writers
consider the sore throat of scarlatina and that of diphtheria identical,
and from a practical point of view there is certainly no difference,
and the very best results are obtained when all severe sore throats
of scarlatina are treated precisely as if they were diphtheria; this has
always been my practice.
The tongue is quite distinctive of the affection; early in the
development of the disease it is generally furred, but later the
coating peels off in patches, and these spots present the appearance
of a ripe strawberry; sometimes the entire surface of the tongue
looks as if cayenne pepper or red sand had been sprinkled on it.
The fever generally increases during the eruptive stage, and the
skin becomes very dry and hot. The pulse may run up to 130 to 140
per minute, while the temperature runs up as high as 106°
Fahrenheit; this state of affairs places the patient in imminent
danger, he now may become restless and even delirious. In a certain
proportion of cases the kidneys become involved and albuminuria is
a result, but this usually passes off with the improvement and
recovery of the patient.
In the third stage the cuticle begins to exfoliate in the form of
branny scales. In the absence of serious complications this stage
marks the beginning of convalescence; the fever subsides, the
appetite returns, and the soreness and redness of the throat
disappear.
 The treatment of this affection always depends upon the nature
of the case. Simple scarlatina requires no medical treatment; the
precaution and intelligence which are comprised in good nursing
supply everything that is required. There is not the same danger of
the eruption striking in with scarlatina as there is with measles, and
the patient need not be kept so warmly covered. When the fever
runs very high, sponging the surface with cool water is very grateful
and reduces the temperature. After the eruption has thoroughly
developed, the water for sponging off may be very cold without the
least danger, and this may be repeated as often as comfort or the
high temperature demands. To relieve the burning and itching of the
skin, the entire body should be rubbed over with glycerine night and
morning; this relieves the system and makes the skin moist and
supple. If the throat is only reddened, a teaspoonful of chlorate of
potash dissolved in a cupful of hot water and when cold used as a
gargle and a teaspoonful of the solution swallowed at the same time
every two hours is all that is necessary. The diphtheritic scarlatina is
treated precisely similar to and according to the instructions laid
down for diphtheria in another part of this work. Move the bowels
freely with the Femina laxative syrup.
(m) Chickenpox has neither distressing symptoms nor is it
significant as regards danger. It is an eruptive fever which
occasionally affects adults, but for the most part children. The
eruption is generally preceded by a slight fever and nausea, and
appears first on the body and afterwards on the scalp where it is
usually more abundant. There always remains healthy white skin
between the vesicles, which at first contain a transparent liquid,
hence called by the Germans waterpox, which afterward becomes
cloudy or opaline. The eruption begins to dry up from the fifth to the
seventh day forming granular crusts that are sometimes followed by
pitting. The disease is contagious and develops twelve to seventeen
days after the exposure. Chickenpox claims no treatment; its only
point of interest is its resemblance to varioloid, but as a successful
vaccination guarantees against the latter, and as the vesicles of
varioloid have a central depression while those of chickenpox have
not, the individuality of the affection is readily established.
 CHAPTER XXXI.

EMERGENCY TREATMENT IN SUDDEN ACCIDENTS.

If the author reviews his experience of the last twenty years, he

recalls to memory innumerable instances in which the lack of a little
special knowledge, in cases of sudden accidents, did not only incur
useless physical suffering, but cost lives which otherwise might have
been saved. Knowledge of this nature is not intuitive, but must be
acquired by study. He therefore offers for the guidance of the
intelligent reader, common sense advice on the immediate
management of accidents which are liable to occur at almost any
moment.
If a child falls any considerable distance to the ground, the
system receives a shock varying from the slightest functional
disturbance to complete insensibility.
In the former case there may probably be only slight pallor of the
countenance, the ideas become confused, there is a disposition to
yawn and a feeling of nausea. Young children have a disposition to
sleep, older ones rub their eyes, stare wildly around and even vomit,
but after a short time they resume their accustomed employment:
these symptoms illustrate a slight concussion of the brain.
When the injury is more serious all the above signs become
aggravated and it may take several hours before the normal
condition is restored.
 The proper course to pursue in all these accidents is to lay the
patient on a sofa or bed, with his head slightly elevated in a
darkened chamber free from all noise and confusion and let him fall
to sleep. In ordinary cases reaction takes place after a quiet slumber.
If however the patient complains of pains in the head and there is
irritability of temper, the advice of a competent physician becomes
necessary.
(a) Broken bones or fractures are defined to be a destruction of
the continuity of one or more of the bones of the body.
Fractures are divided into simple and compound; a simple
fracture is one in which the bone alone is broken, and in which the
skin or integument over the seat of the fracture remains perfectly
intact. A compound fracture is one in which the skin and tissues over
the fracture are lacerated or wounded so that the ends of the broken
bones protrude or are exposed to view.
In a case of fracture, no matter of what variety, the first object to
be accomplished is to carefully remove the patient to a place where
he may be in a comfortable position. If the fracture is in the arm or
leg it should be comfortably supported on a pillow so as to relieve
the injured limb from all strain.
In compound fractures, the wound should be carefully covered
with a soft clean compress which is kept thoroughly wetted with
clean cold water until the surgeon arrives.
Sometimes the circumstances make it necessary to remove or
transport a patient; then the injured limb must be properly
supported so that it will remain motionless on the journey. In case
the arm is fractured the above object is readily accomplished by
placing it in a sling suspended from the neck. In the case of the
lower extremities this object is more difficult. The leg should be
wrapped in cotton first, or some other soft clean substance, after
which a slat should be placed on the outside and inside of the limb,
the same length as the limb; over and around these slats strips of
muslin or a bandage is wound so as to keep them in place. This
contrivance forms a temporary or improvised splint until the surgeon
takes charge of the case.
 (b) Wounds are defined as a recent sudden solution of continuity
in the soft parts or flesh of the body. For the sake of convenience in
description and for practical purposes, wounds are divided into
incised, lacerated, contused, punctured, and poisoned wounds.
An incised wound is a clean smooth cut made by a sharp clean-
cutting instrument.
A lacerated wound is one in which the parts have been torn
asunder or in which the instrument was blunt or dull.
A contused wound is one the result of a bruise or blow inflicted
with a blunt object or by a flat surface.
A punctured wound is one in which the flesh is pierced with a
sharp-pointed instrument, like that made with a stiletto or bayonet.
Poisoned wounds are such as have become infected any time
after the receipt of the injury, or which are the result of a bite or
sting from a reptile or insect.
The danger of wounds depends on their extent and depth, and
upon the locality or organ in which the wound is situated. The
external wounds, that is those which admit of inspection, and
situated on the head, trunk or extremities are of most frequent
occurrence, and the most amenable to treatment.
The treatment of wounds has made wonderful progress since the
antiseptic discoveries of the eminent surgeon, Sir Joseph Lister, and
these sound principles have materially influenced almost every
department of the healing art. It was he who first showed how dust-
laden air affected injuriously the exposed tissues of the wounds; it
was he who introduced all the precautions as to cleanliness of
instruments; the disinfection of hands; the change of clothing; and
the purification of sponges and dressings. The magnificent results of
the practice of modern surgery are not owing to the superior skill of
the surgeon of our time, but to the magnificent conception of the
idea of cleanliness from which has grown the entire superstructure
of antiseptic surgery, culminating in the grand triumphs of surgical
art. To the question What to do with recent wounds? The answer
now becomes self-evident; Keep them clean. The best dressing for
any clean wound is its own secretion carefully protected from the
outside world by a fold of clean soft cloth or absorbent cotton,
wetted with pure cold water. This is to be kept in its proper place by
means of a bandage, and when it is desirable to remove the
compress, it must first be thoroughly soaked with water so as not to
tear or irritate the wound.
Before Lister’s great antiseptic discovery it was the generally
accepted opinion that suppuration and pus were essential to the
healing of wounds; this was an error and the opposite is now
established to be the truth. Pus prevents or rather delays the
wounds from healing, and suppuration in wounds is a fruitful source
of blood poisoning.
If sand, earth, dust or dirt has gotten into or near the wound, it
must be washed off with clean, fresh water, but never employ soiled
or infected clothes for that purpose for these may poison the wound
and do a great deal of mischief. After the wound is clean dress it in
the manner described in a preceding paragraph.
Poisoned wounds are chiefly punctured. The danger of these
wounds lies in the possibility that the poison is absorbed by the
lymphatics and veins, and conveyed to the heart, whence the entire
blood becomes infected. To prevent this a ligature should be tied
above the wound, by means of a strip of muslin or preferably an
elastic suspender, so as to check the free return of the blood by the
veins and lymphatics. After which the poison should be sucked from
the wound, or the wound should be cauterized, with carbolic or nitric
acid by means of a sharp-pointed stick dipped into the acid and then
applied to the wound, or fired with a red-hot iron, crochet or knitting
needle. The poison of snakes and tarantulas is neutralized with an
alkali; the most efficient seems to be spirits of ammonia, but a
strong solution of washing or even baking soda should be
substituted when ammonia is not at hand. I would puncture and
enlarge the wound of the sting with the point of a sharp knife or
scissors, so that the alkali can come into immediate contact with the
injected venom; the patient must be given frequent drinks of whisky,
brandy or strong wine until a physician arrives to supervise further
treatment.
Wounds inflicted by poisonous insects like the bumblebee,
honeybee, wasp, hornet, yellow jacket and mosquitoes produce
wounds which are instantly followed by a sharp, pungent, itching
pain, and in a few moments after by a pale, circumscribed,
inflammatory swelling. Some persons have a peculiarity in their
constitution that the poison of an insect gives rise to exceedingly
alarming symptoms, such as palpitation, nausea, dizziness, dimness
of sight and an indescribable sense of suffocation. The sting is
sometimes left in the skin; for this the wound should be carefully
examined, and when present drawn out. The most prompt and
useful application is water of ammonia, or strong salt water, or
strong soapsuds. Turpentine is also a valuable application. If the
insect has lodged in the throat, large quantities of warm salt water
and mustard must be immediately administered until the patient has
vomited freely, and if there is a sense of suffocation leeches and
afterwards hot poultices should be applied to the neck. If the system
has become poisoned, and some of the distressing symptoms that
were above enumerated are present, the internal use of whisky or
brandy is called for.
Hemorrhage is common to all wounds, and the loss of the blood
depends upon the size and nature of the vessel that is injured.
The bleeding that takes place in ordinary superficial wounds
oozes from minute vessels, the capillaries, and slight pressure
temporarily applied controls it. When an artery is wounded, the
blood flows in intermittent jets, or in a running pulsating stream
from the vessel. The venous blood is dark red and flows in a
continuous stream and not under the same pressure as that coming
from the arteries, hence it is much easier controlled.
The clotted blood with which a wound may be filled, is nature’s
means of arresting the hemorrhage, and it must never be disturbed
or washed off, lest this open the blood vessels again and thereby
renew the bleeding.
 The arrest of hemorrhage is accomplished by the application of
cold or ice water, by hot water and by pressure upon the arteries.
Persons fainting from the loss of blood should always be laid with
their heads lower than the body; cold water should be dashed into
their faces so as to restore them to consciousness. Moderate
hemorrhage from the smallest vessels and from the veins generally
ceases from slight pressure over the wounds or by drawing or
pressing the edges of the wounds together. In a very short time the
blood coagulates and forms a temporary plug until the vessels
themselves become permanently sealed by a similar process. The
pressure must often be continued for a considerable time until the
object has been attained. A folded clean cloth or compress is laid
over the wound which is the source of the hemorrhage, and this is
retained by means of a properly adjusted bandage. If
notwithstanding the pressure exerted by the bandage or with the
hands, the scarlet blood saturates the cloth and continues to flow, it
indicates that a very large vessel is wounded, and thus life may be
seriously threatened and in proportion to the magnitude of the
wounded vessel, a surgeon should now be summoned to make a
further investigation. Hemorrhage from varicose veins of the legs
may be checked by a compress fastened over the site of the wound
by a bandage, but every constriction around the waist or above the
knee by a garter must be loosened. If the patient’s life is threatened
from the bleeding, the limb must be elevated, and the pressure of
the compress increased, or the pressure should be exerted on the
trunk of the bleeding artery above the wound or injury.
(c) Burns and scalds are the most commonly fatal injuries which
occur in modern life. The extended use of steam machinery, the
universal employment of coal oil, the general use of the phosphorus
and sulphur matches, and the flowing manner of woman’s dress has
materially increased the liability of this accident. Of all accidents,
burns involve the victim in the most agonizing pain and protracted
suffering. Burns are liable to serious complications; the obstinacy to
the healing of vast ulcerated surfaces, or the lifelong mutilation to
which they condemn the unhappy patient, the rapid draft they make
on the patient’s strength, and the danger of abscess and ulceration
of internal vital organs which eventually destroy life.
These injuries have been classified into three divisions: First
degree, superficial skin irritation. Second degree, cutaneous
inflammation. Third degree, devitalization of the skin or deeper
parts, or carbonization of a member, or the entire body. The first
degree is only a superficial redness, fading without any definite edge
into the natural skin. This may be produced by the sudden and
momentary application of flame over a larger portion of the body,
from an explosion of gas. The local injury is not dangerous, and the
epidermis remains to protect the surface of the true skin until a new
layer is produced, as the injured one peels off. This hardly calls for
any other treatment but one or several applications of sweet oil. In
the second degree, the local injury has penetrated a little deeper,
and the sudden congestion of blood to the surface, raises the
epidermis from the cutis in blisters filled with the serum of its
vessels. Here there is a more serious condition, and indeed
dangerous in proportion to the extent of surface that has become
involved. Skirts draped largely with lace, and those made of cheese
cloth, swiss, and other gauzy material are of a very inflammable
nature, and when once ignited blaze into a flame that is almost sure
to consume the material before it can be extinguished, so that it has
been deemed advisable on the German stage, to first saturate these
materials in a solution of sulphate of ammonia to make them non-
inflammable; this does not interfere with ironing, nor with the
texture or color of the fabric. Another source of scalds and burns is
the wash boiler or tub on the floor, with hot or boiling water in it, so
that little children stumble or reach into it. Vessels filled with hot
water or other fluids standing on tables or on stoves within reach of
little children, who innocently pull the vessel down, pouring its
scalding contents over them, is another cause of numerous
accidents.
The best course to pursue when skirts or clothing are on fire is to
roll the victim, so as to smother the flames; but the patient herself
has rarely enough presence of mind to do this. She will run for help,
thus fanning the flames, the very worst thing she can do. Take the
nearest blanket or quilt, or if that is not at hand, take an overcoat or
wrap; wrap this around the burning person and throw her to the
floor and roll her until the flames are smothered. Then get some
cold water and pour it on the smoldering clothes until they are
thoroughly saturated, for the hot charred clothing burns into the
flesh. In scalding from hot water or steam the clothing should be
cooled off in the same manner. Cold water must be poured over the
hot and steaming clothes from head to foot, and thus the further
action of the heat is suddenly checked. The patient should now be
carefully removed to a warm room and laid in a blanket, on the table
or floor. If he complains of thirst give a cupful of warm tea or a
warm whisky toddy.
Visitors and strangers should now be requested to leave the
room and the clothing should be removed from the body with the
greatest care. The scissors or a sharp knife should be used to cut
away the garments, so as to avoid all possible straining and dragging
on the patient. The blisters must not be torn, and where they are
very tense they can be pricked with a sharp needle, so as to allow
the escape of the serum. The epidermis forms the best protection
for the cutis, and where the skin is stuck to the linen do not tear this
off, but allow it to remain and cut with a sharp scissors around it.
The application of cold water generally increases the suffering, but
sweet oil, lard oil, vaseline, castor and china nut oil will answer for
the emergency or until a more suitable dressing can be obtained,
after which the surface should be covered with cotton batting to
exclude the air. A very useful application is a mixture of equal parts
of lime water and sweet oil or linseed oil. Carbolized sweet oil is
another useful dressing and superior to lime water liniment; it is
made in proportion of half an ounce of carbolic acid to one pint of
sweet oil; either of the above preparations can be poured over the
burned surface and then it should be covered with cotton batting, or
small pieces of soft linen cloth can be dipped and saturated in the oil
and then applied over the burns. The advice of a physician should be
sought in view of the dangerous complications that may occur from
extensive burns.
(d) Frostbite is the result of exposure to cold, and in certain
regions during the winter months a considerable number are liable
to this accident. But extreme cold weather is not alone responsible
for frostbite; very often this accident occurs in moderately cold
weather, for instance, if persons exhausted from hunger or fatigued
from long travels or stupefied by alcoholic drink lay themselves down
and fall asleep, and a cold wind blows over them which withdraws
the bodily heat, the same effects are accomplished on the system.
The first effect of dry, cold air is a sense of numbness and
weight, with a peculiar prickling or tingling, and a rush of blood to
the surface, giving the skin a lively reddish appearance. If the cold is
maintained for any length of time the blood leaves the surface,
which becomes now of a pale and whitish aspect, forming a striking
contrast to the previous redness. When the cold is suddenly applied
and very intense, the skin exhibits a mottled appearance, which is
due to the presence of congealed blood in the subcutaneous veins.
Moist cold has a similar effect on the living tissues to dry cold. If
the hand is immersed in iced water the blood rushes immediately to
the surface, so that the color of the skin increases, which is followed
by a marked degree of numbness, and an unpleasant burning and
tingling sensation. A reaction comes on in a short time, the blood
quits the surface, and the skin becomes bleached and contracts, the
tissues underneath also shrink and become painful. There is no
difference in the effect of either moist or dry cold, only that the
former is more penetrating and its effects are sooner apparent.
Those parts of the body that are more directly exposed and in which
the circulation is not much protected by fatty tissue, suffer the most
from the effects of cold; after exposure for an unusual length of time
the toes, feet, heels, fingers, hands, nose, and ears, together with
the lips and cheeks are for this reason oftener affected than other
parts of the body. Persons whose constitutions are broken down by
intemperance, starvation and other privations which lower the power
of resistance are more susceptible to this accident.
 The first effect of cold in the general system is bracing and
stimulating; an agreeable glow is felt over the surface of the body
and one feels strengthened and exhilarated. But if the cold
temperature is unusually prolonged this agreeable sensation is
changed into one of pain and drowsiness; the brain becomes
inactive as if under the influence of a powerful opiate or narcotic,
and the desire to go to sleep is so strong that it requires the greatest
effort to keep awake. To yield to this inclination to sleep would result
in slumber that knows no waking, for the blood would now rapidly
accumulate in the internal organs, the breathing would become
irregular and spasmodic, the nervous functions would soon be
suspended and death would ensue from general paralysis. An
individual thus exposed, so as to have become drowsy or
unconscious and then suddenly brought into a hot room is likely to
die from congestion of the brain and lungs, or if he should revive for
a short time, the frost-bitten parts will be stricken with mortification.
Professor Samuel D. Gross says: “The treatment of frostbite requires
no little judgment and adroitness to conduct it to a successful issue.
The great indication is to recall the affected parts gradually to their
natural condition by restoring circulation and sensibility, in the most
gentle and cautious manner, not suddenly, or by severe measures.
The first thing to be done is to immerse them in iced water, or rub
them with snow, the friction being made as carefully and lightly as
possible, lest overaction be produced, as they are necessarily greatly
weakened. If no ice or snow is at hand, the coldest well water that
can be procured must be used; and if immersion is inconvenient,
wet cloths are applied, with the precaution of maintaining the supply
of cold and moisture by constant irrigation. Moderate reaction is
aimed at and fostered. All warm applications, whether dry or moist,
are scrupulously refrained from; the patient must not approach the
fire, nor immerse his limbs in hot water, or even be in a warm room.
Attention to these precepts must on no account be disregarded, as
its neglect would be almost certainly followed by mortification or
other disastrous consequences.”
 (e) Drowning or the submersion of an individual until life is
destroyed by suffocation is not an uncommon accident. “The
immediate cause of death in drowning,” says Dr. Gross, “is
suffocation or insufficiency of air. Respiration being thus arrested,
the blood is unaerated and consequently unfitted for life, although
the circulation may go on for a short time after breathing has
completely ceased.”
The Navarino sponge divers whose occupation has accustomed
them to live under water the extreme limit, average only seventy-six
seconds, while the Ceylon pearl divers seldom remain under water
with impunity more than two-thirds of that time.
Dr. Gross says: “The period at which a person after submersion
may be resuscitated varies very much in different cases and under
different circumstances. In some cases, for reasons not always
explicable, recovery is found to be impossible at the end of one
minute. The chances are never good after submersion of twice this
length of time, especially when the water and the air are both
uncommonly cold.
“The treatment of apnœa from drowning must be prompt and
decided. Every moment of time is most precious. The body being
removed from the water to a dry place, is immediately stripped,
wiped, and covered with a blanket, especially in cold weather. The
mouth, nostrils and throat are cleared of mucus, froth, and any
other substances likely to interfere with the admission of air to the
lungs; the tongue is to be pulled out at the corner of the mouth, and
prevented from falling back upon the glottis; ammonia is rapidly
passed to and fro under the nose; and the body is stretched out at
full length with the face downwards, the forehead resting upon one
arm, for the purpose of allowing any water that may be in the
stomach and air passages to escape by the mouth and nose. If
these means do not speedily revive the patient, artificial respiration
is instituted. For this purpose, the body being placed upon its back,
with the head slightly elevated, the arms, grasped just above the
elbows, are carried outwards and upwards from the chest almost
perpendicularly, and retained in this position for about two seconds,
the object of the procedure being designed to promote the
introduction of air into the lungs as in natural breathing. They are
then lowered and brought closely to the sides of the chest, where
they are held for the same length of time, to expel the air, the effect
being aided by pressure applied to the inferior and lateral portions of
the chest. These alternate movements of elevation and depression
from twelve to fourteen times a minute, and are performed with all
possible gentleness. As soon as signs of life are observed, dry
warmth should be applied to the extremities, the region of the heart,
loins, and abdomen, a little brandy and water being administered, or
if deglutition be impracticable, thrown into the rectum.”
(f) Poisons and their antidotes form an important subject for our
consideration, because many of the poisons are among the most
useful remedies. The daily accounts in the public press of serious
and fatal mistakes in the administration of medicines, are always due
to carelessness and very often to criminal negligence.
No package or bottle should be kept about the house without its
proper label.
Those that contain poisonous drugs or chemical preparations
should be plainly marked Poison, besides the name of their contents.
Vials or packages containing poisonous drugs or chemicals must
not be kept on the same shelf and near those medicines that are
comparatively harmless.
Always look at the label twice; once before the contents are
poured out, and a second time, before the dose is swallowed. Never
take medicine in the dark, in the belief that you are certain of the
right vial and locality; many a sad accident has occurred from this
venture.
Sulphuric, nitric, and muriatic acid cause great heat and a
sensation of burning pain from the mouth down to the stomach.
Acids are neutralized by alkalies, hence one teaspoonful of washing
soda or two teaspoonfuls of bicarbonate of soda dissolved in a pint
of water should be drunk as soon as possible: chalk or powdered
magnesia mixed with water will also answer the purpose.
 Oxalic acid is frequently mistaken for Epsom salts; lime water,
chalk or magnesia mixed with water and taken in large quantities are
antidotes: then administer emetics, which act more quickly if the
stomach is filled with fluids; sometimes the finger run down the
throat will excite quick and sufficient vomiting.
Creosote and carbolic acid benumb the stomach so that emetics
usually will not act, and large quantities of sweet oil or castor oil
should be first drunk; I prefer the former because from one to two
pints of it can be taken; after which lime water or a solution of
Glauber salt (sulphate of sodium) should be taken; the latter is
especially recommended as neutralizing carbolic acid. When
circumstances make it possible the stomach pump or india rubber
siphon tube should be at once employed.
Alkalies, for example, caustic potassa, soda, lye, strong solution
of ammonia, earths and lime are neutralized by drinking vinegar or
lemon or lime juice; afterwards milk in water and flaxseed tea.
Arsenic: Give the white of eggs, lime water or chalk and water;
tablespoonful doses of carbonate of iron, mixed with water, or
calcined magnesia in the same manner, then evacuate the stomach
with an ipecac emetic.
Corrosive sublimate: Give white of eggs, or wheat flour mixed
with water; afterwards give an emetic.
Alcohol: First cleanse out the stomach with an emetic, then dash
cold water on the head and give frequent doses of aromatic spirits of
ammonia in water.
Charcoal or coal gas poisoning: Remove the patient into the open
air, dash cold water on the head and body and stimulate by passing
ammonia to and fro under the nostrils, at the same time rubbing the
chest briskly.
Lead: White lead and sugar of lead should first be treated with
alum emetic, afterwards a cathartic of castor oil or Epsom salt.
Nitrate of silver (lunar caustic): Give a strong solution of common
salt, and then emetics.
 Prussic acid or cyanide of potassium. For this no certain antidote
exists, and it destroys life so suddenly as scarcely to allow of use if
we had one. When there is time chlorine in solution has been
recommended, also water of ammonia and cold affusions.
Opium, laudanum and morphine require the same antidote. If the
patient can swallow an emetic should be given; twenty grains of
sulphate of zinc and a teaspoonful of powdered ipecac mixed in a
draught of water should be given every twenty or thirty minutes until
vomiting is insured. A mixture of half teaspoonful of mustard and a
tablespoonful of salt dissolved in a pint or quart of warm water is
another efficient emetic in these cases. If swallowing is impossible
the stomach pump must be used. When the stomach is cleansed out
give strong coffee and acid drinks, dash cold water on the head and
keep the patient walking.
Belladonna and black henbane: Give emetics, and afterwards a
dose of paregoric, and a hot whisky toddy, or a cupful of strong tea.
Nux Vomica and strychnine have no reliable chemical antidote;
emetics should first be given, or the stomach washed out with a
siphon tube or stomach pump. Chloroform must be employed to
control the spasms, then alcoholic stimulants should be freely
administered.
Aconite, digitalis, hemlock, lobelia, cantharides, poisonous
mushrooms or toadstools, etc., have no certain antidotes. Emetics
should be immediately given when any of them are known to have
been taken. Animal charcoal is recommended to absorb and render
harmless organic poisons in the stomach; teaspoonful doses mixed
with water should be given repeatedly, and for those drugs least
depressing in their action castor oil is also recommended.
When a prompt emetic is urgently demanded and no drugs of
any kind are at hand, large quantities of tepid water should be
drunk, say half gallon to a gallon; this distends the stomach
mechanically, and by titillating the throat prompt and effective
vomiting may be excited; this may be repeated as often as
necessary and the stomach thoroughly washed out.
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