Amish burn treatment or the emergency room?

This is just a heartbreaker.  A 2-year-old boy in Ohio died after severe scalding last week. Following the burn (hot water tipped onto him from the kitchen stove) he was first taken to be treated with an “Amish home burn treatment” of B and W ointment and burdock leaves. When he began going into shock the following day, he was brought to the hospital, but it was too late.

It’s unclear whether this boy was technically Amish (his father is said to have left the community a few years ago; the mother’s status isn’t explained, the home address seems not to be Amish).  The use of non-conventional remedies is common among the Amish.

I have heard good things about the B and W salve, which was invented by an Amishman. However there is a time for salve and there is a time for the emergency room.  For a number of reasons, Amish are less likely to go to the hospital than non-Amish (I touched on this issue recently in a post on the book Grace Leads Me Home).

It sounds like this boy’s case was borderline at best (“severe burns to his lower legs and chest”).  What might be a manageable burn on an adult is proportionally much larger on a child that small.

It seems to me that one problem with relying on home remedies is that you have to rely on your ability to self-diagnose.  Playing it safe sometimes means getting to a professional caregiver.  I can understand reluctance to go to the doctor.  I rarely go myself.  But certain situations demand erring on the safe side.

It makes me wonder–could there be a touch of pride in thinking you can handle your potentially serious medical issue as well as a trained professional?

I don’t mean to provoke–just a food-for-thought question.  As I’ve said before, I’m a conventional medicine person–I don’t intuitively “get” the non-conventional approach.

All that said, I can only feel so sorry for these parents.

More: Is Amish life more dangerous?

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    37 Comments

    1. Lattice

      The B & W salve and Burdock leaves is an amazingly effective treatment, and promotes skin regrowth faster than anything I’ve witnessed, other than skin grafts. Private preliminary studies demonstrate that the leaves have anti-infective properties against Strep and Staph. The problem with burns is that if they cover more than just a very small percentage of the body, the body rapidly loses fluids and dehydration/hypovolemic shock/death is the result.

      Since no “big bucks” pharmaceutical companies have desired to launch a study (the rights belong to God and John Keim), the treatment will not be FDA approved and therefore not become a modern medical practice. It works – I’ve seen the results and yes, I have pride in the effectiveness.

      Those who use this treatment instead of going to the hospital need to be educated about burn surface area related to dehydration risk.

      1. julie

        The mother of this child is not Amish. She married an ex Amish. The mother also has medical background. And there for should have known to take him to the hospital. This beautiful baby may still be alive.

    2. I agree with Lattice about dehydration. My first thought was loss of body fluid. I think it is hard for non-Amish to understand they probably did not know that dehydration was a factor. We have so many opportunities for First Aid classes, even in the public school system, and those who have taken a course could easily identify the degree of the burn and what should be done.
      I can’t help but feel sad for his parents, and the loss they must feel.A very sad story; hopefully this will bring attention to the seriousness of burns.

    3. Marilyn from NY

      Amish burn treatment or the emergency room?

      I believe in home remodies as my Mom came from the hills of Kentucky and knew a lot of them. She was not Amish. I have used some of these remodies on myself and they have worked better than doctors. But if it were my child that had a burn like the one above, I would have called the ambulance and taken them to the hospital. I have read of the B & W Salve in Family Life. It seems to do very well, but still in the case of that child, I would have called the ambulance right away. My Mom would also go only so far with remodies-if my Mom were alive and it was me or one of my brothers that got burned like that-she wouldn’t have used remodies-but called the amublance. This is just my opinion.
      Marilyn

    4. Lee Ann

      I would have called an ambulance. My Dad got burned like that as a child and had to be rushed to the hospital.

      The home remedies, I would only use for non life threatening situations. I feel really bad for those parents to have lost a child. That is the worse thing to happen to lose a small child like this.

    5. Kim in NY

      Comment on Amish Burn Treatment or the Emergency Room?

      We have a large community of Mennonites in our area, some of whom are even trained as First Responders and volunteer with the ambulance squad. Hopefully their education levels regarding first aid are such that they would call the ambulance. We (at the ambulance squad) have a good relationship with both Mennonite and Amish. I hope they understand the difference between a life-threatening emergency and a non-life-threatening emergency.

      I certainly will pray for the family of the two year old, what a tragedy….my heart goes out to them.

    6. Shock

      It is hard to recognize shock. Once shock sets in, it can be an unstoppable spiral down, which it what is sounds like happened with that child.

      Yes, I think it can be pride to think we can do something as well as a professional. It is easy for self-sufficiency to lead to pride. I have also seen the pursuit of humility lead to pride (I know a man that is very proud of how humble he is).

    7. Lance

      I don’t believe we have enough information to say that these people were exhibiting pride for using home remedies vs immediately rushing to the emergency room. Did they have insurance? If not, the cost factor may have had a real effect in the delay of seeking more advanced treatment. The fact that at least one of the parents was Amish also my have contributed. In Marlene Miller’s ‘Grace Leads Me Home’, she repeatedly refers to her husband’s ‘wait and see if it gets worse’ attitude. I have seen this attitude first hand. In this case, it did get worse and the parents responded by going to seek help at about 16 hours after the accident. The mind set of the Amish vs english when outside help is necessary are quite different. Does that make them wrong? or proud for doing it their way?

      I am very sorry for the parents. We will never know if their choices in the matter effected the life of the child. Either way, we can hope that child is with Christ. I will pray for them.

      1. I would agree with you Lance, and I’m not here to judge or criticize the actions here based on the limited info in a news article. And certainly not after someone has suffered such a painful loss. I just wonder if it is worth examining if that human element ever plays into the decision making in these cases (I’m not saying it did here). That’s an individual-level question though (James’ example doesn’t surprise me).

        I definitely think English can overdo it at times (children wearing helmets and knee pads for basic playground activities), but also believe in better safe than sorry, especially when the very young and weak are involved.

        Also, if people are going to rely on self-treatment as the primary method, perhaps there needs to be more info out there on self-evaluating these burns. I don’t know if there is a known protocol in the community of B and W users that says if a child is a certain age, or burns a certain severity, then hospital comes first and ointment second. If people are going to use a non-conventional treatment, it seems like that knowledge should be spread so risks are properly understood. Maybe it is; I do not know.

        1. Kathy

          Humble

          It’s unlikely that pride is a factor when choosing this particular home remedy. The reality in using B & W Ointment and Burdock leaves is that not only does it heal better and faster, it takes away the pain, debridement and skin grafting are not necessary, there is less scaring and yes cost is considerably less. So consider yourself as a parent with a burned two-year old. The “medical” way will put that child through hell and you as a parent will get to endure the pain and agony along with your child. It is not pride that allows them to choose this method, it is just a better way. Your road will be long, as the child grows and out-grows the skin grafts which will inevitably cause deformed fingers or legs and more surgeries will follow to regraft this outgrown skin. If you had a choice, what would you pick? The judgment call in a severe situation was their only mistake. They did not have the education, nor did the person helping them, to know this was a case that needed medical attention. In most hospitals, once you enter their system, you will not leave until they do everything they want to your child – meaning, if they don’t believe in burdock leaf treatment – you no longer have a choice. This is a sad story no matter what, but I would choose the Amish way – and I am not Amish.

          1. Ed

            Kathy, if the B&W salve is a wonderful as is claimed, then the owners of the company selling it really ought to use some of their profits to underwrite an independent academic study comparing treatments with B&W ointment with more conventional treatments. If indeed the B&W salve is efficacious, then such a study would also help us understand the optimal dosage, healing times, and active ingredients and might shed light on additional uses or alternate methods to administer it.

            I don’t expect any such study will ever be done. So I will not be quick to dismiss conventional medicine, much of which has undergone extensive study. Nor would I begrudge hospitals for not offering patients the B&W salve or burdock leaves or other unproven remedies.

      2. OldKat

        I too had wondered about the availability of emergency care because of insurance or as you pointed out, possible lack of insurance. In my state no hospital can refuse emergency care due to lack of insurance or even lack of ability to pay for it. They must take all emergency cases and sort out the payment issue later. Does anyone know if this is the case in Ohio? It is a pretty progressive state, or so I am led to believe, so I would be a bit surprised if emergency care can be denied there for lack of insurance coverage. Like Lance said though, they may have been worried if they could pay the hospital bills that would result from a visit / stay there.

        Fact is we don’t really know what factors did or did not enter into their thinking. Some of you that are more attuned to the Amish mindset might be able to speculate a bit further because of your familiarity with their way of thinking; I have no such insight.

        I can agree with Lance and the rest of you though in saying that this is a true tragedy & I join you in praying for the family and his young soul.

        1. There is a Federal law (EMTALA, Emergency Medical Treatment and Active Labor Act) that requires emergency rooms to treat actual emergencies, and active labor, regardless of ability to pay. As soon as it is safe to transport the patient, the hospital can send them to a pauper hospital. That is why private specialty hospitals are being built without emergency rooms.

          1. Lance

            We all know about the laws that emergency care cannot be withheld based on ability to pay, but that does not stop a medical facility from generating a bill for services rendered. In the Amish world, you feel a obligation to pay that entire bill. In this case, the notoriety of the grandfather’s burn salve may have had too much effect on delaying the seeking of more advanced treatment. It may have made no difference either.

            But, sadly, the child has already died and the parents and family will grieve for a long time, so lets continue to pray for them.

      3. gunda53963

        i don't understand.....

        “we can only hope the child is with christ” where else would a 2 year old innocent be, but with christ?

        on another note. an amish friend of mine recieved a very severe eye injury. i took him to my eye dr and clinic, who recomended getting him to the premeir eye hospital in madison wisconsin.
        long story-short, the bill was north of 10 grand. during the ” how you gonna pay this segment, my ffriend said the amish donn’t believe in insfrance. be caause he was an amish carpenter working with and amish crew, the community would not assist. the initial bill was reduced to 3 grand. his siblinngs (13) LOANED him the money to cover the expense. since he has 10 kids and could not do ANY work for at least 6 weeks, the community and extended family made sure there was food in the pantry and ladies to help mom with the house and kids

        gunda53963

    8. michele

      we should take care when looking for pride in others.
      I was taught to assume the best in people unless proven otherwise, I will assume they loved their child and thought they were doing the right thing. It certainly is the opposite direction from people who treat the local ER as their family practice clinic.

      1. You are right Michele. I am assuming the best here as well. I will also admit this story got to me a little bit. The fact that such a small child was involved struck a chord.

        To be clear, I am not accusing anyone of pride, and certainly not these poor parents. I know there are many factors including cost, familiarity, and insurance that play into medical decisions for some Amish families.

        At the same time, the level of–distrust? discomfort? …?–some people (Amish and non-Amish) have for medical professionals can puzzle me. Perhaps I haven’t had a bad experience as some might have. My default setting is conventional treatment; I realize not everyone has the same, for various reasons.

        The Amish do submit to worldly authority in various ways, but can be very assertive in matters of health. I realize they are probably having faith in the authority of the trusted community and family members. No one knows if the child would have survived if he had been taken to hospital right away, of course. But I think that approach could be more risky in the long run, especially in cases like this, with a young and weak child.

    9. Roberta

      It is very easy to criticize people who make a decision different from the one we would have made and to second-guess people after we know the outcome. In this case, we only know what DID happen, we do not know what would have happened had he been taken to the hospital.

      1. I agree Roberta, just to be clear on my side I am not criticizing these people (see my response to Michele above). I don’t think anyone here wants to do that.

        However as I said in my response to Lance I do think there needs to be education on what can be self-treated and what is a potential medical emergency. Is that knowledge and ability to evaluate out there among those who administer and rely on non-conventional treatments like this one?

        Maybe it is, and maybe this was just a fluke case. I do not know. I think that if people are equipped to identify potential emergency situations it will reduce the risk of tragedies happening. If you’re going to make professional treatment option B, I think it is part of the deal to be able to do that. And maybe most are capable of making such judgements, but again I don’t have any knowledge on that.

    10. Osiah Horst

      Emergency room?

      We often don’t know what we should do. One time we go to the emergency department only to almost feel rebuked for going. Next time we don’t go and someone says “you should have come sooner!” My daoughter took her two year old to emergency after she hadn’t eaten for two days only to have them say she must have the flu. She obviously had a sore mouth or throat but the doctor did not check it until my daughter insisted. Two days later, she took the little one into a different clinic with the same results. This time a nurse said she should not go home without antibiotics so the doctor gave in. These situations help us to quickly lose confidence in the professionals.

      That being said, if it would have been my granddaughter that got burned, I would have insisted they seek proper care immediately. However, we have insurance and can easily drive to emergency. When you don’t have insurance and need to call a driver, you don’t respond the same.

    11. In the case described going to the emergency room would be a given to me but frankly it can be hard to know when doctors feel you should go there or not. I feels like I get either scolded for waiting too long or told that I should have known that the condition would go away on its own every other time I go to the doctor. It sometimes feel like you as a patient should know as well as the doctor and already have diagnosed yourself before you come there.

      1. Kim in NY

        reply to Elin and Osiah Comment on Amish Burn Treatment

        When I was younger and my children were small, I had a couple of books called something like “Parents Guide to Common Childhood Illnesses” or something like that. It had clear descriptions of symptoms, and a section at the bottom of each page that said “See a physician if…..”. It really came in handy for some of those middle of the night decisions you have to make as a parent. You could probably find that type of book in the parenting section of any large bookstore, or on Amazon.com.

        I think it’s important for any parent to find a doctor that they feel they can trust, and communicate well with, but if your family doesn’t have a good relationship with a local doctor, maybe you should look for a book like that to have on hand. It could be a lifesaver!

    12. Nelson

      Hey everyone ,,,,this little boy was grandson to the one who made B & W salve

    13. Debbie Wang

      Last summer my Amish friend got stung by a bee and started to get dizzy. I was there when it happened and offered to take him to the doctor’s. He said he was fine and I went home. Three hours later Rebecca his wife called me and said he was really sick and would I take him to see the doctor (they had already made an appointment). His foot had swollen so much he couldn’t walk. He then told me his cousin died of a bee sting. Anyway, after we got to the doctor’s (the doctors there only treat plain people) he was given an IV. He actually had spent the afternoon outside painting in 90 degree heat and was severely dehydrated and his blood pressure was 90/60. He had no idea how serious the situation was. I am just glad I was there to help them. We are very close and I would do anything for them. Rebecca’s dad calls me her second Mom. I always joke with them and say every Amish family needs a good English friend.

    14. Ed

      What is needed is something in between an emergency room and “let’s just wait and see if it gets worse.”

      The problem with emergency rooms is that they are incredibly expensive, may be distant from rural areas, and you can be stuck waiting hours in them if the injuries are not life-threatening.

      In the old days, I suppose, a small-town doctor might have filled the gap. Someone available close by to weigh in with an expert opinion for these types of injuries, whose fees were reasonable and with administrative paperwork kept to a minimum.

      Now, many of us do have great healthcare today, but it is likely due to having health insurance through work, and having previously identified in-network physicians and specialists and having previously established a relationship with one or more of them.

      For those who are “off the grid” with healthcare, it must be very difficult. I know there are still some sole practicioners in Amish areas, who see self-paying patients on reasonable terms, but most medical practices nowadays are not set up this way. For example, my doctor’s office doesn’t even accept cash; only credit cards!

      For the non-Amish, there are safety nets like medicare, medicaid, SSI-Disability, et cetra, so in many cases even indigent persons can receive quality care. But for the Plain people, who do not participate in these government programs, there are far fewer options.

      I’d be interested to hear if there are any solutions to this; new ways of providing healthcare to the Amish. There has simply got to be a better option than choosing between the B&W Salve or the $550 emergency room visit.

    15. Lattice

      The comment from Nelson (above) states that the boy, Dalton Keim, is the grandson of the man who developed B & W ointment, John Keim. I have no way to confirm that, but if so, what a sad and tragic twist of fate.

      I would like for the B & W Salve distributors to add a package insert that says something like, “If the burned area of the body exceeds the size of the palm of the victim’s hand, seek medical attention immediately.” Again, I am a believer in the B & W treatment, I just think that the Amish would benefit from some reference to measure whether the burn is too large to treat at home.

      I recall reading about a young mother whose apron caught fire when starting the stove (gas was in the kerosene). She chose home treatment, and the burns might have healed well, but the injured body surface area was too great. She likewise went into hypovolemic shock and died.

      1. Lance

        The woman’s name was Ella Miller, she died almost a year ago and you can read about what happened to her here:
        http://www.reuters.com/article/2011/06/02/us-amish-idUSTRE7516KF20110602

        Also, I was in the community where the gas was mixed with kerosene and they are very similar stories. The woman in our community was treated immediately, went a major hospital burn unit within hours, spent 3 months there and barely survived. She and her baby are doing well, although the girl, now 11, I think, is slightly impaired with occasional mild anxiety attacks. It was predicted to be much, much worse. Thanks be to God for His Blessings.

        More info about both of these tragedies is here on this link original spot on this blog:
        https://amishamerica.com/is-amish-life-more-dangerous/

        Scroll down the comments for more info about the burn victim I was involved with.

        1. Lattice

          Oh yes, thanks for the info, Lance.

    16. Chelsea

      I have an Amish friend whose infant daughter was burned pretty badly (20% 2nd degree burns to back and “some” 3rd degree to back as well) a few months ago by boiling water. They did take her to the ER and was transferred to the local Children’s hospital and she stayed there for several days before they were able to take her home to a “B&W Treatment House”. She is doing well now, almost fully healed. They are now convinced of the healing powers of B&W.

      I’d rather be treated for burns by a doctor than by someone who is not certified using a method not certified by the FDA. But that’s how I was raised, to trust modern medicine.

      I know B&W treatment can save a family a lot of money if the burn victim can use that option, but what’s worth more…money or the safety of your loved one? I’d rather pay a little bit more than risk losing a child because of not caring for them in the appropriate manner. I tend to err on the side of caution!

    17. Mary

      I encourage all of you that are not familiar with the B & W salve (burn and wound)to educate yourself with it. I’m hearing that several burn centers are starting to use it in some states. My granddaughter in Africa was severely burned when she fell into a burning fire pit. Her mother had been given a jar of B&W salve as a gift (from an aunt) when they left for Africa. It was a life saver for her with the closest hospital being 6 hrs. away. By the way, this little boys parents are not Amish. And yes, the child was a grandson of John Keim, the man who developed B&W salve.

    18. Yoder

      This is indeed an unfortunate incident to have a child die. I pray that the Keim family would be drawn closer together through it.

      If the child would have been taken to a burn center and passed away, would there be a routine investigation and news stories? It is interesting that we did not hear so much about an adult man that was burned in the same Smicksburg area as Ella Miller. Mr. Hostetler was taken to a burn center in January 2012, but he did not survive.

      Some of the advantages of using the B&W method are lower cost, much less pain or no pain at all, less skin infection, and real skin that grows. The beauty of using a hospital is that they can monitor the insides, like the lungs and blood pressure and temperature, and watch for dehydration and shock. The disadvantage of burn units is that they use scrub tanks and scraping and skin grafts. What is wonderful is when the B&W method can be combined with a hospital setting, especially for young children or burns on a high percent of the body. That is now happening at a hospital in PA and in MI for the plain people. The hospital allows caregivers to come in and apply the B&W method. Generally, after properly cooling the burn, and the B&W salve and scalded burdock leaves have been applied, the pain and crying stop.

      Classes and seminars about the B&W method have been held in various states. At a 7-hour burn seminar, it was instructed that a small child can develop shock real quickly. A story was told of one time when that happened in the Michigan hospital, and the nurses came swarming in to help. The child survived with the proper intervention.

      God has used the B&W ointment and burdock leaves to answer prayers and heal many people that had burns.

      May God help us as we learn together.

    19. Kate H.

      I took the Burns and Wounds treatment class from John Keim. He spoke specifically about how large a burn in term of the percentage of the body size his method could safely treat. I don’t have my Keim workbook here at the moment, but I think that this child’s burns would have fallen outside of the parameters that Keim set. He spoke specifically about dehydration and the times that a simple electrolyte solution could be used at home vs. the need for IV fluids. He spoke over and over about working in tandem with hospitals, like Hills and Dales Hospital in Michigan.

      The B&W treatment works fine for many smaller burns. I have used it on myself, on a friend who had radiation burns from cancer treatments, and on an Amish child with a burn on his hand.

      The parents are going through a terrible loss. I feel very sorry for them and will pray for them.

    20. I think often among the Plain People there is a subtle undercurrent of distrust in the ‘elite educated professionals’ such as doctors. If you spend much time among the Plain you will hear stories that reinforce this distrust. I remember the story of a child that was treated at a burn unit and the parents wanted to take him to a B&W place because of the horrific pain caused by the frequent bandage changes at the burn unit. When they attempted to take him elsewhere it became quite the mess. I don’t remember all the specifics, but the story was told in a way that made one distrust ever even taking a child to the hospital in the first place because the doctors would no longer allow you as a parent to make decisions for your child.
      That being said, if this child that died was actually the grandson of John Keim, and it is true that he stresses the importance of working with the hospitals, I would like to think that it may have been a freak thing. But there is no way that one of my children would not be taken to the hospital if they would have any significant burns.
      Back to the distrust, my husband’s grandparents take ALL KINDS of ‘natural’ supplements and remedies that they read about in some magazines, but if the DR., an educated professional with much more knowledge and resources available, prescribes some medication, they won’t take it. Actually they hardly even go to the doctor anymore just buy more ‘miracle’ supplements. I’m also amazed sometimes at the amount of money that is spent on these supplements and remedies by otherwise reasonable thrifty people, because if a doctor would tell them to pay so much they would think it ridiculous.

    21. Thanks to everyone for the thoughtful feedback and especially for the details about B and W. It sounds like the people who promote and use it take safety seriously. It also seems like a good fit for the Amish for cases where self-treatment is possible, for reasons mentioned already above.

      As I mentioned this story got to me. News stories usually don’t do that, this one just seems especially sad and tragic. There was something in the story about the possibility of an investigation; I don’t know what good that will do but perhaps it has to be done.

      It sounds like there is good information out there about how and when to use B and W and home treatments. At the least, hopefully this story will encourage people to err on the safe side. I guess that’s all you can say at this point, other than prayers for the family.

    22. Marcus Yoder

      When reading the Budget there are a lot of stories about people using B&W salve and burdock leaves.
      Marcus Yoder

    23. Don Curtis

      My son Mark and the treatment

      I have mentioned to you all, before, about my son, Mark, and his joining the Amish. I asked him about the B&W salve and burdock leaves. He told me that he had been to a John Keim presentation on burns in his community. Some in his community are especially trained in the treatment. He told me that John Keim stressed that the treatment was not for all burns. Also, John Keim stressed the need for proper hydration of the patient. John related that in one burn victim who was a small child that Keim stayed up all night with the child and administered saline solution with an eyedropper through the child’s anus because he couldn’t swallow. Mark says the burdock leaves are amazing in taking away pain. They don’t take away the cause of the pain but they really do help with the pain. Mark was having trouble with gout in his foot. A friend wrapped the foot in burdock leaves and the pain just disappeared. Seems like somebody should be investigating the properties of burdock leaves.

    24. Paul Long

      Joe Keim's nephew

      Dalton was the son of Joe Keim’s brother William and wife Jenica. (From #6 episode of Amish Out Of Order)
      http://www.mapministry.org/