Practical medical and surgical family guide in emergencies ...

Front matter

Tfe^v

UNITED STATES OF AMERICA.

PRACTICAL

Preface

THIS edition has been expressly written to benefit and bless suffering humanity everywhere. Observations during a long and busy professional career, have impressed the writer with the belief that a book giving plain directions as to what should be done in cases of diseases, of everyday accidents and poisoning, as well as the means of studying some of the laws that govern and regulate our being, would be of decided benefit, not only to families, teachers, etc., but to the laity generally. It is with such an end in view, that this manual is placed in their hands, presenting succinctly, but at the same time in a sufficiently comprehensive manner the treatment of the many emergencies which are continually arising in our everyday life.

The language is simple, and technical terms have been (as much as possible) carefully omitted, thus the book makes up a complete guide to health, which can be read and understood by all classes. The sections on home nursing and remedies, the care of children and the observations upon diet, ventilation, disinfection, etc., will be found particularly interesting and instructive. The receipes for the sick are replete with facts and lessons especially commendable to mothers and to those under whose care the sick usually fall. Even in health it is well to know something of the constituents of our food and what purpose each serves in the economy of nature ; and, when sickness, and its effects upon the system, are taken into account, it becomes worthy of our seriotis consideration. A constantly recurring problem is therefore — what food are we to give the sick, and when and how should we administer it ?

Vlll PREFACE.

Here the solution can be found, and the necessary instructions to make each preparation the best of its kind, by its being well cooked, palatably seasoned, and attractively served.

" We are indeed fearfully and wonderfully made," and when we think of the powers, faculties and gifts bestowed upon us we cannot but exclaim with Shakespeare : "What a wonderful piece of work is man ; how noble in reason, how infinite in faculty; how like an angel, how like a god." Health is a physical condition upon which pleasure, success and happiness depend. Upon the health of its people is based the prosperity of a nation, for by it every power is increased, every joy enhanced. Sickness thwarts the best intentions and the loftiest aims, and life is incomplete and a failure without the enjoyment of a vigorous constitution. We are continually borne upon the tide of progress and happiness if we possess healthy organs and hopeful hearts. It is indeed wonderful how much we can add to our own personal comfort and length of days by acquiring a practical knowledge of our physical construction and the means of retaining that greatest of earthly blessings — health. It behooves every one to make the best use of their opportunities in learning all they can about themselves in health as well as in sickness. We best meet the purpose of life by doing all we can to preserve the race, by comforting and sustaining, as well as by alleviating the suffering of mankind.

If this little book in any way succeeds in doing this, it will have accomplished the writer's purpose, and like our dear Master " be ever going about and doing good," so that all who secure it will find it ever helpful in giving good counsel in sickness and will find it a safe, trustworthy guide in health.

W. P. K.

313 North Seventh Street, January, 1895.

CONTENTS,

Frontispiece, -

Preface, - vii-viii.

Contents, - - - ix-xiv.

CHAPTER I. Accidents and Emergencies in General

Introductory Remarks. Shock and its Treatment. How to Carry an Injured Person. Fractures— A Full Description of the Different Kinds of Fractures. What to Do until Medical Assistance Can be Obtained. Dislocations— How to Detect Them. Sprains — Their Importance and Treatment.

1-6.

CHAPTER II. Accidents and Emergencies. — Continued

Collapse or Shock in Grave Accidents and What to Do — Full Instructions. Syncope or Fainting. Burns and Scalds, from Fire or Hot Water and Steam. Burns by lime, Caustic-Potash and Other Alkalies. Burns by Acids— Sulphuric (Oil of Vitriol)— Nitric (Aqua Fortis) — Etc. Baking Soda — White of Eggs— Lime-water and linseed Oil (Carron Oil). Splendid Home Dressings.

CHAPTER III. Accidents and Emergencies.— Continued

All Kinds of Wounds and Contusions or Bruises— How to Treat Them. Bleeding from the Mouth or Rectum in Case of an Injury. Mashed Fingers or Toes. How to Stop Bleeding from Wounds. Antiseptic Agents in Wounds. What to Do Where the Lungs or Bowels Protrude. The Extraction of Needles and Splinters. What to Do in Bites of Venomous Serpents. How to Treat the Bites of Insects. Valuable Suggestions in the Bites of Dogs or Other Animals. Gunshot Wounds, etc.

X CONTENTS.

CHAPTER IV. Accidents and Emergencies. — Continued

Asphj-xia — Its Meaning. Asphyxia from Drowning — Resuscitation. How to Determine Whether Life is Extinct. How to Save Lives. Methods of Producing Artificial Respiration. Asphyxia from Strangulation by Hanging. Asphyxia from Suffocation with Noxious Gases and Vapors from Poisonous Mines, Wells, or Privies, from the Fumes of Charcoal, from Common Burning Gas and from the Gas of Bituminous and Anthracite Coal. Asphyxia from Narcotic Poisons— What to Do. Foreign Bodies in the Eye, Ear, Throat, Windpipe and Nostrils. Sunstroke and Heat Prostration — Prevention and Treatment.

21-32.

CHAPTER V. Accidents and Emergencies. — Concluded

Frost-Bite —The Fingers, Toes, Nose, Ears and Lips, the Parts Most Frequently Attacked — Treatment. "Frozen to Death" — Its Meaning. Chilblains — Description and Treatment. Accidents from Lightning — Shock and Burns from It — Treatment. Spitting of Blood. Poison Vine Eruption — Treatment. Whitlow or Felon — Appearance and Treatment. Boils and Carbuncles. Earache— Treatment. Headache — Varieties— Nervous and Congestive, etc. Toothache and the Way to Prevent It. Faceache— Treatment.

33-42.

CHAPTER VI. Poisons and Their Antidotes

What Constitutes a Poison ? Mode of Action of the Different Poisons— Acid, Alkaline Mineral and Vegetable Poisons — Corrosive and Non-Corrosive Poisons. General Instructions, Emetics with Chemical and Physiological Antidotes, the Sheet Anchors — Acetic, Citric, Muriatic, Nitric, Oxalic, Sulphuric, Tartaric, Carbolic and Hydrocyanic (Prussic) Acids. Caustic Soda, Caustic Potash (Common Lj'e), Lime and Lunar Caustic. Tincture of Iodine. Alcohol. Arsenic. " Rough on Rats." Lead. Mercury. Antimony. Ammonia or Hartshorn. Nitrate of Potassa (Saltpetre). Copper, Phosphorus and Sulphate of Zinc.

43-54.

CHAPTER VII. Poisons and Their Antidotes. — Concluded

Vegetable Poisons. Narcotics. Stramonium. Opium and Its Alkaloids. Belladonna Hyoscyamus or Henbane— Strychnine and Nux Vomica— Digitalis— Aconite— Lobelia (Indian Tobacco). Tobacco or Nicotine Poisoning— Savine— Poisoning by Eating Poisonous Meats, Fish, Oysters and Poisonous Mushrooms and Toadstools. A Complete Table of Poisons and Their Antidotes Appended.

55-77.

CONTENTS. XI

CHAPTER VIII. Materia Medica and Therapeutics

Pharmacy— The Derivation of Medical Agents. Hygienic — Mechanical — Imponderable and Medical. Blood-letting by Venesection, Cupping and Leeches. Light, Heat, Cold and Electricity. The Modus Operandi and Application of Medicines. The Different Methods Given, and the Circumstances Modif3 T ing Their Action Fully Described. Apothecaries' Weight aud Measures. Abbreviations and Symbols Used in Writing Prescriptious and in Medicine Generally. The Classification of Medicines According to Their Action on the Animal Economy, Fully Defined. Diuretics — Emetics — Tonics — Astringents — Diaphoretics — Narcotics — Emmenagogues — Cathartics — Antacids^-Anti- Spasmodics — Irritants — Demulcents — Anthelmintics — Anaesthetics — Spinants — Alteratives — Antiseptics, etc.

78-85.

CHAPTER IX. Materia Medica and Therapeutics. — Concluded

Quinine, Its Origin, Discovery and History. The Use and Abuse of Quinine. Drs. A. K. Hill and C. A. Bryce on the Subject. Permanent Deafness as a Result of Over Doses. Its Value in Dyspepsia and Catarrh of the Stomach. Its Employment in Checking Tonsilitis, Inflamed Breasts, Pneumonia, Pleurisy and Other Inflammatory Processes- Peruvian Bark and Its Alkaloids : Quinine and Cinchonidia Specifics for Fever and Ague and Malarial Poisoning in General. The Value of Quinine in Blood Poisoning from the Absorption of Pus or Dike Septic Matters.

CHAPTER X. Genito-Urinary Tract

Woman's Woes— Menstruation. The Proper Time for the Menses. The "Change of Life " or Menopause. Causes and Utility of Menstruation. The Bible and the Mosaic Law on the Subject. The Source of the Menstrual Fluid. Disorders of Menstruation —Headache, Absence of Menstruation, Painful and Excessive Menstruation. Advice to Mothers in Regard to Their Daughter's First Menstruation. The Causes for the Non-appearance or Cessation of the Menses. The Use of Female Pills. Chlorosis or Green-Sickness in Young Girls— Its Causes and Treatment. Sitz or Hip Baths and How to Take Them. How to Relieve Painful Menstruation. Vicarious Menstruation and Its Treatment.

92-99.

CHAPTER XI. Genito-Urinary Tract

Leucorrhcea or the " Whites." Its Causes, Source and Evil Consequences. Backache, Loss of Appetite, and General Exhaustion Sure to Follow its Neglect. Leucorhcea Often the Cause of Inducing Gonorrhoea in the Male. A Frequent Factor of Domestic Unhappiness and Misery. Catarrh of the Womb as a Cause of Leucorrhcea- Successful Home Treatment. Leucorrhcea in Children— Its Origin, History and Infallible Treatment.

IOO-IO3.

Xll CONTENTS.

CHAPTER XII. Genitourinary Tract

Gonorrhoea in the Male, Its Cause, Origin and History. Women Frequently Give Gonorrhoea Without Having the Disease Themselves— through Leucorrhoea. Professors Taylor and Bumstead on the Subject. Safeguards Against Gonorrhoea. The Great Need of Cleanliness— Symptoms— Treatment. Danger Resulting from Improper or Very Strong Injections. Serious Consequence from the Excessive Employment of Copaiba. Many Invaluable Receipts. — Complications — Sequela — Inflamed Eyes — Swelled Testicles— Buboes— Strictures, etc.

CHAPTER XIII. Genito-Urinary Tract. — Gonorrhcea in the Female

The Parts Affected. The Laws of Cleanliness Not to be Overlooked— Treatment— Gonorrhcea in Women is More Quickly and Easily Cured Than in the Male. Constitutional or Internal Remedies Seldom Necessary — Infallible Receipts and Directions.

120-123.

CHAPTER XIV. Genito-Urinary Tract

The Sexual Relation — Society's Serious Mistake — Maid and Lover-^Man and Wife — The Very Serious Consequences of Violating the Laws of Nature — A Lengthy Extract from the Excellent Work Entitled "Lessons in Gynaecology," by the Eminent Wm. Goodell, A. M., M. D., Professor of the Diseases of Women, etc., in the University of Pennsylvania in Philadelphia.

CHAPTER XV. Genito-Urinary Tract. — Lactation

Wet Nursing— Disadvantages to a Healthy Woman if She Does not Nurse Her Infant. Bodily Disease— Sore Breasts— Cancer or Uterine Diseases Often Result if Nursing is Neglected. Mechanical Means. Diet and Medical Agents, Which Promote the Secretion of Milk. How to Check an Over-Abundant Secretion of the Lacteal Fluid. The Influence of Coffee on the Mammary Secretion. Treatment of Sore Nipples. Different Kinds of Nipple Shields.

CHAPTER XVI. Digestive Tract

Food for the Sick and Its Administration— Many Valuable Receipts for the Invalid- Cookery for the Sick. Room— Broths— Soups— Gruels, etc. The Use and Abuse of Alcoholic Stimulants— A Pound of Beef and a Pound of Eggs— How to Vary the Diet —Tuberculous and Other Germs in the Milk— Boiling as a Safeguard— A Warning Against So-called Infant Foods. The Opinion of Ex-Provost Pepper.

143-156.

CONTENTS. Xlll

CHAPTER XVII. Digestive Tract

Our Digestion — Where and How Our Food is Digested and Absorbed Into the Blood. The Function of the Digestive Fluids. Dyspepsia and Its Causes. The Proper Diet for Dyspeptics. Treatment of Indigestion. Gastralgia or Cramp of the Stomach. An Enumeration of the Causes. The Passing of Gail-Stones. Treatment of Cramp. Habitual Constipation, Causes and Treatment.

CHAPTER XVIII. Pure Air and Ventilation

Pure Air, and Its Effects on Health. Diseases Resulting from Bad Ventilation and Impure Air. Bad Air Compared to Soiled Water. Pure Air in the Bed-Room. Methods of Ventilation. The Need and Use of Sunshine. The Proper Care of School Houses.

172-177.

CHAPTER XVIII.— Continued.

Contagion and Disinfection.

Microbes in the Water and Atmosphere — Sterilization and Disinfection. What Are Antiseptics. Principal Agents Used for Disinfection. How Infectious and Contagious Diseases are Propagated and Remedied. The Prevention of Scarlet and Typhoid Fevers— Diphtheria, Cholera and Other Infectious Diseases. How to Disinfect Rooms, and Cellars.

178-183.

CHAPTER XVIII.— Concluded.

Home Nursing and Care of the Sick.

184-187.

CHAPTER XIX. Diseases of Children

Part 1.— Intestinal Worms in Children. They May Cause Serious Sickness and Death Six Kinds of Worms. The Symptoms They Produce. The Cause of Worms. How to Recognize the Presence of Worms. How to Successfully Treat Them. Improper Worm Mixtures Frequently Do Harm. Tape Worms— Their Prevention and Removal.

188-I9I.

Part 11.— Nightmare, or Night Terrors of Children.

192-194.

Part hi. — The Mother's Medicine Box of Home Remedies.

I94-I96.

Part iv.— Cholera Infantum. Complete Instructions as to Prevention, Causes and Treatment.

XIV CONTENTS.

197-201.

Part v.— The Care of Infants During Hot Weather. Home Treatment of Colic. Constipation. Convulsions or " Fits " in Children— Causes and Treatment.

201-205.

Part vi.— Laryngitis or Croup of Children.

205-208.

Part vii.— Whooping Cough.

208-2IO.

Part viii.— Chorea or " St. Vitus Dance."

CHAPTER XX. Special Medical Diseases

Pharyngitis, Tonsillitis or Quinsy— Clergyman's Sore Throat or Catarrh of the Throat- Catarrh of the Nose— Asthma, Its Causes and Treatment. Appendicitis. Bronchitis- Pneumonia— Pleurisy or Pleuritis— and Their Treatment. Pulmonary Consumption, Its Origin, Cause, Prevention and Treatment.

214-238.

CHAPTER XXI. Special Medical Cases

Sick Headache and Its Treatment — Convulsions, Epilepsy or Falling Sickness — Hemorrhoids or Piles and How to Relieve Them — Sciatica, Its Cause and Treatment — Diabetes and Proper Diet for the Diabetic — Diarrhoea in Grown People and Dysentry, and Their Treatment. Bright's Disease— Aphasia — Intermittent Fever or "Fever and Ague," and Malaria, Its Cause, Prevention and Cure — La Grippe — Scarlet Fever, Its Origin, History, Prevention and Treatment— Typhoid and Typhus Fevers and Asiatic Cholera and Their Prevention — Delirium Tremens, Hysteria, Neuralgia, Gastritis, Rheumatism, Nettle Rash, Erysipelas, and Peritonitis and Their Treatment — Scabies or " Itch," and Pediculi, or Dice, and How to Get Rid of the Same— Diphtheria and Measles.

239-302.

CHAPTER XXII. Miscellaneous

Insomnia, Its Cause and Treatment — Fear As a Factor of Disease and Death— The Blood, the Quantity in a Human Being— The Corpuscles and Circulation— The Function of the Blood— Vital Temperature and the Use of the Fever Thermometer— Local and Atmospheric Temperature— Baldness and How to Take Care of the Hair — Many Valuable Hair-Tonics— How to Darken the Hair— Foul Breath and How Remedied— Spermatorrhoea— Its Causes and Consequences— Why Parents and Others, Should Guard the Children in Their Charge Against Evil Habits— Sexual Excesses and What They Entail- How to Make All Kinds of Poultices— Abortion — The Awful Crime and Endangerment to Life of Criminal Abortion— Doctor Cathell's Emphatic Denunciation on the Subject—The Best Anti-fat Remedy— How to Cure Sweating Feet and Correct Foul Odor— The Way to Remove Freckles— Many Invaluable Health Notes.

303-3 2 9.

CHAPTER I. Accidents and Emergencies in General

Introductory Remarks. Shock and its Treatment. How to Carry an Injured Person. Fractures— A Full Description of the Different Kinds of Fractures. What to Do until Medical Assistance can be Obtained. Dislocations— How to Detect Them. Sprains — Their Importance and Treatment.

There is nothing so important in the event of an accident or other emergency as that some person with coolness and sufficient knowledge should assume command and begin to set things straight. It will be found, as a rule, that the simplest things, and usually the most useful, are neglected, while there is a disposition to rely upon cumbrous appliances, often of disadvantage, and sometimes positively hurtful. The object of the writer is to present in a compressed form, for easy recollection and ready reference, a few suggestions as to what should be done in certain cases of emergency, until the arrival of skilled professional assistance. It is not saying too much, perhaps, that what is to be done to give relief or save life, in the great majority of cases, must be done by the unskilled before the aid of a physician can be procured. It has been truly said, " for want of timely care, millions have died of medicable wounds. ' '

As far as possible, the use of technical terms will be omitted, although when necessary they will be used, with a brief definition ; but the writer would respectfully suggest, that, whenever possible, the scientific term should be remembered and used, instead of the popular expression for the same thing. A scientific term, the world over, means but one thing ; while a popular expression, in one place, means one thing, and in another, two or three things ; and, possibly, nothing at all.

2 ACCIDENTS AND EMERGENCIES IN GENERAL.

ACCIDENTS IN GENERAL.

Accidents always, if there are people about, cause crowds to gather around the victim. Trie first thing to be done is to disperse them ; or, at least, get the people to keep away from the injured person. A space of at least ten feet on every side should be kept wholly free from ever} T body except the one or two in charge of the operations for relief. If others are needed for a moment to assist in some special duty, as lifting, removing of dress, etc., the}' can be specially selected from the crowd, and, having been of service, and not further needed can immediately retire. In numerous instances, the writer has seen persons, who were seriously injured, so closely surrounded by a dense mass of ' ' relatives ' ' and ' ' friends, ' ' that it was impossible for the physician to freely use his arms. The kindest thing a by-stander can do, is to insist upon a free space as large as suggested, and select from the crowd persons to hold themselves in readiness to start for whatever the physician or the individual in charge of the case may require. To show how little real interest the inner circle of the crowd usually takes in the restoration of the patient, it will often be found that it is almost impossible to get one of them to run an errand in the interest of the sufferer.

If the person has been thrown from a carriage, injured by a fall from a height, blow or other cause, while there may be no fracture, or other external injury evident, the nervous system has received what is called a "shock." As is commonly said, the person is " faint."

A person suffering from such symptoms should, if possible, be placed flat on the back, with the head, neck, and shoulders slightly raised. The limbs at the same time, should be straightened out, if practicable ; so that the heart, already depressed in action, m.&y act at as little disadvantage as possible. The collar, and everything else calculated in any way to impede the circulation toward the head, or obstruct the movements of the chest, should be loosened or removed. If the injury is slight, re-action will soon come on after giving the person a sip of cold water ; brandy and water (teaspoonful in a tablespoonful of cold -water) every couple of minutes ; or aromatic spirits of ammonia

ACCIDENTS AND EMERGENCIES IN GENERAL. 6

(twenty drops in a tablespoonful of cold water) every couple of minutes. Gentle frictions to the extremities, a few drops of cologne water on a handkerchief to the nostrils ; if the weather is hot, the use of the palm-leaf fan ; hot flannels to the limbs and epigastrium (pit of the stomach); are all likewise useful in assisting re-action.

By this time, should a surgeon have arrived, he will examine and decide upon the special nature of the injury, and inaugurate measures of special relief. Should he not have appeared, and it Is deemed best to remove the patient to the hospital, or his home, a stretcher should be secured, or a substitute, in the shape of a settee or shutter, provided. The injured person should then be gently slipped on, seeing that the body is supported as much as possible along its length, something thrown over or held over the face, to prevent, as much as practicable, the uncomfortable feeling of being stared at in passing along. Four persons of uniform gait should gently lift the stretcher and slowly carry the person to his destination. In most cities, appliances for carrying injured persons are required to be kept at the station-houses, and can be obtained, on application, as well as the services of a good policeman. The authority of the latter is almost invaluable in keeping away the crowd referred to, and in securing useful attention in conveying the person through the streets. If the person is to be taken to the hospital, a dispatch from a police station will secure from most of them, free of charge, an .ambulance, with competent persons to take charge of the injured individual.

FRACTURES AND DISLOCATIONS.

It is often evident to the bystander that a fracture or dislocation exists, without knowing what can be done in the interval which must elapse before the arrival of professional assistance. Of course no one but a very ignorant and bold man "would attempt to do more than make the sufferer comfortable in the meantime.

In instances of suspected fracture or dislocation of the lower extremity, the injured parts should be placed in a comfortable position, and as well supported as possible, to prevent the

4: ACCIDENTS AXD EMERGENCIES IX GENERAL.

twitchings of the leg from the spasmodic action of the muscles of the injured extremity. If necessary to remove the patient to his or her home or the hospital, from the spot where the accident happened, the arrangement of the limb is better made before the patient has been placed on the stretcher or substitute, and a splint of any description applied, for obvious reasons. If found necessary to carry the injured person some distance, and a litter for the purpose cannot be had, the arrangement of the fractured limb against the other, and kept there by handkerchiefs, is often of great comfort to the sufferer.

If the general character of the injury is evident, in sending for the surgeon it is best to tell the messenger, so that, as far as possible, the necessary appliances can be provided before leaving: the office.

In the meanwhile, under no circumstances, should the bystanders be permitted to handle the affected part beyond what is absolutely necessary. As a general rule, a much longer time than is commonly supposed, by most people, may pass between the occurrence of the accident and the arrival of the surgeon without serious injur}' to the patient, or ultimate disadvantage to the fracture. Many persons, thinking that the broken bone must immediately be ' ' set, ' ' are apt to accept the services of the firstperson arriving, asserting himself qualified to do it. Such an individual necessarily makes a more painful examination than is necessary, applies the splint — perhaps not at all the most useful — which the surgeon, arriving later, is obliged, out of consideration for the condition of the sufferer, to acquiesce in.

If the injury is to the upper extremity, the part should be placed in a supporting sling, and kept in a comfortable position. Sometimes, owing to the severity of the injur}* or the condition of the general health of the person at the time, symptoms of shock, from the mildest expression, to insensibility are observed.

As we are on the subject of fractures it would not be out of place here to give a definition of the word, fracture, and an explanation of the many kinds of fracture.

A fracture is the division of a bone into one or more pieces,, from violence.

ACCIDENTS AND EMERGENCIES IN GENERAL. O

A fracture is simple when there is no wound communicating Tvith it ; compound when there is such a wound ; transverse when the line of fracture lies across the bone ; oblique when it slopes ; longitudinal when it is more or less parallel to the long axis ; comminuted when broken in several fragments ; complicated when there is a laceration of an artery or joint, or other additional injun-. A "green stick " or " willow " fracture, is an incomplete fracture, in which some of the bony fibers have given way and the rest have bent, but have not broken. An impacted fracture is one in which one fragment is driven into and fixed into the other. If the same bone is broken at two different places, or more than one bone is broken in the same limb, it is called a multiple -fracture. If cracked only without displacement or separation of ^periosteum, it is called a fissure.

DISLOCATIONS.

A dislocation is the removal of the articulating portion of a "bone from that surface to which it is naturally connected. They Tesult from force applied in such a way as to dislodge the surface of one bone from another ; what is called the head of the bone slipping off into a neighboring depression. Of course, the ligaments binding the parts together, are torn and stretched, beyond the point of slight elasticity found in such tissues and the ^adjacent parts are badly contused.

No directions can be given for detecting a dislocation. It is sometimes evident to the sight, but the possibility of a fracture anust be remembered, and the patient made comfortable, without Jia?idling the injured parts until aid can be summoned. A -dislocated joint is always afterward a weak one, and a small part of the force originally used will produce a return of the trouble.

SPRAINS.

In a sprain, the joint is twisted, so that the ligaments binding the parts together are severely stretched or even torn, with consequent violence to the delicate lining of the joint. A sprain is understood to be short of displacement of the surfaces of the bones, which would be a dislocation.

b ACCIDENTS AND EMERGENCIES IN GENERAE.

They most frequently occur at the wrist and ankle-joints. The injury is rapidly followed by inflammation of the joint and adjacent parts. Not only is the joint directly weakened by the injury, but if there is a tendency to rheumatic disorders, or the constitutional leaning known as strumous, no little future trouble often follows.

There is, of course, great pain, and if it is the ankle or wrist joint injured, often nausea. The tendency to inflammations, should be discouraged by resting the whole body, and keeping; the sprained joint elevated. Cold water in the shape of a " drip >p should be used plentifully until the opinion of a physician can be obtained. Complete rest must be kept up until the inflammation shall have passed and the probably torn ligaments been restored™ Later, stimulating liniments can be used. Often a fracture of the shaft of a bone results in a speedier restoration than the spraini of an ankle-joint, especially if the proper care is not observed,, in case of such an accident. Hops, vinegar and soap, when boiled together, is an excellent domestic application for sprains. I prefer the following liniment — soap liniment, tincture aconite root and chloroform of each, one ounce, to be applied every few hours.

CHAPTER II. Accidents and Emergencies. — Continued

Collapse or Shock in Grave Accidents and What to Do — Full Instructions. Syncope or Fainting. Burns and Scalds, from Fire or Hot Water and Steam. Burns by L,ime, Caustic-Potash and Other Alkalies. Burns by Acids— Sulphuric (Oil of Vitriol) — Nitric (Aqua Fortis)— Etc. Baking-Soda— White of Eggs — Lime-water and Linseed Oil (Carrou Oil). Splendid Home Dressings.

Mild forms of shock (or collapse, as it is sometimes called) are often, by the non-professional, confounded with fainting (syncope). As far as symptoms are concerned, the affections are analagous, varying in degree and duration, rather than in variety, the duration of fainting being usually much shorter.

Life may be destro3^ed by certain agencies as a blow upon the "pit of the stomach," or a sudden and powerful emotion of the mind, and no visible trace be left in any part of the body. This is called " death from shock." This is the extreme result of shock. Usually the patient lies in a state of utter prostration. There is a pallor of the whole surface ; the lips are bloodless and pale. The eyes have lost their lustre, and the eyeball is usually partially covered by the drooping upper lid. The nostrils are usually dilated. The skin is covered with a cold, clammy moisture, often gathered in beads of sweat upon the forehead. The temperature is cold, and perhaps the person shivers. The weakness of the muscles is most marked ; as the phrase is, ' ' the patient is prostrated." The mind is bewildered, often insensibility occurs, unless aroused : and in many cases, nausea and vomiting. In extreme cases, the nausea and vomiting are not so apt to occur.

Sudden and severe injuries, particularly if extensive in character, and involving a large amount of texture, cause shock. Burns — especially of children — extending over a large extent of surface, even if not extending to a great depth, are often followed by shock, and this complication requires often the earliest attention.

Certain poisons, as tobacco, and tartar emetic, act in this manner, depressing the system. So does a current of electricity, as is seen in the effects of lightning.

Loss of blood produces or aggravates shock. Hence a slight injury, with much loss of blood, may be attended with more shock, than a comparatively more severe injury without the loss of blood. Debility favors the influence of shock. A weak system is more easily impressed by it, aud, as should be expected, re-action from its effects is longer in taking place.

As the vital powers of life decline, from engrafted or natural causes, there is less power available as a reserve to meet contingencies. In youth there is an available fund of this kind ; in the adult the resources of the system may be equal to the task of ordinary maintenance, but in the aged, as said before, there is much less ability to deal with sudden losses of strength. The aged, therefore, are slow to rally from the effects of shock. The}?- have more power of resistance than the young. The shock does not readily make an impression, as it does in the young, but when it does, the impression endures. In the young the impression is more easily made, but sooner subsides.

Treatment of shock should consist in first placing the patient as flat on his back as possible with the head raised not over an inch. This is an important point in cases of ordinary fainting, and whenever the vital powers are depressed, stimulants are required. The aromatic character of brandy enables it to be retained by the stomach when whiskey and other forms of alcohol are rejected. A teaspoonful in a tablespoonful of water every minute, until six or eight have been taken, is the best way to give it. If the temperature of the body is raised by it, and there seems a revival of the action of the heart, enough brandy has been given. Twenty drops of the aromatic spirits of ammonia in a teaspoonful of water may be given every couple of minutes, until four or five doses have been taken. The application of heat to the extremities and ( ' pit of the stomach ' ' is very useful. Flannels, wrung out in hot water property wrapped up, should not be neglected. In some households, a tin can, somewhat concave on one surface, to fit the curvature at that point, and with a stopple in the upper surface for the introduction of the hot liquid, can be usefully employed for applying heat to the epigastrium ( " pit of the stomach "). Mustard plasters to the same places are often used,