FIRST AID TO THE INJURED.

FIRST AID TO THE INJURED.

(Concluded.)

CHAPTER X.

DISLOCATIONS AND SPRAINS

are produced by over-exertion or violent strains or twists of the smooth and elastic cartilages which cover the rounded ends of the bones. A fluid which is maintained by a membrane near the joint keeps these wounded ends oiled (so to say), while tough ligaments—retainers allow these ends to move only within certain limits. If these ligaments are torn, strained or inflamed by any extra force or violence—not sufficient to cause dislocation—they are sprained, the membrane alluded to becoming filled with blood and the oiling fluid being exuded in excessive quantities, the joint becoming swollen and discolored. Movement, also, is very painful, as the inflamed ligaments are thereby stretched. To treat a sprain, the joint must have complete rest, and water as hot as can be borne be applied freely round it, the heat being increased gradually and the application kept up as long as it can be borne—half an hour will generally suffice. At the expiration of that period, let ordinary hot, moist fomentations be employed for another half hour. The joint must then be bound up in a wet bandage and kept well elevated. If the ankle, wrist or linger is sprained, let the whole foot, ankle, wrist and hand be plunged into water as hot as can be borne, the heat being gradually increased to the extreme point of endurance for half an hour or an hour. Then let the foot be placed on a chair in an elevated position, or the wrist or hand in a sling, and swathed in hot wet cloths. It will be very painful for a day or two, when the pain will lessen. As soon as that is the case, let the joint be gently moved, rubbed with soap liniment, vaseline or oil and softlv kneaded at intervals. It also strengthens the joint to place it under the tap and let a stream of cold water run on it two or three times a day before beginning to use it fully in walking or working.

CHAPTER XI.

BURNS AND SCALDS.

Burns are caused by the application to the body of hot solids; scalds, arise from fluids, such as steam or gases coming in contact with the person. Each differs in gravity and intensity, according to the location of the injury.

The least to be regarded is one of the first degree. It consists of a mere reddening of the skin— a scorch.

When a burn is of the second degree, blisters are found, and should be carefully handled as the skm that covers them is very tender and may easily be torn open by being handled roughly, whereby a bad and possibly a dangerous sore may result, especially if a large portion of the skin is involved—one-third or one-half. In that case serious, if not fatal results may ensue.

A burn or scald of the third degree involves the charring of a superficial layer of the skin to suc*h an extent that it is dead. This layer must slough away before there can be any recovery and the surface so left is extensive and ulcerating. Severe shock accompanies such burns, often causing death within forty-eight hours. Such burns on recovery always leave a bad scar, even deformity behind them.

TREATMENT OK BURNS.

The first things to be observed are to keep the air from the part affected and also keep it perfectly clean. In order to do this apply to burns of the first and second degree vaseline, olive oil or sweet oil. A very common application is that of Carron oil—a mixture of equal parts of linseed oil and lime water. The objection to it is that it is a filthy mixture and liable to produce sores, sometimes fatal sores at that. Avoid it as well as alt poultices or water dressings, or dusting with flour.

If the patient is badly shocked, artificial respiration (Sylvester’s method; Howard’s if the arms are injured), or inhalation of oxygen.

The clothing must ni’ver be dragged off. Cut it off, and, if any of it sticks to the affected part, cut round it with a pair of sharp scissors, and let it remain.

Xezer puncture blisters of whatever sort, nor expose the burned part to the heat of a fire, as is often done, under the mistaken idea that such a course alleviates the pain. It does not; on the contrary, if that is done, a slight bum—one of the first degree may be thereby changed into one of the second. Keep a perfectly clean dressing on, so as to give neither germs nor poisons any chance to infect the burn. Be careful about using a carbolic lotion, or, although that acid forms an excellent dressing, yet, as a burned surface very quickly absorbs anything that comes in contact with it, poisoning may be the outcome of such an application.

If a patient’s clothing is actually alight, be careful to throw or lay the person down zvith the burning surface uppermost; then throw on the body a rug carpet blanket or something that will stifle the flames—whose tendency is always upwards.

In case of a bad burn of the second degree, and always when it is one of the third degree or if there is an extensive burned surface, send for a doctor at once, or take the patient to one, or the nearest hospital.

FIRST AID TO THE INJURED.

0

FIRST AID TO THE INJURED.

CHAPTER IX.

FRACTURES (concluded).

Whether the bones between the wrist and the fingers or the fingers themselves are broken pain will be felt at the point of fracture; the broken portions of the bone will be movable; crackling will be perceptible; and the knuckle at the termination of the bone is generally sunken.

In binding.up the hand make the splint one of a piece of a cigar box or moderately thick pasteboard. Pad it well as well as the palm of the hand; bind it in place, the splint extending from the iip of the linger a little way up the forearm. When the arm is in the sling let the hand be a little higher than the elbow. In the case of a finger it is sufficient to use a well-padded splint of cigar-box wood, pasteboard or cardboard— even a twig from a tree extending from the tip of the linger up to the wrist. The sling need not be large.

‘The fractures treated of above are those most commonly met with and to which lirst-aid can be most easily applied. There are others, such as those of the skull, pelvis and spine which, while thej can be detected without much difficulty, are quite beyond the province and the power of firstaid to handle. All that can be done is to make the patient as comfortable as possible and summon a surgeon at once.

FKACTl’RKS OF THE SKULL.

In fractures of the skull, where there is an open wound and considerable hemorrhage, bandaging may be resorted to and means taken to stop the flow of blood.

FRACTURES OF THE Sl’INE.

In fractures of the spine there is present paralysis of all that portion of the hody due to the spinal cord being compressed by the broken hone, and, if the lips, of the fingers are gently run along the spine, a deformity will generally be felt. It is safer to leave the patient’s back alone; certainly all attempts to detect crackling or obtain motion must lie avoided, as they are sure to increase the injury to the delicate structures within the spinal canal. All that should be attempted is to place the sufferer lying down in an easy position, with pillows or soft supports lying under him as evenly as possible. He should not be moved from the spot, unless there is absolute necessity for doing so. If the body is cold, applv hot dry cloths to it.

FRACTURES OF THE PELVIS

may he caused by the fall of a heavy weight, by the body being crushed by the wheels of a heavy wagon passing over the hips, or by being squeezed between the ears of a railway or surface road. The patient so injured cannot stand, and. if he tries to rise, he suffers intense pain, and feels as if he were falling apart. Although crackling may IKfelt, it is better not to try for it. Call in medical aid at once; make the patient lie down, and pass a bandage about his pelvis. Keep him absolutely quiet, if possible, ami he perfectly gentle with him. YVhat complicates such an injury is the fact that serious injuries to the bowels and bladder nearly always add complication to it,

CHAPTER X.

DISLOCATIONS AND SPRAIN’S.

A dislocation is the displacement of the end of cue so as not to IK* in proper contact with another. It is caused by a sudden wrench or twist sufficiently violent to rend the ligaments anti allow the bone to slip out of its place. It differs from a fracture, inasmuch as. though in each there is noticeable deformity, yet there is no motion. only rigidity. If a limb, finger or toe is dislocated. it is longer or shorter than that corresponding to it on the other side, and its relation to other parts is changed. There is great pain at the joint, and the limb or ioir.t affected cannot be moved, as in the case of a fracture. I he joint most frequently dislocated is that of the shoulder, on account of its being so shallow 1 hen come the hip. lower jaw and finger joints. Send for a surgeon at once, and. till he comes, make the patient comfortable. If the dislocation involves an upper limb, place it in a sling: if in a lower, place pillows or the like round the limb, and remove the patient in a suitable wagon, not springless, if possible. as to avoid all jolting in transit. Surround the injured joint with hot, moist fomentations.

DISLOCATION OF THE SHOULDER.

Avoid attempting to reduce the dislocation; let the surgeon look after all that. If, however, no surgeon can he found at once, then, but only if the dislocation is that of the lower jaw, finger, toe or shoulder, an attempt may he made to remedy the injury on the spot. The accompanying illustration shows the method of replacing a dislocated shoulder by the foot in the armpit. The patient will be placed lying down on a bed or couch or the ground—the last only as a last resource. lake several handkerchiefs or cloths; roll them into a pad; place them in the armpit, so as to avoid injury by the foot. Let the operator sit hv the patient’s side, with his foot (from which, of course, the shoe or is removed) in a direction opposite to his, and let him place his foot— the one nearest the injured man—in the armpit. The dislocated arm must be grasped very firmly in both the hands and the foot pushed firmly in the armpit. I he dislocated limb must he pulled upon very strongly, and at the same time swung towards tne body. With the snap usually felt, the bone will return to its place. If that is not the case after two attempts, the man had better be left alone and taken to the nearest hospital or surgeon. If, however, the operation is successful, then the injured limb must he bound firmly to the side and kept so for a few days.

DISLOCATION OF THE FINGER.

A dislocated finger can be reduced by a strong pull on it and at the same time pushing the tip forwards, it the end of the bone has slipped on the palm side of the hand, or backwards, if on the hack of the next finger. I he dislocated end must he pushed into its place at the same moment. When the dislocation is reduced, wind round the finger a strip of sticking plaster as wide as the length of the finger. If the attempt has been unsuccessful. it had better be left to the surgeon to manage the business. In any case the toes are hard to set right, especially the big toe. The thumb, also, should be left to the surgeon, as its dislocation presents many difficulties.

REDUCING A DISLOCATION OK SHOULDER.

DISLOCATION OF THE LOWER JAW

often follows yawning or very hearty laughter. When it takes place, the patient’s mouth remains wide open, with the spittle dribbling from its corners and distinct utterance altogether impossible. To bring the jaw back to its normal position, the operator must wind a handkerchief thickly round both his thumbs, so as to form a padding sufficient to save them from injury when the mouth of the patient snaps to suddenly, as it will when the jaw is replaced. One thumb must be placed on each side of the lower jaw, as far hack as possible, with the lingers remaining outside of the mouth, and between the thumbs and the fingers the jaw must he grasped and pressed firmly downwards and backwards. It will then move quickly into its place. Ihe thumbs must be drawn out very quickly, or they will be crushed, as the muscles contract involuntarily and rapidly. A handkerchief. or. better still, a four-tailed bandage, should then he bound about the point of the chin and the top of the head and kept for a short time to keep the jaw in position.

Never attempt to replace the joint in the case of a dislocated hip. Only a surgeon can he trusted in so serious a case.

(To he continued.)

As evidencing the liability of gasolene to catch tire ami endanger life and property at sea as well as on land, it may be mentioned that the little gasolene driven seiner Columbia, of Gloucester, Mass., went afire ai d was burned to the water’s edge about ten miles off the entrance of the harof Newport, R. I. Her crew of two men had barely time to escape in their dory and had to row a distance of twenty miles to shore. Not a vestige of the vessel was left.