ANALYZING THE ORIGINS OF THIS IDIOM TO DETERMINE SALT’S ACTUAL VALUE FOR BACKCOUNTRY INJURIES
Most of us have heard the common idiom “rub salt in a wound”. According to the Cambridge Dictionary, the phrase is used to describe making a bad situation even worse. For example, if you just lost your job and started clearing out your desk, only to have a coworker walk up and brag about his new promotion, he’d be rubbing salt in your metaphorical wound.
The origin of this idiom is easy enough to ascertain. If you’ve ever gotten seawater in a fresh cut, you’ll know that literal salt in a wound can be physically painful. However, you may also recall that saline solution is used for wound irrigation in hospitals around the world. This got us thinking: it’s obvious that rubbing salt in a real wound is painful, but is it really making a bad situation worse? Or could the salt make the situation better in the long term and prevent infection, becoming a viable technique for backcountry medicine?
Note: This article is not a comprehensive first-aid guide. Professional medical treatment should always be sought first before attempting any improvised treatments.
Historical linguists have indicated that the idiom came from a time when salt was used as an improvised antiseptic. “During the earlier centuries, when England was establishing its navy, most sailors were forced into service. While at sea, punishment was often lashes with a cat’o’nine tails. These whippings would almost always break the skin, and salt was rubbed into the wound to prevent infection. In this way, “salt in wound” was a very literal, stinging phrase.”
However, just because it was seen as a viable antiseptic back then doesn’t mean it still is today. After all, we certainly don’t use blood-letting, mercury, or lobotomies to cure our diseases these days.
In our search for an answer to this question, we found the following statement from Walter Sipe, M.D. of the University of California, San Francisco. He wrote the following response in 2006 in an Ask a Scientist column for the Howard Hughes Medical Institute:
Let me start by saying: Do not put salt on your cut. The single most important aspect of wound care in the backcountry is vigorous and copious irrigation with clean water (filtered or chemically treated so it is drinkable). You can generate a high-pressure stream by filling a zip-top plastic bag with water, poking a tiny hole in a bottom corner of it with a needle, and then squeezing the bag so water comes out through the hole. For dirty wounds, vigorous scrubbing to remove foreign bodies is also important. Exposing wounds to iodine, alcohol, peroxide, and pure salt is no more effective than water irrigation at preventing infection and can potentially damage tissues. The safest way to slow bleeding is to hold direct pressure on the wound until the bleeding stops.
Before you go thinking a dip in the ocean might be a better way of salting your wounds, scientists have found that rinsing a wound in seawater is harmful due to the presence of marine bacteria. Additionally, many dangerous bacteria have an extremely high salt tolerance and thrive in salty environments — Staphylococcus aureus, the bacteria behind potentially-deadly MRSA staph infections, is one notable example.
Finally, while it’s true that sterile saline solution is used in many medical facilities, this solution contains a very small amount of dissolved salt for the purpose of mimicking your body’s natural conditions. With regard to saline’s antiseptic properties, multiple scientific studies have found that saline solution is no more effective for preventing infection than distilled water or even clean tap water. In fact, studies indicate that water may be preferable in some cases.
So, the conclusion is clear: next time you hear the phrase “rubbing salt in a wound”, remember that its metaphorical use of “making a bad situation worse” is also true in a medical context. It is not a viable technique for treating wounds in the backcountry. Doing so is likely to be very painful, may further irritate the wound, and it will not kill all the bacteria which might lead to a dangerous infection. Instead, keep the salt for your next meal, and irrigate your wounds thoroughly with clean purified or distilled water until you can seek professional medical treatment.
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Reasons You’re Sleepy
Feeling tired all the time? Well, you’re far from alone. Two out of every five Americans report feeling tired most of the week, and research from the Centers for Disease Control and Prevention shows that 1 in 3 adults fails to get enough sleep. And between work or school, family or friends, and all the other commitments we’re juggling, it’s easy to blame a busy lifestyle on constant fatigue.
But if you’re always asking yourself, “Why am I so tired?” don’t blow it off. Give yourself about 2 to 3 weeks to make some lifestyle changes: Trim your social schedule, scale back your workload at the office, and try to sleep more. “If you’re still feeling the symptoms of fatigue after those changes, then you need professional help,” says Sandra Adamson Fryhofer, MD, an internal medicine doctor in Atlanta. Excess exhaustion could be the sign of a more serious medical condition that can be treated.
Here are the 12 things that could explain your sluggishness.
Lifestyle Factors That Explain Why You’re Always Tired
Chances are, solving the reason you’re tired all the time is easy to control, and takes just a few simple changes to your day-to-day habits.
You’re sleeping on an old mattress or pillow
The National Sleep Foundation recommends replacing your mattress every nine to 10 years, and pillows once a year.
Your bedroom is too warm
A hot bedroom can make it difficult to fall asleep (and stay asleep). The NSF has settled on a magic number for perfect rest: 65 degrees Fahrenheit.
You’re spending too much time on your smartphone
“Exposing eyes to light during the evening stops the body from making melatonin, the sleep hormone,” Richard L. Hansler, PhD, of John Carroll University, told Prevention in a previous interview. For optimal sleep, make your bedroom a phone-free zone.
You’re using alcohol as a sleep aid
Sure, a glass of wine may help you drift off to dreamland. Problem is, the alcohol may be making your sleep quality suffer. “Over the first few hours, you metabolize that alcohol, with the alcohol producing a form of sleep that can prevent the healthy rapid eye movement sleep that is most restful,” said Hansler. Nix the nightcap, and you may find it gives you the energy boost you need.
You’re not drinking enough water
Ever notice that when you’re feeling tired or cranky, you haven’t had a glass of water for a while? That’s no coincidence—being dehydrated can have a real impact on your mood and energy levels. Researchers believe parts of our brain may actually shrink when they’re low on liquids (yikes). And you don’t need to be severely dehydrated to experience these cognitive symptoms, either. You may start feeling sluggish even if you’re only a tiny bit dehydrated—and research shows as many as 75 percent of Americans are failing to drink enough water every day. Mild to moderate dehydration is easy to treat: Just drink more water! Try these nutritionist-approved tricks to drink more water every day.
Health Issues That Could Make You Feel Tired All the Time
So you’ve replaced your mattress, started going to bed at the same time every night, and improved your diet—and you’re still exhausted. If your constant fatigue sticks around even after you’ve made some lifestyle changes, it’s time to talk to your doctor about the following health issues.
The fatigue caused by anemia is the result of a lack of red blood cells, which bring oxygen from your lungs to your tissues and cells. You may feel weak and short of breath. Anemia may be caused by an iron or vitamin deficiency, blood loss, internal bleeding, or a chronic disease such as rheumatoid arthritis, cancer, or kidney failure. Women of childbearing age are especially susceptible to iron deficiency anemia because of blood loss during menstruation and the body’s need for extra iron during pregnancy and breastfeeding, explains Laurence Corash, MD, adjunct professor of laboratory medicine at the University of California, San Francisco.
The symptoms: Feeling tired all the time is a major one. Others include extreme weakness, difficulty sleeping, lack of concentration, rapid heartbeat, chest pains, and headache. Simple exercise, such as climbing the stairs or walking short distances, can wipe you out.
The tests: A thorough evaluation for anemia includes a physical exam and blood tests, including a complete blood count (CBC), to check the levels of your red blood cells. It’s also standard to check the stool for blood loss.
The treatments: Anemia isn’t a disease; it’s a symptom that something else is going on in your body that needs to be resolved. So, treatment will vary depending on the underlying cause of anemia. It may be as simple as eating more iron-rich foods, but talk to your doctor about the right treatment for you.
Related: Get the Secrets of the World’s Healthiest People and start feeling better today.
When your thyroid hormones are out of whack, even everyday activities will wipe you out. The thyroid gland, about the size of the knot on a man’s tie, is found in the front of the neck and produces hormones that control your metabolism. Too much thyroid hormone (hyperthyroidism), and metabolism speeds up. Too little (hypothyroidism), and metabolism slows down.
The symptoms: Hyperthyroidism causes muscle fatigue and weakness, which you may notice first in the thighs. Exercises such as riding a bike or climbing stairs become more difficult. Other thyroid symptoms include unexplained weight loss, feeling warm all the time, increased heart rate, shorter and less frequent menstrual flows, and increased thirst. Hyperthyroidism is most commonly diagnosed in women in their 20s and 30s, but it can occur in older women and men too, says Robert J. McConnell, MD, co-director of the New York Thyroid Center at Columbia University Medical Center in New York City.
Hypothyroidism causes fatigue, an inability to concentrate, and muscle soreness, even with minor activity. Other symptoms include weight gain due to water retention, feeling cold all the time (even in warmer weather), heavier and more frequent menstrual flows, and constipation. Hypothyroidism is most common in women over age 50; in fact, as many as 10% of women past 50 will have at least mild hypothyroidism, says Dr. McConnell.
The tests: Thyroid disease can be detected with a blood test. “Thyroid disorders are so treatable that all people who complain of fatigue and/or muscle weakness should have the test done,” says Dr. McConnell.
More than a million people are diagnosed with type 2 diabetes every year, but many more may not even know they have it. Sugar, also called glucose, is the fuel that keeps your body going. And that means trouble for people with type 2 diabetes who can’t use glucose properly, causing it to build up in the blood. Without enough energy to keep the body running smoothly, people with diabetes often notice fatigue as one of the first warning signs, say Johns Hopkins researchers.
The symptoms: Aside from feeling tired all the time , other signs include excessive thirst, frequent urination, hunger, weight loss, irritability, yeast infections, and blurred vision.
The tests: There are two major tests for diabetes. The fasting plasma glucose test, which is more common, measures your blood glucose level after fasting for 8 hours. With the oral glucose tolerance test (OGTT), blood is drawn twice: just before drinking a glucose syrup, then 2 hours later.
The treatments: Your doctor will advise you on how to control your symptoms through diet changes, oral medications, and/or insulin.
More than “the blues,” depression is a major illness that affects the way we sleep, eat, and feel about ourselves and others. Without treatment, the symptoms of depression may last for weeks, months, or even years.
The symptoms: We don’t all experience depression in the same way. But commonly, depression can cause decreased energy, changes in sleeping and eating patterns, problems with memory and concentration, and feelings of hopelessness, worthlessness, and negativity.
The tests: There’s no blood test for depression, but your doctor may be able to identify it by asking you a series of questions. If you experience five or more of these symptoms below for more than 2 weeks, or if they interfere with your life, see your doctor or mental health professional: fatigue or loss of energy; sleeping too little or too much; a persistent sad, anxious, or “empty” mood; reduced appetite and weight loss; increased appetite and weight gain; loss of interest or pleasure in activities once enjoyed; restlessness or irritability; persistent physical symptoms that don’t respond to treatment, such as headaches, chronic pain, or constipation and other digestive disorders; difficulty concentrating, remembering, or making decisions; feeling guilty, hopeless, or worthless; thoughts of death or suicide.
The treatments: Most people who struggle with depression are able to thrive through a combination of talk therapy and medication.
This baffling condition causes a strong fatigue that comes on quickly. People who suffer from CFS feel too tired to carry on with their normal activities and are easily exhausted with little exertion.
The symptoms: Other signs include headache, muscle and joint pain, weakness, tender lymph nodes, and an inability to concentrate. Chronic fatigue syndrome remains puzzling, because it has no known cause.
The tests: There is none. Your doctor must rule out other conditions with similar symptoms, such as lupus and multiple sclerosis, before making the diagnosis.
The treatments: Sadly, there is no approved medicinal cure for chronic fatigue. Self-care, antidepressants, talk therapy, or joining a support group may help.
You could have this sleep-disrupting problem if you wake up feeling tired no matter how much rest you think you got. Sleep apnea symptoms include brief interruptions of breathing during sleep. In the most common type, obstructive sleep apnea, your upper airway actually closes or collapses for a few seconds, which, in turn, alerts your brain to wake you up to begin breathing again. Someone with obstructive sleep apnea may stop breathing dozens or even hundreds of times a night, says Roseanne S. Barker, MD, former medical director of the Baptist Sleep Institute in Knoxville, TN.
The symptoms: Sleep apnea is often signaled by snoring and is generally followed by tiredness the next day. Because sleep apnea can lead to heart disease, high blood pressure, and stroke, it’s important to be tested.
The tests: This involves an overnight stay at a sleep clinic, where you’ll undergo a polysomnogram, which is a painless test that will monitor your sleep patterns, breathing changes, and brain activity.
The treatments: If you’re diagnosed with sleep apnea, you may be prescribed a CPAP (continuous positive airway pressure) device, a mask that fits over your nose and mouth and blows air into your airways while you sleep. Depending on the severity of your condition, your doctor may also recommend surgery.
B12 Deficiency or Insufficiency
Getting enough vitamin B12 is crucial for brain health, your immune system, and your metabolism. As we age, though, our ability to absorb B12 declines. “Fatigue is one of the first signs of B12 deficiency,” Lisa Cimperman, RD, a spokesperson for the Academy of Nutrition and Dietetics, told Prevention in a previous interview about B12 deficiency symptoms. Certain diabetes and heartburn medications and digestive disorders like IBS and Crohn’s hinder your body’s ability to absorb B12. And if you follow a plant-based diet, you also have an increased risk, since B12 occurs naturally only in meat, eggs, shellfish, and dairy.
The symptoms: In addition to fatigue, you may be low on B12 if you’re experiencing bouts of tingling in hands and feet, memory lapses, dizziness, anxiety, and vision problems.
The tests: If your doctor expects you’re low on B12, you’ll undergo a simple blood test.
The treatments: Depending on your blood test results, your doctor may suggest working more dietary sources of B12 into your eating plan or taking a vitamin B12 supplement.
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