First Aid Journal 1942 - 1943 by Museum of the Order of St John

FIRST AID J w te p m ta itf J o u r n a l jfo r flje A m b u l a n c e a ttb p u r s i n g B e r n i c e * N o . 5 7 5 , V o l. XLVIII.]

GAS—

M AY,

1942.

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S im plifies the t ra n s p o rt o f the in ju re d , and is su itable f o r a du lt a nd child alike. A d j u s t a b l e f o r any in j u r y a pa tie nt m a y h av e. E a s y to a pply in the d a r k . A F i r s t A i d P a r t y can a p p ly the harness in h a l f a m in u t e . T h e st re t c h e r ca n th en be t u rn e d o r pla ced in a n y u n us ua l p o s iti o n , w i t h the u t m o s t safety and c o m f o r t . W ith T w o P o le s th e P e r fe c t I m p r o v is e d Stretch er. A n I d e a l F itm e n t fo r T u n n e llin g w ith o u t a S tretcher. C e r tifie d b y m a n y D o c to r s in E n g la n d a n d S co tla n d as t h e 100 p e r c e n t . A r t i c l e . N o w b e in g D e m o n s tr a te d at th e A .R .P . T r a in in g S c h o o ls in S co tlan d . P o rt L o c a l A u th o ritie s C o n s id e r th e H a rn es s B r it a in ’s F in e s t A r t ic le in th e U n lo a d in g o f M a rin e C a su alties. A n article o f g r e a t v a lu e in the H o s p i ta l and F . A . P o s ts . H . H . F it t e d w i t h le ather st ra ps £1 17 6 ( H i g h l y re co m m e n d ed ) H . H . F it t e d w i t h h e a v y w e b b i n g st ra ps £1 (Ca n be dec onta m in a ted )

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in th e c o u r s e o f w h i c h

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m akes

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165

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166

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163

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T h e M id w ife ry S erv ices

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tim e s,

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168

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169

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172

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M a rsh a ll H a ll's M eth o d ... E x am in a tio n H o w le r T re a tm e n t of Cru shed H an d T r e a t m e n t of In ju re d H a n d C o lo u r of L e w is it e ... D e c o n ta m in a tio n of C lo th e s B le e d in g from L u n g s P russic A cid P o iso n in g T en d e rn es s w ith F ra ctu res... K n o ts of A r m - S lin g s S ca ld s by B itu m in o u s S u b stan ces T r e a t m e n t of S p ra in e d Join t T r e a t m e n t of In fan tile F it s ... F ra c tu r ed L e g w ith M u sta rd G a s D o g B ite of A b d o m in a l W a l l • C o m p licated F ra ctu re of A rm C o m p o u n d F r a c tu r e of C la v ic le A . R . P . S ervices ... A d m i s s i o n to R . C . S . M u s e u m

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174 174

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176

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176

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176

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176 176

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176

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176

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w om en

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1 ,8 9 8

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o ften

danger

T h a t th e

o v e r th e p r o fe s s io n

“

existed

over

o f th e

upon

it.

(w e are q u o tin g

p ro ce e d in g s

m id w iv e s, a n d

have

th e

been

nam es

1 ,0 0 0 h a v e b e e n r e m o v e d fr o m th e R o ll. From 1903 to 1915 th e n u m b e r o f c a s e s u s u a lly exceeded 100 a y e a r. A fter 1916 th e n u m b e r over

dropped

fa irly

ste a d ily ,

1930 th e n u m b e r

but

fro m

cases each

th at

d ate

until

year averaged

46.

1934 th ere h a v e b een fe w e r th an 20 ca ses a y e a r , in 1 o r 2 y e a r s f e w e r t h a n 1 0 . W e sh o u ld S in c e m uch

lik e to q u o t e fu r t h e r ,

m it, a n d w e to

th e

m ust

fu ll te x t

refer

w h o a re in te re ste d

th e a d d ress, w h ic h

A p r i l is s u e o f P u b lic

S o cie ty

but sp a ce d oes not per

readers

appeared

H e a lth , th e o r g a n

in th e

o f M e d ic a l O ffice rs o f H e a lth .

T h is M o n t h ’ s Q u iz . W e a r e v e r y p le a s e d to find th a t so m a n y of o u r r e a d e r s a p p r e c ia te th is fe a tu r e. A s u su al, the fig u res after each p r o b l e m i n d i c a t e t h e p a g e in B a i l l i e r e ’ s C o m p l e t e M e d i c a l D ic tio n a r y u p o n w h ic h a so lu tio n w ill b e fou n d . O w i n g to i n c r e a s e d c o s t s , t h i s D i c t i o n a r y is n o w 3/9 p o s t f r e e .

(p. 2 7 4 )

W h a t is q u a s s i a ?

W h a t i s r e s o l u t i o n ; in w h a t c o n d i t i o n s d o e s it s o m e tim es o ccu r ? (p . 2 8 1 )

3 . D e f i n e r e s p i r a t i o n ; w h a t is t h e n o r m a l r a t e o f t h i s at v a ry in g a g e s ? (p . 2 8 2 ) 4.

W h a t is a r o d e n t u l c e r ?

W h a t is a s a t u r a t e d s o lu tio n ?

(p. 2 8 7 ) (p. 2 9 2 )

(p. 2 9 4 )

W h a t is s c a r i a t i n a ?

7. W h a t do y o u u n d ersta n d by se g re g a tio n ? 8.

W h a t is s e r u m ?

(298)

(p. 3 0 1 )

9. W h a t do you u n d ersta n d b y sin u s ? 10 . W h a t i s u r o t r o p i n e ?

S t. J o h n A m b u la n c e B rig a d e HEADQUARTERS AND DISTRICT REPORTS.

w h o le -tim e ,

m id w iv e s a t t e n d in g a ll b u t 1 0 p e r

th at w h ic h

penal pow ers

e x p e c te d .”

fa v o u ra b le

th at

p re d o m in a n tly

se m i-sk illed ,

a tte n d e d .”

not

m o st c o rd ia lly a g re e

co n fin e m e n ts,

th e c e n tu ry . se lf-ta u g h t,

in v a ria b ly

ce rta in ly

R I D

(p. 3 0 3 )

(p. 3 5 6 )

N o . I (P r in c e o f W a le s ’s) D is tric t O r p i n g t o n 100 /2 . — T h e a n n u a l m e e t i n g o f t h i s D i v i s i o n w a s h e ld o n M a r c h 2 8 th , 1942, w h e n D i v i s i o n a l S u r g e o n D r . J o h n G r a n t presided. A ll th e c h ie f officers of th e D i v i sio n w e r e presen t. In h is r e v i e w of th e w o r k of t h e D i v i s i o n d u r i n g t h e p a st y e a r t h e D i v . S u p t . s a i d t h a t it w a s a y e a r t h a t w o u l d g o d o w n in t h e a n n a l s o f t h e D i v i s i o n , a s l a s t J u n e s a w t h e i r fir s t m o t o r a m b u l a n c e in c o m m i s s i o n , a p r o j e c t w h i c h w a s first c o n s id e r e d a s l o n g a g o a s 1932. H e also a n n o u n ce d the f o r m a t i o n o f a N u r s i n g D i v i s i o n in O r p i n g t o n . A m essage of g o o d w ish e s a n d pro m ises of h elp a n d su p p o rt w a s sent to th e n e w l y fo r m e d D iv isio n . T h e D iv . S e c r e t a r y in h is re p o r t r e c o r d e d th a t the s t r e n g t h o f t h e D i v i s i o n h a d i n c r e a s e d t o 78 m e m b e r s of w h o m 21 w e r e s e r v i n g w i t h H . M . F o r c e s , 26 i n f u l l t i m e C i v i l D e f e n c e a n d 18 in p a r t t i m e C i v i l D e f e n c e d u t i e s . D u r i n g t h e y e a r m e m b e r s o f t h e D i v i s i o n a t t e n d e d 586 c a s e s , c o v e r i n g in a l l s o m e 5 ,5 1 2 m i l e s . O f t h e s e , 72 c a s e s w e r e a t t e n d e d b y t h e D i v i s i o n ’s o w n a m b u l a n c e , w h i c h s i n c e J u n e , 1 9 4 1 , h a d t r a v e l l e d 3,257 m i l e s ; 127 s t r e e t a c c i d e n t s a n d 140 p riva te re m o v a l ca se s w e re also atte n d ed d u r in g the y e a r by m e m b e rs m a n n in g the a m b u la n c e of the O r p in g to n U r b a n D is tric t C o u n cil. A s a tis fa c to r y re p o rt on the fin a n c ia l p osition of the D iv isio n w a s m a d e b y the D iv isio n a l T r e a s u re r. A prop osal, w h ic h receiv ed th e w a r m s u p p o rt of the D iv is io n a l S u r g e o n , w a s m a d e , to try a n d d ev e lo p a C a d e t D i v i s i o n in t h e O r p i n g t o n a r e a . D r . G r a n t p r a is in g the k e e n e s s a n d e fficien cy of m e m b e rs of the D iv is io n d u r i n g th e p a st ye ar, said h o w d ee p ly he r e g r e t t e d th a t w a r co n d itio n s w e r e re s p o n s ib le for p r e v e n ti n g h im fr o m g i v i n g m u c h m o r e of h is tim e to B r i g a d e w o r k a s h e w o u l d d e s i r e , b u t h e a s s u r e d m e m b e r s t h a t h i s i n t e r e s t in the w o r k w a s as g r e a t as ever. H e w e n t on to s a y th a t he w o u l d li k e to p r e s e n t a t r o p h y fo r in d iv id u a l c o m p e titio n . A silver c u p w a s also presen ted for te a m co m p e titio n b y A m b u l a n c e O ffic e r H . T . M iles. T h e m e e t in g e x p re s s e d t h a n k s to the lo ca l d e ta c h m e n ts of th e B r it is h R e d C r o s s S o c ie t y a n d to m e m b e r s o f th e local C i v i l D e f e n c e D e p o t f o r t h e i r r e a l a n d p r a c t i c a l h e l p in m a n y w a y s d u r in g the past year. A v o te of t h a n k s to D iv isio n a l S u r g e o n D r . J o h n G r a n t fo r h is v a lu a b le w o r k , h e lp and e n c o u ra g e m e n t w a s also ca rried w ith a cclam atio n . A n in te r e s tin g n ote of a p ers o n a l n a tu r e w a s in tro d u ced in to th e p r o c e e d i n g s b y th e p r e s e n t a ti o n to D r . G r a n t , of an o c c a s i o n a l t a b l e - b o o k c a s e t o m a r k t h e D i v i s i o n ’s g o o d w is h e s o n th e o c c a s io n of h is r e c e n t m a r r i a g e to D r . M . K . E v a n s . B a r n e t . — F o llo w in g a c o u rse of le ctu re s a r r a n g e d by th e 4 2 n d ( B a r n e t ) D iv is io n , a n d g i v e n b y D r . J. T . L l e w e ll y n T h o m a s , s ix t y - s ix c a n d id a t e s w e r e s u c c e s s fu l in th e e x a m i n ation . O f t h e s e th irty -fiv e w ill r e c e iv e th e ir first certifica te a n d n in eteen a r e -e x a m in a tio n v o u c h e r. S e v e n qualified f o r a m e d a l l i o n a n d fiv e w i l l receiv e a label. The le c t u r e s w e r e w e ll a tt e n d e d b y w a r d e n s , first a id a u x i li a r i e s a n d o t h e r s a n x i o u s to q u a lif y to r e n d e r first a id . T h e prac tica l w o r k w a s d o n e u n d e r th e directio n of S u p t. A . E d w a r d H a w k in s , w h o w a s a ssiste d by m e m b e rs of th e 42nd (B arn et) D iv is io n a n d n u rse s of the 84th ( B a r n e t) D iv is io n .

T h e C a rle to n V o lu n t a r y F irs t A id P o st n e ars co m p letio n . Two

h uts w e re b o u g h t som e w e e k s a g o .

son,

Thom as,

tra n sferred

th em

and to

the

H ornby

site

M essrs.

d ism an tled

for erection .

D ick in

th em

and

T h e w ork w as

d o n e o n e v e n i n g s fr ee fr o m C i v il D e f e n c e d u tie s a n d fin ished o n A p r i l 2 7 th .

N o . 146 ( L . M . S . R . C a m d e n ) . — T h i s D i v i s i o n h e l d a co n cert a t th eir H ead q u a rters, the C o n cert R o o m , L . M . S . R . D in in g C lub, G lo ucester A venu e, N .V V .l, on T u esd ay, A p r i l 2 8 th . T h e r e w a s a la r g e a u d ie n c e w h ic h in clu d ed m a n y m e m b e rs ’ w ives, sw e e th e a rts a n d parents. S e v e ra l p a re n ts and

«»

F I R S T wiv es of m em b ers of the Div ision w h o are n o w overseas, were able to meet for the first time. T h e concert w a s su pported b y the fo ll o w in g :— A. L . C a s t l e m a n E s q ., L o n d o n District G o o d s M a n a g e r an d Mrs. C a s llem a n , R o l a n d Dav ies, C hie f A ccoun tan t, C a m d e n , C. Nix o n , G ood s A g e n t , C am d en , Cap t. R u ss el V . Steele, M . B . , B . S . , Assist. Co mmissio ne r, S . J . A . B . , Dr. an d Mrs. H . C. Sem on , British R e d Cross, T . M cB rid e , D is tric t Officer, S.J.A .B . Mr. H a r w o o d , chief Cl er k, C a m d e n , t o o k the chair. D u r i n g the ev en in g, Mrs. C a s t l e m a n presented IS F ir st Y e a r Certificates to the su ccessful ent rants of the ladies’ class. A m b u la n c e Officer W . J. T a y l o r , w h o o rga n is ed the concert, spo ke on the fine spirit in the B r ig ad e, and the w b r k of the Division. A letter w a s read from G . K i r k h a m , Div is io n al Supt., n ow s e r v in g with the R. A. F. Mr. A. W a r b y and several E . N . S . A . concert artistes g a v e an excellen t s h o w wh ich w a s enjoyed by all present.

N o . I V D is tr ic t LA N CA SH IR E.

L iv e r p o o l . — A very successful da nc e w a s held at the headq uarte rs of the E x c h a n g e A m b u la n c e and C a d e t D i v i sions on Sa tu r da y, April 25 th. Proceeds in aid of D ivis ion al Funds . A first aid clas s for begin n ers h a s been started at headquarters, the first lecture b e in g g i v e n on M a y 1 st. A bo ut 45 persons of both sexe s we re enrolled. I t is g r a t i f y i n g to note th at interest in first aid is so ke en in Liv erpo ol, an d the E x c h a n g e will do all in its power to further th at interest and turn o ut efficient first aiders. F u l l facilities are a v a il a b le at headq uarters, 95 , Sh aw -str eet, for bo th lectures and practi cal wo rk . g T w e n t y - f o u r n ew ca de ts h a v e joined, all h a v i n g passed their entranc e ex am in atio n.

N e l so n . — W e regret to an n oun ce t h at X 7842 S . B . R . , W . D ix o n ha s been reported to h a v e died from w o un ds in a hos pital abroad. H e w a s a m em be r of the “ B ” Division, Ne ls on Corps, an d ha d been s e r v in g as a m em be r of the S . B . R e s er ve since the o utb r ea k of hostilities.

N o . V D I ( D u k e o f C o n n a u g h t’ s) D is tr ic t C h ic h e st e r . — M em b e rs of the Chich este r A m b u la n c e and N u r s i n g D iv is ion s m a d e a very s m a r t ap pe ar an ce when th ey we re inspected b y the M a y o r before their an n u al m e e tin g at the L a n c a s t r ia n Sch oo ls on M o n d a y , Apr il 27 th, at w h ich Dr . A. M. Ba rf or d presided, and presented the cups. T h e “ Ba rf or d ” C u p for first aid w o r k w a s w o n by Pte. W . D e w , and the “ C a t t o n ” M em o r ia l C u p jo in tly b y Corpl. K e y e s an d Pte. H o w le tt . M em b e rs h ip at the end of the yea r stood at 49 , with 21 on a c ti v e service. T h e ye ar s a w the acquisition of a n ew a m b u la n ce , and, t h a n k s to the ge n er o u s respo nse of the citizens to the appe al for this, the m o n e y w a s raised in five months. C o n g r a t u l a t io n s we re ex te nd ed to Sup t. H . H . Bridle on h a v i n g been ad m itt ed to the O rd e r of St. John of Je rusa lem as a S e r v i n g Brother. T h e Super inte nde nt mentioned th at on an a v e r a g e four hours ev er y d a y we re g iv e n up b y m em be rs to the am b u l a n c e th r o u g h o u t the year, and o w i n g to the calls of the nat ional services, the w o r k w a s fa ll in g on few er an d fewer members. H e s po ke w it h w a r m ap pr ova l of the C a d e t Division, both lads and girls, upon w h o m the B r i g a d e relied for its future. A s atisfa ctory financial position w a s reported.

S a n d w ic h

and

D is t r ic t . — F o l l o w i n g are ex tr acts from

the A n n u a l R epo rt of the S a n d w i c h an d D is t r ic t Division, S . J . A . B . , presented at the an n u al m e e tin g held recently.

A I D

167

T h e Div is io n n ow n um ber s 42 ; 1 D iv . S u r g e o n , 1 Div. S up t., l . A m b . Officer, 1 S e r g e a n t, 3 Corporals, an d 35 Pr ivates . In addition, the D iv is io n al T r e a s u r e r and D i v i sional A u d it o r are ho n orary me mbers. D u r i n g the year the D iv . S u r g e o n , D r . E. E. F. Rose, w a s ad m itt ed an H o n o r a r y L if e M e m b e r of the S . J . A . A . for his w o r k in past years in g r a t u ito u s lectures to first aid classes. F iv e m em bers received che vr ons for 3 y e a r ’s efficient service. Fift y -o n e drills or lectures were held, w ith an a v e r a g e a tten d an ce of 12, an ex cellen t result w h e n depleted num ber s an d absen ce s t h r o u g h Civil D e fe n c e an d other duties are considered. * T h e r e were 352 publ ic duties performed, and a total of 285 cases of illness or ac ci den t attended. A t the an n ual re ex a m in a t io n 24 m em b ers we re successful and none failed. A t the an n u al inspection the In s p e c t in g Officer w a s A ss is t a n t C o m m is s io n e r F. C. Cozens, M . A . , M . B . , B . C h . , w h o stated in his report to the C hie f C o m m iss io n e r : “ S a n d w ic h ha s a l w a y s been a s m a r t Divis ion, refl ectin g credit on officers an d men alike, an d the w a r ha s not impa ired this s ta n d a r d . ” A course of lect ure s on a n t i - g a s an d tre atm en t of g a s casu alties w a s g i v e n b y the Div is io n al Sup er inten de nt , who is a qualified lecturer, an d at the sub se quen t e x a m in a t io n by A m b . Officer J. D u d le y , 16 perso ns passe d and none failed. T h e s ta te m en t of ac co u n ts w a s co nsidered m o st satis factory.

N o . IX D is tr ic t C a m b o r n e . — Sup t. W . E. Butler of C a m b o r n e Division, S . J . A . B . , at a spec ial m e e t i n g of the D iv is ion , tendered his resig na ti o n from the position w h ic h he ha s held for 17 years. D u r i n g tha t time Mr. B u tler ha s b r o u g h t the D iv is io n to a s tate of efficiency eq ual to t h at of a n y in the s o u t h - w e s t of E n g l a n d , and r eg ret at his decision w a s expres se d b y m a n y speakers. C o u n t y C o m m is s io n e r W . B l a c k w o o d , D . S . O . , M . B . , w h o presided, supported b y A s s t .- C o m m i s s i o n e r VV. W . Johnston, said th at Mr. B u tler h a d proved him sel f one of the m o st v alu ab le officers the D iv is ion ha d h a d ; he not o nly k n e w his w o r k as an a m b u l a n c e ma n, but he w a s a go o d o rga nis er and leader. Mr. B u tler expr es sed r eg ret a t the steps w h ic h he had found it neces sar y to take, an d it w a s o nly the g r e a t l y in creased pressure of w o r k w h ic h m a d e it necessary. T h e m e e t i n g u n a n im o u s ly elected A m b . Officer J. Jory to succeed Mr. Butler as Superintende nt. M em b e rs of the B r i g a d e presented Sup t. VV. E. Bu tler w it h an electric r e a d i n g la m p e n g r a v e d as fo llo ws : “ P r e sented to S up t. VV. E . Bu tler b y m em b e rs of C a m b o r n e St. John A m b u l a n c e B r i g a d e on his retirem en t after 27 years s er vic e .” -------------- 1 »

•

— ■

Publications Received. T

he f o ll o w in g p ub lica tio ns h a v e reached Statione ry O ffice :—

from

H .M .

1 . A ir R a i d Prec autio ns H a n d b o o k No . 14 ( 1 st edition). T h e Fir e G u a r d s H a n d b o o k — price 2 d. net. * 2 . A ir R a i d Pr eca uti o n s H a n d b o o k No . 4 ( 2 nd edition). D e c o n t a m in a t io n of M a t er ia ls — price 6d. net.

3. A ir R a i d Pr eca uti o n s M e m o r a n d u m No. 3 ( 3rd edition). O r g a n i s a t i o n of D e c o n t a m in a t io n S e rv ic es — price 2d. net. T h e a b o v e are e x c e e d i n g l y useful a n d reliable p ub l ic a tions. T h e y m a y be obtained fr om a n y b r an ch of H . M . S t atio n e ry Office, or t h r o u g h a n y bookseller.

1 68

F I R S T

R I D

Railway Ambulance News. GREAT

W ESTER N

G oo d W o r k b y S t a t io n M a s t e r . — T h e incident here recorded is outst anding' for the resource and perseverance displayed. D u r i n g the severe w eather in Fe br uary , the fo ur-year old son of Mr. E. J. T r e t h e w e y , of N a n p ea n , St. Austell, fell into a dis used q u a rr y w h ic h w a s filled with w a te r and partly covered w ith ice. W h e n rescued some ten minutes later the child w a s flo a t in g face d o w n w a r d s beneath the ice. Artificial respiration w a s applied w it h o u t success, and w h e n Mr. R ic h, the C o m p a n y ’s station m aster at D r in n ic k Mill, w a s called, the child ap pe ared to be dead. Finding th a t the usu al m etho ds ha d been un av ail in g, Mr. Rich, w h o is sec retar y of the local a m b u l a n c e class, applied his mouth to the ch il d ’s and, b y suction, d r ew the icy fr a g m e n t s and wa ter from the throa t and lungs. H e then forced w a rm breath t h r o u g h the ch il d ’s mo uth, co u p lin g this with artificial respiration, and a l t h o u g h s uffering from the severe cold, persevered until the child s ho w ed s ig n s of life. M ed ical as s is tan ce w a s not av ailab le, an d Mr. R ic h continued his efforts until, three hours after b e i n g t a k e n from the water, the child w a s restored.

A New Adjustable Splint. M r . A. G aim e , Fa r n b o r o u g h Division, S. J. A. B ., has sent u s par ticulars of a n ew ad justab le splint w h ich he has de si gn ed an d w hich will soon be in production. E m in e n t med ical men ha ve seen the p ho togr aph s of the splint an d w is h him every success. T h i s splint ha s been design ed for first aid treatm ent of fractures of the elbow, arm, wrist, leg, an k l e and foot, and enables the limb to be supported in a n y possible position in wh ic h it m a y be found. T h i s is very im por tan t in the case of eo mp ound fractures wh en there is a protrusion of bone also w h en the lim b is mut ilated and in a very abn orm al position. W h a t e v e r the position of one portion of the limb relative to the other, it can be firmly and q u ic k l y supported

T h e doctor, w h o w a s afte rw a rd s call ed in, has certified th a t Mr. R i c h ’s splendid w o r k definitely sa v ed the ch il d ’s life.

LONDON

N ORTH

EASTERN

H u l l . — A St. John A m b u la n c e Asso cia tion class w a s ex a m in e d by Dr . R. D. S co r g ie , w h en the fo ll o w in g ca n d i date s were su cc es sful in p a s s i n g :— Mess rs. L. Ballan , S. R. Stinson, and C. E . J a c k s o n ; M isses D . C ha rlton, O. J. Benson. E. L . A pp leya rd, K. R o w a n , G . D u ce , E. Mitchell, and G . H a r lin g . Dr. Sutcliffe, of C o t t i n g h a m , g a v e the usu al lectures to the class, and the instructor w a s Mr. N ix o n , of D a ir y coates. A co mpe tition w a s held, w h en Mr. N ix o n set a case suit able for tw o first aiders. T h e case represented a blitzed b u i l d i n g where a wa rd e n found a y o u n g m an insensible. T h e only l i g h t a v a il a b le w a s obtaine d from a w a r d e n ’s s m all torch. T h e d ia g n o s is revealed the m a n to be su ff erin g from concus sion an d a si m ple frac tu re of the left leg. Fo u r pairs entered for the competition, the results b e in g a s fo llo ws 1 , Mis s B. Po rts and Mis s E . A pp le yar d, 58 points ; 2 , Mr. St in so n an d M is s G. H a r d i n g , 43 | ; 3, Miss E. M it ch ell and M is s K . R o w a n , 43 ; 4 , Miss G . D u c e an d M is s D . Cha rl ton , 40J. M a x i m u m points obtainable we re 72 .

W e are pleased to record th at the British E m p ir e Med al (Civil De fe n ce ) has been a w ar d ed to Police C o n s table John D obson , of H u ll , for c o u r a g e an d devo tion to d u t y in diffi cult a n d d a n g e r o u s ci rcu m st an ce s. W h i l s t d e a l in g w ith in ce n diar y bombs d u r in g an air raid Police C o n s tab le D o b s o n w a s thr ow n by blas t into a shelter w h er e tw o men we re trapped. A l t h o u g h buried up to the shoulders in debris he m a n a g e d to extr icat e himself, an d ev en tu ally succeeded in r e s c u in g both the victims. D e s p it e the fact th at he w a s s uffe ring from s ho ck , C o n s t a b le D o b s o n then helped to rescue a b a d ly injured fireman w h o ha d been blow n into a fire by blast. T w o other m em be rs of the L. N - E . R. Po lice w h o ha ve been co m m e n d e d for b r av e co n d u ct in Civil D e fe n ce are Po lice S e r g t . J. R . P. G r e a v e s and Police S e r g t . J. H . R a w s o n , both of H ull.

F ig .

as easily as a simple fracture of the l e g or forearm, for which purpose the splint m a y also be used. E v e n w h en used as an ordinary b a c k splint for the ankle, a little a d justm en t of the foot’s position m a y relieve the patient of a certain a m o u n t of pain. W h e n required for the elb ow , the s a m e splint is a l w a y s read y for use w ithout h a v i n g to “ tie ,” as in the case of u s i n g ordinary splints. Further, it can be ad justed to a n y a n g l e and can be fitted to inside or outside the limb, also in other positions if required. A short description of the splint is this :— T h e main feature is the metal h in g e d joint on to w h ic h is swivel led tw o pieces of wo oden splint, one l o n g side for the l e g or forearm and the other shorter one for the foot or upper arm . T h is co m bina tio n forms a type of “ U n iv er sa l Joint ” and enables

F ig .

one of the wood sections to be placed in alm ost a n y position relative to the other. A ll the ad just m en ts ar e s im p ly and q u i c k l y m a d e b y m ea ns of four butte rfly nuts, and wh en the se are tigh ten ed , the wh ole splint is absolutely r igid in all positions. T h e wood sections m a y be m ad e in different le n g th s and

F I R S T so the sam e “ j o i n t ” could be used for adult and child size splints. T h e illustration F i g . 1 sho ws the ap plia nce as an ordinary b a c k splint for the ankl e, and F i g . 2 , a r igh t a n g l e splint for the elbow. T h e s e are ju s t tw o of the m a n y posi tions it is possible to obtain. W e un dersta nd that a Provisional P a te n t ha s been applied for, an d that the article will soon be on the m ar ket at a reasonable price.

Deatli of Lady District Officer Miss Cherry. (Sta ff Officer of No.

1 (Prince of W a l e s ’s) District, Northern Are a.)

B y the p as sin g of Miss Cherry, the B r ig a d e ha s lost a trusted officer and friend ; her keenn ess for her w o r k wa s only surpasse d by her devotion to her mother. In spite of illhe alth and ev ac ua tion after bo m b in g, she contin ued her duties to the end, and her .m em o ry will remain an e x am p le and influence to.her co lle agu es. T h e interment took place on M a y 6th at St. M a r y l e bone Cem e te ry , E a s t Fi n ch ley . U n if o rm e d m em bers of H a m p s t e a d A m b u la n c e Di vis io n acte d as bearers, and officers and membe rs of the H a m p s t e a d N u r s i n g Division formed a G u a r d of Honour. T h e St. John A m b u la n c e F l a g w a s draped over the coffin, an d a St. John Cros s of flowers rested on it. T h e r e were present : — L a d y H u d s o n (r epresenting the L a d y S up t.- in -C h ief, Mrs. St. John A tkin son ), L a d y District Supt. Mis s W a l k e r , M . B . E . , Asst. Co m m iss io ne r Capt. A. Rees, L a d y Dis trict Officers M is s T u c k w e l l , Miss Morrish, Mis s R o d ic k , Mrs. T a p p l y , Mrs. R ayn er , Mis s C leasb y, District Officer S. H . Collins, Dr . M a r y Fl etche r ( D i v . Surge on ), L a d y A m b u la n c e Officers Miss Fin ch, Mis s H orisden, Mis s A bbott, Mis s B u r le y and Miss P a w l e y of H a m p stead N u r s i n g Division, Officers of H a m p s t e a d Divis ion ( B . R . C . S . ) , Mrs. M uir (C h a ir m a n of H o u s e C o m m itt e e and mem be r of E x e c u t iv e C ommittee ), and Miss G r e g o r y (matron) of Q u e e n Mary/s M atern ity H om e . T h e fo ll o w in g are short notes r es p ectin g Miss C h e r r y ’s activities H e r duties covered the 22 N u r s i n g D iv is io n s in the No rthern A re a of Lo nd on . Joined H a m p s t e a d N u r s i n g Div is ion in 1915 ; served under the late Miss H o a r e at C a e n W o o d T o w e r s and other hospitals d u r in g the last war. Su cc e ede d Mrs. M a c F a d d e n as L a d y Div is io n al S u p e r intendent of H a m p s t e a d N u r s i n g Division, h o l d in g this position for four yea rs until promoted to present r an k in 1936 . C o m m a n d a n t of V . A . D . 114 L o nd on until time of her deat h ; m a n y of her membe rs n o w s e r vin g in M il ita ry Hosp itals. A l w a y s t o o k a ke en interest in the w o r k of Q u e e n M a r y ’s M ater n ity H o m e , H a m p s t e a d , a s s is t in g there on m a n y occasions. H e ld the St. John L o n g Service M ed a l an d Pa rs. W a s m a d e a S e r v in g Sister of the O rd e r of St. John 20 years ag o . A w a r d e d the Coronation Med al in 1937 .

T h e H en so n v olun ta ry first aid post work er s at Mart on M oss w h o in the past h a v e sh o w n themselves en ter prisin g wo rk er s for various causes , ha ve volunteered for more go o d work.

T h e y h a v e u n an im ous ly a g r e e d

to form a d a r n in g

class to “ All the g a p s ” in soldiers’ socks.

A I D

169

St. Andrew’s Ambulance Association. K ir k c a l d y . — T h e competition for the N a irn C u p (open to the C o u n t y of Fife) w a s held i n - K i r k c a l d y recently. The arbitors were : Dr. M c C r a c k i n (oral) and Dr . C r a w fo r d (practical and transport). T h e results were as fo ll o w s :— 1 , D y s a r t C o -o per ativ e No. 1 , 187 £ ; 2 , D u n fe rm lin e L . N . E . R . , 182 ; 3, Met hil and Dist rict, 174 . Fift ee n te a m s t oo k part, a n d the w i n n i n g t e a m w a s represented b y A. H u t t (captain), W m . C a m p b e ll, R. McAlis te r, J. H u t t and J. Anderson. T h e C a p t a i n ’s prize w a s wo n by R. John ston, D u n f e r m line. D u n f e r m lin e . — T h e Co m pe ti tio n for the M a t h e w s o n C u p (open to the C o u n t y of Fife) w a s held in D u n fe r m l in e on April 1 1 th. T h e arbitors we re : Dr. J. Prim er (oral), Dr. M c C r a c k i n (transport) and Dr. G led hill (practical). The results we re as follows :— 1 , D y s a r t Co-o perativ e No. 1 , 287 ; 2 , C o a l t o w n of B a lgo nie, 267 ; 3 , D u n fe rm lin e L , N . E . R . , 265 . Fifteen t e a m s too k part, and the w'inning tea m wa s represented by A. H u t t (captain), W m . C a m p b e l l , R. McAlis te r, J. H u t t and J. Anderson. G l a s g o w . — Fift ee n colliery t e a m s took part in an a m b u la n ce co mp etition held by the L a n a r k s h ir e an d Dis trict M in e w o r k e r s A m b u la n c e L e a g u e on S a tu r d a y , M a y 2 nd, in the he ad q uar te rs of St. A n d r e w ’s A m b u l a n c e A ss o cia tio n in G lasgow . T h e results were : 1 (shield), B l a n t y r e C o ll ier y (W il l ia m D i x o n L t d . ) ; 2 (silver cup), H a s s o c k r i g g C o ll ier y (Coltn ess Iron C o m p a n y L t d . ) ; 3, B r a n c h a l Collier y (Coltn ess Iron C o m p a n y L t d . ) ; 4 , B o t h w e ll C a s t l e 3/4 Collier y ( B a i r d s a n d Sco tti sh Steel Ltd .). T h e Forrester C u p for the h ig h e s tplaced team w h ic h ha d never p revio usly been a w a r d e d the shield or cup w a s won by C a n d e r i g g Co ll ier y team (Jam es N i m m o and Co. Ltd.). Mr. T . Ash le y, C h ie f In spector of M in es for Scotlan d, presided at the presentation cer em on y, and the a w a r d s were h a nd ed over b y Mr. W il l i a m Pea rson, president of the L a n a r k s h ir e M in e w o r k e r s ’ Unio n. A r d ee r C l u b . — A fte r a winter of hard w o rk , m em bers and the friends of m em bers of this A m b u l a n c e C lass, on M a y 1 st, enjoyed an e v e n in g of r elax ation in d a n c in g . The a tten d an ce w a s go od . D u r i n g an interval in the d a n ce som e pleas an t and official w o r k w a s ac co m plis hed. In a short speech, Dr. H . M. R obe rt s presented to Mr. W . J. R e y n o l d s the St. A n d r e w ’s Silv er M ed a l for sixteen y e a r s ’ co ntin uous and d is ti n gu is h ed am b u l a n c e wo rk . E m p h a s i s i n g th at the a w a r d w a s one for o u ts t a n d in g merit over a l o n g period, Dr. R o b e rts sket ch ed out in brief the a m b u l a n c e caree r of the re cipient. Mr. R e y n o l d s b e g a n his first aid w o r k in F a v e r s h a m , an d in 1932 w a s o rga nis er for the district. O n e yea r later, he be ca m e D iv is io n al Se cre tary, an d d u r i n g the s a m e ye ar he w a s promoted S e r g e a n t. H e g a in e d three service b a d g e s an d w a s captain of the F a v e r s h a m t eam w h ic h, after a brilliant perf orm ance, won the I . C . I. T r o p h y for the first time. O n transfer to Ardeer, Mr. R e y n o l d s joined in the fa ct ory a m b u l a n c e w o r k w it h u n abated zeal, b e c o m i n g first of all Se c r e ta r y of the A rd eer F a c t o r y section of St. A n d r e w ’s A m b u l a n c e Corps, a post w h ic h he filled w it h distinction until 1938 , w h e n he b e c a m e A ss ista n t C o m m a n d a n t . Dr . R o b e rts then called upon Mrs. M c L e o d , wife of the C o m m a n d a n t , to pin on the ribbon of the aw ar d. Mr. R e y n o l d s ex presse d his g r e a t ap pr ec ia tion of the honou r w h ic h ha d been b es tow ed upon him. H e w a s de eply conscious, he said, of the as s istan ce he ha d received from D r . Roberts, Mr. M c L e o d an d Mr. Gibso n.

Mr. Reynolds then gave the examination results for the

F I R S T year. F o r ty - s ix cand id at es had presented themselves for ex a m in a t ien b y Dr. L a u r ie an d all forty-six h a d passed. T h e e x a m in e r ’s opinion of the clas s and its w o r k w a s very go od. T w e l v e certificates, five medallion vouchers and t w e n t y -n in e re- exa m in ation vouchers were gained .

Two More Ambulances for Glasgow. A fully equipped mo bile a m b u l a n c e for e m e r g e n c y ser vice in the K i n n i n g P a r k ar ea of G l a s g o w w a s fo rm ally presented on M a y 2 nd to Sir A le x a n d e r M a c g r e g o r , Medical Officer of H e a l t h for G l a s g o w , at the H e a t h e r Street firstaid post. T h e personnel at the de pot raised £ 4 0 0 in eig h t w e e k s for provision of the am bula nce . Su bstan ti a l support w a s received from local firms, an d the depot or org a nised sales of w o r k and other functions to swell their fund. Dr. T h o m s o n , m ed ical officer at the post, m a d e the presentation. A civil defence a m b u l a n c e subscribed for b y residents in the C am p h il l W a r d of G l a s g o w , and a ch equ e for £ 2 2 5 to provid e an o th er a m b u l a n c e were also presented to Sir A le x a n d e r M a c g r e g o r b y Mrs. Robinson, wife of Mr. W . L. R obinson , the divisional warde n. It w a s o rig in a l l y intend ed to app eal to the people in the w a r d to provide one a m b u l a n c e co st in g £ 2 50 , bu t as the result of an an o n y m o u s g ift of £ 2 7 0 the t a r g e t w a s raised to t w o am bula nces.

R I D

P o lic e A m b u l a n c e N e w s . ____ L__________________________ _ M E TR O P O LITA N

SP EC IA L

CONSTABULARY.

In the an n ual competitions held on April 26th, 1942 , 10 tea ms com pe ted in ea ch of the senior and jun ior co mpe ti tions. T h e j u d g e s w ere.— Senior : C ap t. R . V . Steele, team, Dr . N. B. F a r m a n , individual. Ju nio r: Capt. F. E. Be nd ix, team , Dr. W . D a v a n Neil, individual. T h e results were as follow s :— Seniors : 1 st, Z Division, “ C o ll in ” C u p ; 2 nd, G Division, “ St. C l a i r ” Cup. Juniors : 1 st, P Division, “ R it ch ie ” C u p ; 2 nd, K Division, “ M u n ro ” Cup. T h e “ Brown ” Division.

Efficiency C u p

w a s carried

off by E

Sir W a l k e r Allen, C o m m a n d a n t -in -C h ie f, annou nce d the results and presented the aw ards. H e th an ke d the judg es , and paid tribute to the w o r k of C o m m a n d a n t B r o w n (Officer in c h a r g e of first aid tra inin g and an ti- gas ).

S t a f f S e r g e a n t E. Carnell, of the S . J . A . B . , presented a silver cu p on behalf of Mr. and Mrs. A. H o llan d to A ss is tant Corp s Co m m is s io ne r H . C. Else, at the B r i g a d e headquarters, Rock

Hill,

Ps alte r L a n e ,

an n ual competition

b y the

Sheffield, B r ig a d e 's

early this month,

Divisions.

L e tte rs

th e

E d ito r .

W e a r e in no w a y responsible for the opinions expressed, or t he sta te m en ts made, b y Corr es pon den ts.— E d i t o r .

CR IT IC IS M

AND

REPLY.

Elastoplast

S ir , — It is evide nt tha t I ha ve let the cat a m o n g s t the p ig e o n s ! M y intrusion appe ar s to h a v e upset sev eral of yo ur corre s po nd en ts so m u c h th at they ac cu se m e of criticisms w h ic h I neither m a d e nor implied. I hope, therefore, yo u will permit m e this o pp or tu nity of r eply in g. A . R . P . Fi rst A id wo uld indeed be a flimsy and insecure str uctu re unless built on the r o c k y fou nd ation of the standard T e x t b o o k t eac h in gs , the v alue of w h ic h I did not att em p t to question. It is well k n o w n , howeve r, th at slavish adherence to T e x t b o o k m et ho ds under severe blitz cond itions has, in the past, led not only to un ne ce ssa ry suffering but also to the loss of lives wh ich m i g h t oth er wise h a v e been saved. In m a i n t a i n i n g th at practical consideratio ns of air-raid co nd i tions cr y alo ud for m etho ds of “ applied ” first aid, I w a s only un d er lin in g the fa ct t h at suc h methods h a v e been r eco m m en de d b y the M ed ical A dv is er s of the H o m e Office— and t h e y are men of the h ig h e s t professional s ta nd in g. F o r tu n ately, m ed ical science does not stand still, an d in this sphere, as in others, the w a r ha s inev ita bly led to the revision of m a n y h ig h ly - ch e r is h e d preconceived ideas. T h e r e still are, of course, s tr ee t-ac cide nt cases th a t ca n be handled w itho ut haste, but it is su re ly ostr itch-like to d is re ga rd the specialised tre at m en t of air-raid ca sualties in w h ic h speed is a vital factor. A s D r . C h a rles S m it h s ays at the end of his letter (p. 126 , Fe b. issue)— “ articles, hints, etc., on both typ es of w o r k s ho uld a p pe ar in F ir st A id . ” T h a t , Sir, w a s the tenor of m y first letter, an d th at s u g g e s t i o n I h a v e no hesitation in r e p e a t in g . — Y o u r s faithfully, P. B. B irm ingham ,

1 , M a y 6th, 1942 .

D r e s s in g s

for

13 Sheffield N u r s in g

Jhconom y

c Elastoplast ’ meets the preference of modern surgeons for an undisturbed wound dressing. It meets also another need of to-day — economy. ‘ Elastoplast ’ saves material and doctors’ and nurses’ time. There is no more efficient or more expe ditious way of treating minor injuries than with ‘ Elastoplast’ Wound Dressings.

MADE IN ENGLAND BY T. J. SMITH & NEPHEW LTD., NEPTUNE STREET, HULL

F I R S T

171

R I D

EQUIP YOURSELF FOR W AR

EMERGENCIES

Essential knowledge to treat successfully, ALL possible injuries,

THE

HOUSEHOLD PHYSICIAN Describes in SIMPLE LANGUAGE such necessary informa tion with helpful plates and diagrams.

AND FO RM O R E PEA C EFU L TIM ES The COMPLAINTS OF MEN, WOMEN AND CHILDREN, Their Cause, Treatment and Cure w it h The th e

c o m p le te

in s t r u c t i o n s

500 i l l u s t r a t i o n s re a d in g

m atter

ACCIDENTS B o d ily

A few o f the Subjects tre a te d :

W A R EM ER G EN C IES:— Gas Warfare First Aid Bandages Splints Burns Scalds Haemorrhage Fainting

PE A C E TIM E SUBJECTS:— Influenza, Colds, etc. Measles, Mumps Catarrh Corns and Warts Physical Culture What to Do in Emergencies Treatment for all Skin Diseases The Lungs, Pleurisy Hygiene, Anatomy, Pharmacy The Principles of Nursing The Eye, the Ear The Throat, the Nose The Chest, the Heart The Stomach, the Liver The Teeth, the Muscles Infant Welfare Homoepathy, Neurasthenia 3 7 5 Prescriptions, etc, etc.

In ju ry,

F o re ig n

Eyes,

A ccid e n ts,

D ro w n in g ,

THE Y O U N G

F ir s t

P la te s

A id .

m ak es

u n d ersto od .

S c a ld s, C lo th in g E ars,

case

o f:

A lig h t.

N ose, T h ro at.

E le ctricity

S u ffo ca tio n ,

Bones, F ractu res, C o n c u s s io n , E tc.

fu ll-p a g e e a sily

W hat

Burns an d

B o d ie s

M a c h in e ry

and

m ore

A ccid e n ts.

B le e d in g ,

D islo ca tio n s,

P o iso n ,

S p ra in s,

Broken F a in tin g ,

W I F E will find just the in formatio n she requires.

M O T H E R S w h o wish their d a u g h t e r s to de velop n a t u r a l ly will find e x a c t l y the t e a c h i n g t h e y need. W O M E N O V E R 40 will fr a n k ly discussed.

find

their

difficulties

regarding

he alth

B E A U T Y C U L T U R E — C o m p l e x io n D ie ts, W r i n k l e Cur es , C a r e of the H a n d s , M o uth , E y e s , H air , R ec ip es, etc. P R E S C R I P T I O N S — 375 proved remedies. T h e r e ar e hun dreds of subjects. T h e mu scles, teeth, di ges tion , hair, food valu es, Ju jitsu, P h r e n o l o g y . H o w to d ia g n o s e disea ses from ap pe ar an ce of head, face, n ec k, to n gu e, throat, chest, perspiration, etc.

F M ESSRS. Crown

VIR TUE

C O .,

E LTD .,

E F.A .

—

- ------------------------------

Dept.,

C h a m b e r s , U p p e r P a r l i a m e n t St ree t, N o t t i n g h a m .

P le a s e sen d m e F R E E Booklet on “ THE H O U SE H O L D P H Y S IC IA N ,” stating c a sh price, also m o n th ly te r m s of p a y m e n t w i t h o u t a n y o b l i g a t i o n to p u r c h a s e . NAME. (Send this form in un se aled envelope s ta m p e d I d .) A D D R E S S ..........................

172

F I R S T

R I D In the Civil N u r s i n g Reserve, 4 m em bers ha ve been enrolled in the Mobile Section and 141 in the Immobile , while there are 8 Mobile and 8 Im m o bile Officers in t h e ’ V . A . D . Fiv e of these are servin g in hospitals th r o u gh o u t the country. C la s s e s ha ve been held to g i v e instruction in first aid, h o m e n u rs in g and g a s warfare, and 10,174 students ha ve

Our Nurses’ Page. CO M PILE D No.

AMBULANCE

SISTER .

1 D is t r ic t , S.J.A .B . N o r th er n A r e a . N o . 84 ( B a r n e t ) N u r sin g D i v i s i o n .

att ended these lectures. D u r i n g 1941 , the I n sig n ia of the Order of St. John wa s conferred upon L a d y Corps Sup t. Mrs. W in d le and L a d y Div. Sup t. the L a d y Riverdale, w h o b ec ome Officers, and also upon L a d y Div . Supts. Mrs. C l a r e b r o u g h and Mrs. D u k e , and Mrs. F. M. Brow ne, w h o become Se rv in g Sisters of the Order. N u r s in g Officer Mrs. B a y l e y has received the

— T h e A n n u a l Inspection of this Divis ion w a s held on M o n da y, M a y 4 th, w h e n L a d y Dis tri ct Officer Mrs. T a p p l e y tested the efficiency of the Div is ion in first aid, h o m e n urs in g, squad drill, str etcher drill, and s m ar tn es s on parade. T h e In sp e ct in g Officer expressed pleasure at the excellent and efficient w a y in w h ic h the w o r k w a s carried out, and m a d e spec ial mention of the stretcher drill. She congratu lat ed L a d y D iv . Sup t. Mrs. B urn s and her officers on the result of their t e a c h in g. T h e present s tr e n g t h of the Div is io n is 55 , som e m e m bers are, howe ve r, ev acuated, and others ar e s er vin g w ith

V e l l u m V o t e of T h a n k s . D istr ict N u r sin g A s s o c ia t io n s . M a n y reports com e in of the w o r k of the Dis trict N u r s in g Associations in various parts of the country, and all sho w t h a t this most essential w o rk is not allo we d to sutler t h r o u g h

H . M . Forces. No. 29 (Barnet) C a d et N u r s i n g Division, wh ich is a ttach ed to the senior Division, w a s inspected by Ladyr D is tri ct Officer M is s Clea sby, O ff icer -i n -c ha rge of Cadets, Nort hern Area, w h o ex presse d satisfaction at the smar tnes s of the No.

the war. W e are rather apt to fo rg et the services rendered by tho se splendid w o m en , the Dis trict Nurse s and Midw iv es , w h o carr y on w ith their job quietly and efficiently, often under most t r y in g -a n d difficult conditions du e to the war. M a n y ha ve risked their lives by g o i n g out to a case d u r in g an air raid, or b y p ro te ct in g a mo ther and new -born babe at their o w n personal risk. T h e y are true followers of Florenc e

24 ca dets on parade.

5 D is t r ic t , S . J . A . B . E c c l e s a l l N u rsin g D iv is io n . — O n W e d n e s d a y , April

N ig h t i n g a l e . T h e funds of the D is tri ct N u r s i n g A ss o ci atio n s are in clined to suffer b y reason of the m a n y ca lls m a d e on our purses to further the w a r e ff o r t; but let us not fo rg et the s ick a l w a y s in our midst, and en deav our to assist our own D i s trict N u r s i n g A ss ociation as far as w e ca n afford.

15 th, a most successful W h is t 'D r iv e , o rg a nised by the E c c l e s all N u r s i n g D iv is ion , w a s held in the Div is io n al H e a d quarters, E ccles all C h u r c h M em o ria l H all. There was a l a r g e att e n d a n c e of membe rs an d friends. Afte r the refreshments ha d been served d u r in g the interval, there fo llo wed the principal item of the ev en in g, w h e n a w a r d s were presented by L a d y Corp s Supt. Mrs. J. W in d le, w h o w a s intr oduced by L a d y D iv . Sup t. Mrs. Ulley. T h e recipients we re Mr s. W illis w h o received a label, Mrs. E m l e y , M is s B o w e s, Mis s C o ckc roft, Mrs. C r a n rid g e , Miss Oliffe, M is s W r a g g an d Mrs. K e ls o w h o received medall ions w it h pen dan ts, and Mis s P a l k w h o received a medallion. T h e proceeds am o u n te d to £ 4 4 s.

R e v ie w s . Illu s tr a tio n s oj B a n d a g in g a n d F ir s t A i d . S .R .N .,'D .N .

T w o years a g o w e w e lc o m ed this b o ok as the most c o m plete an d best illustrated g u i d e to b a n d a g i n g wh ich w e ha ve read, and now we ex tend an eq ua lly cordial w e lc o m e to the second edition, w h ic h has been e n la r ged and reyised. A n e w feature is the r e-a rr a n g em e n t of its we ll-jyritten text an d its 300 ex cellen t p h o to gra p h s so t h at every method of b a n d a g i n g can be seen at a g l a n c e from start to finish. T h e bo ok is divided into four sections, w h ic h deal respectively w it h t r ia n g u la r b a n d a g i n g , roller b a n d a g i n g , first aid in ha sm orrhage an d first aid in fractures. In re sponse to requests of readers, descriptions of the barrel b a n d a g e and of the T h o m a s splint h a v e been included in this edition. In cid ental ly, t w o errors were noted. The first is on p. 45, w h er e a narrow b a n d a g e ha s been used for the sm all a r m -s lin g , an d will prove m u ch less comfort able for the patient tha n the broad b a n d a g e ; and the seco nd is on p. 206, where for compression of the ax il la ry artery it is sta ted tha t a l a r g e firm pad should be placed in the armp it, w h ic h is a narrow t ria n gu la r space and w ould not a d m it a

1939 , and n o w comprises 13 N u r s i n g D iv is io n s under the lea dership-of L a d y C o rp s Supt. Mrs. W in d le, formerly L a d y Supt. of the senior Sheffield N u r s i n g Division. T h e total s tr e n g t h of the Corp s is 372 , w ith tw o C a d et N u r s i n g D i v i sions h a v i n g 29 membe rs. B esi d es the ordin ary p ea ce -t im e duties w h ic h includ e a s s is t in g the V ic t o r ia Dis trict N u r s i n g Ass ociation, W e lfa r e Clinics, R o y a l Infirm ary A n n ex e, and t a k i n g ex am in atio ns an d co mpetition s (or the G ir l s ’ Life B r ig a d e , officers and m em be rs are b u s y on w a r - tim e duties, Fir st Aid Po sts and A m b u l a n c e De po ts, F o r c e s ’ C a n t e e n s an d H os p it a l Su p ply D e p o t s h a v e been staffed. D u r i n g the ye ar 1941 , 42,546 hours v o l u n ta r y and 159,519 hours paid d u t y were un de r tak en. In Jan ua ry, 1940 , a S i c k B a y for soldiers w a s opened, an d up to March, 1941 , 166 in-pat ients and 3,149 ou t-patients ha d received treat ment. T h i s service w a s h i g h l y appreciated by the Med ic al Officers of the various units, and the men

periods.

B y Lo is O a k e s , E. & S. L iv in g s t o n e . P r ic e

6/- n e t ; C h ea p E d itio n 4/6 ; p o sta g e 6d.

S h e f f ie l d N u r sin g C o r p s . — T h i s Corp s w a s formed in

w h o received the care of the nurses. V a l u a b l e service w a s rendered by m em bers of the Corp s d u r i n g the h e a v y air raid in D e cem b er , 1940 , some w o r k i n g for very l o n g hours. F o r her g a l l a n t co nd uct in a t t e n d in g the ca su a lt ies d u r i n g a b ig air raid at g r e a t personal risk, M is s M arjo rie Joyc e ha s been a w a r d e d the Certificate of H o n o u r of the O r d e r of St. John. T h i s she received from H e r M a j e s t y the Q u een , C o m m a n d a n t - i n - C h i e f of N u r s i n g Co rp s and D iv is io n s of the B r ig a d e , at an In ve stiture at B u c k i n g h a m P a la c e on F e b r u a r y 1 1 th, 1942 . F i v e m em bers helped to s ta ff L o nd on A ir R a id Shelters for fo rtn ig htly

E d in b u rgh:

l a r g e pad !

W a r w ic k 6 - T u n s ta lls F ir s t A i d to I n ju r e d a n d S ic k . tol : Jo hn W r i g h t & So n s L td. P r ic e yJ6.

•

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W e are pleased to note tha t the 18 th E dition of this p opular stand ar d b o ok of reference for first aid instructors an d senior stud ents (wh ich w e reviewed in the O cto b er 1941 issue of F i r s t A i d ) has been re-printed and th at it has now reached its 232nd th o usa nd copy. C lea rly it is c o n t in u in g its trium p ha nt career of usefulness under C o u n t y S u r g e o n Major N o r m a n H a m m e r , S . J . A . B . , wh o revised this edition.

V F I R S T

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" L T O M E study is the short cut to experience and success -*• and an expert knowledge in Swedish Massage and Anatomy can lead to a congenial occupation and a hand some income. Have you realized the scope and prospects for the trained Masseur ?— he is called in every day by doctors, Nursing Homes, Hydros, Sports and Athletic Clubs, Physical Culturists and Trainers, e t c , and is o f inestimable value to First Aid organizations which is why graduates o f the S M A E Institute are in practice in all parts o f tbe British Empire. THE

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i 74

F I R S T

Queries andAnswers toCorrespondents Q uerie s will be dealt w it h un de r the fo ll o w in g rules :—

1 -— L etter s c o n t a in in g Q uerie s must be m a r k e d on the top left-hand corner of the env elope “ Q u e r y , ” an d addressed

46 , Cannon -street, Lo nd on , E . C . 4. 2 . — A ll Q u e rie s m u s t b e w ritten on one side of paper only. 3 . — All Q u e rie s m u s t be a c com p an ied b y a “ Q u e r y Co u p o n ” to F i r s t A i d ,

R I D

W h a t w a s the nature of the s w e l l i n g ? If it w a s a bruise then continuous application of cold w o uld ha ve been correct treatmen t b ec ause in such ca se cold g iv e s relief for the first 24 hours after the accident. O n the other ha nd immersion of the part in w ate r as hot as the patient could stand w oul d ha ve been incorrect because there is a ris k of s c a ld in g the part. If heat is used, the application should be at a temperat ure w h ich the patient can com fo rtab ly en dure. — N . C . F .

cut from the current issue of the Journal, or, in ca se of

C olour of L ew isite.

Querie s from abroad, from a recent issue.

4 . — T h e T e x t b o o k to w h ic h reference m a y be m ad e in this co lu m n - is the 39th ( 1937 ) E dit ion of the S . J . A . A . M a n u a l of F ir st A id to the Injured. M a r s h a l l H a l l ’s M e t h o d . I I . T . ( R h y l ) . — I should be g r atefu l if yo u will tell me w h at w a s M a r s h a ll H a l l ’s me thod of artificial respiration and for w h a t it is used. D r . M a r s h a ll H a l l in 1856 introduced a me thod of artificial respiration w h ic h is still k n o w n by his n am e and w h ic h is n o w obsolete. It consisted in p la c in g the patient on his fa ce an d then r olling him on to his r ig h t side at the rate of ab o ut 15 times a minute. E xp er ien ce proved tha t further injuries we re often ca us ed and espe cially rupture of the liver wh ic h is s wolle n in cases of d r o w n in g ; and it w a s superseded by S ilv es te r ’s method w h ic h w a s introduced in the fo ll o w in g year.— N . C o r b e t F l e t c h e r .

E xa m in a tio n

H ow ler.

G . C . (Surbiton). — In a recent ex a m in a t io n the doctor as ke d a c a n d id ate h o w she w ould treat a patient w h o ha d been a s p h y x ia t e d by coal g a s . H e w a s surprised and also a m u s e d w h e n the l a d y replied :— “ C o a l g a s is very

d a n g e ro u s to the h u m a n body ; a n d therefore exp erim e n ts s h o u ld on ly be c a rr ied ou t on the in stru cto r ! ” Good!

C rushed

G . C . (B u rt o n -o n -T r e n t).— Pl ea se tell me the colour of liquid lewisite. I believe that this is an oily, colourless liquid similar to gl ycerine ; but in an ex am in atio n, one of m y students w a s told that it is a b r ow n oily liquid. In its pure state, lewisite is a colourless liquid, but in the crude form in w h ich it is likely to be used, it is a d a r k brown oily liq u id . — N . C . F .

D e co n ta m in a tio n o f C l o t h e s . G . C . ( B u r t o n -o n -T r e n t) . — A lso please state the met hod of de co n tam in ation of h e a v y c lo th in g w h ic h ha s been splashed w it h B . B . C . T h is , I under stand, is treated by ste am disinfection but another stud ent w a s told tha t the cl o t h in g should be boiled. B . B . C . is a he a v y oily liquid and persists for several hoyrs. H e a v y clo t h in g could be left to w e ath er but, if re quired for early use, it ca n be placed in very hot w a te r for a period of ha lf an h o u r .— N . C . F .

B leed in g

from

L ungs.

F . S . (B ir m in gha m ). .— Pl ea se tell me w h y blood is b r ig h t red w h e n c o u g h e d up, as both venous an d arter ial blood m u s t be present in the lu n g s . Blo od is b r ig h t red w h e n it contain s o x y g e n . I t follows, therefore, th a t blood c o m i n g from the l u n g s (w here it is in contact w ith air) is a l w a y s b r ig h t red. — N . C . F .

N e x t please ! !— N . C . F .

T reatment

H and.

G . C . (C leeth or pe s) .— R e c e n t ly dis cussion aro se in our D i v i sion as to the position of the kn ots of b a n d a g e s used in he tre atmen t of cr ushed hand . I have alw ays taught th at these should be on the b a c k of the forearm as in the d i a g r a m on p. 86 of the T e x t b o o k . S o m e of m y co ll e agues , ho w eve r, state tha t th e y should be tied on the splint w h ic h is placed a l o n g the front of the forearm. W il l yo u please g i v e yo ur r u lin g and settle the dis cus sion ?

P r u ssic A cid

P o iso n in g.

F . H . ( B a l h a m ) . — Please tell m e if w e s ho uld ad m in is ter an emetic w h en w e ha ve to treat a case of prussic acid poisoning. T h e T e x t b o o k includes prussic acid (w hich is a potent nerve poison) a m o n g the non-corrosives. C o n s eq u en tl y it is g o o d treatmen t to ad ministe r an emetic at the outset of treat me n t provided th at patient is conscio us and able to sw allow . — N . C . F.

In first aid the kn ots of b a n d a g e s are a l w a y s tied w h er e th e y ca n m o st ea sily be un tied by the doctor wh o take s c h a r g e of the case. W i t h cr us hed ha nd, if these are tied on the splint, the fore arm will h a v e to be turned com pletely round both for t y i n g and also for u n t y i n g — w it h increased possibili ties of a g g r a v a t i o n of injury. C o n s e q u e n tly yo ur met hod is correct ; an d it is, as yo u state, in strict ac cor dan ce with F i g . 46 . — N . C . F .

T . M. ( N e w c a s t le - o n - T y n e ) . — Pl ea se tell m e w h y the T e x t book does not me ntion “ ten derness ” a m o n g tfie sig n s an d s y m p t o m s of fractures, a l t h o u g h it is included in other m a n u a ls a m o n g the s ig n s of fracture.

T r e a tm e n t of I njured H a n d .

T h e T e x t b o o k clearly r ega r d s “ t e n d e r n e s s ” as a form of pain ; an d this is a s y m p t o m — not a s i g n . — N . C . F .

R .J . (G a t e s h e a d ) . — R e c e n t l y w e h a d to treat a y o u n g girl wh o k n o c k e d her h a n d a g a i n s t a wa ll, the result b e in g a small s w e l l i n g in the m et a c a r p a l region. I suggested the ap plication of a cold co mpr ess w ith the object of r e d u c in g pain and s w e l l i n g but an older c o ll e a g u e m a in tain ed th at the h a nd should be im m ersed in w a t e r as hot as the patient could bear. W e w o uld m u ch ap preciate y o u r ru lin g.

T enderness w ith

F ractures.

K nots o f A rm -S lin g s. T . M. ( N e w c a s t le - o n - T y n e ) . — Plea se tell m e w h y ar m -s l in g s are a l w a y s tied (where possible) on the injured side. E x p e r ie n ce teac hes us tha t the w e i g h t of the upper limb is carried on the outer part of the sli n g, an d tha t, b y t y in g

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176

F I R S T

the kn ot on the injured side, the w e i g h t of the lim b is borne on the injured side. In other words, the s l i n g is more c o m fortable if kn otted on the injured side.— N . C . F .

S calds by

B itu m in o u s S u b s t a n c e s .

A. E . ^ R h o n d d a ) . — In the F e b r u a r y issue of F i r s t A i d you g e n t l y reproved me for a s k i n g abo ut the treatm ent of bur ns of fingers ca us ed by v it a m ins ; and yo u were g o od e n o u g h to ex plain the actio n of the latter w h e r e b y you settled an a r g u m e n t w h ich arose at D ivis ion al Practice. A s a fact, I m ad e a m is ta k e and m ea nt to ha ve a s k e d ab o ut burns of the fingers caused b y bit um en ; and I shall be g r atefu l for yo ur further help. B it u m e n is the n a m e g i v e n to a n um ber of natural in fl a m m able p it ch y or oily subst an ce s c o n s is tin g of various h yd ro ca rbo ns (such as n ap htha , petroleum an d asphalt). If, therefore, the fingers are scalded (not burned) and coated with som e such substan ce , it is g o od first aid to leave it alone apar t from a p p l y i n g a l ig h t dr es sing, and to send patient fo rthw ith to hospital w h er e a special solvent would be used to dis solve the bit um in ous s u b st a n ce .— N . C . F .

T r ea tm en t o f S pr a in e d Join t. A . E . ( R h o n d d a ) . — Plea se tell me w h y unde r tre atmen t for spr ained joints the T e x t b o o k (p. 97 ) tells us to re-apply the b a n d a g e w h en this fails to giv e're lief. T h e reason for the re-applica tion of the b a n d a g e is th at on a seco nd att em p t it can be more firmly applied and so will g i v e more relief and better support to the sprained joint. — N .C .F .

T reatm en t o f

In fa n tile

F ir s.

A . E . ( R h o n d d a ) . — L a s t l y please tell me w h y in the treatm ent of infantile fits ( T e x t b o o k p. 162 ) w e are told to ap ply a cold s p o n g e to the ch ild ’s head. T h e co ntin uou s application of cold to the head will ca use co ntraction of the bloodvessels in the brain wh ile the hot bat h will dilate those of the body. C o n s eq u en tl y there will be less blood in the brain and a reduction of the pressure w h ic h is c a u s i n g the c o nv ulsio n .— N . C . F .

F ractured

L eg w it h

M ustard G as.

A . O . (Crewe ). — In a recent A . R . P . test a m an w a s found to be suffering from co m p o u n d fracture of the l e g and to ha ve been spraye d w it h mu stard g a s on the body and left ha nd. After t r e a t in g the l e g and hand , w e trans ported patient to a cl e a n s in g station ISO ya rd s a w a y . O u r instructor, howe ve r, said th at after treating-the l e g an d h a n d we should h a v e take n patient to the nearest w a r m place, suc h as sho p or office and that there we “ s ho uld h a v e stripped patient, treated for m usta rd g a s an d wr ap pe d him in b lan k ets while a w a i t i n g the a m b u lance. W e do ub t these instructions and shall w e lc o m e your co m m en ts . T h e mustard g a s on the body w ould be on the cloth i n g ; an d the outer g a r m e n t s should be remove d as a p re ca ution ary measure. T h e ha nd can then be g iv e n first aid tre atm en t b y r e m o v in g a n y free liquid an d then a p p l y in g bleach ointment. A fte r this, the fractured l e g can be treated. T h i s done, patient m u s t be removed at once to a cleans i n g sta tion w h er e alo ne co m plete w a s h i n g of the body (in c l u d i n g the hair) an d irrigatio n of the eyes can be effected. In other word s, the nearest w a r m place w o uld not be suitable for the c l e a n s in g process and yo ur actio n in r e m o v in g patient to the c l e a n s in g station w a s corr ec t.— N . C . F .

R I D D og R .A .

B ite o f A b d o m in a l W a l l .

(B ar n s ley).— Please tell me the correct position in w h ic h a patient should be placed w h en su ffering from m a d d o g bite of the ab d om in al wall.

T h e correct position for such patient w ould be l y i n g flat on his b a c k bec ause he w oul d be s uffering from a g r a v e de g r e e of shock. In cid entally it w o uld be difficult for a d o g to t a k e a mo uthful of the abdom in al w a ll ! !— N . C . F .

C om plicated F r a c tu r e o f A rm. R . A . (B a r n s le y ).— Plea se tell me h o w yo u w o uld treat a patient suffering from fracture of ar m (middle of shaft) co mplicated b y bl ee d in g from br ac hial artery. A s instrumen tal pressure w oul d not be possible w ith this c o m binatio n of injuries, the bleed in g must be controlled by d ig it a l pressure on the sub clavian artery. T h i s done, the wo un d an d fracture should be treated as laid do w n in the T e x t b o o k and the patient remove d w ith all speed to hospital. — N .C .F .

C om pound

F r a c tu r e of C l a v ic l e .

A . C . (B atte rs ea ). — Please state the correct tre at m en t in a case of fracture of clav icl e complicated by protrusion of bone an d by haemorrhage w h ic h is d a r k red in colour and clotted. A m I r ig h t in m y opinion that, the w o u n d b e in g treated and protected by a dr es sing, the fractured clavicle should be treated as laid do w n in T e x t b o o k , special care b e in g used by reason of the p ro trud in g bone ? Y es.— N .C .F .

A .R .P .

S erv ices.

A . C . (B atte rs ea ). — In an article on the A . R . P . Services p ub lished in the A u g u s t 1941 issue of F i r s t A i d , reference is m a d e to the differences betw ee n the 12 hour shifts w o rk ed by stretcher parties an d the 8 hour shifts w ork ed by first aid posts. W h e n 1 wr ote on this point, yo u replied th at the M . O . shou ld h a v e received a circular. A s he ha s not, I shall be g r atefu l if yo u will tell me its official number. O u r information is that the Min ist ry of H o m e Se cur ity has n o w ruled th at all such personnel shall w o r k on the t w e n t y -fo u rs ’ s y s t e m . — E d i t o r .

A d m issio n t o

R .C .S .

M useum .

H . G . ( H a m m e r s m i t h ) . — W i t h reference to yo ur reply in the M a r c h issue of F i r s t A i d ab o ut visits to the M u s e u m of the R o y a l C o ll e g e of S u r geo n s, I applied for admissio n an d w a s told t h at the place ha d been bo m bed and th at the r e m a in in g exhibits h a d been removed to a safer place. C a n yo u please tell me a n y simila r m us eum w h er e entry m a y be possible to first aiders ? A s far as w e k n o w there is no other m us eum av aila ble to y o u . — E d i t o r .

44FIR ST AID ” QUERY and REPLIES COUPON. To be cut out and enclosed with all Queries. M a y , 19 4 2 .

JOHNBALE MEDICALPUBLICATIONS MANUALS OF FIRST AID. By

CORBET FLETCHER, M.B., B.C., M.A.(Cantab.), M.R.C.S. A ID S

F IR S T -A ID .

S e v e n th E d itio n . 1 8 .3 d. p o s t 2 d. First-Aid Simplified and Tabulated, with Aids to Memory.

“ C ol. S i r fatties C a n tlie con tribu tes a n in tr o d u c tio n a n d zve endorse h is gooa opinion o f th e book . " — L a n c e t ,

A ID S

H O M E -N U R S IN G .

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EFFIC IE N C Y

F IR S T -A ID .

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ERRORS

T h ir d

E d itio n .

F IR S T -A ID .

1 8 .3 d. p o s t 2 d.

Errors in First-Aid Detailed and Explained.

difficulties o/ emergency tre a tm e n t by laym en th a n th e offic ia l T extb oo k its e lf. " — L a n c e t .

“ T h is book g ives a c le a r e r in sig h t in to th e m ethods a n d

AM BU LAN CE

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W HY

AN D

W HEREFORE F ifth

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IN T R O D U C T IO N

T O

F IR ST

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b y Jo hn R

W h igham , M .C ., M .S., F . R .C . S . A n e w an d up to da te m an ua l on this subject based on lect ures g i v e n to St. John A m b u l a n c e clas ses over a period of years. W ith m any illustrations. Price Is . 3d. p o s ta g e 2d.

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S.1 3 4 3“ SANOID” INTERLOCKING EXTENSION SPLINTS With Metal sockets for jointing. 2pieces: 25 /8 ths. in. x 3 /1 6 ths. In. x 1 5in. 2pieces : 25 /8 ths. in. x3 /1 6 ths. in. x I3 £in. I piece : 2 5 /8 ths. in. x3 /|6 ths. in. x7 £in. I piece : 2 5 /8 ths. in. x 3 /l6 ths. in. x6in. 2WebbingStrapswithmetal buckles: 1 8in. x I in. 2Webbing Strapswithmetal buckles : 2 7in. x IJin. 3sockets. By this invention Splints made in any convenient lengths make rigidconnectionsbymeansofincurvedoppositeedgesofthemetal sockets or sleeves firmly engaging with transverse grooves in the surfaces ofthe Splints whenpressedhome intothesocket. ★ Unlikethe ordinarysocketted Splint, thistype isrigidlycoupled together and held against relative displacement but can be disengaged bypullingapart withsufficient force. N.B.—To ensure perfect locking it is imperativethat theSplint A should be correctly inserted in the socket, i.e., BY MAKING CERTAIN THAT THE INCURVED EDGE OF METAL SOCKET ENGAGES WITHTHE TRANSVERSE GROOVE OF THE SPLINT. Price : Complete withtwo pairsofstraps - - 4 /- perset. Without straps - - - - - - - - 3/- perset.

Sole Manufacturers :

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Aid Specialists

OLDBURY,

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T e le p h o n e — H o i 6363.

IODINE b r e v e n tio n

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‘t& lje Jiu te p e n te n t Jo u r n a l J w tljc A m b u la n c e a tt^ p u r s i n g JS m m s s r 576,

N o .

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X L V III.]

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Published by DALE, REYNOLDS & CO. LTD., 46, Cannon Street, London, E.C.4.

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“ H U T T ’ PSatent NoH A,164 R N E S S ’’ .5 4 4 . Simplifies the transport o f the injured, and is suitable for adult and child alike. Adjustable for any injury a patient may have. Easy to apply in the dark. A First Aid Party can apply the harness in half a minute. The stretcher can then be turned or placed in any unusual position, with the utmost safety and comfort.' W i t h T w o P o l e s t h e P e r f e c t I m p r o v i s e d S tr etch er . A n I d e a l F i t m e n t fo r T u n n e l l i n g w i t h o u t a St r e t c h e r . C e r t i f i e d b y m a n y D o c t o r s in E n g l a n d a n d S c o t l a n d a s t h e 100 p e r c e n t . A r t i c l e . N o w b e i n g D e m o n s t r a t e d at t h e A . R . P . T r a i n i n g S c h o o l s i n S c o t la n d . Port L o c a l A uth orities C o n s id e r the H arne ss B ritain ’s F in e s t A r tic le in the U n lo a d in g of M a r in e C asu a lties. A n article of great value in the Hospital and F. A . Posts. H.H. Fitted with leather straps £1 12 6 (Highly recommended) H.H. Fitted with heavy webbing straps (Can be decontaminated) H u tt ’s Rescue slings

£1

12/6 per set. 10/6 per pair.

Hutt’s adjustable carrying slings

All orders sent carriage paid. Illustrated booklet with each order, or on application

Direct from Patentee— A . H U T T ,

3 , R e c t o r y L a n e , D y s a r t , Fiife.

18th Edition. Fully Revised. 232nd Thousand. 313Illus. Some coloured* WARWICK & TUNSTALL’S THE

INJURED

, „ . sf u l R E V I V A L

Socce

“ F IR S T A ID ” S/e -

„

D E P E N D S

336pages. O N

P R O M P T

A C T I O N

SICK,

An Advanced Ambulance Handbook. EditedbyNORMAN HAMMER, M.R.C.S., Major, lateR.A.M.C.,T.A. FIRST AID JOURNAL.—" One of the most concise works on the subject

published at a popular price.”

FIRST AID” WALL DIAGRAMS “

(Size2ft. 2 Ins. by3 ft. 4 1 ns.) CompleteSet of 1 9 sheets on tough cartridge paper, with Roller, 6 3-net, postagelOd.; or Mounted on Linen, 9 0 /net, postage l/ld.

The First Aid man’s skill Isunavailingif thevictim’s respiration is allowedtofall —prompt action with the Sparklets Resuscitator is vital to successful recovery.

Special Set of 6 Sheets for the use of LECTURERS & A. R. P. CLASSES comprisingAnatomy, Physio logy, Haemorrhage, Disloca tions and Fractures.

S P E C IA LA M B U L A N C EO U T F IT 8 5 /-C 0 M P L E T E (B r /th h /sM (As used by Red Cross and First Aid Organizations, Police Forces, FireBrigades Electricity Undertakings, Gas Companies, etc.)

Write for leaflet “ Prompt First-Aid Treatment of Asphyxia and other Respiratory FailureEmergencies.’* Sole Makers: SPARKLETS LTD., Dept. 4 2 , LONDON, N.I8

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EVERYBODY EVERY

NURSE—EVERY

FIRST

AIDER

must have a copy of Bailliere’s Nurses’ Complete Medical Dictionary, as well as an Atlas of the Human Body. The Dictionary contains 5 0 0 pages of essential information, giving explanation and pronunciation of thousands of words in common nursing use, and contains a compendium of 20 sections on bandaging, first aid and similar valuable information to nurses and first aid workers. There are two Atlases, one of the Female, and one of the Male. They show the bones, the circulation, the muscles, the nerves, and all the internal organs. In the Female Atlas the abdomen and chest have lift up parts, showing each internal organ, its relative size and shape and exact position. BAILLIERE’S NURSES’ COMPLETE MEDICAL DI CTIONARY. 3s. 6d. BAILLIERE, TINDALL & C O X or DALE, REYNOLDS & C O ., LTD. 46, C A N N O N ST., L O N D O N , E.C. 4.

7 & 8 HENRIETTA ST., L O N D O N , W . C . 2.

Please send me ............ copies of Bailliere's Nurses’ Complete Medical Dictionary, for which Ienclose........... (3/9eachpost free). Please sendme the Male Atlas, for which Ienclose........... (Up thetwo) Please sendme the female Atlas, for which Ienclose............. N A M E .................................................................................................... ADDRESS .................................... ..............................................

................................ F.A. 22 .

ATLASES

THE MALE A N D FEMALE 5s. 6d. each. (Postage 6d.)

F IR S T A ID Jm fep m fo n f J o u r n a l j o r rl)c A m b u l a n c e nnb 3f t u r s i r i g j S c n r i c c * Editor: WALTER SCOTT, F.R.San.l., F.R.S.A. No. 576.—

V o l.

XLVIII.

N O TIC E

JUNE,

E n ttr td at 1 \_Stationtrs' H a ll\

1942.

PRICE THREEPENCE

[ 4/- P h r

Annum .

P ost

F ree

READERS.

EDITORIAL. F I R S T A I D is published on the a o t h o f e a c h m o n t h . Annual Subscription is 4 s . post free ; single copies 3d .

The

Its aim and object being the advancement of Ambulance Work in all its branches, the Editor invites Readers to send Articles and Reports on subjects pertaining to the Movement and also welcomes suggestions for Practical Papers. All Reports, &c., should be addressed to the Editor at the address below, and should reach him before the 12th of each month, and must be accompanied ( not necessarily fo r p u b lica tio n ) by the name and address of the Correspondent. Subscriptions, Advertisements and other business Communications connected with F I R S T A I D should be forwarded to the Publishers. D A L E , R E Y N O L D S & Co., L t d . , 46, C a n n o n S t r e e t , L o n d o n , E.C.4. Telegraphic A d d ress— “ T w en tv -fo u r, London Telephone— C ity 37 10 .

CONTENTS

T H IS

NUMBER.

E d i t o r i a l :— F ir st A id in Schoo ls

177

R ed Cross and St. John F l a g D a y Co-ordin atio n of Civil D e fe n ce Se rvice s

178 ...

178

T h i s M o n t h ’s Q u iz

179

S . J . A . B . H e a d q u a r t e r s an d D istri ct Repo rts

179

A N e w an d Im pro ve d F r a ct u r e Splint

180

Let ter s to the E dit or

...

181

Effects of E lectri c S h o c k

181

A m b u la n ce s for the Natio n R a ilw a y A m bulance New s

181 182

O ur Nurses’ P a g e

184

Q u er ies a n d A n s w e r s t o C o r r e s p o n d e n t s B u r n s of F a c e an d E y e s ... E x a m in a t io n H o w le r T r e a t m e n t of Fr actu r ed Sp in e and E l b o w T r a n s p o r t of Spin al In ju ry ... S pin al I n j u r y : L o a d i n g Str etch er

...

T r e a t m e n t of Fr actu r ed Pa te ll a A s p h y x i a an d Se ve re d A rt er y C o n g e s t io n of L i m b T r e a t m e n t of Burns T r a n s p o r t of Fr actu r ed Spin e C a s e s ... T h r e e -h a n d e d S e at T r a n s p o r t of Spin al In ju ry F a c e - u p ... Drill B o o k G l a s s E m b e d d e d in A x i l la

...

186 186 186 186 186 186 186 186 188 188 188 188 188 188

T h e t e a c h i n g o f first aid in s c h o o l s , w h i c h ha s been a n in S c h o o l s . n o u n c e d b y the B o a r d o f E d u c a t i o n, is a s t e p in t he r i g h t d i r ect io n. W h a t has hi therto been d o n e in t hat w a y ha s been s p o r a d i c to a d e g r e e ; i ndeed it m a y be r e g a r d e d as n e g l i g i b l e . T h e r e w a s a t ime w h e n p h y s i o l o g y f ig ur ed in the c u r r i c u l u m o f m a n y firstc l a s s s c h oo l s , but this is not t he s a m e t h i n g , f o r an i nd i v i d ua l s o a k ed to t he f i n ge r -t i p s w i th p h y s i o l o g i c a l lore m a y be f o u n d w a n t i n g w h e n it c o m e s to r e n d e r i n g first aid, to t a k i n g t hat p r o m p t act io n a nd e x h i b i t i n g t hat r es o ur c e a n d i ni ti at iv e w h i c h is s o vi tal at c r uci al m o m e n t s . It is s u g g e s t e d , a m o n g o th e r t h i n g s , t hat chi l dr en s h o u l d be t a u g h t at least to k n o w w h e r e d oc t o r s a nd fi rst -ai ders are to be f o un d a n d to s u m m o n h e l p b y t e l e p h o n e or o t h e r p r o m p t a n d e f f ec t ive m e a ns . F e w ch i l dr en are t a u g h t to use t he t e l e p h on e , a nd t he m a j o r i t y o f t h e m r e g a r d the i n s t r u m e n t wi th n e r v o u s n e s s a nd a p p r e h e n s i o n . In the i ns tr uc t i o n s i ssued b y the B o a r d the o p i ni o n is e x p r e s s ed t hat a b i l i t y to k e e p a c o ol hea d, b e h a v e s e n s i b l y , a nd a c t d e l ib e r a t e l y c a n best be a c q u i r e d t h r o u g h i nd i v i d u a l a nd t ea m c o mp e t i t i o n s , o r t h r o u g h d r a m a t i s e d p r ac t i ce in w h i c h s o m e o f the f l u s t e r i n g c o n d i t i o n s of an a c c i d e n t are r e p r o d u c ed , a n d it is s u g g e s t e d t hat c hi l dr e n s h o u l d be t a u g h t h o w to s h e lt e r a nd c o m f o r t a pati ent, to k n o w w h e r e b l a nk e t s , first aid e q u i p m e n t , e t c. , are kept , to g e t h o t w a t e r a nd tea, to r e m o v e s o u r c e s o f f u r t he r d a n g e r , to st op b l e e d i n g a nd treat s h o c k a nd w o u n d s , a nd to a p p l y artificial r espi ra t i on. T h e y s h o u l d be t a u g h t h o w to a p p l y s i m p l e d r e s s i n g s and b a n d a g e s , and h o w to deal wi t h, s c al ds , b u r ns , f a i n t i n g , s p r a i n s , a nd s i m p l e g r a z e s a nd cut s, a nd , a b o v e all, t h e y s h o u l d c l e a r l y u nd e r s t a n d the d a n g e r o f t r y i n g to m o v e p e r s o n s w i t h s e r i o us i nj ur i es . A l l t his g r o u n d is c o v e r e d b y t he o r d i n a r y t r a i n i n g in first aid, a n d official r e c o gn i t i o n b y t he B o a r d wi ll g o f ar to b r i n g a b o u t a co n d i t i o n o f t h i n g s w h i c h has been l o n g d es i rab l e, a nd w h i c h t he t erri bl e conf li ct in w h i c h w e are e n g a g e d h as a g g r a v a t e d to an intensive degree. C h i l d r e n a re no l o n g e r t he c hi l dr e n t h e y we re. T h e y are m a n y y e a r s in a d v a n c e o f t hei r y e a r s a nd m a y be e n tr us t ed to c a r r y F

irst

F I R S T

o ut d ut ie s in a m a n n e r a nd w i t h an eff i ci ency w h i c h w o u l d h a v e bee n n o t h i n g less t han a s t o n i s h i n g to t hei r V i c t o r i a n a nc e s t o r s . School teaching is no l o n g e r t he t h i n g o f rote a n d r out i ne it o nc e w a s , a nd m u c h of a u se f ul a nd pr ac ti cal na t ure has b e e n i nt rod u c e d into t he s c h o l a s t i c c u r r i c u l u m . T h e t hree R ’s are not n o w the a l p h a and o m e g a of e d u c a t i o n , a nd the rod m a y be sai d to h a v e been f i na l l y s h e l v e d . T h e s c h o o l t r a i n i n g s h o u l d be a p r ep a ra t i on for w h a t t he p u pi l wi ll h a v e to f a ce w h e n he e m e r g e s into the g r e a t w o r ld , a nd w e m a y y e t see t he d a y w h e n the n e w s p a p e r wi l l a s s u m e its d ue i m p o r t a n ce in the c l as s - ro o m. M e a n w h i l e , as w e h a v e sai d, this e x cu r s i o n into first aid t r a i n i n g is a s t e p in t he r i g h t direct i on, a nd it m u s t i n e v i t a b l y h a v e f a r - r e a c h i n g and m o m e n t o u s results.

Red Cross and St. John Flag Day. A s a special send-off to R e d Cross and St. John Na ti o n al F l a g D a y , H . M . T h e Q u een , w h o is President of the British R e d Cros s So ciety, paid a visit to see the fl ag d a y org aniser s and w o rk er s at St. J a m e s ’s Pa lace. U p o n arrival H e r M a j e s t y w a s we lc o m ed b y D a m e Beryl Oliver , H e a d of D e t a c h m e n t D e p a r t m e n t ; L a d y Lo uis M o u n tbatten , D e p u t y L a d y Supt. S. J. A. B ., and C h a ir m a n of C o u n t y of L o n d o n F l a g D a y C o m m itt e e ; L a d y Li m er ic k, D e p u t y C h a ir m a n of the E x e c u tiv e C o m m itt e e of the Red Cros s an d St. John W a r O r g a n is a t io n and President of C o u n t y of L o n d o n B ran ch of the British R ed Cross So ci et y ; L o rd L u k e , C h a ir m a n of N a ti o n al F l a g D a y C o m m itt e e ; and Co unci llor S. E d g s o n , J . P . , and Mrs. E d g s o n (the M a y o r and M ay or es s of W estm in ste r). Ac the en tra nce to the orderly room of the H o n o u ra b le Corp s of G e n t le m e n -a t -A r m s , a R e d Cr os s nurse (M iss O ’ Reilly, W e s t m in s t e r N u r s i n g D e ta c h m e n t ) and a St. John nurse (M is s L ee s, M a y fa ir N u r s i n g D iv is ion ) we re on d u t y w it h their g a y b e f l a g g e d trays and fl a g d a y tins, from w h om H e r M a je s t y pur ch as ed a rosette of flags. A fte r l e a v i n g the orderly room the Q u e e n visited St. J a m e s ’s P a la ce Fi rst A id Post. T o overco me petrol sh o rt age , bicycles, bar row s and mil k carts borr owed from a da iry were used by H a m m e r s m i t h (L on do n ) R e d Cr os s w o rk ers to distribute their emblem s. W i t h 140,000 e m b lem s to distribute to the depots and shops t h r o u g h o u t the b o ro ugh, and no petrol for the cars t h a t u s u a lly do the jo b, resourceful R e d Cross work er s decided upon this novel method. O n the d a y after fl a g da y, the bicyc les and carts we re used a g a i n to b r in g b a c k the tins a n d trays.

The ing

O rder

o f St.

John

o f J e r u s a l e m . — T h e follo w

Se rvice s h a v e been a r r a n g e d

conn ectio n

w it h St.

J o h n ’s D a y , W e d n e s d a y , Ju n e

24th :— In the C ha pe l Roya l,

St.

g r a c io u s

J a m e s ’s

P alace ,

by the

permission

H is

M a j e s t y the K i n g , S o v e r e ig n H e a d of the Orde r, a celebra tion of H o l y C o m m u n io n will be held at

24th.

B y kin d in vitation of the D e a n

O r d e r will att end S u n d a y , June the D e an .

the

E venin g

8.30 a. m . on June

of W e s t m in s t e r the

Se rv ic e in

the

Abbey

2 1 st, at 6.30 p.m. ; preacher, T h e R i g h t Re v.

A I D

Co-ordination of Civil Defence Services. E x t r a c t s from L ec tu r es delivered by SIR

HENRY

M ARTYN,

K .C .V .O .,

F .R .C .S .

L a d ies an d G en tlem en ,— I am not propos ing to deliver yo u to - d a y a lecture upon F ir st Aid, yo u probably k n o w as m u ch ab o ut it a s I do ; nor a m I propo sing to ende av ou r to teac h the W a r d e n s or the Po lice men or the R e s c u e P a r t y W o r k e r their jobs, they m ost certainly k n o w them better tha n 1 do. W h a t I do w a n t to do is to try to s h o w to everyone of yo u how in tim ate ly ea ch is concerned in the mat ter of s a v in g life d u r in g an air raid w h a t e v e r be the service to w h ic h he belongs. I w a n t you to r e g a r d this— not as a fo rm al lecture— but as one of those in ti m a te fireside ch ats w h ic h President R oo sev elt ha s m ad e so familiar. Y o u may , I hope, find some thread of co ntin uity run n i n g through out, but, in the at m o sp he re of a fireside chat, 1 am more free to w a nd er at will over the w id e subject wh ich I ha ve chosen and to confine mys elf to practical essentials rather than theory. I r egar d yo u as a class of post g r a d u a t e students, men and w o m e n w h o h a v e bec ome qualified in your o w n parti cu lar branches of Civil De fence, an d w h o n o w need to be taken a little further a l o n g the road of the fi ght bet wee n life and de ath in order that the w o r k yo u do m a y beco m e the more vital and interesting.

C o -o r d i n a t i o n o f C i v i l D e f e n c e S e r v i c e s . F o r t w o and a half years w e ha ve all of us trained and practised at our o w n particu lar jobs, the Fir st A id Party, the R e s c u e Party, the P o lic em an an d the W a r d e n , and, I thin k, w e can all of us s a y justly that w e h a v e individually reached a fairly h i g h state of proficiency. T h e r e is, however, one alm ost universal defect wh ich is app are nt in most Civil D e fe n c e w o r k — th at of l a c k of collaboration bet wee n the services. E v e n the H i g h C o m m an d are not free from it, and w e ha ve o nly to read the Rep ort of the C o m m is s io n of E n q u ir y into the Pearl H ar b o u r disaster to appreciate the terrible results w h ic h l a c k of col labora tion m a y b r in g in its train. T h e trouble is, in reality, little more than the “ g r o w i n g p a i n s ” of a g r e a t organisat ion. H o w m a n y of us can recall the sam e tro ubles in 1914 - 18 — the artillery b ar r age th a t c a m e down too late or lifted too ea rl y— the counter a t t a c k th a t lost direction— the reliefs t h at failed to arrive w h en t h ey were m e a n t to. D u r i n g the ea rly part of this w a r it w a s especiall y ob vious in th a t difficult mat ter of A ir R a i d w a r n in g s , w e can all of us r em em ber an in stan ce w h en the R a id e r s Passed s i g n a l coincided w it h the fall of the first b o m b ! A t present, ea ch service tends to r egar d this w a r as its o w n particu lar private wa r, its o w n personal property, and not— as it is in fa ct— a w a r w h ic h invol ves ever y man, w o m a n and child in these Islands. W e are all of us inclined to t hin k th at our duties lie within ca refully enclosed w a t e r t ig h t c o m p a rtm en ts instead of b e i n g so in tim ate ly and closely co nnected th at not one s in g le service can reach a s t a g e of full efficiency until every m em ber of tha t service is not only 100 per cent, efficient in his o w n job but 50 per cent, efficient in the duties of the other services. I h a v e h a d the o pp or tu nity of w a t c h i n g an d um p ir in g a l a r g e n um ber of combined exercises, an d on a lm o s t every

F I R S T

occasion this l a c k of colla bor atio n has been only too apparent. I ha ve heard men s a y at exercise after exercise, “ O h , it will be all r i g h t on the n i g h t . ” B elie ve me, it will not 1 I ha ve heard som e order described as “ B lu e Pencil red t a p e . ” Believe me, it is not ! I h a v e even heard it said tha t it is better to rely upon personal initiative rather than upon detailed training. Belie ve me, personal initiative, w ithout perfect t ra in in g upon w hich to base it, is, in 99 cases out of 100, more li kel y to create ch aos th an co ordination. W e are all part of one g r e a t spid er’s w e b in wh ich the w e a k n e s s of one strand can ruin the str e n g t h of the whole, and in no part of Civil D e fe n ce w o r k is the s tr en gth of in ti m a te collaboration more vital th an in the t a s k of life s a v i n g d u r in g aerial attack. In that ta s k ea ch service is most cl osely concerned, and one m is ta k e b y a n y one of them can a d d one more n a m e to the list of those “ Died of W o u n d s . ” L e t us consider for a m o m en t the life of one ca su a lt y— such as a m an with an a bd om in al w o u n d — lies s ucc es sively in the h a nd s of som e of the Civil D e fe n ce Services. T h e W a r d e n , if he is wo rth his salt as the eyes and ears of the services, ha s spotted him at once, an d perhaps has even ha d a m o m en t to spare to cover him up. The Fir st Aid P a r t y Le ade r, in a rapid reconnaisa nce, ha s d i a g nosed his u r g e n c y and ha s set one of his sq uad on to dress him as a priority case. T h e Police or Sp ecia ls ha ve been wa rned and the w a y cleared for the a m b u l a n c e to approach as near to the incident as possible, an d traffic control is k e e p in g the exits clear. A word to a nearby W a r d e n and a m e s s a g e flashes from Incident Post to Control and from Control to H os p it a l that an u r g e n t a b d om in al is c o m i n g in. T h e am b u l a n c e slides s w ift ly a w a y with bells c l a n g i n g to find a bearer party a w a i t i n g it on the steps of the hospital. A bed in the resuscitation wa rd sta nd s ready, and a surg ica l team w a its in the thea tre to operate as soon as the co nd i tion of the case allows. T h a t is perfect co-ordination of services, and n oth in g short of it constitutes efficiency. If ea ch of the c o g s in the m ac h in e has fitted sm oo thly, the ca s u a lt y m a y be on the table within half an hour of his in jury— and for ever y m in u te ’s de la y beyond th at time his chan ce of life g o e s down in a steeply fa ll in g curve.

179

R I D

St. John Ambulance Brigade H EADQUARTERS

AND

D IS T R IC T

REPORTS.

N o . I (P r in c e o f W a le s ’s) D is tr ic t C entral A rea G azette. T h e A ss is tant C o m m iss io n e r is g l a d to ha ve been able to visit a n u m b er of D iv is io n s d u r i n g the last few mont hs. It is e n c o u r a g i n g to note t h at even wh en de pleted b y the re quir em ent s of the services, D iv is io n s are m a k i n g a real effort to meet at r e g u l a r intervals an d to m a in t a in the sta nd ards required of the B r ig a d e . E v a c u a t e d m em b e rs are k e e p in g up their efficiency by a r r a n g i n g to be at t a c h e d to local Divisions. D iv is io n s visited and in spected in clude :— No . 87 . N. L o n g Acre, No. 89 . L . P . T . B . and 125 . N. B a k e r Street, No. 140 . P a d d in g to n and D is t r ic t P . O . and 108 . E usto n. T h e A ss is ta n t C o m m is s io n e r w a s a c co m p a n ie d b y D is t r ic t Officer T . M c B r id e and L a d y D is tric t Officer Mrs. T a p p l e y . So cial fun ctions atten de d were those of 58/5 ( W . P . and St. Maryl ebo ne ) Divis ion, an d 146 C a m d e n Division. The 2 1 st b irth day party, supper and d a n c e of 58/3 K . E . B. and B o r o u g h of Holborn, at w h ic h the M a y o r of H olbo rn pre sided, w a s a g r e a t success. T h e A s s is t a n t C o m m iss io n e r w a s h a p p y to note the str e n g t h of the D iv is io n in the present difficult times. C en tra l Area C h u r c h P a r a d e . — T h e an n u al C h u r c h Pa ra de will t a k e place this y ea r a t St. P a u l ’s Ca t h e d r a l on S u n d a y , June 28th. T h e service will c o m m e n c e at 3.15 p.m. T h e P a r a d e will fall in at 2.50 p.m . outside the C ath e d r al. Ch u r c h O r d e r . — Officers— S a m B r o w n e Be lts w ith brace. P e a k ca ps (and not field service caps) will be worn. T h e A s s is t a n t C o m m is s io n e r is a n x io u s to m a k e the P a r a d e a success, and hopes, th a t like last year, S u p e r in t e n d ents of A m b u l a n c e an d N u r s i n g D iv is io n s will do all in their pow er to assist. H e reg r ets the short notice w h ic h is u n avoidable. Sub scrip tion s for the Cen tra l A re a F u n d . — No. 78 (Cit) of Lo n d on ) Division, £ 2 2s. ; No . 2 ( H a g g e r s t o n ) Divis ion, £ 2 ; No. 115 N u r s i n g (St. J o h n ’s W o o d ), £ 2 2 s. ; No. 7 ( T o y n b e e H all), £ i .

( To be continued.) N o . IX D is tr ic t

This Month’s Quiz. S till

w e receive appr ec ia tiv e letters on this feature.

usual, the figures after ea ch problem indicate the p a g e in Ba illie re ’s C o m p l e t e Med ic al D ic t io n a r y upon will

be found.

w h ich a solu-

A s w e h a v e before mentioned, the price of

this dictionary has, o w i n g to increased costs, been raised to

3/9 post free. 1. W h a t is u u n a ’s paste ?

(p.

353 )

2 . W’ hat is a v alve ? W h a t is its fu nct ion ? 3. W h a t is venesection ? (p. 361 )

(p.

358 )

4 . De fin e the term vital, (p. 365 ) 5 . W h a t is w a te r ba la nce ? (p. 367 ) 6. W h a t is Y o u n g ’s rule used for ?

(p.

372 )

8. W h a t do y o u un der st a nd b y the term (p. 160 )

9 . W h a t is f u m ig a t io n ? 10.

(p.

W h a t is ha llucin at io n ?

13 1 ) (p.

147 )

hyp n otism ’

F a l m o u t h . — T h e m a y o r of F a l m o u t h (Co un . R . E . U i l l ) presided a t the an n u al m e e t i n g of the F a l m o u t h Divis ion, S.J.A .B . H e w a s a c co m p a n ie d b y the m ay oress (Mr s. Gill). In his report for 194 1 , the hon. secr etar y (S e rg t . S. Bray ) said t h at d u r in g the y ea r the n u m b er of first aid cases treated w a s 8, 738 . Pa ti e nts transp orted in the mo tor a m b u lance num b er ed 674 , m a n y of w h o m we re Se rv ic e cases, w it h a m i l e a g e of 4 , 810 . T h e s tr e n g t h of the D iv is io n at the end of the year w a s four officers and 61 other r an ks , and one officer on the reserve. S ix te en m em b e rs are s e r v i n g w it h H . M . Forces, and the re m ain de r are d o i n g d u t y in the var iou s branches of Civil D e fe n ce an d t u r n i n g o ut w h en required to ass ist the m ed ical services of the a r m e d forces. T h e D iv is io n t h a n k e d D r . H . A. Jo hn son (D iv is ion al hon. S u r g e o n ) for his lectures and instruction. F i v e m em bers passed the h o m e n u r s in g e x am in atio n . Corp or al W . J. H o p kin s w a s a w a r d e d the b r ig a d e service m ed al for 15 y e a r s ’ efficient service. Supt. J. J a c k m a n , in his report said t h at 1941 w a s a record year. T h e h e a l t h y s ta te of the finances ha d been b r o u g h t ab o u t b y the en thus ia s m of the m a n y people w h o ha d w o r k e d for the caus e, an d by m a i n t a i n i n g strict e c o n o m y in r u n n in g the Divis ion. T h e m e n ’s section at M a w n a n ,

i8o

F I R S T

a b l y led by Mr. A. Se aton , ha d co ntinued to main tain its efficiency, an d a ca det section w a s n o w b e in g trained. T h e ir o w n C a d e t Division ha d ha d a chequered year, the nu mbe rs f l u c t u a t in g as new yo uth o rga nis atio ns ha d co m e into bein g, b u t they were more staple now. H e ap prec ia ted their h a p p y relations w ith the British R e d Cros s de ta chm en t, the F a lm o u t h and M a w n a n N u r s i n g Di vis io n , the B u d o c k N u r s i n g C l a s s and the G ir l s ’ C a d e t Div is ion, es pe cially in r a is in g funds for the n ew motor a m b u lance, w h ich it w a s hoped would be commissio ne d for service in the district within the n e x t three w eek s. T h e i r th a n k s we re due to Sup t. Pellowe, of the R e d r u th Division, for a l l o w i n g his a m b u l a n c e to do the w o r k of the district wh ile their veh icle w a s laid up for repairs. C o n g r a t u l a t io n s were offered to Mrs. P. L a n y o n , J . P . , C . C . , on her appo in tm ent as l a d y co u n ty officer for gi r l cadets, Mr. A. V . B a k e r as c o u n t y officer for bo y cadets, and Mrs. R o d g e r as la dy div isional superintend ent of the F a lm o u t h N u r s i n g Division. A s y o u n g e r men were b e in g called for service with the armed forces there w a s a need for recruits a m o n g me n over m ilitary a g e . H e m a d e a special appe al to old members of the b r ig a d e, or men who h a v e qualified in first aid, to co m e fo rw ard as hon orary m em be rs for the w a r period and help in the w o r k th at m u s t g o on. H e w is he d to personally t h a n k all r a n k s for their loyal support d u r in g the year. T r an sp or t Se rg t . R. Pen h aligon , had, b y his cheerful devotion to duty and careful atten tion to his patients, w o n the est ee m of the Div is ion an d the confidence of the public. T h e M a y o r said the results of their y e a r ’s w o r k at F a l m o uth left n o t h in g to be desired. O n all sides he heard n o t h in g but praise for their services to the town, and he w a s g l a d th e y ha d g iv e n suc h satisfaction. Provision of their n e w motor a m b u l a n c e ha d called for a b i g effort financially, an d th at effort had been responded to in a creditable manner. H e co n g r a t u l a t e d the Division on w h a t they were do in g, and w is he d the m em bers ever y success. Mr. B. H. W Hill (secr etary and treasurer of the S u p port Co m m it tee ) s po ke of the g r e a t succ es s of the S h ill in g T i c k e t S c h e m e and also of the w a tc h competition for the w a tc h g iv e n b y Mrs. Tern pieman, a m em b e r of the Co m m it tee . A fte r r e m a r k i n g on the g r e a t v alu e of the lectures, Mr. H . A. John son said a k n o w l e d g e of first aid w a s su re ly a noble art and s o m e t h in g to be acquired by all the com m unit y. Mr. D. M. W a k e c o n g r a t u l a t e d Sup t. J a c k m a n , an d all officers an d men on their devo tion and attention to duty. In pro po sin g a vote of t h a n k s to the M a y o r and May oress, Supt. J a c k m a n said the D iv is io n w a s one fa m ily w ith a splendid spirit of co mra de ship, and as l o n g as it so continued t h e y could ha ve no fear for the Division. H e w a r m l y th an ked Courf. and Mrs. G ill for their interest an d go o d wishes. In respect to w o r k for the n ew am bu la n ce , the spirit of their m em bers had been wonderful. Mr. W . T u r n b u l l seconded the vote of th an ks , and the M ay or , res po nd in g, said he w a s pleased to be ab le to return a n y kin dn es s and to help in a n y w ay.

R I D gir l ca det s to tea. D r . M a y R u t l e d g e j u d g e d the ca d ets ’ competition. Mr. G a y m e r referred to the im p e n d in g departure from A tt l e b o r o u g h of Dr. G . S. K e e l in g , w h o has been hon. s u rge o n to A tt leb o ro u g h Di vision for m a n y years, and expr es se d their best wishes for a lo n g an d ha pp y retirement. •

•

A New and Improved Fracture Splint. W e h a v e received from Mr. C. E . L. W h i t l o c k particulars of a triple-folding b a c k splint, for w h ic h he ha s been gr a n te d a provisional patent. T h e splint is m ad e of t ap er in g wood in three sections, and ha s been specially d e sig n ed for fractures of, or severe lacerations to, the low er extremities, and can be ha d padded or it can be padded as required. T h e applia nc e is e x tr em e ly easy to man ip ula te and, w h en used in conjunction with l e g and t h ig h splints, can be carried in an ordinary “ Fi rst Aid ” equipment . It will g i v e more support to the injured lim b an d obviate an y further m ove m en t, thus e n s u rin g g r e a t e r com fort to the patient w h e n co nveye d in an am b u l a n c e or other vehicl e over l o n g distan ces to a hospital, the reb y m in im is in g pain and shock. W h e n the patient arrives at the hospital, the doctors m a y ac ce pt the a t t e n d a n t ’s or first aider’s dia gn o s is and a llo w the lim b to remain on the splint, and should the patient ha ve further injuries he m a y be s ubm itted to X - r a y ex amintion. T h e splint is l i g h t in w e igh t , c o m p a c t for inclusion in “ Fi rst A i d ” equipment , for “ F ir st A i d ” rooms, ha ve r sac ks , am bula nce s, etc. It ca n be m a d e in tw o most useful sizes.

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N o . X D is tr ic t A t t l e b o r o u g h . — In a S . J . A . B . Co m pe ti tion at A t t l e b o r o u g h on M a y 17 th, the Lo rd B u r y C u p w a s w o n by A t t l e b o r o u g h tea m with 100 m ar ks . D is s g a in e d 94 and T h e tfo r d 88. D r. W . R u t l e d g e (A ss is tant C o u n t y Commissio ne r) , the j u d g e , c o n g r a t u l a t e d the team s on their exce llen t wo rk . T h e w i n n i n g team included Cpl. H. C. Fran cis, P. W o o d co ck. J. Pooley, L. L a w r e n c e and F. H ouch en . T h e cup w a s presented to Cpl. Fr a n c is b y Lord A l b e m arle (c o unty president), w h o also presented first aid outfits to the A tt l e b o r o u g h Se nior B o y C a d e t s ’ team, w h o wo n the local ca d e t s ’ compe tition. T h e s e prizes we re giv e n by the A t i l e b o r o u g h president, Mr. W . C. G a y m e r , w h o afte rw a rd s en terta ined the co mp etitors, officials a n d the local bo y and

No. 1 size.— F o r adults, a l e n g th of wood 6 in. wide, tapered to 4 in. at one end.

4 ft. l o n g by

No. 2 size .— F o r y o u n g an d m ed iu m built persons, a l e n g th of wood 3 ft. l o n g by 6 in. wide, ta p e r in g to 4 in. at one end. T h e l e n g th s are m a r k e d “ T o p ” and “ B o t to m ” sides, and are cut into sections k n o w n as No s. 1 , 2 an d 3. No. 1 section c o m m e n c i n g at the 4 in. or n ar ro w end is cut 12 in. lo n g. No . 2 section is cut 18 in. from w h er e No . 1 is cut,

F I R S T and No. 3 section is the r e m a in in g 18 in. of the wood at the 6 in. w id e end of the 4 ft. len gth . T h e process of m e a s u r in g and c u t t i n g the various sec tions of No . 2 size are simila r to th at of the No . 1 size. No. 1 section is 8 in., No. 2 section 14 in., an d N o . 3 sec tion 14 in. T h e sections are jo ined t o ge th er b y a h i n g e or hin ge s, coun tersunk and sc re wed into the wood, an d are fixed as follows :— No . 1 section h in g e or h in g e s on the top side of No. 2 section, No . 3 section h in g e or h in g e s to the bottom side of No. 2 section. W h e n the splint is not required, No. 1 section folds on the top side of No. 2 section, and No. 3 folds b a c k on to the bottom side of the No . 2 section. A s soon as the splint is required for use, it is unfolded, laid flat, No . 1 section is placed in an u p r ig h t position, and is the foot support. It is kep t r igid b y a collapsible s ta y fixed to the e d g e s of No s. 1 and 2 sections. T h e illustration A is self descriptive of the sections hin ged to ge th er and sh o w s the ta p e r in g of the splint. B shows the splint open for use.

L e tte rs

th e

E d ito r .

W e are in no w a y responsible for the opinions expressed, or the state men ts ma de, b y C o rr es po nde nts.— E d i t o r . TREATM ENT

D R O W N IN G .

D ear S ir,— G l a n c i n g t h r o u g h the M ar ch , 1942 , issue of your excellent m a g a z in e , I w a s interested in the final co m m en t on p. ISO under the ab o v e h e a d in g : “ In cid ental ly, it is news to me th at a conscious patient can be in a s tate of asp hyxia an d require artificial respiration.” W e ha ve no reports of a n y such condition fo ll o w in g d r ow nin g accidents, and a s s u m e tha t it could only happen fo ll o win g electric s h o c k or possibly a b lo w on the head c a u s in g tem p orary p aralysis of the respiratory centre. I appreciate tha t the reply to “ R . T . ” w a s in the discussion of d r o w n in g and, therefore, these ca ses w o uld not be per tinent. I t h o u g h t , howe ver, th at yo u m i g h t be interested to k n o w th a t w e h a v e ha d a n um ber of cases reported of as p h xia re sult in g from electric s ho ck, w h ic h were succes s fully revived by artificial respiration ; and th at after breath in g w a s restored, the victim s stated tha t they had been men tally conscious th r o u g h o u t the process but, due to paralysis, we re u n able to breathe or in a n y w a y s ign if y that they we re alive. O n e case a c tu a ll y reported h e a r in g the discussion as to w h ether or not artificial respiration should be continued o w i n g to the r ig id ity th a t occurs in electric s h o c k and is s om etim es m is ta k en for r igor mortis. I a l w a y s enjoy r e a d in g the Que rie s a n d A n s w e r s to Correspondents, as I find a close resem bl an ce to m a n y of the questions w h ich com e into our office from stu den ts of Fir st Aid. I al m o s t feel as t h o u g h I ha ve ha d the pleasure of m e e ti n g “ N . C . F . ” , and hope, some d a y after the mess is over, th at this m a y be possible. C o rdia lly yours, L . M. T h o m p s o n , M . D . , A ss is ta nt N a tio n a l D irec to r Fir st Aid, W a t e r S a fe t y and A cc iden t Pr evention Service. A m er ic an R e d Cross, Na ti o n al H ead qu ar ter s, W a s h in g t o n , D . C . [Y o u r kin d letter is m u c h apprecia ted ; and first aiders t hr ough out the British E m p ir e send cordial g r e e t i n g s to their co ll e a g u e s in U . S . A . — E d i t o r ,

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E ffe c ts o f E lec tric S h o ck . T h e d a n g e r to life in an electr ic s h o c k consists of the fact that it affects the muscles of the heart, thus s to p p in g the h e a r t ’s action. T h e current w hich, w h e n passed t h r o u g h the he ar t mus cles, will g i v e a fatal s h o c k to a person in nor mal health is ab o u t '01 am p . ; the v o l t a g e n ecessary to c a u s e this current to flow, depends, natura lly , on the resis tan ce— this m ain l y on cond itions of co ntact. E v e n 110 volts h a v e been k n o w n to g i v e a fatal s h o c k w h en surfa ces of co n t a ct ha ve been l a r g e an d moist. C o n t a c t w it h tw o hand s is less d a n g e r o u s th an that bet wee n the left h a nd an d r ig h t foot, as in the former case, the he ar t is not in the direct flow of the current. Persons with hear t ai lm ents are likew is e more su sceptib le to fatal s h o c k th an h e a lt h y persons. T h e effects of a l t e r n a t in g cu rre nt at the usu al co m m er ci al fr equencies are more severe than those of direct curre nt ; but a t very h i g h frequencies the nerves cea se to re-act, and electricity at suc h frequencies, is therefore, not so d a n g e r o u s to life. Serious burns are more fre qu ently a co nseq uen ce of direct action tha n of a l t e r n a t in g current shock. T h e tre atm en t for electr ic s h o c k is to en de av our to restore the suspended action of the hear t by artificial respira tion. It is n otew or th y th at the effects of electric s ho ck , if not im m ed iately fatal, seldom last l o n g e r th an a few hours, apar t from incidental burns.

Ambulances for the Nation. In connection w it h the C e n t e n a r y celebrat ions of the H e a r t s of O a k B u i l d i n g Society, 12 fully-equip pe d R olls R o y c e A m b u lances h a v e been presented to the var ions au thorities for Civil D e fe n ce an d P o s t - w a r Service. T h e y ha ve been built b y the L o n d o n C o u n t y C o u n c il at a cost of ^ 1,500 each. T w o ha ve been presented to Lo nd on , and 1 ea ch to Liverpoo l, M an ch es te r, H u ll , B i r m i n g h a m , Bristol, Cardiff, P l y m o u th , So u t h a m p t o n , D e v o n and G lasgow . T h e s e we re inspected by their M aje stie s T h e K i n g and Q u e e n at B u c k i n g h a m P a la c e in the Q u a d r a n g l e , w h e n e i g h t of the officers of the Socie ty , i n c lu d in g the Pr esident, V ic e - P r e s id e n t and S e cre ta ry were present ed to their Majesties. A spl endid film of the c er em o n y w a s made, an d it is b e in g s h o w n t h r o u g h o u t the co u n tr y by the U n iv e r s a l N e w s. A fte r the inspection of the a m b u la n ce s, th e y we re driven to E u s t o n - r o a d and ha nd ed over to their respective repre sen tatives b y the Min ister of H e a l t h , the R t. H o n . E rn es t Br o w n , M . P . , and then driven off to their destinations. T h e So c ie t y co ntinued its m e e t in g s on the fo ll o w in g da ys, w h e n Corp s Sup t. Ca p t. E . F. M illin g t o n , D . S . M . , Pr es to n Corps, w a s elected the Pr es iden t of the S o c ie t y for its C e n t e n a r y Y e a r .

C h a r t o f W a r G a s e s . — W e ha ve received fr om the M in istr y of H o m e Se c u r it y a b ook let entitled as abov e. T h i s deal s w it h w a r gas es , their nature, effects upon the h u m a n body and first aid treatm ent. T h e g a s e s de alt w ith a r e _ T e a r g a s e s , c h o k i n g ga s e s , blister g a s e s , nose irritant g a s e s and s yst em ic poison g a s e s . It is a m o st useful little p u b lication, an d ca n be h a d from H . M . St a t io n e r y Office at its var iou s ad dress es or t h r o u g h a n y bookseller, price Id. or 1/6 net for 25 copies.

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A I D Cros s S o cie ty de mon strated their un deniabl e efficiency in first aid w o r k at a fete held b y the C a m b r i d g e R a i l w a y O r p h a n F u n d C o m m itt e e at the R o m s e y Sch ool, C o le rid ge road, on M a y 25 th. O p e n i n g the fete, the M a y o r said t h at ju s t then the rail w a y s we re d o in g a terrific t a s k in h e lp in g the w a r effort, an d e v e r y t h in g he could do to help them he would. The R a i l w a y O r p h a n F u n d w a s both g o o d and useful in the help it w a s g i v i n g to these homeles s children. O f the N u r s i n g A ssociations, the M a y o r said that in these da ys their w o r k w a s im m en s ely importa nt, and all units should be in first clas s trim. H e co n g r a t u l a t e d the R a i l w a y F u n d C o m m itt e e on w h a t they had done, and e x pressed the hope th at the object the m e e tin g desired would be more th an fulfilled. A m o n g the attractions at the fete were a n umber of side shows , wh ich, in clu d in g darts, stalls and hoop-la, were con s tantly frequented by the more junior m em bers of those present. T h e first aid competition w a s the principal attra ction of the da y. A m b u la n c e parties an d nurses ha d to s ho w how ot deal w it h a person w h o h a d been shot in the chest and had, as a result, fallen from a motor cycle. T h e sw if t and me ticu lous w a y in w h ic h they carried out their duties earned them all the co ngratulatio ns of their ex am in er s at the end of the m eetin g. Co m pe ti tio n winner s we re :— , B o y Cad et s, R h a d e g u n d R o a d “ B ” : L. L o n g d o n , J. Furness, C. P o w a l l and J. Reed. Girl C ad ets : D a p h n e R ic h m o n d , Do ree n D o g g e t t , M ar ie D r e w and D . Beryl Sm it h. • N u r s i n g Div is io n : Mrs. Short, Mis s K. Pullen, Mrs. A d y an d Miss C old well. T h e w i n n i n g m e n ’s team w a s the L . N . E . R . tea m : Messrs. R. H alls, H . W ils on , W . R adc liffe and H . Forsd yk e.

Railway Ambulance News. LONDON

N ORTH

EASTERN

A social e v e n in g in connection w ith the L. N. E. R. A m b u lan ce C l a s s w a s held at the close of last month in the C a m e r o n T e a R oo m s . T e n first year, 11 second year, 2 fourth year, 1 e ig h th year, 1 fourteenth ye ar an d 1 fifteenth ye ar certificates w e re presented, an d Mr . Morrison received a g o l d m ed al from the L . N . E . f t . for l o n g service in a m b u lance wo rk . Mr. Morrison called upon Mr. A le x. M a c g r e g o r to pre sent spec ial ca sh prizes to the first an d second ye ar pupils. T h e s e prizes h a v e been donated by Mr. M a c G r e g o r for the pas t ten years, and we re g a in e d by Miss T h o m s o n ( 1 st year) a n d Mr. R. M a c k a y (2 nd year). Dr. M a c l v o r w a s presented w it h a fitted m ed ical case in appr ec ia tio n of the services g i v e n to the clas s d u r in g the session. In m a k i n g the presentation, Mr . Nes s co n gr a t u la t ed Mr. Morr ison on the co mp let io n of his 15 th y ea r in the A m b u l a n c e Class, an d in a s k i n g D r . M a c l v o r to ac ce pt the gift , he ex presse d the g r a t it u d e of the m em be rs w h o had atten d ed the class. Dr . M a c l v o r s u ita b ly replied, and a c k n o w l e d g e d the as s is tan ce he received from Mr. N e s s and Mr. Morrison. H e als o stressed the im po r ta n ce of a k n o w l e d g e of first aid, es peci ally at this time of war.

In te re stin g C o m p etitio n at R o m s e y . — M en and w o m e n of the St. John A m b u l a n c e Corp s and British R e d

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wonderful opportunity awaits now the trained workers in this great profession. Men and women of initiative, willing to study, anxious to become their own masters, have a real, sound, chance of realising their ambitions, surely, quickly, and undoubtedly.

Massage is a Profession in Demand! Massage is a recognised science, a reputable, growing providing a handsome income for capable operators.

profession,

You can qualify now as a masseur in the comfort of your own home, and pain an expert knowledge of anatomy, physiology, and Swedish Massage easily and without drudgery. The S M A E (Swedish Massage and Electrical) Institute can coach you to proficiency and guarantee your success. If you are interested in a healing profession, and would become your own master; send N O W for this booklet Free and post free. 5

LEATHERHEAD, SURREY.

r e

F I R S T

A I D

183

EQUIP YOURSELF FOR WAR

EMERGENCIES

Essential knowledge to treat successfully, ALL possible injuries,

THE

HOUSEHOLD PHYSICIAN Describes in SIMPLE LANGUAGE such necessary informa tion with helpful plates and diagrams.

A ND FO RM O R E PEA C EFU L TIM ES The COMPLAINTS OF MEN, WOMEN AND CHILDREN, Their Cause, Treatment and Cure w it h The th e

c o m p le te

in s t r u c t i o n s

500 i l l u s t r a t i o n s r e a d in g

m atter

and

m ore

ACCIDENTS

fu ll-p a g e e a sily

W hat

F ir s t

P la te s

A id .

m ak es

u n d ersto od .

case

o f:

B o d ily In ju ry, B u r n s a n d S c a l d s , C l o t h i n g A li g h t . F o r e i g n B o d i e s in E y e s , E a r s , N o s e , T h r o a t .

A few o f the Subjects tre a te d :

W A R EM ER G EN C IES:— Gas Warfare First Aid Bandages Splints Burns Scalds Haemorrhage Fainting

PE A C E TIM E SUBJECTS:— Influenza,Colds,etc. Measles, Mumps Catarrh Corns and Warts Physical Culture What to Do in Emergencies Treatment for all Skin Diseases The Lungs, Pleurisy Hygiene, Anatomy, Pharmacy The Principles of Nursing The Eye, the Ear The Throat, the Nose The Chest, the Heart The Stomach, the Liver The Teeth, the Muscles Infant Welfare Homcepathy, Neurasthenia 3 7 5 Prescriptions, etc., etc.

M a c h in e ry

A ccid e n ts,

D ro w n in g ,

S u ffo ca tio n ,

Bones, F ractu res, C o n c u s s io n , E tc. THE

YOUNG

E le ctricity

A ccid e n ts.

B le e d in g ,

D islo ca tio n s,

P o iso n ,

S p ra in s,

Broken F a in tin g ,

W I F E will find just the in formatio n she requires.

M O T H E R S w h o w is h their d a u g h t e r s to de velop n a t u ra lly w il l find e x a c t l y the t e a c h in g they need. W O M E N O V E R 40 will fr a n k ly discussed.

find

their

difficulties

regarding

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B E A U T Y C U L T U R E — C o m p l e x io n D ie ts, W r in k l e Cur es , C a r e of the H a n d s , Mouth , E ye s, H air, R ecipes, etc. P R E S C R I P T I O N S — 375 proved remedies. T h e r e are hun dreds of su bjects. T h e mus cles, teeth, diges tio n , hair, food valu es, Ju jitsu, P h ren o lo g y. H o w to d ia g n o s e disea ses from ap pe ar an ce of head, face, neck, ton gu e, throat, chest, perspiration, etc.

F M ESSRS. Crown

VIR TU E

C O .,

E L T D .,

E F.A .

D ept.,

C h a m b e r s , U p p e r P a r l i a m e n t Street, N o t t i n g h a m .

P le a s e s e n d m e F R E E B o o k let on “ TH E H O U S E H O L D P H Y S I C I A N ,” statin g c a s h p rice, also m o n t h l y te r m s of p a y m e n t w i t h o u t a n y o b l i g a t i o n to p u r c h a s e . NAME. (S end this form in un se al ed en vel op e s ta m p e d Id.) A D D R E S S ............................................. ! ..........................................

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Our Nurses’ Page. CO M PILE D

AMBULANCE

SISTER .

G e n e r a l S e r v ic e a n d A u x i li a r y R e s e r v e M em bers, S . J . A . B . — In v ie w of the ex cellen t service b e in g g iv e n by G e n e r a l Se rv ice and A u x il ia r y R es er ve m em bers at tach ed to N u r s i n g D iv is io n s of the S . J . A . B . , the C h ie f C o m m iss io ner ha s san ction ed the a w a r d of the W a r Se rv ice B a r to them. T h e s y st e m of applicatio n and me thod of w e a r i n g the Ba r will be as for fu lly enrolled m em b e rs of N u r s i n g Divisions. T h i s order is retrospective, an d particulars of W a r Ser vice carried out since the o u tb r ea k of w a r m a y be submitted, provided c o v e r in g s ig n e d reports from e m p l o y in g authorities unde r w h o m the A u x il ia r y R e s er ve and G en er al Se rvice M e m b e r s w o rk ed are produced. T h o s e A u x il ia r y R es er ve or G en er al Se rv ice M e m b e r s w h o later joined the B r ig a d e , but h a v e until n o w only been allo w ed to co unt tow ards the B a r service do ne since their full en rolmen t as B r i g a d e m e m bers, m a y n o w count their previous w a r w o r k to w a r d s the Ba r, an d their ap plicatio ns s ho uld be m a d e ac co r d in gly . It m u s t be cl ea rly sta ted on F o r m N S / W S /1 w h ether service ha s been or is in a G en er al Se rv ice or A u x il ia r y R es er ve capacity .

No.

4 D i s t r i c t , S.J.A .B .

W h a l l e y N u r s i n g D i v i s i o n . — A successful w h is t drive, orga n is ed by the Divis ion, w a s held in the Co-o perativ e C a f e on T u e s d a y , M a y 19 th. T h e prizes we re kin d l y presented to the winner s b y Asst. C o m m is s io n e r M a jo r Macken zi e. A w a r m w e lc o m e w a s g iv e n d u r i n g the e v e n in g to Mrs. T u r n e r , the n e w L a d y Div . President, w h o received her b a d g e of office. M a jo r M a c k e n z ie also presented a w a r d s g a i n e d recently by m em be rs of the Division, T h e s e included 12 medallions, 5 labels and 1 pendant.

No.

6 D is tric t,

S .J .A .B .

G o s f o r t h N u r s i n g D i v i s i o n . — A m b u l a n c e Sister E. Gar diner , a d j u d g e d the most efficient m em be r of the D i v i sion, w a s presented, on M a y 1 1 th, w it h the Porteous Silver C u p b y L a d y C o u n t y Officer Miss L . Whitf or d. Afte r c o n g r a t u l a t i n g the winner, Mis s Wh itf ord compli men ted the D iv is io n on its splendid record of w a r service, a notabl e feature b e i n g tha t despite the call of other services, t h e m em b e rs h ip ha d increase from 20 to 60. T h e donor of t h e tro ph y presented th a t e v en in g, D r . H . B. Porteous, D iv is io n al S u r g e o n , ha s been on ac ti v e service since the o u tb r e a k of war. T e n m em be rs ar e w o r k i n g as V . A . D ’s., 12 are fu ll-time m em bers of the Civil N u r s i n g R e serve, an d the r em ainde r are e n g a g e d in par t- tim e w o r k at first-aid posts, blood tra nsfusion service, and in d e m o n s tr a t i n g to class es atten ded b y ad ults an d also to g ir ls w h o ha ve joined the Y o u t h Service.

A w a r d s P r e s e n te d t o M em bers o f C iv il N u rsin g R e s e r v e . — M is s Ashford , R e g i o n a l Officer of the Civil N u r s i n g R es er ve for M an ch este r, presented ribbons and stars, a w a r d e d for a y e a r ’s sat isf act ory service, to me mbers of the C . N . R . a ttach ed to G a r l a n d s E m e r g e n c y H o s p it a l on T u e s d a y , M a y 10 th. M is s Ash ford a s k e d the n u r s in g a u x il ia r y to do a little m o re th an she ha d do ne by c o n s id e rin g n u r s in g as a career. T h e n u r s in g service w a s of vital im po rta n ce, an d more nurses we re needed, not me rely for wa r- ti m e , but for service after the w a r. It g a v e her g r e a t ple as ur e to m a k e the a w a r d s for w o r k we ll done, an d to h a nd ea ch recipient a letter of t h a n k s from the authorities,

A I D Mis s K i n g , the matr on, in tro duced Mis s Ash ford, to w h o m a he ar ty vote of t h a n k s w a s ac cord ed on the pro posal of Mrs. M ac lare n, C o m m a n d a n t , No. 6 B . R . C . S . de tach men t.

P r esen tation to

N u rses a t B ish o ps S to r t f o r d .

Sir D a v i d Rutherford, C h a ir m a n of the Hertfor dshire C o u n t y Coun cil , visited H a y m e a d s on T h u r s d a y mo rn in g, M a y 28th, to present l o n g service b a d g e s to a n u m b er of nurses. A ld erm a n J. S. Sym o n ds , C h a i r m a n of the Board of G uardia ns, presided, and ex tend ed a h e a r ty w e lc o m e to Sir D a v id . In reply, Sir D a v i d paid tribute to the w o r k of the n ur s in g profession an d to the efficiency w h ic h prevailed at Haymeads. Sister S. C. H o w a r d w a s presented with a med al for 10 y e a r s ’ ser vice ; b a d g e s for five y e a r s ’ service were received by Siste r G . H a r t and A ss ista nt N u r s e M. R . H a c k e tt . A ss is t a n t N u r s e J. M. So m er ville w a s u n a b l e to att end to receive a b a d g e for five y e a rs ’ service.

C a r l isl e N u r sin g A sso c ia t io n . T h e es tab lish men t of a .su bstantial ca pital inve stmen t fund in connection with the C ar lisle D istri ct N u r s i n g Asso cia tion w a s u r g e d b y Mr. M a t t h e w T h o m p s o n , hon. treasurer, at the A n n u a l M e e t i n g held on W e d n e s d a y , M a y 20 th. T h e fifty-first report referred to the loss the association ha d su sta in ed t h r o u g h the de ath of Mrs. Sco tt- Stee le, one of its founders, w h o for 27 years ac te d as hon. secretary, and the n as ch a ir m a n and president. Mrs. C. W . D o n a l d was the present C h a irm a n , and Mrs. Sc o tt- N ic ho lso n , cha ir m a n from 1926 to last year, w a s still of in va lu ab le help as vicepresident. D u r i n g the past year 1,657 ca ses we re nursed, and 26,454 visits we re paid. T h e r e were 327 m id w if e ry and m at e r n ity cases, en t a ilin g 7,807 visits. A n ap pe al w a s m a d e for more subscribers as we ll as an increase in contr i butors to the provident n ur s in g service so as to increase the r e g u la r income. Mr. M a t t h e w T h o m p s o n s ub mitted the financial s ta te m en t for the past year, s h o w i n g subscriptions an d donations t o t a l l in g ^ 1,205 18 s. 5 d. T h e r e w a s a g r a t i f y i n g in cr ea se of £ 8 2 in patients’ fees an d donations. A first co n tribution of ^600 from the l e g a c y an n oun ce d last ye ar had been received. O n the expe nd iture side there ha d been an increase, as w a s to be expected, b u t the ex pe nses ha d been k e p t as l o w as possible. T h e ba la nce in ha nd at the end of the yea r w a s ^ j l 80. C o m m e n t i n g on the in ve stmen t of ^ 1,026 in a C o rp o r a tion h o u s in g bond an d w a r stock, Mr. T h o m s o n said he w a s p articu larly an x io u s to see a su bst an tial ca pital in ve st m en t fund, so th a t w h e n the w a r cease d their splendid w o r k could be still further developed. T h e M a y o r paid tribute to the officials, m at ron and nurses for their u n tir in g services. Sin ce the assoc ia tion b e c a m e a c o n n e ct in g lin k with the local authority, m u ch v a l u a b l e w o r k h a d been done.

“ B l i t z e d ” C i t y ’ s T h a n k s . — T h e T o w n C l e r k and A . R . P . Controller of the C i t y of E x e t e r h a s w ritten the f o ll o w in g letter to the R e d Cr os s and St. John H ead q u ar ter s r e g a r d i n g the F l y i n g C o lu m n :— “ I a m desired by the R i g h t W o r sh ipfu l the M a y o r an d the E m e r g e n c y C o m m itt e e of the C i t y Co unci l to express to yo u their very g r atefu l t h a n k s for, and sincere appreciation of, the ex cellent service rendered by yo ur R e d Cr os s unit in c o m i n g to the as s istan ce of the C it y after the recent air raids . . . ”

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“PORTLAKD” A M BU LA N C E G EAR TheGear illustrated (A.B.C.D.) carres tw o stretchers on one side of Ambulance, leaving other side clear for sitting patients. UP A N D D O W N action is quick easy for loading or unloading.

A. B. C.

Shows the two stretchers in position. Shows the topstretcher lowered ready for loading. Illustrates the same Gear with the top stretcher frame hingeddown for use when only one stretcher case is carried.

D. Shows the same position as in “ C 7’ only with cushions and back rest fitted for convalescent cases. W here Ambulances are required to carry four beds two Gears are fitted, one on EITHER SIDE, and the same advantages apply as described above.

Full catalogueofAmbulanceEquipment No. 7wA ill besent onrequest.

G R E A TP O R T L A N DS T ., L O N D O N ,W .1 Telegraphic Address:—

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KARVALID, WESDO, LONDON

i 86

FIRST

Queries andAnswers toCorrespondents Q uerie s will be de alt w it h unde r the fo ll o w in g rules :—

1 . — L etter s c o n t a in in g Q uerie s m u s t be m a r k e d on the top left-hand corner of the env elop e “ Q u e r y , ” an d addressed to F i r s t A i d , 46 , Can n on -s tre et , Lo n d o n , E . C . 4 .

2 .— A ll Q uerie s m u s t be w'ritten on one side of paper only. 3 .— A ll Q u e rie s m u s t be a c com p an ie d by a “ Q u e r y C o u p o n ” cu t from the curre nt issu e of the Journal, or, in case of Q u e rie s from abroad, from a recent issue.

4. — T h e T e x t b o o k to w h ic h reference m a y be m a d e in this co lu m n is the 39th ( 1937 ) E dit ion of the S . J . A . A . M a n u a l of F i r s t A id to t h e Injured. Burns of F a c e and E yes. J. B . (H uns let) . — S o m e w e e k s a g o , one of our men, whilst c h a r g i n g ha nd electric lam p s, w a s burned ab o ut the face, m o uth and eyes by an alkalin e. T h e man w a s treated in our first aid departm en t b y m ea n s of a solution of v i n e g a r and w a te r ; and the left eye, w h ic h s h o w ed s ig n s of b lister in g, w a s covered b y a sterilised eye pad, this b e in g the only b a n d a g e applied to the face. T h e man w a s then p acked off hurriedly b y t ax i to the Infirmary. A s this is a very u n c o m m o n ty pe of ac cide nt at these W o r k s , it aroused m u c h discussion at our safety first m ee ti n g. T h e que stion aro se “ did the m a n receive proper first aid tre atm en t ? ” and w e shall be o blig ed if yo u will let us h a v e yo u r co m m en ts , s a y i n g wh et her or not, in yo ur opinion, the m a n received full and ad equa te tre atm en t p e n d in g his rem o va l for m ed ic al attention. A p a r t from the fact that, in m y opinion, the fa ce should h a v e been protected w it h a clean dry dres si n g, the tre atmen t of the case w a s s a t is fa ct o r y.— N . C o r b e t F l e t c h e r . E x a m i n a t i o n H o w le r . L . R. (C a n n o n s P a r k ) . — In a recent ex a m in a t io n the doctor a s k e d a c a n d id ate w h a t w o uld be the s tate of a patient w h o w a s su ffering from an ex te nsiv e haemorr hage of the brain. T h e latter p ro m ptly replied— “ T h a t p a tien t

w o u ld be in C r o m e r !'" Good !

N e x t , please ! !— N . C . F .

T r e a t m e n t o f F r a c t u r e d S p in e a n d E l b o w . D . H . ( K i n g s b r i d g e ) . — A t a recent practice w e ha d to treat a patient who, fully conscious, w a s s uffe ring from s usp ec ted fracture of lu m b ar spine and from fracture in vo lvin g e lb o w joint. T h r e e b a n d a g e s we re applied ac c o r d in g to the T e x t b o ok for tre at m en t of spine and an a n g u l a r splint to elb ow . T h i s done, the patient w a s removed on stretcher in supine position. W e w e lc o m e yo ur co m m en ts , please. W i t h this c o m bin a ti o n of injuries I consider th at it w ould h a v e been better to h a v e k ep t the upper lim b ex tend ed and tied to b o dy and t h ig h . O th e r w ise , the flexed elbo w placed a cro ss the front of the b o d y w o uld be un com fo rtable to patient an d m i g h t p os sibl y a d ve rs el y affect the spinal injury. — N .C .F . T r a n s p o r t o f S p in a l I n j u r y . E . W . (A berdare). — Plea se tell us the correct method of tra ns por t of an un co n sci ous patient w h o is found l y i n g face d o w n w a r d s in a bo m bed room and w h o ha s a sus pected fracture of the spine in the lu m b a r region. In this case, as the in jury cann ot be defined, I consider t h at the patien t should be r em ove d in the position fo und .— N .C .F . S p i n a l I n j u r y : L o a d i n g S tr etch er . H . B . ( L e e d s ) . — Co nsid era bl e dissa tisfaction ha s frequentlybeen expr es se d by re ally co m pe te nt first aid te a m s

AID r e g a r d i n g the met hod of loa d in g, and the difficulty of correctly positioning the patient on the stretcher in the fa ce d o w n w a r d s position. W o u l d you be so kin d as to g i v e m e a criticism of the fo ll o w in g me thod of loa din g. ( 1 ) Fold a b lan ket l e n g t h w a y s and place it w ith the centre, or fold near to the patient, on that side to wh ich he will be turned. (2 ) Fold and roll tw o b lanke ts , and la y them across the first b la n k e t on a level w ith the patient’ s shoulders and hips. ( 3) W i t h g r e a t care and u s i n g all the ass istance available, turn the patient so th a t he rolls onto the folded b lan ket an d is fa ce down . (4 ) Pa ss a l o n g spine pole d o w n the inside of the fold of the b lan ke t, and roll a seco nd pole in t h e side ed ge s of the blan ket, as near as possible to the pat ie n t’s side. ( 5 ) T w o bearers on either side lift an d load the stretcher. ( T h e str etcher m ust be m a d e ready, placed in position, no transv erse boar ds and loa ded in the s a m e m an ner as t h at for lo a d in g in the face u pw ar ds position). T h e difficulty seem s to be in the tw o rolled blankets, w h ic h I h a v e found interfere a little w it h rolling of the second pole. I h a v e also tried lif ti n g b y the above b lan ket method, ex ce pt t h a j the rolled b lan kets we re placed in the correct position (i.e., should er and hips) on the stretcher, and then the patien t w a s low ered onto them. T h i s latter me thod see ms better for the bearers, but perhaps not so for the patient. T o me yo ur s u g g e s t e d met hod of l o a d in g stretcher does not offer a n y a d v a n t a g e s over the me thod laid d o w n in the T e x t b o o k ; an d it does involve risks w h e n the patient is lifted b y b la n k e t on to stretcher..— N . C . F . T r e a t m e n t of F r a c t u r e d Patella. W . H . (Pinner ). — R e c e n t ly I hear d an instructor tell his pupils th a t for fractured patella the injured l e g should be raised on the should er of the k n e e l in g first aider before p u t t in g the splint under the limb. I said th at this w a s w r o n g as the T e x t b o o k said “ support the foot off the gr o u n d b y a pillow, roll of cl o t h in g or ru gs. ” H e a r g u e d • t h a t this w a s said to be after the splint h a d been secured. I main tain ed th a t a chair seat w a s too h i g h and th a t tw o bricks, or a roll of r u g s w a s sufficient and g a v e room to put the splint into position. H e wished to put the l e g so h i g h so as to m a k e it easier to g e t the splint into posi tion. I shall be m u ch o b lig e d if yo u will k in d l y g i v e yo ur ruling. All that is necessary is to raise the low er lim b sufficiently to relax the t h ig h muscles an d so to avo id traction on the upper fr a g m e n t of the fractured patella. In short, I a g r e e w ith y o u . — N . C . F . A s p h y x ia and S e ve re d A rtery. P . C . (C h e lsea ). — Plea se tell us h o w a first aider should treat a patient su ffering from a s p h y x ia an d a severed femoral artery, an d no help w a s available. If it w a s quit e clear th at the ar ter y w a s severed, the first aider s ho uld first pla ce a tourniquet on the femoral ar tery r e a d y for im m ed ia te t i g h t e n i n g a t the first s ig n of blee ding. H e should then proceed w ith artificial respiration. O f course yo u realise that in suc h cases of a s p h yx ia , bleed in g is not severe d u r in g the a s p h y x ia l s t a g e an d tha t it m a y be co m e serious w it h return to co nsci o usn ess.— N . C . F . C o ngestio n of L im b . C . H . ( P u t n e y ) . — In its instructions for the control of arterial b l e e d in g the T e x t b o o k in R u l e 11 on p. 110 tells us to “ relax indirect pressure . . . . as p ro lon ged m ain ten an ce of indirect pressure m a y caus e da n g e r o u s c o n g e s tion of the l i m b . ” In d e a l in g w ith venous h ie m or r hage

F I R S T

187

A I D

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1 88

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the T e x t b o o k in R u le 6 on p. 128 tells us to ‘ ‘ A p p l y a firm b a n d a g e , e t c . ” there is no me ntion of r e m o v in g this b a n d a g e after d r es sin g the wound. P le a se let me k n o w if this b a n d a g e should be treated in the s a m e w a y as the pad and b a n d a g e , as it s eem s there is the s a m e d a n g e r of co nge st io n in ea ch case. T h e p ad a n d b a n d a g e used for control of venous hasmorrh a g e ca nn o t be applied so t i g h t l y th at the w h o le return circulat ion is stopped. Blood finds its w a y b a c k t h r o u g h the deep vessels, and co nseq uen tl y co nge st io n of the lim b cann ot t a k e place. In the tre atm en t of venous haemorrhage, there fore, it is not n ecessary to relax the d r e s sin g on w o u n d . — N .C .F . T r e a tm e n t o f Burns. H . W . (S o uth H a r r o w ) . — A s the m e m b e r in c h a r g e of the F ir st A id R o o m in an an n ex e (w h ic h is one mil e a w a y from the m ain factory) I recently ha d to treat a fell ow w o r k m a n w h o w a s suffering from burns and w h o had smothered his injuries w ith vaseline. So I treated the bur ns w ith flavine, told him t h at it w o uld ha ve been better if he h a d not applied vaseline, and referred him to the O / C of the F ir st A id R o o m in the m ain factory. T h e patient told m y superior officer w h at I had said ; and, to m y utter surprise, the latter informed the patient tha t his tre atm en t w a s perfectly correct and supplied me w ith liquid paraffin for further dre ssings. A s I ha ve a l w a y s been t a u g h t not to use g r e a s e on burns, I w e lc o m e yo u r commen ts. It w o u ld ap pear t h a t the latest in structions from the M in istr y of H e a l t h (M a rch , 1942 ) on the tre atm en t of burns h a v e not ye t reached you. T h e s e authorise the use of paraffin molle flav um (or v a s e l in e ).— N . C . F . T r a n s p o r t o f F r a c t u r e d S p in e C a s e s . M . B . (N o rth la n d s).— Plea se tell me w h a t is the reason for tra n s p o r ti n g cert ain cases of spinal fractures on the b a c k and certain others on the face. A s surge on -l ectur er I h a v e been t e a c h in g first aid for 20 ye a rs and ha ve often been a s k e d this question. I fear t h at I ca nn o t v pu ch for the a c c u r a c y of the tw o a n s w e r s w h ic h I h a v e a l w a y s g iv en , n a m e l y (1) to be ab le the better to observe the fa ce of the unconscious patient an d (2) to e n c o u r a g e the n at ur al cu rve s— for w a rd s an d b a c k w a r d s — of the bo dy as the case m a y be. So will yo u kin d l y criticise and e n lig h t en ? R e m o v a l fa ce u p w a r d is in dica ted w ith fractures of the n e c k b ec ause the cervical ver tebrae must be kep t in their natu ral al ig n m e n t . T h i s is not possible if the patient is loaded face d o w n w a r d or if his he ad is turned to one side to av oid interference w it h br eathin g. O n the other hand , r em ova l face d o w n w a r d is indicated w ith fractures of the t ho ra cic and lu m b ar vertebrae beca use th er eb y (1) the risk of pressure on the spinal cord is minim ise d, (2) the natu ral cu rve s of the spine are retained, an d ( 3) the ex a m in a t io n of the patient on his arrival at hospital is fa cili tated .— N . C . F . T h r e e - H a n d e d Seat. T . M . ( N e w c a s t l e - o n - T y n e ) . — O n r e a d in g the instructions of the T e x t b o o k (pp. 197 - 198 ) on fo rm atio n of three-ha nde d seat, one is led to believe th at in all cases the bearer on the r i g h t of the patient g r a s p s his o w n wrist (with r ig h t or left hand ) thus l e a v i n g the other bearer to support the (r ig ht or left) injured lim b of patient. D o you not th in k tha t an injured r ig h t l e g o u g h t to be supported by the r i g h t ha nd of bearer on the r ig h t side of patient and vice versa ? I w e lc o m e yo u r ru lin g.

A I D T u t ! T u t 1 1 If yo u look a g a i n (and more carefully) at yo ur T e x t b o o k , yo u will find tha t it instructs you to read “ r ig h t ” for “ left ” and “ left ” for “ r i g h t , ” w h ic h me ans th at the bearers will do precisely w h a t yo u s u g g e s t . — N . C . F . T r a n s p o r t o f S p in a l I n j u r y F a c e - U p . T . M. ( N e w c a s t l e - o n - T y n e ) . — P lea se tell m e h o w m a n y b a n d a g e s R u le 3 on p. 74 of the T e x t b o o k intends us to use in the preparation for tra nsport of cases of spinal injuries fa c e -u p w a r d s ? S h ould we use S or 10 b a n d a g e s ? T h e latter would m a k e a s tr o nge r jo b but w hich is correct ? F i v e b a n d a g e s are indicated, three b e in g passed under the patient from one side, an d tw o from the other s ide.— N .C .F . D r i l l Bo o k . P. B. ( B r ig h o u s e ) . — A s a m em be r of the B r i g a d e I would like to k n o w where I m a y obtain a Drill B o o k d esc ribin g in detail the n ew me thod of Fo o t Drill (in threes) for Platoon, C o m p a n y and B atta lio n formation. I ha ve a few bo ok s as advertised for H o m e G u a r d s but these only deal with p ar ad e formation. N o such drill b o ok has ye t been published b y the B r i g a d e ; and, as yo u say, the A r m y and H o m e G u a r d books do not contain m u c h detail. Y o u should, howeve r, bear in mind that fo rmation of co mpa nies in threes is su ita ble only for route m a r c h i n g an d that formation of stretcher s qu ad s requires tw o ranks. Further, with the excep tion of fo rm in g fours, p ra ctically the wh ole of the old drill c a n be mad e ap plicable to m o ve m en ts in thr ee s.— E d i t o r . G l a s s E m b e d d e d in A x i l l a . VV.B. (G ar fo rth)'— A t a recent incident one of the patients ha d a label w h ic h read as follow s :— “ A p i e c e of g l a s s is em b e dded in the r ig h t ar m -p it ; and there is severe arterial b l e e d in g . ” I w it h d r e w the piece of g l a s s , put 1 a g o o d hard d r es sin g on wo un d an d used the dressi n g as a pad for pressure on the ax illa. A n o th er m em be r of the sq ua d kep t pressure on the su b clavian ar tery whilst I did this. L a t e r I w a s told by the O bs e r v e r that I should not do this, bu t leave g l a s s in and put dressi n g at either side of g la s s, and k ee p pressure on the su bc lavian. As I t h o u g h t this w o uld be al m o s t im possible to ke ep on whils t t ra v e ll in g to the Fi rst Aid Post, I did not contr adict h im but decided to write to you. It is correct to remo ve fo re ig n bodies w h ic h ca n be seen an d are easily r em ova ble ; an d on the fa ct s supplied by you I see no reason to call into que stion the first part of your t reatm ent. I do, howe ve r, seriously que stion the value of the d r es sin g to control the a x il la ry arter y bec ause it is too soft. T o do this effectively you shou ld ha ve placed on the dr e s sin g a pad the siz e , sh ap e a n d c o n sisten cy of a billiard ball, fives or g o l f ball or a stone. A lso m ain tain transport m em be rs

yo u err w h en yo u s u g g e s t th at it is not possible to d ig it a l pressure on the s ub cla via n arter y d u r in g to hospital. It ha s been done a g a i n an d a g a i n by of the B r i g a d e . — N . C . F .

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V o l.

XLIX.

N O TICE

JULY,

1942.

\,..E”U r‘ d,a‘ ,,1 L station,™ Ha!l\

PRICAEn n uTmHR EEPENCE , P ost F ree

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READERS.

EDITORIAL. F I R 5 T A I D is published on the j o t h o f e a c h m o n t h . A nnual Subscription is 4 s . post free ; sin gle copies 3d .

The

Its aim and ob ject bein g the advan cem en t o f A m b u lan ce W ork in a ll its branches, the E d ito r in vites R eaders to send A rticle s and Reports on subjects pertaining to the M ovem en t and also w elcom es suggestions for P ractica l Papers. A ll R epo rts, & c ., should be addressed to the E d ito r at the address b elo w , and should reach him before the 1 2 t h o f each m onth, and m ust be accom panied ( not necessarily fo r p u b lica tio n ) b y the name and address o f the C o rrespondent. Su b scription s, A d vertisem en ts and other business C om m unications connected w ith F I R S T A I D should be forw arded to the Publishers. D A L E , R E Y N O L D S & C o ., L t d . ,

46, C a n n o n S t r e e t , L o n d o n , E.C.4. Telegraphic A d d ress— “ Tw en ty -fou r, L o n d o n ." Telephone— C ity 3710 .

CONTENTS

T H IS

NUMBER.

E d i t o r i a l :— D u t ie s of the Nur se ... T his M o n t h ’s Q u iz Co-ordinat ion of Civil D e fe n ce Services S . J . A . B . H ead q u ar ter s and Dis trict Reports R a il w a y A m b u l a n c e N e w s E v e r y H o m e a G a s Cen tre 11 M ar tinic ” C la s p for S u r g i c a l B a n d a g e s Letters to the E dit or

...

O ur N u r se s ’ P a g e

Queries

and

Answers

1 2 2

3 5 5 6 6 6

Correspondents :_

A r m s l i n g for M ul tip le Injuries E x a m in a tio n H o w le r T r e a t m e n t of C ar bid e P o is o n in g C o m p o u n d F r a ct u r e of C l a v ic le S m e l l i n g S a l t s w it h H e a d Injurie s Act io n of H e a t on C ir cula ti o n Applic atio n of C o ld w ith H e a d Injuries T r e a t m e n t of L y s o l P o is o n in g F ract ures of T h i g h an d P a te ll a H u m o u r in F ir st Aid Eftects of A s p h y x ia Insensibil ity w ith A p o p l e x y .. . In d ex for R ep lies to Q uerie s A pplic atio n of L i n t . . . W ar T im e Treatm ent R o p i n g Pa ti ent to Stretcher

10 10 10 10 10 10 10 10 10 10 12 12 12 12 12 12

If Govern m ent Commissions, D e p a r t m e n t a l C o m m i t t e e s , a nd bo ar d s a nd c o u n c i l s a nd c o m mi tt ees g e n e r a l l y c o ul d b r i n g a b o u t a s a t i s f a c t o r y s ol ut i on to s o m e o f t he p r o b l e ms w h i c h c o n f r o n t the nat i on, v a s t i m p r o v e m e n t w o u l d be n ot i ce a bl e in m a n y d i r ect io ns. T h e o u t s t a n d i n g r eas o n for f a i lur e to effect this is l ac k o f co -o rd i n a t i on . T h e end to w h i c h all e n qu i ri es s h o u l d tend is not hel d r i g i d l y in v i e w , a nd w h i l e o n e a sp e c t of a c a se wi l l r ecei ve t he f ul lest att ent i on, others, e q u a l l y i m p o r t an t , wi l l e i t he r be o v e r l o o k e d or wi l l r ecei ve bu t s h o r t shri ft . W hat is s a d l y w a n t e d n o w is s o m e c l ea r defi ni t i on o f t he d ut i es of a nurse, l e a v i n g a si de t ho s e e x t r a n e o u s dut ies w h i c h so often fa.ll to her lot. Unfortu n a t e l y, h o w e v e r , c o n d i t i o ns are s o at v a r i a n c e wi th r e g a rd to the car e o f the s i c k that, d ir ec t l y t he q u e s ti o n ari ses, difficulties o f a n i g h i n s u r m o u n t a b l e na t ure pr ese nt t h e m s e l v e s . In a tt e n d a n c e u p o n p e r s o n s o f m e a n s t he s e are r edu ce d to a m i n i m u m , for t he nu r se is not e x p e c t e d to ^o b e y o n d h er a ct ua l n u r s i n g dut ies o r to e n te r into the p r o v i n c e w h i c h s h o u l d be o c c u p i e d b y the s e r v a n t s of the h o u s e, or in s m a l l e r e s t a b l i s h m e n t s b y t he d ai l y he l p or c h a r w o m a n , o r e v e n b y the mi st ress her sel f. B u t , a las, w h e n it is a ca se of a t t e n d a n c e u p o n the s i c k poor, c i r c u m s t a n c e s are rever s ed, a nd the c o n s c i e n t i o u s nu r se fi nds her sel f c o n f ro n t e d b y dut ies for w h i c h h er t r a i n i n g a nd u p b r i n g i n g m a y not h a v e befitted her. Even a l t h o u g h s h e m a y not p u t h er h a n d s to d o m e s t i c w o r k hersel f, s h e m u s t , in t he i nt er est s o f her pati ent, e x e r c i s e a c o n t r o l l i n g i nf l ue n ce o v e r the s l a c k n e s s a nd laisser-faire w h i c h are s u c h p r o n o u nc e d fea t ures o f t he a v e r a g e w o r k i n g - c l a s s home. A g r e a t o b s t a c l e to r e c r u i t i n g f o r the s e rv i c e h a s bee n t his u n k n o w n q u a n t i t y , w h i c h h as b y m a n y c o m e to be r e g a r d e d as i n t i ma t e l y a ss oc i at ed w i t h t he dut ies o f a nur se . W e would not a n s w e r for h o w ma t te r s s t a nd n o w , b u t in the old d a y s it w a s no u n c o m m o n t h i n g for t he s t u d e n t fr om t he n e a r - b y h os p i t al , in a t t e n d i n g a m i d w i f e r y ca se , to turn a nd l i g h t a fire a n d p r e p a r e a c u p o f t ea — e v e n to a d m i n i s t e r practi cal c o n s o l a tion to f r ac t i o us c h i l d r e n . O f c o u rs e, t he nu r se

Duties o f th e Nurse.

F I R S T

c a n ne ver , in the m a j o r i t y of c a se s, st ick s ol idl y to h er last. S h e m u s t be r ea d y f o r a n y a nd e v e r y e m e r g e n c y , a n d e v e n be ca l led u p o n , t e mp o r a ri l y at least, to p e r f o r m w o r k w h i c h falls l e g i t i m a t e l y to the m e d i c al pr acti t i oner . T h e w h o l e mat t er p r e s e nt s a v a s t a nd c o m p l i c a t e d p r o b l e m , w h i c h can be s o l v e d o n l y b y the c l os es t c o- o pe r at i on and u n i t y o f p u r p os e on t he part o f t hos e w h o are on t he a d m i n i s t r a t i v e si de, a l t h o u g h these m u s t at t he s a m e t ime h a v e t he a d v i c e a n d a ss is ta n ce of t hos e w h o h a v e qua l i fi ed b y a c t ua l e x pe r i e nc e . That t here can be no definite definition (if t he e x p r e s s i on m a y be a l l o w e d ) o f a n u r s e ’s dut ies is besi de t he ca se . A p p r o x i m a t i o n w o u l d g o far t o w a r d s the s e t t i n g u p of a w o r k a b l e s ta nd a r d .

This Months’ Quiz. S t i l l w e r e c e iv e a p p r e c i a t i v e l e t t e r s o n t h is f e a t u r e . As u s u a l , t h e f i g u r e s a f t e r e a c h p r o b le m in d i c a t e t h e p a g e in B a i l l i e r e ’ s C o m p l e t e M e d i c a l D i c t i o n a r y u p o n w h i c h a s o lu t io n w i l l b e f o u n d . A s w e h a v e b e f o r e m e n t io n e d , t h e p r ic e o f t h i s d i c t i o n a r y h a s , o w i n g t o in c r e a s e d c o s t , b e e n r a i s e d t o 3/9 p o s t fr e e . 1. W h a t d o y o u u n d e rs ta n d (p . 8 1 ) 2 . W h a t is c r e a t i o n ?

“ co u n ter

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(p . 82)

3. W h a t d o y o u u n d e r s t a n d b y “ c r i s e s ” ? 4.

D e fin e th e w o rd “ c u t a n e o u s .”

5 . W ’ h a t is “ d e c o m p r e s s i o n ” ?

6 . W h a t is “ d e m e n t i a ” ?

(p . 8 3)

(p . 84) (8 7 )

(p . 88 )

7 . W h a t is m e a n t b y “ d i c r o t i c ” ? * 8 . W h a t is “ d i s a r t i c u l a t i o n ” ?

(p . 9 3)

(p . 9 5 )

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a n d a n u m b e r o f r e p r e s e n t a t i v e s o f t h e J o in t O r g a n i s a t i o n .

Publishers N o te .— W i l l r e a d e r s p le as e n o t e t h a t all ba ck n u m b e r s o f “ Fir st A i d ” a r e n o w o u t of p r in t and c a n n o t b e su pp lie d.

W i l l S o u t h A fr ic a n and o t h e r C o lo n i a l read er s

p le a s e add t o t h e i r r e m i t t a n c e s , “ o r English e q u i v a l e n t . ”

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Co-ordination of Civil Defence Services. E x t r a c t s fr o m S IR

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L e c t u r e s d e l iv e r e d b y

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O r g a n isa tio n o f th e C ivil

D efen ce M e d ica l S e r v ic e s .

B e f o r e a n y s e r v ic e c a n b e c o m e r e a l l y e ffic ie n t a t it s j o b t h e m e m b e r s m u s t h a v e , a t l e a s t , s o m e g e n e r a l id e a o f t h e o r g a n i s a t i o n o f t h a t s e r v i c e a s a w h o le , w h a t r e s o u r c e s c a n b e r e lie d u p o n , a n d h o t v t h e s e r e s o u r c e s c a n b e c a lle d in t o u s e . T h e h u m b le s t T o m m y is v e r y w e ll in f o r m e d in d e e d o f a ll t h e f o r c e s o f a m o d e r n a r m y w h ic h c a n b e b r o u g h t t o h is a s s i s t a n c e fr o m a m a c h in e g u n t o a s q u a d r o n o f a e r o p la n e s , a n d y e t it is e x t r a o r d i n a r y h o w i g n o r a n t is t h e g e n e r a l p u b lic a s a w h o le o f t h e r e s o u r c e s o f m o d e r n m e d ic in e w h ic h c a n b e m o b ilis e d in a id o f t h e a i r r a id v ic t im . Y o u a ll o f y o u k n o w o f h o s p it a ls , b u t m o s t o f y o u t h in k o f t h e m o n ly a s p la c e s to w h i c h y o u t a k e y o u r w o u n d e d , a f t e r w h i c h a l l i n t e r e s t in t h e m c e a s e s s o f a r a s y o u a r e c o n cern ed . A ll o f y o u k n o w o f d o c to rs , b u t m o s t o f y o u t h in k of t h e m o n ly a s i n d i v i d u a ls w h o l e c t u r e to y o u o r t r e a t y o u r w o u n d e d ; b u t fe w o f y o u r e a lis e th e v a s t o r g a n is a tio n w h ic h h a s b e e n b u i lt u p f o r t h e s a v i n g o f l if e a n d h o w c lo s e l y t h e p r e l i m i n a r y w o r k w h i c h t h e C i v i l D e f e n c e S e r v i c e s d o in t h e fie ld m u s t — if it is to b e e f f e c t iv e — fit in w i t h it . L e t u s c o n s id e r f ir s t ly t h e o r g a n i s a t i o n o f t h e M e d ic a l P r o f e s s io n it s e lf . I t is t h e c o m m o n im p r e s s io n o f t h e la y m a n t h a t o n c e a d o c t o r b e c o m e s q u a lif ie d a s a P h y s i c i a n a n d S u r g e o n — a s a ll h a v e to b e — t h a t h e b e c o m e s a t o n c e c a p a b l e o f d e a l i n g w it h a n y t h i n g fr o m a d if f ic u lt a b d o m in a l o p e r a t io n t o p r o d u c i n g a b a b y — b e lie v e m e , h e is n o t ! T h e fir s t t h i n g w h ic h a d o c t o r h a s to d o a f t e r c o m p le t i n g a m in im u m o f s i x y e a r s ’ t r a i n i n g a n d p a s s i n g a l a r g e n u m b e r o f e x a m i n a t i o n s is t o o b t a in f u r t h e r e x p e r i e n c e in th e w a r d s o f a h o s p ita l a s a h o u s e s u r g e o n o r h o u se p h y s i c i a n p r o b a b ly f o r a y e a r . H e m a y , a t t h e e n d o f t h a t t im e , e le c t t o s e t t l e d o w n in t o G e n e r a l P r a c t i c e , w h e r e , w i t h a g o o d g e n e r a l k n o w l e d g e , h e b e c o m e s t h e s a l t o f t h e e a r t h o f t h e p r o f e s s io n , o n e o f t h o s e to w h o m t h e h i g h e s t h o n o u r is d u e . O n t h e o t h e r h a n d , h e m a y d e s ir e t o b e c o m e a s u r g e o n , w h i c h e n t a i ls a t l e a s t a n o t h e r f o u r o r fiv e y e a r s ’ e x p e r ie n c e in t h e w a r d s o f h o s p it a ls a n d t h e p a s s i n g o f h i g h e r , a n d v e r y m u c h m o r e d if f ic u lt , e x a m i n a t i o n s . W h e n h e h a s f in a lly o b t a in e d t h e m a g i c le t t e r s F . R . C . S . — o r a n e q u i v a l e n t s u r g i c a l d e g r e e — h e s o o n e r o r l a t e r fin d s h i m s e l f u p o n t h e s t a f f o f o n e o f t h e l a r g e h o s p it a ls , q u a lif ie d a n d a b l e t o o p e r a t e u p o n w h a t e v e r is n e c e s s a r y . U n fo r t u n a t e ly , h o w e v e r , th e m a t t e r d o e s n o t e n d th ere. T h e a r t o f s u r g e r y h a s b e c o m e s o c o m p le x s in c e t h e l a s t w a r t h a t e x p e r i e n c e b y o n e m a n in a l l it s b r a n c h e s is u t t e r l y im p o s s ib le , a n d s p e c i a l i s a t i o n h a s b e c o m e im p e r a t iv e . I t w a s fo u n d , fo r in s ta n c e , th a t e v e n th e tr e a tm e n t o f a s im p le f r a c t u r e h a d b e c o m e s o s p e c i a li s e d t h a t w h e n it w a s u n d e r t a k e n b y w h a t is n o w k n o w n a s a n O r t h o p a e d i c S u r g e o n , n o t o n ly w a s t h e r e s u l t o b t a in e d in f i n i t e ly b e t t e r , b u t t h e v ic t im r e t u r n e d t o w o r k v e r y m u c h m o r e q u i c k l y . T h e p r o b le m o f o p e r a t io n s u p o n t h e c h e s t s p r a n g in to p r o m in e n c e a f t e r t h e l a s t w a r . A t t h a t t im e , a n y e x t e n s iv e o p e r a t i n g u p o n t h e i n t e r i o r o f t h e c h e s t a n d t h e l u n g s th e m - * s e lv e s w a s a l m o s t u n t h o u g h t o f. W i t h t h e g r o w t h o f s p e c i a li s a t i o n a n d a n i n c r e a s i n g k n o w l e d g e o f a n a e s t h e t i c s , it

F I R S T g r a d u a l l y b e c a m e p o s s ib le t o u n d e r t a k e s u c c e s s f u l l y e v e n s o s e r io u s a n o p e r a t io n a s t h e c o m p le t e r e m o v a l o f h a l f o r m o r e o f a d i s e a s e d o r i n j u r e d lu n g . T h a t o p e n e d u p w i d e fie ld s , a n d t h e r e a r e n o w a c o n s id e r a b l e n u m b e r o f e x p e r t s w h o d e v o t e t h e i r e n t i r e liv e s to o p e r a t io n s u p o n t h is p a r t o f t h e b o d y . D i s e a s e s o f, a n d o p e r a t io n s u p o n , t h e e y e h a v e , a lm o s t fr o m t h e b e g i n n i n g , b e e n in t h e h a n d s o f O p h t h a l m i c S u r g e o n s , a n d , m o re la t e ly , o p e r a tio n s u p o n th e e a r s , n o se a n d t h r o a t a r e p a s s i n g m o r e a n d m o r e in t o t h e h a n d s o f t h o s e w h o u n d e r t a k e t h is w o r k o n ly . O p e r a t i o n s u p o n t h e b r a i n h a v e a ls o , s i n c e 1 9 1 8 , b e e n g r e a t l y d e v e lo p e d , a n d a r e u n d e r t a k e n a l m o s t e x c l u s i v e l y b y s p e c i a li s t s in b r a in s u r g e r y . V e r y e a r l y in t h e c o u r s e o f t h e l a s t w a r a c o m p le t e ly n ew b r a n c h o f s u r g e r y a ro se , k n o w n a s P la s tic S u r g e r y , in a u g u r a t e d b y S ir H a r o ld G illie s . T h e g h a s t l y f a c i a l i n j u r i e s w h ic h c a n b e p r o d u c e d b y h i g h e x p lo s i v e s p r o m p t e d h im t o d e v e lo p m e t h o d s b y w h ic h t h e a p p a l l i n g d i s f iu r e m e n t s r e s u l t i n g c o u ld b e c u r e d . G r a d u a l l y , S i r H a r o l d a n d t h o s e w o r k i n g u n d e r h im h a v e b r o u g h t t h is w o r k o f r e s t o r a t io n t o a n a m a z i n g d e g r e e o f p e r f e c t io n . I t is n o w a l m o s t p o s s ib le t o g i v e a m a n a c o m p le t e ly n e w f a c e if h e h a p p e n s t o lo s e h i s o ld o n e , a n d , w ith th e g r e a t e s t e a s e , to c h a n g e th e s h a p e o f a n y o n e ’s n o se if t h e o w n e r h a p p e n s t o d i s l i k e it, a l t h o u g h n a t u r a l l y t h e p r o c e s s e s in v o lv e d a r e l e n g t h y a n d o ft e n e n t a i l a s e r ie s o f i n t r i c a t e o p e r a t io n s . T h e r e i s a s t o r y o f t h e la s t w a r , t h e t r u t h o f w h ic h I c a n n o t v o u c h fo r . S i r H a r o l d h a d e s t a b li s h e d a p l a s t i c h o s p it a l in a l a r g e t o w n n o t f a r fr o m L o n d o n , w h i c h t o w n h a d a ls o b e e n c h o s e n b y t h e a u t h o r i t i e s a s a r e f u g e fo r e x p e c t a n t m o t h e r s fr o m t h e u b i q u it o u s Z e p p e l in . N a tu r a lly t h e s i t u a t i o n o f t h e P l a s t i c H o s p i t a l n e c e s s it a t e d t h e p r e s e n c e in t h e t o w n o f a n u m b e r o f m e n w i t h m o r e o r le s s d i s f i g u r i n g w o u n d s o f t h e f a c e in t h e p r o c e s s o f r e p a ir . T h e C i t y F a t h e r s b e c a m e a n x i o u s le s t t h e s i g h t o f t h e s e m e n m i g h t h a v e s e r io u s e f f e c t s u p o n t h e n e w g e n e r a t i o n a b o u t to b e p r o d u c e d b y t h e e x p e c t a n t m o t h e r s , a n d , s t r o n g in t h e ir c o n v i c t i o n t h a t t h e h o s p it a l w a s m e r e l y s o m e n e w m e d ic a l fa d , w i r e d t o t h e a u t h o r i t i e s p e r e m p t o r i ly r e q u e s t i n g it s im m e d i a t e r e m o v a l. T h e r e q u e s t w a s p a s s e d to th e W a r O ffic e , w h o , n e v e r g i v e n to w a s t e o f w o r d s , r e p l ie d in t h r e e — “ M o v e th e m o th e rs ! ” N o w a d a y s , s p e c i a l p l a s t i c h o s p i t a ls a r e o v e r E n g l a n d , a n d , in t h e L o n d o n a r e a a t s in g le c a s e w ith a w o u n d in v o lv in g s e v e r e fa c e , o r f r a c t u r e s o f t h e j a w , g o e s a t o n c e a v a ila b le .

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N o w c o n s id e r th e im m e n s it y o f th e p r o b le m s fa c e d b y th e a u t h o r it ie s a t th e b e g in n in g o f th e w a r . E ven your h i g h l y t r a i n e d g e n e r a l s u r g e o n is n o t to b e fo u n d g r o w i n g o n g o o s e b e r r y b u s h e s , a n d t h e n u m b e r o f s p e c i a l i s t s in t h e v a r io u s b r a n c h e s o f s u r g e r y w a s e v e n m o r e lim it e d . I n s p i t e o f t h is , i t w a s g o i n g t o b e n e c e s s a r y t o p r o d u c e m e n a b l e t o c o p e w i t h t h e w o r k in t h e v a s t l y e x p a n d e d A r m y , N a v y a n d A ir F o r c e b o th a t h o m e a n d a b r o a d , to p r o v id e f o r a n u n k n o w n n u m b e r o f c a s u a l t i e s f r o m a i r r a id s a m o n g t h e c iv il p o p u l a t io n a n d y e t t o c o n t i n u e t o m e e t t h e o r d i n a r y n e e d s o f t h e p e o p le a t l a r g e . O n e t h in g w a s im m e d ia te ly a p p a r e n t, th e m is ta k e s o f th e la s t w a r m u s t n o t b e r e p e a te d . A t t h a t t im e t h e W a r O ffic e o r t h e N a v y a s k e d f o r a d o c t o r a n d g o t h im a n d u s e d h im c o m p le t e ly r e g a r d l e s s o f h i s p a r t i c u l a r a b i l i t i e s . E x p e r t s o n m i d w i f e r y a n d t h e d i s e a s e s o f w o m e n f o u n d t h e m s e lv e s p o s te d a s M e d i c a l O f f i c e r s in c h a r g e o f B a t t a l i o n s in t h e fr o n t lin e ; m e n w h o h a d n o t h a n d le d a m i c r o s c o p e f o r y e a r s fo u n d t h e m s e lv e s e x p e c t e d t o t a k e c h a r g e o f a l a b o r a t o r y d e m a n d in g th e m o st e x p e r t k n o w le d g e o f b a c te r io lo g y a n d p a th o lo g y .

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B r ig a d e H e a d q u a r te r s C o m m i s s i o n e r s ’ C o n f e r e n c e . — T h i s w a s h e ld o n F r i d a y , J u n e 2 6 th , th e C h ie f C o m m is s io n e r , S ir J o h n D u n c a n , p r e s id in g . I t w a s p l e a s i n g t o fin d n e a r l y e v e r y c o u n t y w a s r e p r e s e n t e d a n d t h e C h i e f C o m m i s s i o n e r e x p r e s s e d h is p le a s u r e a t s u c h a n e x c e l l e n t r e s p o n s e t o h is in v i t a t i o n . M a n y it e m s w e r e d o w n o n t h e a g e n d a , t h e m o s t im p o r ta n t b e in g a llo tm e n t o f “ F l a g D a y ” a n d “ P e n n y -a w e e k ” p r o c e e d s ; p r o p o s e d n e w b a d g e s o f r a n k s ; o m is s io n o f “ L a d y ” in t i t l e o f S u p e r i n t e n d e n t s a n d O f f i c e r s o f N u r s i n g U n i t ; a n e w C o m m i s s i o n e r ’s h a t b a d g e ; t h e in s t i t u t i o n o f N u r s in g C o r p s (w h e r e n e c e s s a r y ) u n d e r th e ir o w n N u r s i n g O f f i c e r s ; t h e a d o p t io n o f a “ S t . J o h n ” F l a s h ; t h e i n s t i t u t io n o f “ I n s t r u c t o r s ’ C e r t i f i c a t e s ” f o r m e m b e r s w h o u n d e r t a k e to g i v e t h e s h o r t c o u r s e ; a n d m a n y o t h e r i t e m s a f f e c t i n g t h e B r i g a d e a s a w h o le . S i r J o h n in h is a d d r e s s o f w e lc o m e , r e f e r r e d t o t h e g r e a t i n c r e a s e o f N u r s i n g p e r s o n n e l w h i c h n o w h a s a r a t i o o f 1 to I f m a le m e m b e r s a s a g a i n s t 1 t o 3 p r e - w a r . A m essage w a s s e n t fr o m th e C o n fe r e n c e to M rs . S t . J o h n A tk in s o n ( L a d y S u p t . - i n - C h i e f ) o n h e r s e r io u s il l n e s s w i t h b e s t w i s h e s fo r a s p e e d y r e c o v e r y . S i r J o h n w e lc o m e d L a d y L o u i s M o u n t b a t t e n a n d t h a n k e d h e r f o r s t e p p i n g in t o t h e b r e a c h w h e n M r s . A t k i n s o n w a s t a k e n ill. T h e im p o r ta n c e o f th e C a d e t M o v e m e n t, w h ic h h a d b e e n a tt a c h e d to th e G o v e r n m e n t Y o u t h O r g a n i s a t i o n , w a s a l s o r e f e r r e d to , a s w a s t h e e x c e lle n t w o r k w h ic h B r ig a d e m e m b e r s h a d d o n e d u r in g a i r r a id s . T h e C h i e f C o m m i s s i o n e r a n n o u n c e d t h a t it h a d b e e n a g r e e d b e tw e e n th e B . R .C .S . a n d th e B r ig a d e th a t s u r g e o n s o f o n e o r g a n i s a t i o n w o u ld w o r k w i t h t h e o t h e r o r g a n i s a t i o n a n d v ic e v e r s a . H e a ls o a n n o u n c e d t h a t f o r t h e d u r a t i o n , g lo v e s n e e d n o t b e w o rn e x c e p t o n c e r e m o n ia l p a r a d e s , a n d th a t h a n d b a g s m a y b e c a r r ie d w ith th e s a m e e x c e p tio n .

N o . I ( P r i n c e o f W a l e s ’s ) D i s t r i c t C e n t r a l A r e a , N o . 9 .— O n S u n d a y a fte r n o o n , J u n e 2 8 th , m e m b e r s o f t h i s a r e a a t t e n d e d D i v i n e S e n ic e a t S t . P a u l ’ s C a t h e d r a l , a n d m a n y f r ie n d s a ls o w e r e p r e s e n t . The p a r a d e f o r m e d u p o n t h e n o r t h s id e o f t h e C a t h e d r a l u n d e r th e c o m m a n d o f th e A s s is t a n t C o m m is s io n e r , C a p t. R u s s e ll V . S t e e l e , a n d m a r c h e d in t o t h e C a t h e d r a l . T h e C o lo u r s w e r e c a r r i e d b y S u p t . E lv i n w i t h e s c o r t . T h e v e r y im p r e s s iv e s e r v ic e w a s c o n d u c te d b y th e R e v . C a n o n A le x a n d e r , M .A ., a n d th e in s p ir in g s e r m o n w a s p re a ch e d b y th e R e v . O . H a r d m a n , D .D . T h e S e r v ic e w a s c o n c lu d e d w it h t h e s i n g i n g o f t h e B r i g a d e H y m n , f o l lo w e d b y th e N a tio n a l A n th e m . A fte r th e S e r v ic e th e p a r a d e w a s f o r m e d u p in f r o n t o f t h e C a th e d r a l, th e A m b u la n c e m e m b e r s in f r o n t , t h e N u r s i n g m e m b e r s o n t h e w i d e l a n d i n g h a l f w a y u p t h e s t e p s , w i t h t h e C o l o u r s in t h e c e n t r e . T h is m a d e a v e r y im p r e s s iv e sc e n e . T h e S u r g e o n - in - C h ie f, D r . N . C o r b e t F le tc h e r , w h o w a s fo r s o m e y e a r s A s s i s t a n t C o m m i s s i o n e r o f C e n t r a l A r e a , i n s p e c t e d t h e p a r a d e , a n d e x p r e s s e d h is g r e a t p l e a s u r e a t m e e t i n g s o m e o f h is o ld B r i g a d e f r ie n d s . C o l. W o o l r y w y c h P e r o w n e ( H o s p i t a l l e r ) , M r . F i n c h a m ( A s s is ta n t L ib r a r ia n o f th e O r d e r ), a n d M is s A . M . W a l k e r ( L a d y D i s t r i c t S u p t .- i n - C h i e f ) w e r e a l s o p r e s e n t . T h e A r e a is in d e b t e d t o t h e C a t h e d r a l a u t h o r i t i e s f o r t h e i r k i n d n e s s in p e r m i t t i n g t h e B r i g a d e t o a t t e n d a n d f o r th e g r a c io u s fa c ilit ie s g r a n t e d to th e m . N o . 55 ( S o u t h a l l ) . — T h e M a y o r o f H e s to n a n d I s le w o r t h ( A l d e r m a n J . E . D i l l i n g h a m , J . P . ) p u b l i c l y p a id t r i b u t e t o t h e fin e w a r w o r k o f t h e m e m b e r s o f t h e N o . 5 5

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( S o u th a ll- N o r w o o d ) A m b u la n c e a n d N u r s in g D iv is io n s , a n d th e H e s to n S e c tio n o f th e S .J .A .B ., a t H e s to n S e n io r S c h o o l on F r id a y e v e n in g , J u n e 1 9 th , w h e n h e w itn e s s e d a d e m o n s t r a t i o n o f fir s t a id a n d h o m e n u r s i n g b y t h e m e m b e r s , a n d p r e s e n te d a w a r d s to H e s t o n c la s s m e m b e r s . T h e a r r a n g e m e n t s fo r t h e e v e n i n g w e r e in t h e c a p a b le h a n d s of S u p t. J. E . T a y lo r , S .B . T h e p ro g ra m m e opened w ith a p a r a d e o f th e A m b u la n c e , N u r s in g a n d C a d e t D iv i s io n s a n d a n in s p e c t io n b y t h e M a y o r a n d M a y o r e s s . Then f o l lo w e d s q u a d a n d s t r e t c h e r d r ill, d e m o n s t r a t i o n s b y t h e A m b u la n c e D iv is io n o f m e th o d s o f d e a lin g w ith v a r io u s c a s u a lt ie s , ill u s t r a t i o n s o f v a r i o u s t y p e s o f b a n d a g i n g b y t h e N u r s i n g D i v i s i o n , b e d m a k i n g , a n d a d e m o n s t r a t io n o f t h e T h o m a s S p lin t. T h e a m b u la n c e a n d n u r s in g c a d e ts g a v e d is p la y s a n d a m a r c h p a s t. B e fo r e p r e s e n tin g th e a w a r d s th e M a y o r s k e tc h e d th e h is to r y o f th e S t. J o h n A m b u la n c e A s s o c ia tio n a n d g a v e a n a c c o u n t o f it s a m a z i n g f o r t i t u d e a n d s t r u g g l e s t h r o u g h o u t th e a g e s . H i s W o r s h i p c o n c lu d e d a n i n s p i r i n g a d d r e s s b y s t a t i n g t h a t h e h i m s e lf h e ld a S t . J o h n A m b u l a n c e c e r t i f i c a t e m a n y y e a r s a g o a n d h a d n e v e r f o r g o t t e n a ll h e h a d le a r n e d . T h e M a y o r th en p re s e n te d th e c la s s a w a r d s a n d w a s th a n k e d b y S u p t. T a y lo r a n d A s s t. C o m m is s io n e r W a r r e n . M r s . C a r t e r , le c t u r e r t o t h e H e s t o n H o m e N u r s i n g c la s s , w a s p r e s e n te d w ith a h a n d b a g .

N o . II D is tr ic t C h e l t e n h a m . — T h r e e C h e lt e n h a m O f f ic e r s of th e S .J .A .B . h a v e b een h o n o u r e d b y th e K in g . M is s D o r o t h y B . F a b e r ( L a d y C o u n t y S u p t . ) is p r o m o t e d t o t h e r a n k o f O f f i c e r ( S is t e r ) in t h e O r d e r ; A m b u l a n c e O f f ic e r M is s I r e n e L . G r i f f i t h s h a s b e e n a w a r d e d t h e d i g n i t y o f S e r v i n g S i s t e r in t h e O r d e r ; a n d M r . V i c t o r D e n t ( S u p t . of th e R o to l A ir s c r e w s S t. J o h n A m b u la n c e D iv is io n ) b e c o m e s S e r v i n g B r o t h e r in t h e O r d e r . T h e s e h o n o u r s a r e w e ll d e s e r v e d , a n d w i l l g i v e m u c h p le a s u r e to t h o s e w h o k n o w t h e r e c i p i e n t s a n d t h e w o r k t h e y h a v e d o n e fo r th e a m b u la n c e s e r v ic e .

N o . H I D is tr ic t. L e i c e s t e r . — T h e B . U . S . M . C o . D iv is io n , L e ic e s te r C o r p s , h e ld a F i e l d D a y a n d D i v i s i o n a l I n s p e c t io n o n S u n d a y , J u n e 2 1st. T h e I n s p e c t io n w a s c a r r i e d o u t in t h e a f t e r n o o n b y C o r p s O f f ic e r J . F a r m e r s u p p o r t e d b y C o r p s O f f i c e r F . S m i t h a n d B . P . C o o p e r E s q . , P r e s id e n t o f t h e D iv is io n . V i c e - P r e s i d e n t s B a d g e s w e r e p r e s e n t e d to F . D a l b y E s q . a n d C o r p s O f f i c e r F . S m i t h , a n d W a r r a n t s to H o n . S g t . L . M a n s c h o tt, S e c r e t a r y ; P te . W . H . P a lm e r , T r e a s u r e r ; P te . K . E ls m o r e , S to r e k e e p e r . T h e t e a m t e s t s w e r e j u d g e d b y C o r p s O f f ic e r F . S m i t h , a n d t h e w i n n i n g t e a m w a s le d b y C o r p o r a l J. O ’ N e ill. F i r s t a id , g a s p r a c t i c e a n d s p o r t s f i g u r e d in t n e d a y ’ s e v e n t s . D iv . S u p t. J. M . J o n e s a n d th e D iv is io n a l C o m m itte e w e r e h e a r t i l y c o n g r a u l a t e d fo r a r r a n g i n g s u c h a s p le n d id p ro gram m e. N o r t h a m p t o n . — M en , N u rse s a n d C a d e ts of th e N o rth a m p t o n D i v i s i o n s p a r a d e d o n S u n d a y m o r n i n g , J u n e 2 8 th . D i v i s i o n a l S u p t . H . I. E d w a r d s w a s in c h a r g e o f t h e p a r a d e , L a d y C o r p s S u p t . M r s . E . C a r p e n t e r b e i n g in c h a r g e o f t h e N u r s in g D iv is io n s . T h e p a r a d e , n u m b e r i n g a b o u t IS O , m a r c h e d t o K e t t e r i n g R o a d M e t h o d i s t C h u r c h , w h e r e t h e y w e r e j o in e d b y H i s W o r s h i p t h e M a y o r ( A ld e r m a n J. E . B u g b y , J . P . ) a n d t h e M a y o r e s s , w h o w e r e s u p p o r te d b y m e m b e r s of th e C o r p o r a tio n . T h e p a r a d e a n d - D i v i n e S e r v i c e w a s h e ld to c o m m e m o r a t e t h e t im e - h o n o u r e d e v e n t o f S t . J o h n ’ s d a y , w h i c h is a n a n n u a l cerem o n y. T h e S e r v ic e w a s c o n d u c te d b y th e R e v . F . H . E d w a r d s , a n d H i s W o r s h i p t h e M a y o r r e a d t h e le s s o n . T h e R ev,

H I D E d w a r d s p r e a c h e d a v e r y a p p r o p r ia te a n d in s p ir in g se rm o n d e a l i n g w it h t h e w o r k o f t h e B r i g a d e fr o m it s v e r y e a r l y d a y s r i g h t u p to t h e p r e s e n t p e r io d . H e p o in t e d o u t it s a d a p t a b i l i t y in b o t h p e a c e a n d w a r a n d it s g r e a t id e a l o f b e i n g a l w a y s a t t h e s e r v ic e o f t h e s u f f e r i n g .

N o . I V D is tr ic t L A N C A S H IR E . L i v e r p o o l . — T h e fir s t a id c l a s s n o w in s e s s io n a t t h e E x c h a n g e A m b u l a n c e D i v i s i o n ’ s h e a d q u a r t e r s is m a k i n g g o o d p r o g r e s s , t h e m e m b e r s d i s p l a y i n g a k e e n in t e r e s t in t h e i r w o r k , a n d l o o k i n g f o r w a r d t o p a s s i n g t h e ir e x a m i n a t io n a n d b e c o m i n g p r o f ic ie n t fir s t a id e r s . T h e r e c e n t ly a p p o in t e d c o m m i t t e e s a r e d o i n g g o o d w o r k a s r e g a r d s t h e r e p a ir a n d r e n o v a t i o n o f t h e p r e m is e s a t h e a d q u a r t e r s , a n d it is t h e h o p e o f a ll c o n c e r n e d , t h a t w h e n t h e i r l a b o u r s a r e c o m p le t e d , E x c h a n g e D i v i s i o n w i l l h a v e h e a d q u a r t e r s t o b e p r o u d o f.

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B r i g h t o n . — T h e a n n u a l i n s p e c t io n o f t h e B r i g h t o n C o r p s w a s h e ld o n S u n d a y , J u n e 1 4 t h , in t h e g r o u n d s o f B r ig h t o n C o lle g e . T h e p a r a d e w a s in s p e c t e d b y A s s i s t a n t C o u n ty C o m m is s io n e r W . J. B . T r o t te r w h o w a s a c c o m p a n ie d b y t h e C o u n t e s s o f B e s s b o r o u g h ( L a d y C o u n t y P r e s i d e n t ) , M is s D . I . H u b b a r d , S . S . S t . J . , J . P . ( L a d y C o u n t y S u p t .) , C o u n t y S u r g e o n R . S . H a r p e r , S . B . S t . J . a n d o t h e r c o u n t y o ff ic e r s . A f t e r t h e m a r c h p a s t a r e a l i s t i c a i r r a id “ in c id e n t ” w a s s t a g e d b y a m b u la n c e a n d n u r s in g m e m b e rs. A d d r e s s i n g t h e C o r p s a t t h e c o n c lu s io n o f t h e in s p e c t io n , t h e C o m m i s s i o n e r s a id h e h a d t h e h i g h e s t h o p e f o r t h e f u t u r e o f t h e B r i g a d e in B r i g h t o n . H e lo o k e d f o r w a r d t o t h e t im e w h e n t h e B r i g h t o n C o r p s w o u ld p o s s e s s p e r m a n e n t h e a d q u a r t e r s o f it s o w n , a n d h e s a w s t r o n g e v id e n c e o f g r o w t h a n d v ir ilit y . T h e C o u n te s s o f B e s s b o r o u g h c o n g r a tu la te d th e A m b u l a n c e a n d N u r s i n g C a d e t s o n t h e ir s m a r t n e s s , a n d s a id s h e h o p e d t h e ir n u m b e r s w o u ld r a p id ly in c r e a s e . T h e p a ra d e w a s u n d e r th e c o m m a n d o f th e C o rp s S u r g e o n a n d S u p t. ( D r . F . H . S tu tta fo r d ) w h o w a s su p p o rte d b y C o r p s O f f ic e r s W i l l i a m s , G r a c e a n d W i n d e r . P r o m in e n t lo c a l v i s i t o r s p r e s e n t , i n c lu d e d F l o r e n c e L a d y B a d d e le y ( L a d y o f G r a c e o f t h e O r d e r o f S t . J o h n ) , A ld e r m a n M is s M a r g a r e t H a r d y , M . B . E . , J . P . , D r . W . R . T a y l o r , M . B . E . ( M e d i c a l O f f i c e r f o r C i v i l D e f e n c e ) a n d C a n o n T . J. J a m e s , M . C . , M .A . ( C o r p s C h a p la in ) .

N o . IX D is tr ic t C a m b o r n e . — T h e a n n u a l e x a m in a tio n o f th e C a m b o r n e D i v i s i o n w a s h e ld r e c e n t ly , t h e e x a m i n e r b e i n g C o u n t y C o m m is s io n e r W . B l a c k w o o d , D . S . O . , M . B . T h e S u p e r in t e n d e n t is p le a s e d to r e p o r t t h a t m e m b e r s h ip s h o w s a c o n s i d e r a b le in c r e a s e . T h e f o l l o w i n g p r o m o t io n s h a v e b e e n m a d e : A m b u l a n c e O f f ic e r T . H . W i l l i a m s , T r a n s p o r t O f f ic e r H . E . L u k e , S e r g e a n t W . R e e d , C o r p o r a ls N . C . F in e , J . M e n h e n n e t t , W . In ch , T ra n sp o rt C o rp o ra l W . T o y a n d C a d et S u p e r in te n d e n t H . S . T r e m e llin g . I n r e c o g n i t i o n o f 2 2 y e a r s ’ e f f ic ie n t s e r v ic e , S e r g e a n t N . H a r r i s h a s b e e n h o n o u r e d w it h t h e r a n k o f S t a f f S e rg e a n t.

A t a m e e t i n g o f t h e H u d d e r s f ie l d Y o u t h C o m m i t t e e it w a s r e p o r t e d t h a t u n d e r a r r a n g e m e n t s m a d e b e t w e e n th e S t. J o h n A m b u la n c e A s s o c ia tio n a n d th e E d u c a tio n a n d Y o u t h C o m m i t t e e s , a n y Y o u t h G r o u p w i s h i n g t o o r g a n is e c la s s e s in fir s t a id a n d a m b u l a n c e w o r k s h o u ld a s k th e E d u c a t i o n C o m m i t t e e t o p r o v id e s u c h a c l a s s o n t h e g r o u p p r e m is e s , a n d f o r t h e c l a s s t o b e t r e a t e d a s a n e v e n i n g c la s s u n d e r t h e E d u c a t i o n C o m m i t t e e ’s s c h e m e f o r e v e n in g c la s s e s ,

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o n e o r o th e r o r a ll o f th e th re e ra c e s o f g e r m s , S tr e p to c o c c i, S t a p h y lo c o c c i a n d B . p y o c y a n e u s a re fo u n d in e v e r y s k i n i n f e c t io n c o m m o n t o t h is c o u n t r y , a n d A N T I P E O L O I N T M E N T c o n t a i n s t h e a n tib o d ie s ( a n t i v i r u s ) o f t h e s e g e r m s . H e a l i n g is e x p e d it e d b y t h e p r o v e d i n g r e d i e n t s o f t h e o in t m e n t , a n d s e p t ic d e v e lo p m e n t is s t o p p e d o r p r e v e n t e d b y it s a n t i v i r u s s t e r i l e v a c c i n e f il t r a t e s . A N T IP E O L O I N T M E N T is u n s u r p a s s e d f o r B U R N S a n d S C A L D S , f o r it is m i c r o b i c i d e a n d n o n - a d h e s iv e , a n d d r e s s i n g s d o n o t r e q u ir e t o b e c h a n g e d e v e r y d a y .

RHINO-ANTIPEOL a f f o r d s r a p id r e lie f o f C O M M O N C O L D S , I N F L U E N Z A , A N D C A T A R R H . C o n t a in in g th e a n tib o d ie s o f th e g e r m s c o m m o n to in fe c tio n s o f th e n o s e a n d p h a r y n x ( S t a p h y lo c o c c i, S t r e p to c o c c i, B . p y o c y a n e u s , p n e u m o c o c c i, p n e u m o b a c illi , e n t e r o c o c c i, M . c a t a r r h a l i s , B . P f e if f e r ) , R h i n o - A n t i p e o l is n o t ju s t a p a l l i a t i v e , b u t is a r e m o v e r o f th e c a u s e o f t h e i n f e c t io n . D u r i n g e p id e m ic s it is t h e id e a l p r e v e n t i v e o f m i c r o b e d e v e lo p m e n t .

OPHTHALM O-ANTIPEOL is a s e m i- f lu i d o in t m e n t , m o r e c o n v e n i e n t t h a n t h e o r d i n a r y A n t i p e o l o in t m e n t f o r o c u l a r in f e c t io n s a n d le s io n s . E y e s a f f e c t e d b y s m o k e a n d d u s t a r e s o o t h e d a lm o s t i m m e d i a t e l y b y t h e a p p l i c a t i o n o f O p h t h a l m o - A n t i p e o l , a n d t h e a n t i v i r u s p r e v e n t s g e r m s f r o m d e v e lo p i n g . Clinical Sam ples on request from M ED ICO -BIO LO GICAL LABOR ATO RIES LT D ., Cargreen Road. South N orw ood, London, S.E .25

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A c o m p e t i t i o n fo r t h e “ G e o f f r e y L u t t r e l l ” C u p , p r e s e n t e d b y G e o f f r e y F . L u t t r e l l , a d i r e c t o r o f t h e G . VV. R . , f o r c o m p e t it i o n b e t w e e n t h e s t a f f s o f t h e T a u n t o n d i s t r i c t t o o k p la c e a t T a u n to n on S a tu r d a y , J u n e 2 7 th . T h r e e te a m s e n te re d : W e llin g to n , T a u n to n N o s. 1 a n d 2, T h e a d ju d ic a to r w a s M r. J. G r e e n , o f E x e te r . The r e s u lts w e re a s fo llo w s W e l l i n g t o n , 85 p o in t s ; T a u n t o n N o . 1 , 8 1 ; T a u n t o n N o . 2, 7 0 ; p o s s ib le , 10 0 . T h e p r e s e n ta tio n o f th e c u p w a s m a d e b y M r. A . H . C h r is tis o n , C h ie f L o c o m o tiv e S u p t., N e w to n A b b o t. O th e r s p r e s e n t w e r e M r. F . H o lla n d , D iv is io n a l E n g in e e r , T a u n t o n ; M r. H . G . W o r t h , T r a ff ic S u p t., E x e t e r ; D r . lie s a n d D r . W in c k w o r th , T a u n to n ; M r. R . A . N e w s o n , D iv . A m b u la n c e S e c r e ta r y , N e w to n A b b o t. T h e W e llin g to n te a m w a s c o m p o se d o f C . G . B u c k la n d ( c a p t .) , C . H . C l a r k , T . L e e w o r t h y a n d H . J. B r ic e .

M illb a y R a ilw a y D iv is io n d u r in g th e p a s t y e a r tre a te d 3 5 0 c a s e s o f fir s t a i d , t h e m a j o r i t y o f w h i c h w e r e d u r i n g t h e e n e m y a i r r a i d s o n t h e c it y . T h e D i v i s i o n h a s a ls o a s s is t e d a t t h e P l y m o u t h a n d D i s t r i c t a m b u l a n c e s e r v ic e s t a t i o n s w i t h t r a n s p o r t o f 380 p a t ie n t s , c o v e r i n g 2 ,5 7 0 m ile s . The m e m b e r s h a v e a ls o b e e n a c t i v e i n d i v i d u a l l y in a s s i s t i n g t h e lo c a l a u t h o r i t i e s in t e a c h i n g fir s t a id to v a r i o u s o r g a n i s a t i o n s . M r . J . A . I lo t t , w h o w a s , a p p o in t e d S u p e r i n t e n d e n t o f t h e M i l l b a y D i v i s i o n , w h ic h fo u n d e d t h e S t . J o h n A m b u l a n c e B r i g a d e in P l y m o u t h iu 1 8 9 6 , is in c h a r g e o f t h e D i v i s i o n , w h i c h c o m p r is e s 40 m e m b e r s , o f w h o m 1 1 a r e s e r v i n g in t h e

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Every Home a Gas Centre. N o t a s in g le re fu sa l h a s b e en g iv e n b y E a s tb o u r n e h o u s e w i v e s w h e n a s k e d w h e t h e r t h e y w o u ld o p e n t h e i r h o m e s a s g a s c l e a n s i n g c e n t r e s in t h e e v e n t o f a g a s a t t a c k o n t h e to w n . D r. J o h n F e n to n ( M e d ic a l O ffic e r o f H e a lth ) h a s p r o v id e d a p a n e l o f q u a lif ie d g a s l e c t u r e r s , a n d a l l h o u s e w i v e s w h o s ig n if y w illin g n e s s to c o -o p e r a te w ill h a v e th e o p p o r t u n i t y s h o r t l y t o a t t e n d a g a s le c t u r e . I t w i l l l a s t o n ly a b o u t a n h o u r , a n d is b e i n g m a d e m o s t i n t e r e s t i n g . H o u s e w iv e s re s p o n s ib le fo r g a s c a s u a lt ie s m u s t k n o w s o m e th in g a b o u t th e s u b je c t. T h e y s h o u ld k e e p in t o u c h w i t h t h e ir W a rd e n s a b o u t a r r a n g e m e n ts fo r th e le c tu r e s ,

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1 D i s t r i c t , S .J .A .B . S h i r l e y N u r s i n g D i v i s i o n . — T h e a n n u a l g e n e ra l m e e t i n g w a s h e ld o n F r i d a y , J u n e 5 t h , a t B e n s o n F i r s t A id P o s t. L a d y D i s t r i c t O f f i c e r M is s G r i n d l e y w a s in t h e c h a ir , s u p p o r te d b y L a d y D iv . P r e s id e n t M rs. F . B . L e w in , v ic e -P r e s id e n t M r . J. A . P a r k e , L a d y D i v . S u p t . M r s . K a n a a r , L a d y A m b u l a n c e O f f ic e r M r s . D a n e , a n d t h e D i v . S e c r e t a r y a n d T reasu rer. T h e T r e a s u r e r ’s r e p o r t s h o w e d th e fin a n c e s o f th e D iv i s io n t o b e s a t i s f a c t o r y , a l t h o u g h t h e b a l a n c e in h a n d w a s l o w e r t h a n t h a t b r o u g h t f o r w a r d f r o m t h e p r e v io u s y e a r . T h e S e c r e t a r y r e p o r t e d t h a t t h e m e m b e r s h ip o f t h e D i v i s i o n h a d in c r e a s e d , a n d a tte n d a n c e s w e re h ig h ly s a tis fa c to r y . L a d y D i v . S u p t . M r s . K a n a a r s a id t h a t t h e M e d ic a l C o m fo r t s ’ D e p o t h a d b e e n o f g r e a t e r s e r v ic e d u r in g th e y e a r . I n c o n j u n c t i o n w i t h t h e H o m e G u a r d , R e g i m e n t a l A id P o s t s h a d b e e n e s t a b lis h e d t h r o u g h o u t th e d is tr ic t, a n d m a n y m e m b e r s h a d o ff e r e d t h e u s e o f t h e ir h o m e s f o r t h is p u r p o s e . T h e c h a i r m a n p r e s e n t e d M r s . L e w i n w i t h h e r P r e s i d e n t ’s b a d g e o f o ffic e , a n d M r . P a r k e h a n d e d M r s . K a n a a r a fin e s h i e ld to b e c o m p e t e d f o r a n n u a l l y b y m e m b e r s o f t h e D i v i s io n , f o r w h i c h h e w a s h e a r t i l y t h a n k e d . T h e m e e t i n g w a e p r e c e d e d b y a n im p o r t a n t e v e n t in t h e h is to r y o f th e D iv is io n , th e fo r m a tio n o f th e S h ir le y C a d e t N u r s in g D iv is io n . M r s . C h e y n e y , L a d y D i s t r i c t O f f ic e r fo r C a d e t s , w a s p r e s e n t to e n r o l 3 2 c a d e t s w h o h a d p a s s e d t h e q u a l i f y i n g fir s t a id e x a m i n a t i o n . S h e p re s e n te d th e C a d e t D iv is io n w ith its C o d e o f C h iv a lr y , a n d c o n g r a t u la t e d A m b u l a n c e S i s t e r H a y w a r d , w h o h a d t r a i n e d t h e g i r l s a n d w a s in c h a r g e of th e m , on th e s u c c e s s o f th e w o r k sh e h ad u n d e r ta k e n . A c o m p e t it i o n h a d b e e n h e ld , a n d M r . J. A . P a r k e p r e s e n t e d p r i z e s ' to t h e w i n n e r s — C a d e t s A n n e S m i t h , A d a G a s s o n , J ill P a r k e a n d S y lv ia W e s t.

8 D i s t r i c t , S .J .A .B . M a l d e n a n d C o o m b e N u r s in g D iv is io n .— T h e M ayo r, A ld e r m a n F . S . W a g n e r , a tte n d e d th e a n n u a l g e n e r a l m e e t i n g o f t h i s D i v i s i o n w h i c h w a s h e ld o n T u e s d a y , J u n e 9 th . L a d y D i v . P r e s i d e n t M r s . W . K . B a l d r y w a s in t h e c h a ir , a n d w a s s u p p o r t e d b y t h e M a y o r e s s , M r s . W a g n e r , v ic e P r e s i d e n t , a n d L a d y D i s t r i c t O f f ic e r M is s W e s t . I t w a s re p o r te d , th a t n o t w it h s t a n d in g th e c a lls m a d e b y C iv il D e fe n c e d u tie s , a s s is t a n c e h a d b een g iv e n b y m e m b e rs a t th e lo c a l h o s p ita ls a n d to th e D is t r ic t N u r s in g A s s o c ia t io n , a n d a t t h e O d e o n C i n e m a . M e m b e rs h a d a ls o d e m o n s t r a t e d p r a c t i c a l w o r k a t fir s t a i d c la s s e s . D u r i n g t h e y e a r 3 7 p a t ie n t s h a d r e c e iv e d fir s t a id t r e a t N o.

m e n t. S i x m e m b e r s h a d c o m p le t e d t h r e e y e a r s ’ e f f ic ie n t s e r v ic e in t h e D i v i s i o n a n d h a d g a i n e d t h e ir c h e v r o n s . A C a d e t N u r s i n g D i v i s i o n is b e i n g f o r m e d , a n d p r o s p e c tiv e c a d e ts w e r e p r e s e n t a t th e m e e tin g .

N o.

9 D i s t r i c t , S .J .A .B . W e y m o u t h C a d e t N u r s i n g D i v i s i o n .— L o o k in g n eat a n d s e r v i c e a b l e in t h e i r u n i f o r m s , m e m b e r s o f t h i s D i v i s i o n r e c e iv e d t h e ir p r o fic ie n c y b a d g e s a n d c e r t ific a t e s a t th e S t. J o h n A m b u l a n c e H a l l , W e y m o u t h , r e c e n t ly . P ro u d e st of a l l , a l t h o u g h s h e h a s t w o y e a r s t o w a i t b e fo r e s h e c a n d o n u n if o r m , w a s n in e - y e a r - o l d Y v o n n e D a y w h o t o o k h e r fir s t a id c e r tific a te . S h e is f o l l o w i n g w o r t h i l y in t h e m a t e r n a l fo o ts te p s o f L a d y C a d e t S u p t. M rs. D a y . D r . G o r d o n W a l l a c e , M e d ic a l O f f i c e r o f H e a l t h , w a s in t h e c h a i r , a n d t h e r e w e r e a ls o p r e s e n t L a d y C o u n t y S u p t . M rs. C o o p e r, a n d o th ers. I n h e r i n t e r e s t i n g r e p o r t o n t h e y e a r , M r s . D a y r e fe r r e d

R I D to t h e f in a n c ia l p o s it io n a s s l i l l q u it e g o o d . T h e C adet D iv is io n w a s s t ill s u p p o r t e d m y m e m b e r s ’ w e e k l y s u b s c r i p t io n s o i 2 d . p e r w e e k . T h e s e n io r N u r s i n g D i v i s i o n h a d g i v e n t h e m a g r a n t o f £ S fr o m t h e p r o c e e d s o f t h e F a g D a y . W i t h t h is m o n e y t h e y h a d b o u g h t a fir s t a id c a s e . T h e g i r l s h e ld a c o m p e t it io n f o r a b l a n k e t t h e y h a d k n i t t e d , w h ic h r e a lis e d n e a r l y T h i s w a s h a n d e d o v e r to t h e b u i l d i n g fu n d . T h e fir s t a id e x a m i n a t i o n t h is y e a r h a d b e e n d is a p p o in t i n g , t w e n t y g i r l s t a k i n g it a n d o n ly 1 3 p a s s i n g . T h is h ad m a d e t h e m r e a l i s e t h a t o n ly fir s t c l a s s k n o w l e d g e w a s g o o d e n o u g h fo r t h e B r i g a d e . N in e c a d e t s w e r e s u c c e s s f u l in h o m e n u r s i n g ; 1 1 p a s s e d t h e h y g i e n e e x a m i n a t i o n ; 11 p a s s e d in c h ild w e lf a r e , 1 3 in h a n d ic r a f t , a n d 1 7 in c o o k e r y . C a d e t O l i v e C o x w a s p r o m o t e d to s e r g e a n t , a n d C a d e t s C i c e l y B u t l e r a n d J o s e p h in e P a c k w o o d t o c o r p o r a l s . A t e a c h F la g D a y th e c a d e ts h a d d o n e u s e fu l w o r k , a n d t h e y d e l i g h t e d to t u r n o u t fo r a n y p a r a d e s . T h e rep o rt c o n c lu d e d w it h t h a n k s to C a p t a i n H in c h c li f f e , D r . G o r d o n W a l l a c e a n d L a d y D iv . S u p t . M r s . B a r t le t t . T h e c h a i r m a n c o n g r a t u l a t e d t h e D i v i s i o n o n it s w o r k , a n d s a id h e c o n s id e r e d t h e r e p o r t v e r y s a t i s f a c t o r y in d e e d . T h e n f o l lo w e d t h e d is t r ib u t io n o f b a d g e s a n d c e r t if ic a t e s . A f t e r t h e d is t r ib u t io n M r s . S h e w e l l g a v e t h e g i r l s a w o r d of e n c o u ra g e m e n t. “ I t is n o t t h e g i r l s w h o c o m e o u t o n to p a t t h e e x a m i n a t i o n s t h a t I a d m i r e , ” s h e s a id , “ b u t t h o s e w h o s t i c k it a n d c o m e b a c k a g a i n . ” S h e c o n g r a t u l a t e d t h e m a l l o n t h e ir s u c c e s s e s a n d h o p e d t h e y w o u ld a l w a y s in v i t e h e r to t h e s e p r e s e n t a t i o n s . L a d y C a d e t O f f ic e r M r s . B e s t t o ld t h e g i r l s s h e h a d b e e n m u c h im p r e s s e d b y w h a t s h e h a d s e e n , a n d o ff e r e d h e r c o n g r a tu la tio n s . L a d y C o u n ty S u p t. M rs. C o o p e r, a fte r g iv in g a w a y th e p r o f ic ie n c y b a d g e s r e m a r k e d “ I k n o w t h a t in t h e f u t u r e y o u to o w ill b e G r a n d P r io r C a d e ts . W e h a d 1 0 in t h e W e y m o u t h D i v i s i o n , s o y o u h a v e a r e c o r d f o r G r a n d P r io r B a d g e s .” S h e s p o k e o f t h e s u c c e s s o f t h e c a d e t m o v e m e n t in o t h e r t o w n s , n o t a b l y in D o r c h e s t e r w h e r e t h e r e w e r e 9 0 , a n d a ls o in W a r e h a m w e r e t h e r e w a s a l a r g e D i v is io n . D r . W a l l a c e s a id t h e r e w a s n o r e a s o n w h y t h e y s h o u ld n o t a s s o c i a t e t h e m s e lv e s w i t h t h e G i r l s ’ T r a i n i n g C o r p s m o v e m e n t , b u t t h e y m u s t n o t g i v e u p t h e ir w o r k in t h e C a d e t N u r s i n g D i v is io n . H e t h r i lle d t h e s e n io r c a d e t s b y s a y i n g , “ T h e n e w w a r - t i m e n u r s e r y is to b e o p e n e d v e r y s h o r t ly a t E l w e l l M a n o r , a n d I in v i t e y o u s e n io r c a d e t s h o l d i n g c h ild w e l f a r e c e r t i f i c a t e s to h a n d in y o u r n a m e s to M r s . D a y a s v o lu n t a r y h e lp e r s t h e r e . ” M rs. C o o p e r w a r m ly th a n k e d D r. W a l l a c e f o r g i v i n g t h e g i r l s s u c h a n o p p o r t u n it y . A f t e r w a r d s , t h e c a d e t s w e n t o n t h e s t a g e a n d t o ld t h e s to r y o f th e C r u s a d e s a n d th e O r d e r of S t. J o h n .

N o.

10 D i s t r i c t , S .J .A .B . W e s t N o r f o l k a n d K in g s L y n n N u r s in g D iv isio n s. — T h e s e D i v i s i o n s a t t e n d e d a C h u r c h P a r a d e a t S t . M a r g a r e t ’s C h u r c h , K in g s L y n n , o n J u n e 1 4 th , w h e r e th e s e r v ic e w a s c o n d u c te d b y th e v ic a r , a n d th e s e rm o n p r e a c h e d b y th e R e v . R . B r i n k e r , C h a p l a i n t o t h e P o l is h F o r c e s in G t . B r it a in . A m o n g t h e o f f ic e r s w h o a t t e n d e d w e r e A s s i s t a n t C o u n t y C o m m i s s io n e r D r . W . E . R u t l e d g e a n d h is w if e , L a d y C o u n t y S u p t. D r . M a y R u tle d g e . . F o llo w in g th e s e r v ic e , th e A s s is ta n t C o u n t y C o m m is s io n e r w a s jo in e d b y t h e M a y o r a n d p r o c e e d e d to in s p e c t th e D iv is io n s . H e c o n g r a t u l a t e d a ll o n t h e ir s m a r t a p p e a r a n c e , a n d th e n to o k th e s a lu te a t th e m a rc h p a st.

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Q u e r i e s w i l l b e d e a l t w i t h u n d e r t h e f o l l o w i n g r u l e s :— 1 . — L e t t e r s c o n t a i n i n g Q u e r i e s m u s t b e m a r k e d o n t h e to p le f t - h a n d c o r n e r o f t h e e n v e lo p e “ Q u e r y , ’ ’ a n d a d d r e s s e d to F i r s t A i d , 4 6 , C a n n o n - s tr e e t, L o n d o n , E .C .4 . 2 . — A l l Q u e r i e s m u s t b e w r i t t e n o n o n e s id e o f p a p e r o n ly . 3 .— A ll Q u e r ie s m u s t b e a c c o m p a n ie d b y a “ Q u e r y C o u p o n ” c u t f r o m t h e c u r r e n t is s u e o f t h e J o u r n a l, o r , in c a s e o f Q u e r i e s f r o m a b r o a d , fr o m a r e c e n t is s u e . 4 .— T h e T e x t b o o k t o w h i c h

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D . ( G a t e s h e a d ) . — T o s e t t l e a n a r g u m e n t , w i l l y o u p le a s e s a y w h i c h a r m s l i n g s h o u ld b e u s e d fo r a p a t ie n t s u f f e r i n g f r o m p r o f u s e a r t e r i a l b l e e d i n g f r o m t h e p a lm o f h a n d , c o m p o u n d f r a c t u r e o f t h e a r m , a n d c o m p lic a t e d f r a c t u r e o f t h e r ib s , a ll i n j u r ie s b e i n g o n t h e s a m e s id e o f th e b o d y ?

T h i s c o m b i n a t io n o f i n j u r i e s d e m a n d s a r e c u m b e n t p o s it i o n o f p a t i e n t a n d h i s r e m o v a l o n s t r e t c h e r . In th e s e c i r c u m s t a n c e s I t h i n k t h a t a s m a ll a r m s l i n g w i l l d o a l l t h a t is n e c e s s a r y , e s p e c i a l l y a s t h e f r a c t u r e d a r m is t h e i n j u r y m o s t l i a b l e to a g g r a v a t i o n d u r i n g t r e a t m e n t a n d t r a n s p o r t . N. C o rb et F le tc h e r.

R . D . ( B r i s t o l ) . — P le a s e t e ll m e if t h e a c t i o n o f h e a t a p p lie d t o t h e b o d y i n c r e a s e s t h e v o l u m e o f b lo o d s u p p l y in t h e d ila t e d b lo o d v e s s e l s o n t h e p r in c i p le o f t h e e x p a n s io n in w a te r on b o ilin g . T h e a c t i o n o f h e a t a p p lie d t o t h e b o d y is t o d i l a t e t h e s u r f a c e b lo o d v e s s e l s a n d t h e r e b y t o d r a w a n in c r e a s e d q u a n t i t y o f b lo o d t o t h e p a r t u n d e r t r e a t m e n t . — N . C . F . A p p lic a tio n o f C o ld w ith H e a d I n ju r ie s . J .C . ( I s l e o f M a n ) . — P l e a s e t e ll m e if th e. in s t r u c t i o n s o f t h e T e x t b o o k ( R u l e 3 o n p . 1 6 4 ) to a p p l y ic e o r c o ld w a t e r to t h e h e a d c o n t i n u o u s l y in c a s e s o f h e a d in j u r i e s w o u ld s t ill a p p ly if t h e r e w a s a s e v e r e w o u n d o f t h e c r a n iu m t o g e t h e r w it h f r a c t u r e , o r if t h e c o r r e c t t r e a t m e n t in s u c h a c a s e w o u ld b e t o d r e s s t h e w o u n d a n d a p p l y a r i n g p a d .

E x a m in a t io n H o w le r . L .R . ( C h a r lto n P a r k ) . — In a re c e n t e x a m in a tio n I a s k e d o n e c a n d i d a t e h o w h e w o u ld t r e a t a w o m a n w h o s e d r e s s w a s o n fir e . I c o n fe s s th a t I p r o te s te d w h e n h e re p lie d — ‘ 1 I w o u l d th r o w h e r o n th e g r o u n d a n d s m o th e r h e r w ith a w e t b la n k e t! " T o m e th e tre a tm e n t s u g g e s te d w a s a lt o g e t h e r to o d r a s tic 1 1 Good !

N e x t , p le a s e 1 !— N . C . F . T r e a tm e n t o f C a r b id e P o is o n in g .

J . G . ( L e e d s ) . — P l e a s e t e ll m e h o w w e s h o u ld t r e a t a p a t ie n t w h o h a s s w a l l o w e d s o r tie c a l c i u m c a r b id e . L i t t l e is k n o w n a b o u t t h e t r e a t m e n t o f c a l c i u m c a r b id e p o i s o n i n g ( w h i c h m a y p r o v e f a t a l in 3 o r 4 h o u r s ) e x c e p t t h a t t r e a t m e n t m u s t b e i m m e d i a t e a n d p r e v e n t t h e p r o d u c t io n o f a c e ty le n e g a s . T h e s u b j e c t h a s b e e n u n d e r d i s c u s s i o n in th e s e c o lu m n s d u r in g th e p a s t t w e lv e y e a r s . T h e n e t r e s u lt o f t h e s e d is c u s s i o n s is t h a t g l y c e r i n e ( w h i c h a b s o r b s w a t e r ) is t h e b e s t a n t i d o t e in t h e h a n d s o f f i r s t a i d e r s w h o s h o u ld a d m i n i s t e r it f r e e l y a n d t h e n t a k e s t e p s to m a k e t h e p a t ie n t v o m it to c le a r th e s t o m a c h . E l s e w h e r e it h a s b e e n s u g g e s t e d t h a t m e d i c i n a l p a r a f f in a c t s s i m i l a r l y t o g l y c e r i n e e x c e p t t h a t it is i n s o l u b l e in w a t e r a n d a l c o h o l . F o r t h is r e a s o n I w o u ld t r y t h e p a r a f f i n if I c o u ld n o t o b t a i n g l y c e r i n e fo r a d m in is t r a t io n to m y p a t ie n t .— N .C .F . C o m p o u n d F ra c tu r e o f C la v ic le . T . R . ( W a lw o r t h ) .— W it h r e fe r e n c e to y o u r r e p ly to th e q u e r y p u b lis h e d u n d e r t h e a b o v e h e a d i n g in t h e M a y i s s u e o f F i r s t A i d , w o u ld n o t th e tr e a tm e n t w h ic h y o u s u g g e s t ( f u lc r u m , S t . J o h n s l i n g , a n d b r o a d b a n d a g e ) v io la t e R u le 4 o f th e G e n e r a l R u le s fo r T r e a t m e n t of F r a c t u r e s (T e x tb o o k p. 67) ? I fe a r th a t th e b ro a d b a n d a g e a p p lie d o n t h e p o in t o f e l b o w w o u ld e x e r t e x t e n s i o n o n t h e p r o t r u d i n g f r a g m e n t s ; a n d I s u g g e s t t h a t it w o u ld b e b e t t e r t o o m it t h is b a n d a g e . I w o u ld v a l u e y o u r a d v i c e a n d c o m m e n t s o n t h is s u g g e s t i o n . I f th ere

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O f c o u rse y o u a r e r ig h t. A p p lic a t i o n o f ic e o r c o ld w a t e r is n o t t h e c o r r e c t t r e a t m e n t o f a w o u n d .'— N . C . F . T r e a tm e n t o f L y s o l P o is o n in g . J . C . ( I s l e o f M a n ) . — P l e a s e t e ll m e if in t h e t r e a t m e n t o f l y s o l p o i s o n i n g a n a n t i d o t e i s t o b e g i v e n , a n d if s o , if it is a d m i n i s t e r e d b e fo r e o r a f t e r t h e E p s o m s a l t s o r m e d ic in a l p a r a ffin . I f in s u c h a c a s e y o u a d m i n i s t e r m e d ic in a l p a r a ffin , y o u , w ill d o a ll t h a t th e T e x t b o o k r e q u ir e s y o u to d o . W h e n t h is is n o t a v a i l a b l e t h e n y o u s h o u ld a d m i n i s t e r E p s o m s a l t s w h ic h on th e o r e tic a l g r o u n d s w a s o n c e r e c o m m e n d e d a s th e a n t i d o t e to l y s o l . — N . C . F . • F r a c t u r e s o f T h ig h a n d P a te lla . E .C . ( T h o r n to n H e a t h ) .— A t a r e c e n t p r a c tic e a te s t c a s e w a s g i v e n t o o u r t e a m o f a f r a c t u r e d le f t t h i g h a n d r i g h t p a t e l la . T h e r e w a s a d i v i s i o n o f o p in io n w h e t h e r w e s h o u ld c o n t r o l t h e f r a c t u r e d p a t e l l a fir s t b y a b a c k s p l in t a n d f o u r b a n d a g e s , t ie b o t h f e e t t o g e t h e r a n d t h e n d e a l w i t h t h e f r a c t u r e d t h i g h in t h e u s u a l m a n n e r , t h e b a n d a g e s b e i n g p la c e d r o u n d b o t h lim b s , o r w h e t h e r w e s h o u ld t r e a t t h e p a t e l la in a c c o r d a n c e w i t h t h e T e x t b o o k i n s t r u c t i o n s (p . 90) e le v a t e , a n d a p p l y a s e c o n d s p l in t to t h e t h i g h o n t h e in n e r s id e , d e a l i n g w i t h e a c h lim b s e p a r a te ly . Y o u r r u l i n g a s t o t h e c o r r e c t m e t h o d w o u ld b e g r e a t l y a p p r e c ia t e d . W i t h t h is c o m b i n a t io n o f in j u r i e s t h e f r a c t u r e d t h i g h r e q u i r e s p r e f e r e n t i a l t r e a t m e n t a s t h e m o r e s e r io u s i n j u r y , w h i l s t t h a t f o r t h e f r a c t u r e d p a t e l l a m u s t b e m o d if ie d . Con s e q u e n t ly , a f t e r c o n t r o l l i n g t h e f r a c t u r e d r i g h t p a t e l la w it h a f i g u r e - o f - e i g h t b a n d a g e , y o u s h o u ld p r o c e e d t o t r e a t t h e f r a c t u r e d le f t t h i g h in a c c o r d a n c e w i t h t h e T e x t b o o k i n s t r u c t io n s .— N .C . F . H u m o u r in F ir s t A id . M .R . (C a n n o n S t .) .— O n e e v e n in g n ot lo n g a g o o u r s u r g e o n , a t t h e c lo s e o f h is le c t u r e , s a i d — “ I h a v e t o ld y o u a l l th a t I k n o w a b o u t f r a c t u r e s a n d t h e ir t r e a t m e n t ; a n d so I w i l l

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a s k y o u s o m e q u e s t i o n s ." T o o u r u n u t t e r a b l e s u r p r is e a n d p r o f o u n d a m u s e m e n t o u r y o u n g e s t r e c r u it p r o m p t ly a n d in n o c e n t l y r e p l i e d — “ W e ll, S i r , w h a t d o y o u w a n t to k n o w ? ” G ood!

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S . ( G l a s g o w ) . — I w o n d e r if y o u c o u ld t e ll m e w h i c h o f t h e f o l l o w i n g is c o r r e c t ? I n a n a r t i c l e in t h e S e p t e m b e r , 1 9 4 0 , i s s u e o f F i r s t A i d on “ M e c h a n ic a l R e v iv ic a t io n ,” D r. G ilb e r t B u r n e t s t a t e s r e g a r d i n g a s p h y x i a , “ . . . . o f c o u r s e , t h e fin a l r e s u l t is t h e s a m e . O x y g e n is n o t c o n s u m e d , t h e r e f o r e c a r b o n - d i o x i d e is n o t p r o d u c e d in t h e b lo o d , a n d c o n s e q u e n t l y t h e r e s p i r a t o r y c e n t r e , w h i c h r e q u ir e s t h is a s a s t i m u l a n t , c e a s e s to f u n c t i o n a n d s o a u t o m a t i c a l l y b r e a th in g c e a s e s .” D r . H . M . R o b e r t s o n “ A s p h y x i a ” in t h e J a n u a r y , 1 9 4 1 , is s u e , w r ite s t h u s : “ W h e n th e q u a n tity o f c a r b o n ic a c i d i s n o r m a l, r e s p i r a t i o n w o r k s w i t h a s t e a d y a n d c o m f o r t a b l e f r e q u e n c y a n d u n if o r m f o r c e , b u t if t h e c a r b o n i c a c i d in t h e b lo o d i n c r e a s e s , e i t h e r t h r o u g h n o t b e i n g e li m i n a t e d o r f r o m w a n t o f o x y g e n , t h e r e s p i r a t o r y c e n tr e im m e d ia t e ly e m its m o re p o w e r fu l s tim u li a n d c a u s e s t h e r e s p i r a t o r y m o v e m e n t s to b e c o m e q u i c k e r a n d d eep er . . . . ”

1 w a s a l w a y s u n d e r t h e im p r e s s io n t h a t in a s p h y x i a t h e b lo o d w a s lo a d e d w i t h c a r b o n i c a c i d g a s b u t a c c o r d i n g t o t h e fir s t e x t r a c t t h a t is n o t s o . I f m y a s s u m p t io n is c o r r e c t a n d t h e b lo o d i s lo a d e d w i t h c a r b o n d io x i d e w h y is it a d v i s a b l e to u s e a C 0 2 i n h a l a t o r ? I a m a r e g u l a r r e a d e r o f F i r s t A id a n d c u t o u t a n d p a s te y o u r re p lies in to a s c r a p b o o k . I find th is b o o k e x c e lle n t fo r referen ce. Y o u e r r in t h i n k i n g t h a t in a s p h y x i a c a r b o n - d i o x i d e is p r e s e n t in l a r g e q u a n t i t i e s in t h e b lo o d s t r e a m . T h i s g a s is o n e o f th e p r o d u c ts o f th e c o m b in a tio n o f o x y g e n w ith o th e r e le m e n t s . C o n s e q u e n tly , c a rb o n d io x id e c a n n o t b e fo rm e d e x c e p t in t h e p r e s e n c e o f o x y g e n . F r o m t h is y o u w i ll r e a lis e th a t b o th d o c to rs w e r e t e a c h in g th e s a m e f a c t .— N .C .F . I n s e n s ib ilit y w ith A p o p le x y . C .M . ( N e a s d e n ) .— R e c e n tly a n o th e r m e m b e r o f m y D iv is io n a n d I h e a r d o f a c a s e o f a p o p l e x y w h ic h g a v e a ll t h e s i g n s a n d s y m p t o m s o f t h a t c o n d it i o n e x c e p t t h a t t h e p a t ie n t w a s f u l l y c o n s c i o u s . T h i s s u r p r is e d u s b e c a u s e w e b o t h t h o u g h t t h a t in a l l s u c h c a s e s i n s e n s i b i l i t y is p r e s e n t a s t h e r e s u lt o f h a e m o r r h a g e in t o t h e b r a in t i s s u e s . S o w e w e l c o m e y o u r v a lu e d o p in io n , e s p e c i a l l y a s t h e T e x t b o o k is s ile n t o n t h is p o in t. W i t h s u c h c a s e s t h e d e g r e e o f i n s e n s i b i li t y w i l l v a r y w it h t h e s iz e o f t h e h a e m o r r h a g e in t o t h e b r a in . C o n s e q u e n tly t h e p a t i e n t m a y b e t o t a l l y u n c o n s c i o u s i f t h e h a : m o r r h a g e is s e v e r e o r f u l l y c o n s c io u s if t h i s is s l i g h t . I n c i d e n t a l l y it w i ll h e lp y o u if I p o in t o u t t h a t t h e o n ly c o n d it i o n in w h i c h t h e p a t i e n t is a l w a y s a n d c o m p le t e ly u n c o n s c i o u s is E p ile p s y ( “ s u d d e n a n d c o m p l e t e ” — T e x t b o o k p . 1 6 0 ) ; a n d t h a t in a l l t h e o t h e r s n a m e d in t h e T e x t b o o k t h e p a t ie n t m a y b e f u l l y c o n s c i o u s , p a r t i a l l y u n c o n s c i o u s o r c o m p le t e ly u n c o n s c io u s .— N .C . F . I n d e x fo r R e p l ie s to Q u e r ie s . W . J . ( Y o r k ) . — B y p i e c in g t o g e t h e r in f o r m a t i o n o b t a in e d fr o m y o u r v e r y v a l u a b l e a n s w e r s in F i r s t A i d , I in t e n d to - c o m p r i s e s o m e fo r m o f n o t e b o o k ; b u t u p - t o - d a t e I h a v e b e e n u n a b l e t o d e c id e o n i t s e x a c t c h a r a c t e r in r e g a r d t o t h e m o s t s u i t a b l e in d e x . I s h o u ld , t h e r e f o r e , b e g r a t e f u l if y o u w o u ld k i n d l y g i v e m e y o u r a d v i c e o n t h e m a t t e r . W h e n f ir s t I b e g a n t o a n s w e r q u e r i e s I w a s f a c e d w it h t h e s a m e p r o b le m ; a n d I im p r o v i s e d a t h u m b in d e x w h i c h is

R I D b a s e d o n m y a id to m e m o r y w o r d — M I S H A P S — a n d in w h ic h I p a s t e q u e r ie s a n d t h e ir a n s w e r s . T h i s w o r d c o v e r s t h e w h o le s c o p e o f fir s t a id a n d c o m p r is e s M a i m s ( i n c l u d i n g f r a c t u r e s , d i s lo c a t i o n s , s p r a i n s a n d s t r a i n s ) , I n s e n s i b i l i t y , S c a l d s a n d a l l lo c a l in j u r i e s ( in c lu d i n g b u r n s , b it e s , b r u is e s , & c . ), H a e m o r r h a g e ( a n d w o u n d s ) , A s p h y x i a ( a n d a r t i f i c i a l r e s p ir a t io n ) , P o i s o n i n g a n d S h o c k . T o th e s e I a d d e d tw o m o re h e a d in g s — T r a n s p o r t a n d O d d m e n ts. T h i s in d e x h a s s e r v e d m e w e ll d o w n t h e y e a r s , a n d I c a n q u i c k l y lo o k u p a n y q u e r y w i t h w h i c h I h a v e d e a l t o n a p r e v io u s o c c a s i o n . — N . C . F . A p p lic a tio n o f L in t. ( D . P . T e d d in g t o n ) .— I h a v e a lw a y s u n d e r s to o d t h a t th e s m o o t h s id e o f lin t s h o u ld b e a p p lie d t o a w o u n d . H ow e v e r, I h a v e n o w h e a r d fr o m s e v e r a l s o u r c e s (1 ) th a t th e flu ffy s id e s h o u ld b e a p p lie d , in w h i t e lin t , s o t h a t w h e n t h e l a t t e r is r e m o v e d t h e l i t t l e h a i r s r e m a in in t h e f o r m in g s c a b , o r w o u n d , a n d so p rev e n t th e s k in o r sc a b b e i n g p u lle d a w a y w i t h t h e l i n t a n d ( 2 ) t h a t t h e f lu f f d o e s n o t h a r m t h e w o u n d in a n y w a y , a n d in t h e c a s e o f b o r a c i c l i n t is d e f in it e l y b e n e f ic ia l. F o r t h is r e a s o n , w h e n b u y i n g lin t , t h e flu f fy s id e is a l w a y s f o u n d to b e t u r n e d i n w a r d s . I s h o u ld b e m o s t g r a t e f u l f o r y o u r o p in io n c o n c e r n i n g t h is m a t t e r . T h e p o in t is o f lit t le i m p o r t a n c e b u t p r o b a b ly in p r a c t ic e t h e m a j o r i t y a p p ly t h e s m o o t h s u r f a c e o f p la in lin t to w o u n d s a n d t h e flu f fy s u r f a c e o f b o r a c i c lin t to in f la m e d p a r t s a s fo m e n t a t i o n s o n t h e p r in c i p le t h a t t h is c o n t a i n s m o r e b o r a c ic p o w d er. T h is , to g e t h e r w ith th e re d u c e d r is k o f c o lle c tin g d u s t , p r o b a b ly e x p l a i n s t h e i n t u r n i n g o f p la in a n d b o r a c ic lin t in r o l l s . — N . C . F . W a r T im e T re a tm e n t. H . T . ( C h e s t e r ) . — T h i s D e p o t is m a n n e d e n t ir e ly b y p a r t t im e v o lu n te e r s w h o a r e a ll m e m b e r s o f S .J .A .B . R e c e n tly w e e a c h h a d a c o p y o f t h e e n c lo s e d b o o k is s u e d to u s . T h e s q u a d o f w h ic h I a m a m e m b e r h a v e h a d a fe w a r g u m e n t s a b o u t t h is b o o k , a n d a t l a s t d e c id e d t o a s k y o u f o r y o u r v a lu e d o p in io n o f s a m e , s e e i n g t h a t it d iffe r s v e r y m u c h fr o m o u r T e x t b o o k . W e t h o r o u g h ly e n j o y y o u r a n s w e r s t o q u e r i e s a n d lo o k f o r w a r d e a g e r ly ' fo r e a c h is s u e o f F i r s t A i d . M o s t , if n o t a ll, o f t h e in s t r u c t io n s , w h i c h a p p e a r t o b e c o n t r a r y to t h o s e o f t h e T e x t b o o k , a r e n e c e s s i t a t e d b y t h e p e c u li a r c o n d it io n s w h i c h m u s t p r e v a i l d u r i n g t h e f u s s a n d b o t h e r o f a i r r a i d s a n d w h i c h c a l l f o r a m o d if ic a t io n o f o r t h o d o x f ir s t a id . P e r s o n a l l y I fin d n o f a u l t w it h t h e b o o k le t w h ic h s e e m s to m e to b e b a s e d o n c o m m o n s e n s e a n d m o s t p r a c tic a l— N .C . F . R o p i n g P a t ie n t to S t r e t c h e r . J . C . ( B r o o m ) . — P l e a s e a d v i s e h o w w e c a n r o p e a c a s u a l t y to a s t r e t c h e r b y u s e o f t r i a n g u l a r b a n d a g e s o n ly . T h e r e is n o o f f ic ia l ly d e s c r ib e d m e t h o d o f t y i n g a p a t ie n t t o t h e s t r e t c h e r ; a n d s o I s u g g e s t t h a t y o u fin d o u t fr o m y o u r lo c a l C i v i l D e f e n c e d e p o t h o w p a t ie n t s a r e lo w e r e d o n s tr e tc h e r fro m d a m a g e d b u ild in g s .— N .C .F .

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P O C K E T F IR S T A ID S E R IE S . B y C o l. R . J. B L A C K H A M , C .B ., C . M .G ., C .I .E ., D .S .O ., M .D . ( 1 ) P o i s o n i n g , ( 2 ) H a s m o r r h a g e , (3 ) I n s e n s i b i l i t y , ( 4 ) A s p h y x i a ( S u s p e n d e d B r e a t h i n g ) , (5 ) F r a c t u r e s , D i s l o c a t i o n s a n d S p r a i n s , (6 ) W o u n d s , B i t e s , B u r n s , S c a l d s , R u p t u r e a n d M in o r I n j u r i e s . T h e S e r ie s c o n ta in s a ll th e e s s e n tia ls of F i r s t A id . P r in t e d o n lin e n - lin e d c a r d s , 3£ in . x 5 * in . T h ir d E d itio n 6 d . n e t each , p o s ta g e 2d . e x tr a . B y th e s a m e A u th o r— ■ A IR R A ID F IR S T A ID A S e r i e s o f 1 5 C h a r t s c o v e r in g a ll th e d u tie s o f a F ir s t A id W o r k e r , g iv in g fu ll in stru ctio n s as t o A i r R a id effects and p r e c a u tio n s, re c o g n itio n and tre a tm e n t o f in ju rie s. T h e I d e a l W a U C h a r t . S i z e 2 2 \ in . x 1 4 * i n ., h a s b e e n p r e p a r e d fo r u s e in A i r R a i d S h e l t e r s , R e d C r o s s a n d S t J o h n ’s A m b u l a n c e S t a t i o n s a n d C l a s s e s , a n d a l l p la c e s w h e r e F i r s t A id a n d N u r s i n g a r e r e q u ir e d . P r i c e 2 s . 6 d . P o s t a g e 6 d . T h e H o m e C h a rt. S i z e 1 3 in . x 7^ i n ., h a s b e e n s p e c i a l l y p r e p a r e d f o r u s e in t h e H o m e o r s m a l l g r o u p s , p r ic e l s . 6 d . post 3d. A l s o in B o o k l e t F o r m . P r ic e 9 d. ; p o s t Id

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INFLUENZA INCURVED EDGE OF SOCKET S .1343 " SANOID ” INTERLOCKING EXTENSION SPLINTS With Metal sockets for jointing. 2 pieces: 2 5/8ths. in. x 3/l6ths. In. x 15 in. 2 pieces : 2 5/8ths. in. x 3/l6ths. in. x 13} in. I piece : 2 5/8ths. in. x 3;l6ths. in. x 7} in. I piece : 2 5/8ths. in. x 3/l6ths. in. x 6 in. 2 Webbing Straps with metal buckles : 18 in. x I in. 2 Webbing Straps with metal buckles : 27 in. x l i in. 3 sockets. A, . By this invention Splints made in any convenient lengths make A rigid connections by means of incurved opposite edges of the metal sockets or sleeves firmly engaging with transverse grooves in the surfaces of the Splints when pressed home into the socket. Unlike the ordinary socketted Splint, this type is rigidly coupled ★ together and held against relative displacement but can be disengaged by pulling apart with sufficient force. A. - N.B.—To ensure perfect locking it is imperative that the Splint A should be correctly inserted in the socket, i.e., BY MAKING CERTAIN THAT THE INCURVED EDGE OF METAL SOCKET ENGAGES WITH THE TRANSVERSE GROOVE OF THE SPLINT. Price : Complete with two pairs of straps - - 4/- per set. W ithout straps - - - - - - - - 3 / - per set. Sole Manufacturers : %

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CONTENTS

T H IS

NUM BER.

E d it o r ia l — M e d ic a l

N o m e n c la tu r e

...

C o - o r d in a t i o n o f C i v i l D e f e n c e S e r v i c e s

... ...

14 14

S .J .A .B . H e a d q u a r te r s a n d D is tr ic t R e p o r ts

...

A F e w W o r d s o n S p in a l I n ju r ie s

...

T h i s M o n t h ’s Q u i z

...

L e t t e r s to t h e E d i t o r

...

R a ilw a y A m b u la n c e N e w s

R e v ie w s

...

O u r N u rses’ P a g e

...

Q u e r ie s a n d A n s w e r s to C o r r e s p o n d e n ts A r tific ia l R e s p ir a tio n

...

E x a m in a tio n H o w le r

...

T r a n s p o r t o f S p in a l I n ju r y ...

...

D e f i n it i o n o f “ F i t ”

> ...

'...

...

H u m o u r in H o m e - N u r s i n g . . .

E t h i c s o f F i r s t A id

...

O f f i c i a l C h a n g e s in T r e a t m e n t

...

I n d i c a t i o n fo r S i l v e s t e r ’ s M e t h o d

...

Q u a n tity o f A ir B re a th e d S c o ttis h H u m o u r

...

S c h a f e r o r ‘S i l v e s t e r

... ...

...

S h o u ld e r C a r r y o f S tr e tc h e r

...

F r a c tu r e d L e g w ith M u s ta r d G a s

...

C . D . I n s t r u c to r ’s B a d g e

A n ti- d im C o m p o u n d

T o t ho s e e n g a g e d in n u r s i n g a nd first aid w h o h a v e not had N o m e n c l a t u r e the a d v a n t a g e of a c l assi ca l e d u c at io n, t here e x i s t s m u c h m y s t i fication c o n c e r n i n g med ic al w o r d s a nd t er ms . We do not for o ne m o m e n t a d v o c a t e , or e v e n s u g g e s t , a s e r i o us s t u d y o f the dead l a n g u a g e s , o f G r e e k or L a t i n , but w e are s ur e t hat reader s w o u l d find thei r pa th m u c h cl ea re d w e r e t h e y to m a k e t hemsel ves , a c q u a i n t e d wi th the prefi xes a n d suf fi xes o f t hos e l a n g u a g e s — k n o w l e d g e o f w h i c h c o u ld be a c qu i r ed wi th little dif fi culty. A f ew e x a m p l e s wi l l s e r v e to d r i v e h o m e o ur po i n t a nd to p r o v e o f w h a t mat eri al a s s is t an ce s u c h k n o w l e d g e w o u l d be in g r a s p i n g med ic al t er ms , i ndeed sc ient i fi c t e rms in g e ne r a l . W e are not g o i n g to i ns ul t the i n t e l l i g e n c e o f o u r reader s b y s t a t i n g t hat the G r e e k suffix, Ms, is i n v a r i a b l y used for f o r m i n g the n a m e s of i n f l a m m a t o r y d is ea ses , o r t ha t a (or an bef or e a v o w e l ) s i g ni f i e s not. W e wi ll t a k e s u c h a prefi x as the G r e e k eu, w h i c h g i v e s the c l ue to a n u m b e r of w o r d s , bo t h in m e d ic i n e a nd o r d i n a r y pa rl anc e . In the G r e e k it h a s “ we l l ” or s i m i la r s i g ni f i c a t i o n , a nd w e h a v e eugenic, the p r o d u c t i o n of fine off s p r i n g , eupeptic, h a v i n g g o o d d i g e s t i o n , euthanasia, g e n t l e a nd e a s y deat h, eutocia, e a s y c h i l d b i r t h , and eup/astic, c a p a b l e o f b e i n g t r a n s f o r m e d into h e a l t h y tissue. In e v e r y d a y l a n g u a g e w e h a v e e u l o g y , e u p h o n y , a nd so on. C a r e m us t , o f c o u rs e , be used in d e c i d i n g w h i c h a c t u a l l y is t he prefi x. T h u s in analgesia, the prefi x is an, a n d t he m e a n i n g a b s e n c e of pai n (an, not, algeo, feel pa i n . ) A n o t h e r prefi x s i g n i f y i n g “ n o t ” is ne, a n d w e h a v e nepenthe (ne, not, penthos, g ri e f ) a l t h o u g h the w o r d is u sed m a i n l y as a po et ic al e x p r e s s i o n f o r a drug producing forgetfulness. Another very w i d e l y used prefi x is hyper, m e a n i n g “ o ve r , a b o v e , e x c e s s i v e , ” a nd w e h a v e w o r d s s u c h as hyperaemia, e x c e s s of b l oo d , hyperalgia, e x c e s s i v e s e n s i b i l i t y to pai n (see algeo a b o v e ) liyperemesis, e x c e s s i v e v o m i t i n g , hyperostosis, t h i c k e n i n g o f . bone, hyperplasia, e x c e s s i v e f o r ma t io n o f t issue, hypertrophy, e n l a r g e m e n t o f o r g a n . T he n there is hypo, m e a n i n g b e l o w , w i t h hypochondria, m o r b i d state of d ep r e s s io n , hypodermic, i nt ro d uc e d b e n e a t h t he s k i n , hypostasis, a s e d i m e n t o r d ep o si t , hyposthenia, "decreased M e d ic a l

F I R S T

s t r e n g t h , hypotonia, defi ci ent m u s c u l a r tone, and m a n y o th e r s ; a nd it is i m p o r t a n t to note the differ ent m e a n i n g s to be at t ach ed to hyper a nd hypo, the o n e b e i n g pr ac t i c a l l y the a nt it h es is o f the other. W o r t h n o t i n g is the G r e e k prefix dys, m e a n i n g “ b a d , ” w h i c h qua l i fi es m a n y w o r d s . W e have not a t t e m p t e d to deal w i t h act ual w o r d s f o rme d f r om the G r e e k or L a t i n , b u t h a v e co nf in ed o u r selves to pr efi xes, and upon t hese a lo ne s e v e r a l a rt i cl es c o ul d be wr i tt en . W e ha v e , h o w e v e r, sai d e n o u g h , w e h o p e , to p r o v e the aid t hat s u c h k n o w l e d g e wi l l be to the st ud ent , the p r o b a tioner, the n e o p h y t e , a nd o t her s of a l a r g e r growth.

Co-ordination of Civil Defence Services. E x tr a c t s fro m S IR

H EN RY

L e c t u r e s d e liv e r e d

M ARTYN,

K .C .V .O .,

by F .R .C .S .

( C o n t i n u e d fr o m p a g e j . )

I w a s l u c k y in t h a t b e i n g a s u r g e o n I w a s p o s te d in A u g u s t , 1 9 1 4 , to t h e s u r g i c a l s t a f f o f a g e n e r a l h o s p it a l in F ran ce. I r e m e m b e r v i v i d l y , d u r i n g t h e r e t r e a t fr o m M o n s , w h e n t h e h o s p i t a ls h a d b e e n e v a c t u a t e d t o S t . N a z a i r e , b e i n g s e n t a t a n u n g o d l y h o u r o f a v e r y w e t m o r n i n g in c h a r g e o f s o m e m e n to b r i n g u p s o m e m u c h n e e d e d m e d ic a l s t o r e s f r o m t h e d o c k s . A s w e m a r c h e d a l o n g t h e q u a y s id e b e t w e e n a l o n g li n e o f c o a l t r u c k s a n d t h e s h ip s , t h e r e e m e r g e d fr o m b e n e a t h o n e o f t h e t r u c k s a t a ll f i g u r e , s o a k e d to t h e s k i n a n d c o m p l e t e l y c o v e r e d in c o a l d u s t f r o m h e a d t o fo o t . T h e a p p a r i t i o n r e s o l v e d it s e lf in t o w h a t I h a d la s t s e e n m o v i n g m a j e s t i c a l l y in t h e p u r li e u s o f H a r l e y - s t r e e t c la d in to p h a t a n d m o r n in g c o a t, o n e o f th e le a d in g c o n s u ltin g p h y s ic ia n s o f L o n d o n w ith a n in c o m p a r a b le b r a in , b u t e m p lo y e d s in c e t h e o u t b r e a k o f w a r b y a n a ll k n o w i n g a u t h o r i t y a s M e d i c a l O f f i c e r o f a lin e r e g i m e n t t h e n e n g a g e d in u n lo a d in g s to re s ! T h o s e s o r t o f m i s t a k e s c o u ld n e v e r b e a llo w e d t o r e c u r , a n d b e f o r e w a r b r o k e o u t a c o m m i t t e e , fo r m e d l a r g e l y fr o m t h e s t a f f s o f t h e g r e a t T e a c h i n g H o s p i t a l s , h a d b e e n a p p o in t e d t o a d v i s e t h e M i n i s t r y o f H e a lt h u p o n t h e e a r m a r k i n g o f t h e n e c e s s a r y n u m b e r o f t r a in e d s u r g e o n s a n d s p e c i a l i s t s r e q u ir e d f o r t h e e f f i c ie n t s t a f f i n g o f h o s p it a ls . E v e n s o , t h e n u m b e r w a s in s u f f i c ie n t t o c o v e r t h e n e e d s o f t h e g r e a t l y e n l a r g e d h o s p i t a ls , a n d a s e r v i c e k n o w n a s t h e E m e r g e n c y M e d ic a l S e r v i c e w a s e s t a b lis h e d . T h i s in e f f e c t r e s o l v e d i t s e l f in t o t h e f o r m a t io n o f a n u m b e r o f m o b il e t e a m s o f s u r g e o n s , b a s e d u p o n t h e l a r g e r h o s p i t a l s , p r e p a r e d t o m o v e a t a m o m e n t ’s n o t ic e t o a n y p o in t w h e r e t h e i r s e r v i c e s m i g h t b e r e q u ir e d , e i t h e r to r e i n f o r c e a h a r d p r e s s e d s t a f f o r t o p r o v id e s p e c i a l i s t o p in io n . E a c h t e a m c o n s is t e d o f a s u r g e o n , a n a n a e s t h e t i s t a n d a t h e a t r e s is te r , a n d w a s c o m p le t e ly e q u ip p e d w it h in s t r u m en ts a n d tra n s p o rt. T h e s y s t e m h a s n o w r e a c h e d a s t a g e o f g r e a t e ff ic ie n c y , a n d th e te a m s fu n c tio n o v e r w id e a r e a s . D u r in g th e a t t a c k s u p o n P l y m o u t h a n d B r i s t o l s p e c i a l i s t s fr o m L o n d o n m a d e r e p e a t e d v i s i t s t o t h e W e s t n o t o n ly t o h e lp in t h e r o u t in e w o r k , b u t a l s o t o p r o v id e e x p e r t s in t h o s e b r a n c h e s o f s u r g e r y w h o w e r e n o t a v a ila b le lo c a lly . T h e p r o b l e m s a s r e g a r d s t h e h o s p i t a ls t h e m s e l v e s w e r e a lm o s t e q u a lly d iffic u lt.'

R I D T h e g r e a t t e a c h in g h o s p ita ls o f L o n d o n a n d th e la r g e r c i t i e s w e r e s i t u a t e d , w it h t h e ir h u n d r e d s , e v e n t h o u s a n d s , o f b e d s , f o r th e. m o s t p a r t in t h e c e n t r e s o f t h e t a r g e t a r e a s . I t w a s o b v i o u s ly u s e le s s to r e l y u p o n t h e m f o r t h e t h i r t y o r f o r t y t h o u s a n d c a s u a l t i e s p e r n i g h t w h i c h w e r e a t fir s t t h o u g h t p o s s ib le . T h e e n t ir e h o s p it a l s y s t e m o f L o n d o n h a d to b e r e o r g a n i s e d , a n d r e o r g a n i s e d it w a s . L o n d o n w a s d iv id e d in t o s e c t o r s r a d i a t i n g fr o m t h e c e n t r e o u t in t o t h e p r o v in c e s . T h e o n e o r m o re g r e a t h o s p it a ls n e a r t h e a p e x o f e a c h s e c t o r w e r e e v a c u a t e d o f e v e r y th in g e x c e p t a fe w b e d s a n d th e O u t P a tie n t D e p a r tm e n ts , S t u d e n t s , N u r s e s a n d S t a f f w e r e s p l it u p a n d a t t a c h e d to t h e l a r g e r o f t h e p r o v in c ia l h o s p i t a ls a t t h e b a s e s o f t h e s e c t o r s f a r o u t in t h e c o u n t r y . M a n y o f th e s e w e re e n la r g e d b y th e b u ild in g o f h u tte d e x t e n s i o n s , a n d e n t i r e ly n e w h o s p i t a ls w e r e b u ilt w h e r e n ecessary. T h e o r i g i n a l g r e a t t e a c h i n g h o s p it a ls b e c a m e , in e ffe c t , e m e r g e n c y h o s p it a ls o n ly in t e n d e d fo r d e a l i n g w i t h t h o s e a i r r a id c a s u a l t i e s w h i c h w e r e t o o ill to t o le r a t e e v e n t h e s h o r t e s t t r a n s p o r t , t o g e t h e r w it h t h e O u t P a t i e n t D e p a r t m e n t s a n d a f e w b e d s u t ilis e d fo r t h e n e e d s o f t h e lo c a l p o p u l a t io n . T h e n e x t r i n g o f h o s p it a ls , s i t u a t e d o n t h e e d g e o f t h e t a r g e t a r e a , s u c h a s th o s e a t H a m m e r s m ith , H a m p s te a d , e t c . , b e c a m e C a s u a l t y C l e a r i n g S t a t i o n s , w h i le t h o s e in t h e o u t e r r i n g a c t e d a s B a s e H o s p i t a l s t o w h i c h t h e le s s s e r i o u s ly i n ju r e d c o u ld b e t r a n s p o r t e d a t o n c e , a n d w h e r e t h o s e m o r e g r a v e l y h u r t c o u ld b e r e c e i v e d fr o m t h e t a r g e t a r e a a s s o o n a s t h e i r c o n d it io n a l l o w e d o f t r a n s p o r t . M e a n w h i l e , t h e s u p p l y o f t h e r a n k a n d file o f t h e M e d ic a l P r o f e s s i o n r e q u ir e d t o m e e t t h e c o n s t a n t l y i n c r e a s in g n e e d s o f th e S e r v ic e s h a d to b e o r g a n is e d w ith a s l i t t l e d i s t u r b a n c e a s p o s s ib le w i t h t h e h e a lt h o f t h e c iv il p o p u l a t io n . M e d ic a l C o m m i t t e e s w e r e s e t u p t h r o u g h o u t t h e c o u n t r y r e s p o n s ib l e fo r l a r g e t o w n s o r r u r a l a r e a s . T o t h e s e C o m m i t t e e s c a m e a t i n t e r v a l s d e m a n d s fr o m W a r O f f ic e , A d m i r a l t y o r A i r F o r c e , t r a n s m i t t e d t h r o u g h t h e M i n i s t r y o f H e a l t h , fo r t h e s u p p l y o f s u c h a n d s u c h a n u m b er of m en . T h e C o m m i t t e e s , p r o v id e d w i t h d e t a ile d li s t s o f t h e d o c t o r s in t h e ir o w n a r e a s a n d k n o w i n g e x a c t l y t h e r e q u i r e m e n t s o f t h e c i v i l p o p u l a t io n , w e r e in a p o s it io n a t o n c e t o s u p p l y t h e n u m b e r o f m e n n e e d e d w i t h t h e m in im u m in t e r f e r e n c e w i t h n o r m a l w o r k . T h e v a s t o r g a n i s a t i o n o f t h e C i v i l D e f e n c e M e d ic a l S e r v i c e s e n g a g e d in t h e s t a f f i n g a n d t r a i n i n g o f t h e p e r so n n e l o f F ir s t A id P o s ts , M o b i le U n its , e t c ., w a s a r r a n g e d b y th e M in is tr y of H e a lth w o r k in g t h r o u g h th e m a c h i n e r y , w h i c h w a s a l r e a d y e x t a n t , o f t h e M e d ic a l O f f ic e r s o f H e a lth . T h e o r g a n is a t io n o f th e F ir s t A id a n d R e s c u e P a r tie s c a m e u n d e r th e a u th o r ity o f th e M in is tr y o f H o m e S e c u r ity . I n t h e l a r g e r t o w n s o n e o r m o r e F i r s t A id P o s t s w e r e e s t a b li s h e d , e a c h s t a f f e d w it h a M e d ic a l O f f i c e r a n d a n u m b e r o f n u r s e s , in v i l l a g e s F i r s t A id P o i n t s o n ly w e r e fo r m e d , o f w h i c h t h e s t a f f c o n s is t e d o f f o u r o r fiv e v o l u n t a r y w o r k e r s w i t h t h e m in im u m o f e q u ip m e n t . M o b i le M e d ic a l U n i t s , e a c h p r o v id e d w it h t r a n s p o r t fo r p e r s o n n e l a n d a lo r r y c a r r y i n g t h e c o m p le t e e q u i p m e n t o f a F i r s t A id P o s t , a n d s t a ffe d w i t h a d o c t o r a n d n u r s e s , w e r e e s t a b li s h e d t h r o u g h o u t t h e c o u n t r y . T h e s e U n its w e r e in t e n d e d e i t h e r t o a c t a s r e i n f o r c e m e n t s t o h e a v i l y b lit z e d a r e a s o r t o s e r v e a s a n A id P o s t in a n y p la c e o n ly h it h e r t o e q u ip p e d w it h a p o in t . N o w , I t h i n k , y o u s h o u ld h a v e a v e r y f a i r p ic t u r e o f t h e d if f ic u lt ie s w h i c h e x i s t e d , a n d t h e w a y in w h i c h t h e y h a v e b e e n o v e r c o m e , a n d , in g e n e r a l , s o m e k n o w l e d g e o f t h e f o r c e s w h i c h lie b e h in d y o u r f r o n t lin e s e r v ic e s . W i t h t h a t k n o w l e d g e t o w o r k u p o n , le t u s g o a lit t le w a y in t o t h e m e t h o d s b y w h i c h t h e s e f o r c e s c a n b e b r o u g h t in t o p la y . ( T o be c o n t in u e d .)

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N o . I ( P r i n c e o f W a l e s ’s ) D i s t r i c t O r p i n g t o n 1 0 0 / 2 .— T h e a n n u a l d i s t r i b u t i o n o f a w a r d s a n d t r o p h i e s t o o k p la c e o n S a t u r d a y , J u ly 1 1 t h , 1 9 4 2 , a t t h e B r it i s h R e s t a u r a n t , O r p i n g t o n , w h e n M r . E . U z z e ll, W e l f a r e O f f i c e r o f t h e S o u t h e r n R a i l w a y p r e s id e d o v e r a l a r g e a tte n d a n c e . , D r . M a r c i a G r a n t , w if e o f t h e D i v i s i o n a l S u r g e o n , p r e s e n t e d t h e v o u c h e r s , m e d a lli o n s a n d l a b e l s e a r n e d d u r i n g 1 9 4 1 , a n d fo llo w in g th e s e p r e s e n ta tio n s , P r iv a te F r a n k T h u r s t o n h a n d e d to t h e N u r s i n g D i v i s i o n a s i l v e r c u p p r e s e n t e d b y t h e o ff ic e r s a n d m e n o f t h e A m b u l a n c e D i v i s i o n . D r . J o h n G r a n t p r e s e n te d a c u p fo r in d iv id u a l c o m p e ti t io n t o t h e A m b u l a n c e D i v i s i o n . T h i s w a s l a t e r h a n d e d to t h e w in n e r , P r i v a t e F r a n k T h u r s t o n . A m b u l a n c e O f f ic e r H . T . M ile s a ls o p r e s e n t e d a c u p to t h e A m b u l a n c e D i v i s i o n f o r t e a m c o m p e t it i o n . M r . E . U z z e ll o n b e h a lf o f t h e S . J . A . A . ( S o u t h e r n R a i l w a y C e n t r e ) n e x t p r e s e n t e d t h e A s s o c i a t i o n ’ s M e r it o r io u s C e r t i f i c a t e t o M r . F . C r o u c h a n d t h e A s s o c i a t i o n ’ s M e r it o r io u s L o n g S e r v i c e C e r t i f i c a t e to D i v . S u p t . A . P . W i l l i a m s . T h e C h a i r m a n c o n g r a t u l a t e d a l l r a n k s o n t h e i r e f f ic ie n c y , a n d M is s G r i n d l e y s a i d t h a t t h e N u r s i n g D i v i s i o n w o u ld a p p r e c i a t e t h e t r o p h y p r e s e n t e d to t h e m b y t h e m e n o f t h e A m b u l a n c e D i v is io n . M r. H . J. L e s te r , J . P . , C h a ir m a n o f th e O r p in g to n U . D . C . , t h a n k e d t h e B r i g a d e f o r t h e i r s p l e n d id w o r k in O r p i n g t o n a n d s a id t h a t t h e i r n e w M o t o r A m b u l a n c e w a s a v e r y u s e fu l a d ju n c t a n d o n e m u c h a p p r e c ia te d b y th e r e s id e n t s . O n S a t u r d a y , J u l y 1 8 t h , t h e c o m p e t it i o n fo r t h e T e a m T r o p h y w a s h e ld a t t h e C i v i l D e f e n c e D e p o t , O r p i n g t o n . A f t e r a k e e n f i g h t t h e j u d g e s , M r . W . A . H a g e l l a n d D iv . S u p t . B r o w n o f B r o m l e y D i v i s i o n , d e c la r e d t h e t e a m le a d b y P r iv a t e A . A n t h o n y th e w in n e r s . T h e te a m o b ta in in g 2nd p la c e w a s l e a d b y P r i v a t e F r a n k T h u r s t o n . N o . SS ( S o u t h a l l - N o r w o o d ) . — G i f t s r e c e iv e d fr o m s c h o o lc h i ld r e n o f t h e A m e r i c a n J u n io r R e d C r o s s w e r e p r e s e n t e d b y t h e M a y o r ( A ld e r m a n M r s . F . S . A m o s ) to c a d e t s o f th e S .J .A .B . A m b u la n c e a n d N u r s in g D iv is io n s w h e n t h e y g a v e a d is p la y a t th e B r itis h L e g io n H a ll, S o u th a ll. A f t e r c o m p a n y a n d s t r e t c h e r d r ill, t h e c a d e t s , w h o s e a g e s r a n g e fr o m 1 1 to 1 7 y e a r s , g a v e a d e m o n s t r a t io n o f fir s t a id a n d h o m e n u r s i n g , w h ic h i n c lu d e d t h e t r e a t m e n t o f a f r a c t u r e d t h i g h k n e e a n d o t h e r i n j u r ie s . T h e d is p la y c o n c lu d e d w it h r o l le r b a n d a g e w o r k b y t h e n u r s i n g c a d e t s a n d t h e S c h a f e r m e t h o d o f a r t i f i c i a l r e s p ir a t i o n b y t h e a m b u l a n c e c a d e ts. D r . V i n c e n t , D i v i s i o n a l S u r g e o n t o t h e A c t o n D i v is io n , c o m m e n t e d o n t h e h i g h e f f ic ie n c y o f t h e c a d e t s a n d t h e M a y o r c o n g r a t u l a t e d t h e m o n t h e i r fin e d is p la y . D i s t r i c t O f f i c e r W a l s b y , w h o is o ff ic e r in c h a r g e o f t h e C a d e t D iv is io n s , r e m a r k e d th a t th e w o r k o f th e S o u th a ll c a d e t s w a s e x c e l le n t . C a d e t D iv is io n s , h e s a id , w e r e b e c o m i n g a - v e r y l a r g e u n it in t h e S . J . A . B . , a n d w e r e r a p i d ly in c r e a s in g u n d e r th e y o u th m o v e m e n t.

N d . II D is tr ic t R e a d in g .— O n A u g u st B a n k H o l i d a y M o n d a y 200 m e m b e r s o f th e C a d e t D iv is io n s a tta c h e d to th e R e a d in g C o r p s s p e n t a v e r y p l e a s a n t t im e a t S o u t h g a t e F a r m , R e a d i n g ( b y k in d p e r m is s io n o f M r . J. B u c k n a l l , J u n r .) , a s g u e s t s o f t h e G r e y f r i a r s V o l u n t a r y F i r e W a t c h e r s , u n d e r t h e le a d e r s h ip o f M r . a n d M r s . A . P r e w , w h o s e s o c i a l a c t i v i t i e s a r e s o w id e ly k n o w n . T e a w a s p r o v id e d , a n d a s p o r ts p r o g r a m m e w a s a r r a n g e d , e a c h e v e n t b e in g k e e n ly c o n te s te d , e s p e c ia lly t h e t u g o f w a r , w h i c h w a s w o n b y t h e S t . A n d r e w ’s H o m e

C a p t . W . G o o d le y , O . B . E . , M . C . , t a k i n g t h e s a l u t e a t t h e E a s t e r n A r e a , N o . 1 ( P r i n c e o f W a l e s ’ s) D i s t r i c t I n s p e c t io n , h e ld a t I lf o r d o n J u n e 2 7 t h , w h e n n e a r l y 1,2 0 0 m e n , w o m e n a n d c a d e t s p a r a d e d u n d e r A s s t. C o m m is s io n e r C a p t. F . E . B e n d ix .

fo r B o y s S e c tio n , c a p ta in e d b y M a s te r G e o . C r u e s e . T h is S e c t i o n is a t t a c h e d t o t h e G r e a t W e s t e r n C a d e t D i v i s i o n u n d e r th e c o m m a n d o f C a d e t S u p t. F . W e b b . A m o n g th o s e p r e s e n t w e r e M r. C . A . P o o le , M .A ., th e C o u n t y C o m m i s s i o n e r , a n d M r s . P o o l e , C o u n t y O f f i c e r in c h a r g e o f G i r l C a d e t s , w h o s e u n it e d w o r k f o r t h e C a d e t D i v i s i o n s t h r o u g h o u t t h e C o u n t y is s o g r e a t l y a d m i r e d . T h e C o m m i s s i o n e r , w h e n p r e s e n t i n g t h e p r iz e s , w h i c h w e r e k i n d l y g i v e n b y t h e G r e y f r i a r s C o m m i t t e e a n d in c lu d e d a s i l v e r c u p p r e s e n t e d b y M r . G . M e t t a m a n d M is s D . P r e w fo r th e c a p ta in o f th e w in n in g t u g o f w a r te a m , t h a n k e d th e G r e y f r i a r s C o m m i t t e e fo r t h e i r w o n d e r f u l w o r k in g i v i n g t h e C a d e t s s u c h a d a y ’ s p le a s u r e , “ t h e m e m o r y o f w h i c h , ” h e s a id , “ w ill r e m a in fo r m a n y a d a y . ” M r . P r e w s u i t a b l y r e p l ie d , a n d s t a t e d t h a t t h e y w e r e v e r y p le a s e d to b e a b l e to d o s o m e t h i n g f o r t h e S . J . A . B . , w h o s e fin e w o r k w a s s o w e l l k n o w n , a n d t h e y h o p e d t o d o m o r e f o r t h e m in t h e f u t u r e .

N o . X D is tr ic t C a m b r i d g e . — T h e P y e D i v i s i o n o f t h e S . J . A . B . , h e ld t h e i r f ir s t a n n u a l m e e t i n g a t t h e i r h e a d q u a r t e r s o n t h e f a c to ry , o n T u e s d a y , J u ly 7 th , w h e n M r. C . O . S t a n le y th e P r e s i d e n t , p r e s id e d . D iv is io n a l S u p t. A n d e r s o n re p o r te d th a t s in c e th e fo r m a t io n o f t h e D i v i s i o n in J u n e , 1 9 4 0 , t h e i r n u m b e r s h a d g r o w n c o n s id e r a b ly . S e v e r a l w e re d o in g u s e fu l w o r k b y a s s is t in g t h e B o r o u g h A . R . P . a s fir s t a i d e r s a n d o t h e r s h a d e n r o lle d in th e fa c t o r y A . R . P . o r g a n is a t io n . A q u a lif ie d l e c t u r e r o f S t. B a r t h o lo m e w ’s H o s p ita l, L o n d o n , h a d a g r e e d to a c c e p t t h e p o s it i o n o f D i v i s i o n a l S u r g e o n , a n d h i s k n o w l e d g e a n d a s s i s t a n c e w o u ld b e a c o n s i d e r a b l e a s s e t t o t h e B r i g a d e . M e m b e rs w e r e c o m p e t in g k e e n ly fo r a n E ffic ie n c y C u p g iv e n b y A m b u la n c e O ffic e r N o rto n a n d h im s e lf fo r w o r k d o n e a t t h e w e e k l y p a r a d e s , a n d t h r o u g h o u t t h e p e r io d u n d e r r e v i e w s e v e r a l s e r io u s a c c i d e n t s h a d b e e n h a n d le d b y m e m b e r s b e s id e s n u m e r o u s s m a l l in c id e n t s . M e m b e r s w e r e t h a n k e d fo r t h e i r s u p p o r t o n C h u r c h P a r a d e s a n d a ls o f o r t h e p u b li c d u t ie s

F I R S T

u n d e rta k e n . S o m e e x p e r i e n c e in c o m p e t it io n s h a d b e e n g a i n e d , a n d a l s o s e v e r a l p r o m o t io n s h a d b e e n g r a n t e d . T h e S e c r e t a r y a n d T r e a s u r e r , S e r g e a n t R . N . F a r d e ll , p r e s e n t e d t h e r e c e ip t s a n d p a y m e n t s a c c o u n t , a n d e x p r e s s e d a p p r e c i a t i o n f o r t h e a s s i s t a n c e g i v e n b y t h e fir m . C o r p s S u p t. S . D ic k e r th e n a d d re s s e d th e m e e tin g a n d r e m in d e d a l l p r e s e r ff t h a t t h e S t . J o h n A m b u l a n c e m o v e m e n t w a s t h e o ld e s t O r d e r o f C h i v a l r y n o w in e x i s t e n c e . It w as a m o v e m e n t t h a t s h o w e d n o c l a s s d i s t in c t io n , a t r a m p b e in g g i v e n j u s t a s c a r e f u l a t t e n t i o n a s a m i llio n a i r e . M em b ers e x p e c t e d n o r e w a r d , a n d t h e e x p r e s s io n “ T h a n k y o u ” w a s a ll t h a t w a s r e q u i r e d . T h e C o r p s S u p t . t h e n p r e s e n t e d M r. C . O . S t a n le y w ith th e D iv is io n a l P r e s id e n t’s b a d g e . M r . S t a n l e y r e p l ie d , e x p r e s s i n g a p p r e c ia t io n o f t h e h o n o u r s h o w n t o h im .

R I D th o s e o f a n a t t a c k o f lu m b a g o . T h e p a in o f a s e v e r e s t r a in m a y b e s o a c u t e t h a t t h e p o s s ib ilit y o f a p a r t ia l f r a c t u r e c a n o n ly b e e x c lu d e d b y X - r a y e x a m i n a t i o n . D i a g n o s is . — T h e p r im a r y o b je c t s o f fir s t a id a r e to e s t a b lis h a p r o v is i o n a l d i a g n o s i s a n d to t r e a t t h e p a t ie n t f o r t h e m o s t s e r io u s p o s s ib le i n ju r y h e m a y h a v e s u s t a in e d . A l t h o u g h d is t in c t io n b e t w e e n s p r a in s , s t r a i n s a n d p a r t ia l f r a c t u r e s m a y b e e a s y in m a n y c a s e s , e x a m i n a t i o n m a y in v o lv e u n n e c e s s a r y e x p o s u r e o f t h e p a t ie n t a n d d e l a y in t r a n s p o r t . I f, t h e r e f o r e , t h e r e is t h e s l i g h t e s t s u s p ic io n o f a f r a c t u r e , t h e c a s e m u s t b e t r e a t e d a s s u c h u n t i l t h e p a t ie n t h a s r e c o v e r e d fr o m s h o c k a n d a m o r e a c c u r a t e d i a g n o s i s c a n b e m a d e fr o m a n X - r a y e x a m in a tio n .

A m b u l a n c e O f f ic e r N o r t o n e x p r e s s e d a p p r e c i a t io n fo r t h e w o r k d o n e t h r o u g h o u t t h e p a s t p e r io d b y t h e S e c r e t a r y , a n d t h e m e e t i n g c lo s e d w i t h a n e x p r e s s i o n o f t h a n k s to M r . S t a n l e y f o r t h e i n t e r e s t t h a t h e h a d t a k e n in t h e D iv is io n .

Few Words on Spinal Injuries. [ S p in a l I n ju r ie s m a y a ffe c t a n y s t r u c tu r e s o f th e s p i n e a n d m a y i n c lu d e s p r a i n s , s t r a in s , a n d d i s l o c a t io n s in a d d it io n t o f r a c t u r e s . T h e f o l l o w i n g a r t ic le , w h i c h is e x t r a c t e d fr o m C h a p t e r X V * o f “ B e l i l i o s ’ H a n d b o o k o f F ir s t A id a n d B a n d a g i n g ,” d is c u s s e s in d e t a i l t h e v a r i o u s i n j u r ie s , t h e i r d i a g n o s i s , e t c .]

T h e s p i n a l c o lu m n c o n s is t s o f t h i r t y - t h r e e v e r t e b r * , m o s t o f w h i c h m o v e s l i g h t l y o n o n e a n o t h e r , g i v i n g t h e n o r m a l fr e e m o v e m e n t to th e s p in e . A t th e lo w e r en d , h o w e v e r , th e in d i v i d u a l b o n e s a r e f u s e d t o g e t h e r , f o r m i n g t h e s a c r u m a n d coccyx. E a c h v e r t e b r a c o n s i s t s o f t h e b o d y , w h i c h f o r m s t h e c h ie f s u p p o r t f o r t h e b o n e a b o v e it , a n d a r i n g o f b o n e , t h e n e u r a l a r c h , fr o m w h ic h p r o je c t th e v a r io u s p r o c e s s e s — e . g . , th e tr a n s v e r s e a n d s p in o u s. P la t e s o f c a r t i l a g e , t h e i n t e r v e r t e b r a l d is c s , a r e p la c e d b e t w e e n t h e b o d ie s o f t h e v e r te b ia .- to a c t a s b u f f e r s a n d r e d u c e t h e j o l t s a n d j a r s to w h ic h t h e s p in e , a n d t h e r e f o r e t h e s p i n a l c o r d , is li a b le . T h e b o n e s a r e jo in e d t o g e t h e r b y n u m e r o u s lig a m e n t s a n d p o w e rfu l m u s c le s a re a tt a c h e d to th e ir p r o c e s s e s . T h e s p i n a l c o r d p a s s e s d o w n t h e v e r t e b r a l c o lu m n in t h e b o n y c h a n n e l f o r m e d b y t h e n e u r a l a r c h e s ; it is t h u s w e ll p r o t e c t e d f r o m i n j u r ie s . I n ju r ie s m a y a ffe c t a n y o f th e s tr u c t u r e s fo r m in g th e s p in e — b o n e s, jo in ts , lig a m e n t s o r m u s c le s . S p i n a l in j u r i e s t h e r e f o r e in c lu d e : ( 1 ) S p r a in s . — T h e lig a m e n t s a r e s tr e tc h e d o r to rn . (2) S t r a in s . — T h e m u s c l e s m a y b e to rn a t th e ir a tta c h m e n ts . (3 ) D is lo c a t io n s . — D i s p l a c e m e n t s o f t h e b o n e s m a y o c c u r a n d a r e m o s t c o m m o n in t h e c e r v i c a l r e g i o n ; c o m p le t e d i s lo c a t i o n s a r e u n c o m m o n . (4 ) F r a c t u r e s . — F r a c t u r e s o f t h e s p i n e m a y o c c u r a n d a r e o f v a r io u s ty p e s. A c h a r a c t e r i s t i c f e a t u r e o f m o s t s p i n a l in j u r i e s is r i g i d i t y o f t h e m u s c l e s a t t h e s it e o f i n j u r y c a u s e d b y s p a s m . S p r a in s . — S p r a i n s o c c u r a s a r e s u lt o f f o r c i b le b e n d i n g of th e s p in e o r s u d d e n t w is ts a n d ja r s . T h e y ca u se sev ere p a in a t t h e s i t e o f i n j u r y , w i t h t e n d e r n e s s , s w e l l i n g a n d b r u is in g . T h e p a in is m a d e w o r s e b y a n y m o v e m e n t w h ic h t e n d s t o s t r e t c h t h e in j u r e d l i g a m e n t , a n d e v e n g e n t l e m o v e m e n t s c a u s e s e v e r e p a in .

F ig .

A T y p ic a l T h o r a c ic V e r te b r a fro m A b o v e .

F r a c t u r e s— C a u s e s . — F ra ctu re s ca n t y p e o f v io le n c e — e . g . :

be ca u sed by a n y

( 1 ) D i r e c t V io le n c e , s u c h a s a s e v e r e b lo w o n t h e b a c k , a f a l l fr o m a h e i g h t o n to a p r o j e c t i n g s u r f a c e , o r fr o m g u n sh o t w ou n d s. (2 ) I n d i r e c t V io le n c e — fo r in s t a n c e , w h e n a p a t ie n t a l i g h t s fr o m a h e i g h t o n t o t h e fe e t , o r t a k e s a h e a d e r in t o s h a llo w w a te r . F r a c t u r e o f th e sp in e t h r o u g h t r a v e llin g on t o p o f a b u s a s it p a s s e s u n d e r a lo w b r i d g e s u p p l ie s a f u r t h e r e x a m p l e o f t h is t y p e o f in j u r y . T h e p a t i e n t ’ s h e a d is s t r u c k b y t h e b r i d g e a n d h is s p in e is b r o k e n a s it is b e n t v io le n t l y o v e r t h e b a c k o f t h e s e a t b e h in d h im .

S tr a in s . — M u s c le s m a y b e s tr e tc h e d o r to r n a s a r e s u lt o f a v i o le n t a c t i o n ; t h e y t h e n c a u s e s y m p t o m s s i m i l a r to

F ig . * R e p r in t e d b y k in d p e r m is s io n o f t h e p u b lis h e r s . C o p ie s o f t h e h a n d b o o k m a y b e o b t a in e d fr o m B a illi^ r e , T i n d a l l & C o x , a t 7/8 , H e n r i e t t a S t r e e t , L o n d o n , W . C . 2 , o r D a le , R e y n o ld s & C o . L t d ., 46, C a n n o n S tr e e t, L o n d o n , E . C . 4 , p r ic e 4/9 p o s t fr e e .

1. —

th e

2. — C o m p l e t e F r a c t u r e - D i s l o c a t i o n o f t h e S p in e in L o w e r T h o r a c i c R e g i o n , w it h D i s p l a c e m e n t a n d C o m p r e s s io n o f t h e S p i n a l C o r d .

( 3) M u s c u la r A c t i o n c a n c a u s e f r a c t u r e s , b u t t h e s e u s u a l l y a ffe c t t h e t r a n s v e r s e p r o c e s s e s o f t h e l u m b a r v e r t e b r a - .

F I R S T V a r ie t ie s o f F r a c t u r e . — F ra ctu re s classified a s fo llo w s :

the

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L e tte rs

(a) F r a c t u r e s o f t h e s p i n o u s p r o c e s s e s a r e c o m p a r a t i v e l y r a r e ; t h e y c a u s e s e v e r e p a in a n d t e n d e r n e s s o v e r t h e v e r t e b r a , o ft e n a c c o m p a n ie d b y s w e l l i n g a n d b r u i s i n g . Irreg u l a r i t y in t h e lin e o f t h e s p i n o u s p r o c e s s e s is a v a l u a b l e s i g n , w h i le c r e p i t u s a n d a b n o r m a l m o b i l i t y a r e o c c a s i o n a l l y n o t ic e d . (b) F r a c t u r e o f t h e t r a n s v e r s e p r o c e s s e s o c c u r s m o s t o ft e n in t h e l u m b a r r e g i o n , w h e r e t h e p o w e r f u l m u s c l e s w h ic h h o ld th e s p in e e r e c t a r e a tta c h e d . S y m p to m s a n d s ig n s s im ila r to t h o s e o f t h e p r e c e d i n g i n j u r y m a y b e p r e s e n t , a n d t h e r e is a ls o s o m e r i g i d i t y o f n e i g h b o u r i n g m u s c l e s ; b u t it is g e n e r a l l y im p o s s ib le t o d i a g n o s e t h i s f r a c t u r e w i t h o u t a n X - r a y . M a n y p a i n f u l b a c k s s u s t a in e d in s p o r t a r e p r o b a b ly c a s e s o f u n d i a g n o s e d f r a c t u r e s o f t h is ty p e . (c) F r a c t u r e o f t h e b o d ie s is o ft e n d u e t o in d i r e c t v io le n c e , a n d in c lu d e s t h e c o m p r e s s io n f r a c t u r e in w h i c h t h e b o d ie s o f t h e v e r t e b r a e a r e c r u s h e d in t h e s a m e w a y a s c a r r i a g e s a r e t e le s c o p e d in a r a i l w a y a c c id e n t . (2) C o m p le te F r a c t u r e s a n d F r a c t u r e - D is lo c a t io n s . — C o m p le t e f r a c t u r e s o f t h e s p i n e p r e s e n t a v e r y d i ffe r e n t p i c t u r e a n d a r e u s u a l l y a s s o c i a t e d w it h s u c h d i s p l a c e m e n t o f t h e f r a g m e n t s t h a t t h e c o n d i t io n is t e r m e d a f r a c t u r e - d i s l o c a t i o n . In t h e s e c a s e s t h e r e is g r e a t d a n g e r o f s e v e r e i n j u r y t o t h e sp in a l co rd . T h e s p i n a l c o r d c o n s is t s o f n u m e r o u s n e r v e fib r e s a r r a n g e d in t r a c t s p a s s i n g u p w a r d s a n d d o w n w a r d s , to a n d fr o m t h e b r a in ; t h e g r e y m a t t e r , p la c e d in t h e c e n t r e , is c o m p o s e d l a r g e l y o f n e r v e c e lls . N e rv e s a re g iv e n o ff a t fr e q u e n t in te r v a ls a n d a re b o th m o to r a n d s e n s o ry . The s p i n a l c o r d c a n b e a p t l y c o m p a r e d w it h t h e t r u n k lin e o f a t e le p h o n e s e r v ic e t o w h i c h e v e r y i n d i v id u a l p a r t o f t h e b o d y is a s u b s c r ib e r . T h u s m o t o r a n d s e n s o r y n e r v e fib r e s b e c o m e t h e d o w n a n d u p lin e s w h ic h a r e n o r m a l l y c o n n e c t e d to s u b s c r i b e r s ’ h o u s e s , w h i le t h e b r a in a n d g r e y m a t t e r o f t h e s p i n a l c o r d c o n s t i t u t e t h e e x c h a n g e w i t h it s t e le p h o n i s t s . T h e c h i e f d a n g e r o f a f r a c t u r e - d i s l o c a t i o n o f t h e s p i n e is , t h e r e f o r e , t h e p o s s ib ilit y o f i n j u r y t o t h e s p i n a l c o r d , w h i c h , if s e v e r e l y d a m a g e d , is i n c a p a b l e o f r e c o v e r y .

This Months’ Quiz. T h e f i g u r e s a f t e r e a c h p r o b le m i n d i c a t e t h e p a g e i n B a i l l i e r e ’ s C o m p l e t e M e d i c a l D i c t i o n a r y u p o n w h i c h a s o lu t io n w i l l b e fo u n d . T h e p r ic e o f t h e d i c t i o n a r y is 3/9 p o s t fr e e . W h a t is u n d e r s t o o d b y “ e l e p h a n t i a s i s ” ?

3 . W h a t is “ e n c e p h a l i t i s ” ? c a lle d ? (p . 1 0 6 )

W h a t is t h is d i s e a s e o ft e n (p . 1 1 0 )

fo r m s

M e n t io n

and

d e f in e

tw o

(p . 10 3 )

(p . 10 4 )

4 . W h a t is t h e “ e p i d e r m i s ” ?

(p . 1 1 0 )

“ e n ile n s v ” y

6. W h a t d o y o u u n d e rs ta n d b y “ f lo c c u le n t ” ?

(p . 1 2 5 )

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R e v ie w s . I o d i n e F a c t s N o s . 144 .- 2 0 7 . — T h i s is t h e l a t e s t p a m p h le t p u b lis h e d b y t h e I o d in e E d u c a t i o n a l B u r e a u , o f S t o n e H o u s e , B i s h o p s g a t e , L o n d o n , E . C . 2. L i k e a ll p r e d e c e s s o r s it is b o t h i n t e r e s t i n g a n d i n s t r u c t i v e ; a n d , w h i l e it in c lu d e s o v e r s i x t y r e p o r t s w i t h r e f e r e n c e to t h e u s e s o f I o d in e in m e d ic in e , a g r i c u l t u r e a n d i n d u s t r y , it c o n c e n t r a t e s m a i n l y on th e h y g ie n e o f w a r . T h e B u r e a u in v ite s re a d e r s o f F i r s t A i d to s e n d a l o n g t h e ir e n q u i r i e s , a n d s t a t e s t h a t t h e r e is n o c h a r g e fo r l i t e r a t u r e o r i n f o r m a t io n .

F i r t A i d in E m e r g e n c i e s . B y E ld r id g e L . M .D . L o n d o n : J. B . L e p p in c o tt C o y .

E lia s o n , A . B . , P r i c e gs.

T h i s is t h e e le v e n t h e d i t i o n o f a b o o k w h i c h , s i n c e it w a s fir s t p u b lis h e d in 1 9 3 5 , h a s d e s e r v e d l y e n jo y e d g r e a t p o p u l a r i t v in A m e r i c a . I t is a s i g n o f t h e t im e s t h a t fo r t h e fir s t t im e it i n c lu d e s a n a p p e n d ix g i v i n g in c o m p a c t fo r m a d i s c u s s i o n o f p r e v e n t i v e a n d f ir s t a id m e a s u r e s u s e d in C i v i l D e f e n c e . I n t h e m a in , o f c o u r s e , t h e b o o k f o l l o w s t h e s a m e lin e s a s s i m i l a r m a n u a l s p u b lis h e d in t h is c o u n t r y , t h o u g h it e x c e e d s t h e l i m i t a t i o n s a p p l i c a b l e h e r e b e c a u s e it is p r e p a r e d f o r fir s t a i d e r s w h o m a y h a v e t o r e t a i n c h a r g e o f t h e ir p a t i e n t s f o r d a y s b e fo r e m e d i c a l a id is a v a i l a b l e . C onse q u e n t l y w e fin d i n s t r u c t i o n s w i t h r e f e r e n c e t o t h e s t i t c h i n g o f w o u n d s , t o t h e u s e o f a d h e s i v e p l a s t e r in t h e t r e a t m e n t o f s p r a i n e d j o i n t s , t o t h e r e d u c t i o n o f d is l o c a t e d j o i n t s , a n d to th e h a n d lin g o f c a s e s o f in fe c tio u s d is e a s e s . T h e re are d i f f e r e n c e s a l s o in fir s t a id t r e a t m e n t . T h u s in t h e a p p l i c a t i o n o f t h e t r i a n g u l a r b a n d a g e t h e k n e e b a n d a g e is k n o t t e d b e lo w t h e j o i n t , t h e s h o u l d e r " b a n d a g e is a p p lie d w i t h o u t a s e c o n d b a n d a g e a s a r m - s l i n g , a n d t h e b a n d a g e w h ic h a v o i d s p r e s s u r e o v e r t h e s h o u l d e r - g i r d l e is m o r e i n t r i c a t e t h a n o u r S t . J o h n s l i n g . A g a i n , t h e fr e e h a n d w it h t h e t h r e e - h a n d e d s e a t is u s e d t o s u p p o r t t h e p a t i e n t ’ s b a c k a n d n o t h is l o w e r li m b , a n d t h e d ia g r a m fo r th e fo r e - a n d - a ft m e th o d o f tr a n s p o r t s h o w s th e b e a r e r s o u t o f s t e p , a l t h o u g h t h is is t h e o n e h a n d s e a t in w h i c h t h e y s h o u ld m o v e o f f in s t e p . A g a i n , s in c e t h e n in t h e d i t i o n , w h i c h w e r e v i e w e d in 1 9 3 8 , S c h a f e r ’ s m e t h o d h a s d i s p la c e d S i l v e s t e r , w h i c h is n o l o n g e r d e s c r ib e d . F i n a l l y , t h o u g h t h e m e t h o d is c a lle d “ S c h a e f e r ” , it d if f e r s m a t e r i a l l y in it s i n s t r u c t i o n s fr o m t h o s e a p p r o v e d b y S c h a f e r h i m s e l f in 1 9 3 1 .

Publishers N o te .— W i l l r e a d e r s ple as e n o t e t h a t all bac k n u m b e r s o f “ Fir st A i d ” a r e n o w o u t o f p ri n t and c a n n o t be supplied.

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p le as e add t o t h e ir r e m i t t a n c e s , “ o r English e q u i v a l e n t . ’ ’

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A I D D u r in g th e h a lf y e a r e n d e d M a r c h 3 1 s t, 19 4 2 , m e m b e rs b e c a m e e n t it l e d t o L o n g S e r v i c e G o l d A w a r d s a n d w i l l b e p r e s e n t e d w it h c e r t if ic a t e s , w h i c h w i ll b e e x c h a n g e d f o r t h e a p p r o p r i a t e g o l d t o k e n a s s o o n a s c i r c u m s t a n c e s p e r m it . W e r e g r e t th a t p r e s s u r e o n s p a c e p r e v e n ts u s g iv in g a f u l l l i s t o f t h e r e c ip i e n t s . T h e t o t a l s a r e : 3 1 G o l d M e d a ls , 13 2 0 -y e a r B a rs , 2 2 5 -y e a r B a r s a n d 4 3 0 -y e a r B a rs .

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H i s M a j e s t y t h e K i n g h a s b e e n g r a c i o u s l y p le a s e d to b e s to w th e D ig n i t y o f S e r v in g B r o th e r o f th e O r d e r o f S t. J o h n u p o n M r . A . B a r k e r , G u a r d , G a t e s h e a d ; M r . J. W . H o o k e r , C h i e f C l e r k , Y a r d m a s t e r ’ s O f f ic e , W e s t H a r t l e p o o l ; M r. W . N ix o n , E n g in e F it t e r E x a m in e r , H u ll ; a n d M r. H . R o b e r t s , C h a r g e J o in e r , G a t e s h e a d , in r e c o g n i t i o n o f t h e ir s e r v i c e s t o t h e O r d e r o v e r a l o n g p e r io d o f y e a r s .

SO U TH ER N T w i c k e n h a m . — T h e a n n u a l c o n c e rt a n d p r e s e n ta tio n of a w a r d s w a s h e ld a t S t . M a r y ’ s H a l l , T w i c k e n h a m o n J u ly 2 3 r d . A m o n g th e 240 p e rs o n s p r e s e n t w e r e th e M a y o r of T w i c k e n h a m ( C o u n c i llo r C . W . B r e k e t t ) , t h e T r a f f i c M a n a g e r (M r. R . M . T . R ic h a r d s ) a n d M rs. R ic h a r d s , D iv is io n a l S u p t . M r . D e P u s y , W e l f a r e O f f ic e r M r . U z z e l l , a n d M r . W e b b ( S t a t i o n M a s t e r , S t r a w b e r r y H i l l ) , M r . B e ll a n d M r s . B e ll. M rs. R ic h a r d s p re s e n te d th e 87 a w a r d s a n d 4 S ilv e r M e d a ls ( 1 4 y e a r s ) a n d 2 B r o n z e M e d a ls ( 7 y e a r s ) . M r . U z z e ll g a v e a c o r d ia l w e lc o m e t o t h e M a y o r a n d p a id t r i b u t e t o t h e c l a s s f o r t h e i r fin e r e c o r d . H i s w o r s h i p s a id h e w a s v e r y p le a s e d to b e p r e s e n t . T h e c o n c e r t p a r t y u n d e r M r . T o m J e ff r e y s w a s v e r y g o o d a n d t h o r o u g h l y e n jo y e d b y a ll.

I t is w i t h d e e p r e g r e t t h a t w e h a v e to r e c o r d t h e d e a t h o f M r . J. W . B e e r , t h e L e e d s D i s t r i c t A m b u l a n c e S e c r e t a r y , w h i c h t o o k p l a c e 'r e c e n t l y w h i l s t h e w a s o n d u t y . M r . B e e r c o m m e n c e d h is a s s o c i a t i o n w i t h t h e L . & N . E . R a i l w a y A m b u l a n c e m o v e m e n t a t L e e d s in 1 9 3 0 . A t a ll t i m e s h e w a s u n t i r i n g in h is e ffo r t s t o p r o m o t e t h e fir s t a id m o v e m e n t. H e w a s a n id e a l s e c r e t a r y , w h o w a s h e ld in h i g h e s t e e m b y a l l w h o c a m e in c o n t a c t w i t h h im .

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B y th e d e a th o f M rs. S t. J o h n A tk in s o n on J u ly S th , th e B r i g a d e h a s s u f f e r e d a v e r y g r e a t lo s s . F o r m a n y y e a r s t h e d e c e a s e d la d y h a d b e e n c o n n e c t e d w i t h t h e O r d e r o f S t . J o h n , a n d in 1 9 3 9 , o n t h e d e a t h o f L a d y P e r r o t t , s h e b e c a m e L a d y S u p e r in t e n d e n t - in - C h ie f . S h e b r o u g h t t o t h i s p o s it i o n a g r e a t s e n s e o f d u t y a n d a h i g h s t a n d a r d o f e f f ic ie n c y , a n d w h i l e s h e o c c u p i e d it t h e N u r s i n g D i v i s i o n s o f t h e B r i g a d e in c r e a s e d in n u m b e r s a n d e f f ic ie n c y . T o t h e m a n y d if f ic u lt p r o b l e m s c r e a t e d b y t h e w a r . M r s . S t . J o h n A t k i n s o n b r o u g h t s o u n d j u d g m e n t w h i c h e n a b le d h e r to o v e r c o m e t h e m . S h e n e v e r s p a r e d h e r s e lf , a n d w a s a n in s p i r a t i o n t o a l l w h o w o r k e d w i t h o r u n d e r h e r . In d eed s h e c o n t in u e d h e r w o r k l o n g a f t e r h e r h e a lt h w a s f a r fr o m s a t is fa c to r y . M r s . A t k i n s o n is s u c c e e d e d b y L a d y L o u i s M o u n t b a t t e n , w h o s o a b l y c a r r i e d o n d u r i n g h e r p r e d e c e s s o r ’ s l a s t illn e s s . O f f ic e r s a n d m e m b e r s o f t h e N u r s i n g D i v i s i o n s o f t h e B r i g a d e w i l l a ll j o in in w i s h i n g t h e ir n e w C h i e f e v e r y h a p p i n e s s a n d s u c c e s s in t h e a r d u o u s d u t i e s s h e h a s u n d e r t a k e n , a n d w h i c h t h e y a r e c o n f i d e n t s h e w i l l f u lf il to t h e f u r t h e r h o n o u r o f th e O r d e r o f w h ic h th e y a r e so p ro u d . I n sp ec t io n b y t h e L a d y S u p e r in t e n d e n t -in- C h ie f , S .J .A .B . L i v e r p o o l N u r s i n g C o r p s “ E . ” — L a d y L o u is M o u n t b a t t e n , t h e n e w L a d y S u p e r i n t e n d e n t - i n - C h i e f , v is it e d t h e L iv e r p o o l C o rp s H e a d q u a r te r s on A u g u s t 2 nd d u r in g h e r to u r o f L a n c a s h ir e . S h e w a s a c c o m p a n i e d b y C o m m is s io n e r W . G . S m ith . A w a i t i n g h e r a r r i v a l w e r e A s s i s t a n t C o m m i s s i o n e r C o l. G . C . E . S i m p s o n , D i s t r i c t O f f i c e r C o l. D . C . L e y l a n d O r t o n , C o u n t y S u r g e o n D r . VV. M u r r a y C a i r n s , C o r p s P r e s id e n t t h e D o w a g e r C o u n te s s o f S e fto n , C o rp s S u r g e o n D r . P . A . I n c e , L a d y C o r p s S u p t . M is s C r a i g , C o r p s a n d D i v i s i o n a l O f f i c e r s , a s w e ll a s t h e n i g h t s t a f f o f t h e F i s t A id S t a t i o n a t C o rp s H e a d q u a rte rs. T h e r e w e r e a ls o p r e s e n t M r . C . P o r t e r r e p r e s e n t i n g t h e A s s o c i a t i o n C o m m i t t e e , a n d A id . F . C . W ils o n . L a d y M o u n t b a t t e n in s p e c t e d t h e H e a d q u a r t e r s , a n d p a r t i c u l a r l y t h e F i r s t A id S t a t i o n , w h i c h s h e c o n s id e r e d v e r y w e ll e q u ip p e d . S h e a d d re sse d th e m e m b e rs on p a ra d e , d e p l o r i n g t h e lo s s a l l h a d s u s t a i n e d b y t h e d e a t h o f M r s . S t . J o h n A t k i n s o n , a n d t h a n k i n g t h e o f f ic e r s a n d m e m b e r s o f t h e C o r p s f o r t h e i r l o y a l t y a n d d e v o t io n t o d u t y .

K e n t N u r s i n g D i v i s i o n s . — O f f ic e r s a n d m e m b e r s fr o m a ll p a r t s o f K e n t h a d t h e h o n o u r o f b e i n g in s p e c t e d o.n J u ly 3 0 th b y L a d y L o u i s M o u n t b a t t e n in t h e g r o u n d s o f th e O p t h a l m i c H o s p i t a l , k i n d l y le n t f o r t h e o c c a s i o n . A ccom p a n y in g L a d y M o u n tb a tte n w a s L a d y V io le t A s to r , w h o t o o k p a r t in t h e in s p e c t io n . T h e p a r a d e w a s d r a w n u p on th e la w n u n d e r L a d y C o u n t y S u p t . M r s . F a l w a s s e r , A s s t . C o u n t y S u p t . M is s M a y , L a d y C o u n t y O f f i c e r s M r s . M a y , M is s A ll e n a n d t h e H o n . M rs. N eam e. T h e c a d e t s , u n d e r C o u n t y O f f ic e r M is s C u r z o n - S m i t h li n e d t h e a v e n u e l e a d i n g t o t h e la w n . L a d y M o u n tb a tte n s h o o k h a n d s w ith a ll th e m e m b e rs p r e s e n t , s p e a k i n 'g t o t h e m i n d i v i d u a l l y . F o llo w in g th e in s p e c t io n a d i s p l a y o f p r a c t i c a l w o r k w a s g i v e n , in w h ic h t h e c a d e t s a ls o t o o k p a r t . T h e n a ll fo r m e d a c ir c le to h e a r L a d y M o u n tb a tte n a d d re s s th em . S h e s a i d it g a v e h e r v e r y g r e a t p l e a s u r e t o c o m e to M a i d s t o n e a n d t o s e e s o m a n y o ff ic e r s a n d m e m b e r s o n p ara d e. T h e y w e r e a ll d e l i g h t e d t o h a v e t h e M a y o r a n d M a y o r e s s w ith th e m , r e a lis in g th e g r e a t a m o u n t o f w o r k th e M a y o r h a d to d o . S h e h a d h e a r d fr o m L a d y V i o l e t A s t o r o f

R I D th e r e m a r k a b ly g o o d w o r k c a r r ie d o u t b y th e K e n t N u r s in g D iv is io n s o v e r a n u m b e r o f y e a r s , w o r k w h ic h h a d b een a m p li f ie d d u r i n g t h e r e c e n t b a d a i r r a id s . W h e n M a id s t o n e a n d o t h e r t o w n s in t h e c o u n t y h a d b e e n b o m b e d t h e y h a d n o b ly u p h e ld t h e p r o u d t r a d i t i o n s o f t h e ir O r d e r . Sh e con g r a t u l a t e d a l l o n t h e ir c o u r a g e a n d d e v o t e d s e r v ic e in s p ite o f e v e r y t h i n g t h e y h a d h a d t o f a c e u p to . I t m a d e t h e m fe e l tr e m e n d o u s ly p ro u d o f th e S t. J o h n A m b u la n c e B r ig a d e . M e m b e r s w e r e w o r k i n g o n la n d a n d s e a , in t h e N a v y , A r m y a n d v o l u n t a r y s e r v ic e s . M o re n u rse s w e re n e ed e d , a n d m o re m e m b e r s w e r e w a n t e d fo r g e n e r a l s e r v ic e . T h e r e w a s a lit t le n ic h e f o r e v e r y s o r t o f p e r s o n f o r e v e r y k i n d o f w o r k . S p e a k i n g o f t h e m a g n i f i c e n t s p i r it o f t h e B r i g a d e , L a d y M o u n t b a t t e n s a id s h e fo u n d it e v e r y w h e r e t h e s a m e , a l l o v e r t h e w o r ld . I t w a s a s p i r it o f c o m r a d e s h ip t h a t d id n o t e x i s t t o t h e s a m e d e g r e e in a n y o t h e r b o d y . I n c o n c lu s i o n s h e t h a n k e d t h e m f o r t h e s p le n d id w o r k t h e y w e r e d o i n g f o r t h e B r ig a d e a n d fo r E n g la n d . In th e c o u r s e o f a s h o rt sp e e c h , L a d y V io le t A s to r e x p r e s se d h e r a p p r e c ia tio n o f th e g r e a t h o n o u r L a d y M o u n t b a t t e n h a d c o n f e r r e d u p o n t h e m b y c o m i n g t o M a id s t o n e to in sp e c t th e m . T h e ir n e w L a d y S u p t.- in - C h ie f h a d d o n e g r e a t w o r k fo r t h e B r i g a d e a t t h e t im e w h e n L o n d o n w a s b e i n g s u b je c t e d to it s w o r s t a i r r a id s . L a d y A s t o r a ls o e x p r e s s e d h e r t h a n k s to M r s . F a l w a s s e r fo r a l l t h a t s h e w a s d o i n g in K e n t . N u r s e s in A i r A m b u l a n c e s . A n e w f o r c e o f f l y i n g , n u r s e s is b e i n g b u ilt u p b y t h e W .A .A .F . E v e n tu a lly o n e V i l l tra v e l w tth e v e r y a ir a m b u la n c e in t h is c o u n t r y . T h e s e n u r s e s w e a r o r d in a r y W . A . A . F . u n if o r m b u t w it h th e d is t in g u is h in g s t a ff a n d s e r p e n t’s b a d g e of th e R .A . F . M e d ic a l S e r v i c e s . A fir s t a id b o x o f d r e s s i n g s , d r u g s a n d d i s i n f e c t a n t , a n d a s m a ll c a s e o f s u r g i c a l i n s t r u m e n t s a r e c a r r ie d in e a c h a i r a m b u la n c e . I f n e c e s s a r y t h e n u r s e m u s t b e p r e p a r e d to p e r fo r m m in o r o p e r a t io n s . N o t a l l t h e g i r l s w h o v o lu n t e e r f o r t h is w o r k t a k e to t h e a ir . O n e w h o a c t e d a s t h e “ p a t i e n t ” a t a d e m o n s t r a t io n w a s g r o u n d e d b e c a u s e t h e v ib r a t io n o f t h e p la n e c a u s e d a n e r v o u s d is t u r b a n c e . A n o t h e r f a ile d to s u r m o u n t a ir s i c k n ess. B u t o n t h e w h o le t h e y a r e a g r e a t e r s u c c e s s a s a ir n u rs e s th a n th e m en . T h e c r e w o f a n a i r a m b u l a n c e c o n s is t s o f a p ilo t , o b s e r v e r a n d W . A . A . F . o r d e r ly . T h e l a t t e r s it s o n a w o o d e n b o x a t t h e h e a d o f t h e p a t ie n t w it h i n r e a c h o f t h e o x y g e n a p p a r a t u s . S h e c a r r ie s a fla s k o f w a te r a n d a n o th e r o f h o t m ilk , a n d k e e p s a h y p o r d e r m i c s y r i n g e r e a d y t o r e lie v e p a in . T h e m e d ic a l o ff ic e r o f o n e s t a t i o n c o n s id e r e d t h e w o m e n m o re s u c c e s s fu l th a n th e m en . H e s a id t h e y w e r e g o o d w o r k e r s , a n d t h e p a t ie n t s d e r iv e d g r e a t e r c o n f id e n c e a n d m o r e c o m fo r t fr o m h a v in g a w o m a n lo o k in g a fte r th e m . T h e a i r a m b u l a n c e is m e t b y t h e M . O . o n la n d i n g , w h o e x a m i n e s t h e p a t ie n t a n d c h e c k s h is m e d ic a l h is t o r y , b u t it is t h e g i r l s w h o h a v e t h e r e s p o n s ib i lit y in t h e a ir .

N e w c a s t l e P .C . H o n o u r e d . — A r a r e d is tin c tio n h a s b een a w a r d e d t o a p o l ic e c o n s t a b l e in t h e N e w c a s t l e - o n - T y n e F o rce. P .C . E r n e s t H a r k in g h a s b e en p re s e n te d w ith th e C r o s s of a S e r v in g B ro th e r o f th e O rd e r o f S t. J o h n of J e ru s a le m . T h i s is t h e fir s t t im e a n a w a r d o f t h is n a t u r e h a s b e e n r e c e iv e d b y a p o l ic e m a n in t h is F o r c e . P .C . H a r k in g w a s in i t i a t e d in t o fir s t a id in t h e S . J . A . B . t h i r t y y e a r s a g o , H e j o in e d t h e P o l i c e F o r c e in 1 9 1 4 . In 1 9 1 5 h e w a s on a c t i v e s e r v i c e 'i n t h e R o y a l N a v y , h is d u t ie s b e i n g t h a t o f a S ic k B e rth A tte n d a n t. O n h is d e m o b i li s a t i o n h e s u b s e q u e n t l y b e c a m e i n s t r u c t o r in fir s t a i d in t h e N e w c a s t le F o rce. D u r i n g t h e c r i s i s a n d t h e p r e s e n t w a r h e h a s t r a in e d m a n y b r a n c h e s o f th e C iv il D e fe n c e . O w i n g to h is k n o w l e d g e in fir s t a id , h e h a s s a v e d f o u r l iv e s a n d h a s b e e n c o m p li m e n t e d o n t h e a c t i o n h e t o o k in t h e s e c a s e s .

F I R S T

R I D

WOUNDS, BURNS, H EAL

R A P ID L Y

etc.

and

WILL NOT TURN SEPTIC IF

TREATED

WITH

A N T I P E O L C U T A N E O U S B

O I N T M E N T

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o n e o r o ilie r o r a ll o f th e th re e ra c e s o f g e r m s , S tr e p to c o c c i, S ta p h y lo c o c c i a n d B . p y o c y a n e u s a re fo u n d in e v e r y s k i n i n f e c t io n c o m m o n t o t h is c o u n t r y , a n d A N T I P E O L O I N T M E N T c o n t a i n s ih e ] a n tib o d ie s ( a n t i v i r u s ) o f t h e s e g e r m s . H e a l i n g is e x p e d it e d b y t h e p r o v e d i n g r e d i e n t s o f t h e o in t m e n t , a n d s e p t ic d e v e lo p m e n t is s t o p p e d o r p r e v e n t e d b y it s a n t i v i r u s s t e r ile v a c c i n e f il t r a t e s . A N T IP E O L O I N T M E N T is u n s u r p a s s e d f o r B U R N S a n d S C A L D S , fo r it is m ic r o b ic id e a n d n o n - a d h e s iv e , a n d d r e s s i n g s d o n o t r e q u ir e to b e c h a n g e d e v e r y d a y . A

R H IN O -A N TIP E O L a ffo r d s r a p id r e lie f o f C O M M O N C O L D S , I N F L U E N Z A , A N D C A T A R R H . C o n t a in in g th e a n tib o d ie s o f th e g e r m s c o m m o n to in f e c t i o n s o f t h e n o s e a n d p h a r y n x ( S t a p h y l o c o c c i , S t r e p t o c o c c i , B . p y o c y a n e u s , p n e u m o c o c c i , p n e u m o b a c i lli, e n t e r o c o c c i, M . c a t a r r h a l i s , B . P f e if f e r ) , R h i n o - A n t i p e o l is n o t ju s t a p a lli a t i v e , b u t is a r e m o v e r o f th e c a u s e o f t h e in f e c t io n . D u r i n g e p id e m ic s i t is t h e id e a l p r e v e n t i v e o f m ic r o b e d e v e lo p m e n t .

OPHTHALM O -A N TIP EO L is a s e m i- f lu id o in t m e n t , m o r e c o n v e n ie n t t h a n t h e o r d i n a r y A n t i p e o l o in t m e n t fo r o c u l a r in f e c t io n s a n d le s io n s . E y e s a ffe c te d b y s m o k e a n d d u s t a r e so o th e d a lm o s t im m e d ia te ly b y th e a p p lic a tio n o f O p h th a lm o -A n tip e o l, a n d th e a n t i v i r u s p r e v e n t s g e r m s fr o m d e v e lo p i n g . Clinical Sam ples on request from M ED ICO *BIOLO GiCAL LABOR ATO RIES LTD ., Cargreen Road, South N orw ood, London, S.E.25

arte rs

riN V A L I D F U R N I T U R E

P A T E N T

“ PORTLAND A M BU LA N C E G EA N The Gear illustrated (A.B.C.D.) carres two stretchers on one side of Ambulance, leaving other side clear for sitting patients. UP A N D D O W N action is quick easy for loading or unloading. A.

Shows the two stretchers in position.

Shows the top stretcher lowered ready for loading.

Illustrates the same Gear with the top stretcher frame hinged down for use when only one stretcher case is carried.

D . Shows the same position as in “ C " only with cushions and back rest fitted for convalescent cases.

Where Ambulances are required to carry four beds two Gears are fitted, one on EITHER SIDE, and the same advantages apply as described above. full catalogue of Ambulance Equipment No, 7A will be sent on request.

G R E A TP O R T L A N DS T ./L O N D O N ,W .1 Telegraphic Address:—

P/ione :

Langham 1049.

KARVALID, WESDO. LONDON

F I R S T

Queries andAnswers toCorrespondents Q u e r i e s w i l l b e d e a l t w i t h u n d e r t h e f o l l o w i n g r u le s :— 1 . — L e t t e r s c o n t a in in g Q u e r ie s m u s t b e m a r k e d o n th e to p le f t - h a n d c o r n e r o f t h e e n v e lo p e “ Q u e r y , ” a n d a d d r e s s e d to F i r s t A i d , 46 , C a n n o n - s tr e e t, L o n d o n , E .C .4 . 2 .— A l l Q u e r i e s m u s t b e w r i t t e n o n o n e s id e o f p a p e r o n ly . 3 .— A ll Q u e r ie s m u s t b e a c c o m p a n ie d b y a “ Q u e r y C o u p o n ” c u t f r o m t h e c u r r e n t i s s u e o f t h e J o u r n a l, o r , in c a s e o f Q u e r i e s fr o m a b r o a d , f r o m a r e c e n t is s u e . 4 .— T h e T e x t b o o k t o w h i c h r e f e r e n c e m a y b e m a d e in t h is c o l u m n i s t h e 3 9 th ( 1 9 3 7 ) E d it i o n o f t h e S . J . A . A . M a n u a l o f F ir s t A id to th e I n ju r e d . A r t ific ia l R e s p ir a tio n . J . R . ( B r o m l e y ) . — I h a v e h e a r d fr o m a n i n s t r u c t o r o f t h e R o y a l L ife S a v in g S o c ie ty th a t S c h a fe r ’s m e th o d o f a r t i f i c i a l r e s p i r a t i o n a s d e s c r i b e d in t h e S t . J o h n , L o n d o n C o u n t y C o u n c il a n d B r itis h R e d C r o s s S o c ie ty t e x t b o o k s is , in e a c h c a s e , t o b e d r o p p e d in f a v o u r o f t h e m e t h o d a s p r a c t ic e d b y t h e R . L . S . S . b e c a u s e it is q u i c k e r a n d m o r e e ff e c t i v e . C a n y o u in fo r m p le a s e ? I t w o u ld b e a g o o d t h i n g f o r t h o s e c o n c e r n e d i f a l l t e a c h i n g o r g a n i s a t i o n s d e s c r ib e d S c h a f e r ’ s m e t h o d in i d e n t ic a l t e r m s , w i t h o u t v a r i a t i o n s a n d a s it w a s a p p r o v e d b y P r o f e s s o r S h a r p e y - S c h a f e r in 1 9 3 1 . T h u s fa r, h o w e v e r , I h a v e n o t h e a r d t h a t t h is h a s b e c o m e a n e s t a b li s h e d f a c t . I n c id e n ta lly , t h o u g h y o u a re a m e m b e r o f th e B r ig a d e , y o u e v id e n tly d o n o t k n o w y o u r T e x t b o o k . I f, t h e r e f o r e , y o u w i l l t u r n t o p. 1 4 t h e r e i n , y o u w i l l fin d a n a c k n o w l e d g e m e n t o f t h e h e lp g i v e n b y t h e R . L . S . S . in t h e d e s c r ip t io n o f S c h a f e r ’ s m e t h o d !— N . C o r b e t F l e t c h e r . E x a m in a t io n H o w le r . M . R . ( C a n n o n S t . ) . — N o t l o n g a g o I a s k e d a c a n d i d a t e in e x a m i n a t i o n t o d e f in e a d i s lo c a t i o n ; a n d I w a s m u c h a m u s e d w h e n h e r e p l ie d — “ A d is lo c a tio n i s s a i d to o c c u r w h e n a f t e r a n in j u r y a j o i n t c h a n g e s c o lo u r / ” C le a r ly t h e c a n d i d a t e m u d d e l le d u p d i s c o lo u r a t i o n a n d d i s l o c a t io n ! G ood !

N e x t , p le a s e ! !— N . C . F . T r a n s p o r t o f S p in a l I n ju r y .

W . Y . ( P a l m e r s G r e e n ) . — M a y I a s k if t h e r e p l y g i v e n to t h e q u e r y , w h i c h w a s p u b lis h e d u n d e r t h e a b o v e t it le in t h e J u n e is s u e o f F i r s t A i d , is n o t a t v a r i a n c e w i t h t h e T e x t b o o k ? T h e p a t i e n t w a s s a id t o b e u n c o n s c i o u s a n d th e s ite o f th e s p in a l in ju r y u n c e r ta in t h o u g h s u s p e c te d in t h e l u m b a r r e g i o n . M e a n w h ile m y th a n k s . T h e r e p l y in t h e J u n e i s s u e w a s n o t a t v a r i a n c e w it h t h e T e x t b o o k , b e c a u s e t h e i n j u r y w a s o b v i o u s l y in t h e l u m b a r r e g io n . T h e c o n s c i o u s o r u n c o n s c io u s s t a t e d o e s n o t i n i t s e l f d e c id e t h e p o s it i o n in w h i c h t h e p a t ie n t s u f f e r i n g f r o m s p i n a l i n j u r y is t o b e c a r r i e d ; a n d t h e r u l i n g in p a r . A o n p . 7 3 is in t r o d u c e d t o m e e t t h o s e c a s e s in w h i c h t h e r e m a y b e a n u n s u s p e c t e d f r a c t u r e in t h e c e r v i c a l r e g i o n . — N . C . F . D e fin itio n o f “ F it .” C.

P . ( C o v e n t r y ) . — W e r e c e n t l y d is c u s s e d a m o n g o u r s e lv e s t h e m e a n i n g o f t h e t e r m “ fit ” ; a n d a s w e c o u ld n o t a g r e e w e a s k y o u r k in d e x p la n a tio n .

T h e r o o t m e a n i n g o f t h e t e r m “ fit ” is “ a s u d d e n a t t a c k of a n y th in g , su c h a s la u g h t e r .” A p p lie d to f ir s t a id it is t a k e n t o s i g n i f y “ a s u d d e n s e i s u r e in w h i c h t h e r e is p a r t ia l, o r c o m p le t e lo s s o f c o n s c i o u s n e s s , w i t h o r w i t h o u t c o n v u ls io n s . T h e t e r m is u n s c i e n t i f i c a n d is u s e d c h i e f ly b y p e o p le w h o c a n n o t d i s c r i m i n a t e b e t w e e n it s v a r i o u s c a u s e s . I t s h o u ld , t h e r e fo r e , n o t b e u se d w ith o u t a q u a lif y in g a d je c tiv e , fo r e x a m p l e h y s t e r i c a l fit, a p o p le c t i c fit, e p i le p t ic -fit a n d s o o n . — N .C .F .

A I D E th ic s o f F ir s t A id . J .M . ( R u a b o n ) . — R e t u r n i n g h o m e t h e o t h e r e v e n i n g fr o m a p r a c t i c e o f t h e H o m e G u a r d (in w h i c h I a m a s t r e t c h e r b e a r e r ) a n d h a v i n g f u ll fir s t a id e q u ip m e n t w i t h m e I c a lle d a t t h e lo c a l h o t e l. T e n m in u t e s l a t e r ( 9 .3 7 p .m .) I h e a r d a w o m a n s c r e a m a n d g o i n g in t o t h e a d j o i n i n g r o o m I fo u n d t h a t a c e l l a r d o o r in t h e flo o r h a d b e e n le ft o p e n a n d t h a t a w a i t r e s s h a d fa lle n d o w n t h e s t e p s in t o a c e lla r . M y o ff e r o f a s s i s t a n c e w a s r e f u s e d a n d b r a n d y w a s g i v e n t o t h e p a t ie n t . A t 9 .5 5 p .m . I r e m in d e d t h e h o s t e s s t h a t a d o c t o r h a d n o t y e t b e e n c a lle d ; a n d t h is w a s done a t on ce. T h e p a t ie n t w a s t h e n b r o u g h t u p f r o m t h e c e l l a r a n d s e a t e d o n a c h a i r in t h e r o o m ; a n d 1 n o te d t h a t s h e w a s s u ff e r in g fr o m a w o u n d of th e a r m a n d fr o m s h o c k . A t 1 0 .1 0 p .m . t h e d o c to r * c a m e a n d t o o k c h a r g e o f t h e p a t ie n t . W i l l y o u p le a s e t e ll m e if t h e h o t e l p e o p le h a d t h e r i g h t t o r e f u s e m y o ff e r to r e n d e r f ir s t a id a n d if t h e y w e r e in o r d e r in g i v i n g b r a n d y to t h e p a t i e n t ? T h e r e is n o l a w w h i c h c o m p e ls a n y o n e e i t h e r t o s e e k a d v i c e fr o m d o c t o r o r fir s t a i d e r o r t o a c c e p t it w h e n o ff e r e d ! N e i t h e r is t h e r e a n y l a w w h ic h fo r b i d s t h e a d m i n i s t r a t i o n o f b r a n d y t o a n in ju r e d p e r s o n . I t is , h o w e v e r , t r u e t h a t b r a n d y m a y d o p o s it i v e h a r m in c e r t a i n c a s e s ; a n d c o n s e q u e n t ly t h e T e x t b o o k ( P r i n c i p le N o . 1 2 , p . 2 6 ) s p e c i f i c a l ly w a r n s fir s t a i d e r s t h a t t h e a d m i n i s t r a t i o n o f a l c o h o l m u s t b e w it h h e ld u n t i l o r d e r e d b y t h e d o c t o r e x c e p t in t r e a t m e n t o f s n a k e b it e ( R u l e 2, p . 1 3 4 ) a n d o f c y a n i d e p o i s o n i n g ( R u l e 2, p. 1 7 6 ) . — N . C . F . H u m o u r in H o m e -N u r s in g . A . B . ( D a r t f o r d ) . — d u r i n g le c t u r e s o n H o m e - N u r s i n g g i v e n to o u r D i v i s i o n t h e S i s t e r T u t o r h a d b e e n u s i n g “ G r a n n y ” a s a f ig u r e - o f - s p e e c h . O n e d a y sh e s a id — G ran n y has b r o n c h it is a n d t h e d o c t o r h a s a s k e d y o u to e r e c t a s t e a m te n t.” A f t e r s h e h a d r e c e iv e d s a t i s f a c t o r y r e p l ie s w it h r e f e r e n c e t o t h e e r e c t io n o f t h e s a id t e n t , S i s t e r t h e n a s k e d w h a t w e w o u ld h a n g in t h e t e n t . T o t h is a s m a r t m e m b e r o f t h e D i v i s i o n p r o m p t ly r e p l i e d — “ G r a n n y 1 ” a n d w e a ll b u rs t o u t la u g h in g . I t h o u g h t t h a t t h e s t o r y w a s w o r t h y o f s p a c e in y o u r c o lu m n s ; a n d I t h a n k y o u f o r y o u r i n t e r e s t i n g a n d e n l i g h t e n i n g r e a d i n g in F i r s t A i d . G ood!

N e x t , p le a s e ! !— N . C . F . O ffic ia l C h a n g e s in T r e a tm e n t.

A . T . ( M i t c h a m ) . — W e s h a l l b e g l a d if y o u w i l l k i n d l y le t u s k n o w w h a t p r o c e d u r e is n e c e s s a r y in o r d e r t h a t w e m a y b e k e p t in f o r m e d o f c h a n g e s o f t r e a t m e n t in c o n n e c t i o n w it h fir s t a id , a s r e c o m m e n d e d b y t h e M i n i s t r y o f H e a lth . W e d o n o t k n o w a n y m e a n s b y w h i c h y o u c a n o b t a in t h e c i r c u l a r s d ir e c t f r o m t h e M i n i s t r y . If, h o w e v e r, y o u h a v e a n e q u ip p e d F i r s t A id P o s t w e s u g g e s t t h a t y o u m a k e c o n t a c t w i t h y o u r lo c a l M . O . H . a n d o b t a in fr o m h im t h e n e c e s s a r y d e ta ils .— E d i t o r . I n d ic a tio n fo r S ilv e s t e r ’s M e th o d . G . C . ( B a t l e y ) . — ( 1 ) A t a r e c e n t c o m p e t it io n in t h is a r e a t h e t e a m s w e r e c a lle d u p o n t o t r e a t a m a n w h o , w h ils t e n g a g e d o n r e p a i r s t o a h o u s e , h a d f a l l e n o f f a la d d e r in t o a n a d j o i n i n g r iv e r . W h e n th e te a m s a r r iv e d on th e te s t th e y w e r e g iv e n a n o th e r t a lly in fo r m in g th e m th a t t h e m a n h a d b e e n r e m o v e d f r o m t h e r iv e r , a p p a r e n t l y dead. T h e y w e r e a ls o in f o r m e d t h a t t h e m a n w a s s u f f e r i n g fr o m a v e r t i c a l w o u n d o f t h e a b d o m e n a c c o m p a n ie d b y c a p i l l a r y h a e m o r r h a g e , n o o r g a n s p r o t r u d in g . I s h o u ld b e v e r y p le a s e d if y o u w o u ld g i v e m e y o u r o p in io n a s t o w h i c h m e t h o d o f a r t i f i c i a l r e s p ir a t io n y o u w o u ld a d v is e . T h e T e x tb o o k c le a r ly s t a te s th a t S y l v e s t e r ’ s m e t h o d is t o b o u s e d o n ly w h e n it is im p o s s ib le t o t u r n t h e p a t i e n t o n t o h is f a c e . O n e o f o u r j u d g e s , w h o is a l s o a D i v i s i o n a l S u r g e o n o f S . J . A . B . t e lls u s t h a t in t h is i n s t a n c e h e w o u ld u s e

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A N T E D p a r t i c u l a r s o f S . J . A . B . C a d e t U n i f o r m fo r d is p o s a l. B o x 207, ” F ir s t A id ,” 46, C a n n o n -stre e t, L o n d o n , E .C .4 .

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S c h a f e r ’ s m e t h o d o n ly if h e w e r e b y h i m s e lf , a n d t h a t h e w o u ld u s e S y l v e s t e r ’s if h e h a d a s s i s t a n t s a v a i l a b l e n o m a t t e r w h a t o t h e r in j u r ie s h e h a d . A l s o (2 ) I s h o u ld l i k e to k n o w w h a t c o n s t i t u t e s a c o n d it i o n w h e r e b y it b e c o m e s i m p o s s ib le to t u r n t h e p a t i e n t o n t o h is f a c e . Y o u r k in d a d v i c e o n b o t h p o in t s w ill b e m u c h a p p r e c ia te d . ( 1 ) I n t h e c i r c u m s t a n c e s n a m e d , I w o u ld q u i c k l y p r o t e c t t h e w o u n d w i t h a d r e s s i n g , a n d h o ld it in p o s it io n w i t h a b r o a d b a n d a g e e n c i r c l i n g t h e a b d o m e n a n d t ie d o f f o n t h e p a tie n t’s b a c k . T h i s d o n e , I w o u ld c o m m e n c e S c h a f e r ’ s m e t h o d w i t h o u t d e l a y w h e t h e r 1 w a s a lo n e o r h a d a t e a m o f a s s is ta n ts . (2 ) T h e in s t r u c t i o n in t h e T e x t b o o k t o r e s o r t to S i l v e s t e r ’ s m e t h o d w h e n it is im p o s s i b le t o t u r n p a t ie n t o n t o h is f a c e w a s i n t r o d u c e d b e c a u s e e x p e r i e n c e in m in e s a n d c o ll i e r i e s t a u g h t u s t h a t s o m e t i m e s p a t i e n t s a r e t r a p p e d b y f a l l s o f c o a l o r s t o n e w h i l e l y i n g o n t h e ir b a c k s . For s u c h c a s e s S c h a f e r ’ s m e t h o d i s q u i t e i m p o s s ib le , a n d S i l v e s t e r ’ s m e t h o d o ff e r s t h e o n ly c h a n c e o f im m e d i a t e tre a tm e n t. S i m i l a r l y , t h e l a t t e r m e t h o d is in d ic a t e d w h e n a f t e r a n a i r r a id a n a s p h y x i a t e d p a t i^ h t is f o u n d l y i n g o n h i s b a c k a n d p in n e d d o w n b y d e b r is o f a b li t z e d h o u s e a c r o s s t h e l o w e r lim b s . (3 ) T h o u g h y o u s e e m to k n o w y o u t T e x t b o o k , y o u h a v e n o t y e t le a r n e d th e c o r r e c t s p e llin g of “ S i lv e s t e r ” ! — N .C .F . Q u a n tity o f A ir B r e a th e d . J . R . ( D a r l i n g t o n ) . — P l e a s e t e ll m e t h e q u a n t i t i e s o f a i r c o n t a in e d in t h e l u n g s a f t e r in s p i r a t i o n a n d a f t e r e x p ir a t i o n . B r e a t h i n g o r t id a l a i r is t h e q u a n t i t y o f a i r w h ic h is h a b i t u a l l y c h a n g e d in e a c h a c t o f b r e a t h i n g . In a h e a lth y m a n t h i s is a b o u t 20 c u b i c i n c h e s . Y o u w i l l r e a l i s e t h a t t h is a m o u n t o f a i r d o e s n o t fill t h e l u n g s ; t h a t in f a c t it o n ly p a s s e s in t o t h e u p p e r r e s p i r a t o r y p a s s a g e s ; a n d t h a t t h e a i r fin d s it s w a y i n t o t h e a l v e o l i b y t h e m u c h s l o w e r p r o c e s s o f d if f u s io n . C o m p l e m e n t a l a i r is t h e q u a n t i t y o v e r a n d a b o v e t h is w h i c h c a n b e d r a w n in t o t h e l u n g s in t h e d e e p e s t in s p ir a t io n . R e s e r v e a i r i s t h e q u a n t i t y w h i c h r e m a i n s in t h e l u n g s a f t e r o r d i n a r y e x p i r a t i o n ( s u c h a s t h a t w h i c h e x p e ls t h e t id a l a ir ) a n d w h i c h m a y b e e x p e lle d b y f o r c ib le a n d d e e p e r e x p ir a tio n . R e s i d u a l a i r is t h e q u a n t i t y w h i c h r e m a i n s in t h e l u n g s a f t e r t h e m o s t v i o l e n t e x p i r a t o r y e ffo r t . T h e a m o u n ts o f th e la s t th re e v a r y b u t e a c h c a n be r e c k o n e d a t 10 0 c u b i c i n c h e s . — N . C . F . S c o ttis h H u m o u r. A . H . ( T h o r n t o n ) . — H e r e is a w o r t h w h i l e s t o r y w h i c h y o u m a y c a r e to p rin t in F i r s t A id . A S c o t , s e e k i n g c h e a p a d v i c e f r o m a m e d ic a l f r ie n d w h o w a s a ls o a S c o t , a s k e d w h a t s h o u ld b e d o n e f o r a s p r a in e d a n k l t . T h e d o c t o r r e p lie d — " L i m p : R u n : L im p ! ” G ood !

R I D t h e f r a c t u r e d f e m u r e s p e c i a lly s in c e a t r a in e d s q u a d o f fir s t a i d e r s w a s o n t h e s p o t. A ls o , a s h e c a n b e s o p la c e d it is c o n t r a r y to t h e T e x t b o o k in s t r u c t io n s to r e s o r t to S i l v e s t e r ’ s m e th o d o f a r tific ia l r e s p ir a tio n .— N .C .F . S h o u ld e r C a r r y o f S tre tc h e r . E.

H . ( B e x l e y ) . — 1 a m h e l p i n g to t r a in m e m b e r s o f t h e H o m e G u a r d in f ir s t a id a n d u p to t h e p r e s e n t h a v e a l w a y s t a u g h t t h e t w o - h a n d e d c a r r y fo r s t r e t c h e r d r ill. I now u n d e r s t a n d t h a t t h e n e w a r m y r u l i n g is a f o u r - h a n d e d c a r r y o n t h e s h o u ld e r s . C a n y o u p le a s e t e ll m e w h a t a r e t h e n e c e s s a r y in s t r u c t i o n s o r n a m e a b o o k in w h i c h th es e a r e g iv e n ?

T h e s h o u ld e r c a r r y w a s u s e d d u r i n g t h e fir s t G r e a t W a r fo r t r a n s p o r t in t h e t r e n c h e s . In C iv il D e fe n c e w o r k , h o w e v e r , t h e n e e d fo r s u c h m e t h o d o f c a r r y i n g p a t ie n t s h a s v e r y r a r e ly o c c u rre d . Y o u w i l l fin d r e f e r e n c e t o it in A . R . P . H a n d b o o k N o. 1 .— N .C .F . F r a c tu r e d L e g w ith M u s ta r d G a s . A . H . ( I l f o r d ) . — Y o u r r e p ly t o t h e q u e r y , w h i c h w a s p u b lis h e d u n d e r t h e a b o v e h e a d i n g in t h e M a y is s u e o f F i r s t A i d , d o e s n o t a c c o r d w i t h t h e in s t r u c t io n s i s s u e d b y t h e M in i s t r ie s o f H o m e S e c u r i t y a n d H e a l t h r e g a r d i n g d i s p o s a l o f c o n t a m in a t e d w o u n d e d p a t ie n t . A s t r e t c h e r c a s e c o n t a m in a t e d b y m u sta rd g a s m u s t b e t a k e n t o a h o s p it a l e q u ip p e d w i t h a c l e a n s i n g s t a t i o n , lis t s o f w h i c h a r e c a r r ie d b y a ll C i v i l D e f e n c e A m b u la n c e s . S u f f ic ie n t p r e l i m i n a r y c l e a n s i n g s h o u ld h a v e b e e n d o n e o n t h e s i t e b y t h e p e r s o n s f i n d i n g t h e p a t i e n t to p r e v e n t a n y s e r io u s i n ju r y a r i s i n g fr o m t h e s p l a s h i n g b y m u s t a r d , a n d s u r e ly a c l e a n s i n g s t a t i o n w h e t h e r a t t a c h e d to a F i r s t A id P o s t o r n o t , is n o t a s u i t a b l e p la c e to r e c e i v e a p a t ie n t w i t h a c o m p o u n d f r a c t u r e o f t h e fe m u r . N e i t h e r in t h e q u e r y n o r in t h e a n s w e r w a s a n y r e f e r e n c e m a d e to a F i r s t A i d P o s t ; a n d I a m a t a lo s s t o u n d e r s t a n d w h y y o u s h o u ld h a v e a s s u m e d t h a t t h is w a s t h e c a s e ! 1— N .C .F . C .D . I n s tr u c to r ’s B a d g e . R . E . ( P e n a r t h ) . — A c c o r d i n g t o A i r R a i d P r e c a u t io n s B u l l e t i n N o . 8 a b a d g e b e a r i n g t h e w o r d “ I n s t r u c t o r ” — w it h t h e a p p r o p r ia t e le t t e r s a b o v e a n d t h e w o r d s “ C i v i l D e fe n c e ” b e lo w — a r e o b ta in a b le by I n s tru c to rs A .R .P .S ., C .A .G .S ., L .A .R .P . or L .A .G .C . S u r e ly th e In s tr u c to r s G r a d e I o f o u r o r g a n is a tio n a r e o f e q u a l s t a n d i n g to a n I n s t r u c t o r L . A . R . P . o r L . A . G . C . H a v e t h e y b e e n a c c i d e n t a l l y o r p u r p o s e ly o m it t e d fr o m t h e l is t , o r a r e t h e y n o t a l l o w e d t o w e a r t h e b a d g e ? T h e q u e s t i o n o f t h e e x t e n s io n o f t h e is s u e o f a b a d g e to G r a d e I I n s t r u c t o r s o f S t . J o h n is a m a t t e r w h i c h is e n t i r e l y in t h e h a n d s o f t h e M i n i s t r y o f H o m e S e c u r i t y . — E d i t o r . A n ti- d im

N e x t , p le a s e ! !— N . C . F . S c h a fe r o r S ilv e s te r .

* E .C . ( A s h in g t o n ) .— A t a re c e n t D iv is io n a l P r a c t ic e w e w e re g i v e n a t e s t in w h i c h a m a n w a s s u p p o s e d to h a v e f a lle n o u t o f a b o a t in t o t h e s e a a n d t o h a v e b e e n b r o u g h t a s h o r e a s p h y x i a t e d a n d s u f f e r i n g a ls o fr o m s im p le f r a c tu re o f r ig h t fe m u r . S o m e s q u a d s c o n t r o ll e d t h e f r a c t u r e , t u r n e d p a t ie n t o n to h is f a c e a n d a t o n c e c o m m e n c e d S c h a f e r ’s m e t h o d o f a r t if i c ia l r e s p ir a t io n , w h i le o t h e r s le f t p a t i e n t o n h i s b a c k a s f o u n d a n d t r e a t e d t h e a s p h y x ia b y S ilv e s t e r ’s m e th o d . A s w e c o u ld n o t a g r e e a s to w h i c h w a s t h e c o r r e c t t r e a t m e n t , w e a g r e e d t o s u b m i t t h e p o in t to y o u a n d a w a it y o u r r u lin g w ith k e e n e n th u s ia s m . P r o v id e d t h a t th e p a t ie n t is t u r n e d on to h is fa c e w ith e x t r e m e c a r e , it is u n l i k e l y t h a t f u r t h e r h a r m w o u l d r e s u l t t o

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R . E . ( P e n a r t h ) . — If a n t i- d im c o m p o u n d b e c o m e s h a r d a n d d iffic u lt to u s e , is t h e r e a n y m e a n s o f r e n d e r i n g it u s a b l e ? A s a r e g u l a r r e a d e r o f F i r s t A i d I h a v e d e r iv e d ( a n d s t ill d e r iv e ) v a l u a b l e i n f o r m a t io n fr o m t h e Q u e r y C o lu m n , a n d 1 s h a l l b e g r a t e f u l f o r a r e p l y t o m y tw o q u e s tio n s . I f y o u b r e a t h e o n a n t i- d im c o m p o n n d , y o u w i l l fin d t h a t it b e c o m e s s o f t e n o u g h f o r f u r t h e r u s e . — N . C . F .

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E d ito rial—

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Co-ordination of Civil Defence Services

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S .J .A .B . Headquarters and D istrict Reports

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Th e Nervous System

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“ H utt’s H arness ”

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R ailw ay Am bulance News

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Stanmore First Aid Association

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Our Nurses’ P ag e

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32 34 34 34 34 34 34 34

Q u e r i e s a n d A n s w e r s t o C o r r e s p o n d e n t s :—

Responsible Person

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Exam ination H ow ler

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Burns by Electricity ... Strongest Ligam ent in Body

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Hum our in First Aid

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Transport of Patient ... Transport of Spinal In ju ry...

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F a k in g of Injuries... ... . Fractured Clavicle and Scapula

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Ethics of First A id ...

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Treatm ent of D o g Bite

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36 36 36 36 36 **36

VV h e n a true history of the War, A .R .P . and free from party penmanshi p, C i v i l D e f e n c e , comes to be written, A . R . P . will

hold an honoured place. The name may be scrapped and fade from public memory, but the record of its work can never be obliterated, forming as it does a record of heroism and endurance such as the world had never yet be held. Heroism is a word that is much misunder stood, and it is used much too freely and bestowed too often upon deeds which are performed only in the excitement of the moment and entirely without t hought of the consequences. W e remember some years a g o chat ti ng with a policeman, and we asked him what he considered the bravest deed he had ever done, and he awarded the palm to his action in s t oppi ng a pair of runaway horses. But, he added, ‘ ‘ if I had gi ve n it a second’s t ho ug ht I should never have attempted it. It was just in the excitement of the moment . ” Comme ndabl e as is such modesty, it nevertheless strikes the right key, and heroism in that case was not the word to be applied. Hi story has so mislead us with pinchbeck heroes that it has become i ncreasingly difficult to allot to the word heroism any definite and distinct meaning. T h e man who pursues a monotonous calling, g o i n g to his work day after day, and sacrificing his whole life for his family, is a hero of a sort— in modern parlance. But we are not concerned with this non descript being, which exists in its millions and forms a large proportion of masculine humani ty. O u r concern is with those who, on the call of the siren, cast themselves into the hell of bombs and fire and guns, stolidly and calmly, with the fullest knowl e dge of the possible consequences, perform i n g deeds of bravery and self-sacrifice which mi g h t appal the stoutest hearts. A n d these are for the great part ordinary men and women, unacquainted with danger, fostered in the lap of peace and homelife, h av i n g their first baptism under the most ter rible circumstances. It may be said that from the nurses, the police and the firemen calmness and de votion to duty were onl y to be expected, but da n gerous as mi ght have been their duties in peace time, not hi ng of a wartime nature had ever had to be encountered. W e l l they met the stress and strain

FIRST i mposed upon them, and as heroes they one and all acquitted themselves ! T h e work of the doctors, too, must not be overlooked, and many a life was saved o wi n g to their action in penetrating danger ous ruins and administering much-needed anaes thetics. In the same way, no structure was deemed too dangerous a condition for the entry of the firemen and police (and, it may be added, many an onlooker), and ruinous floors and tottering roofs were propped up by l i vi ng humani ty while the bodies of those buried were recovered for the pur pose of possible resuscitation. Merely to touch upon the hundredsof the individual cases of heroism which were displayed during that season of in tensive blitzes is a task upon which lack of space forbids our embarkation.

C o - o r d i n a t i o n o f C iv il D e f e n c e S e r v ic e s .

S IR

E xtracts from Lectures delivered by H E N R Y L. M A R T Y N , K .C .V .O ., F .R .C .S . ( Continued from page 1 4 .)

T he C ontrol of the B a ttle .

I should like to impress upon you one principle for a start— an air raid is a battle, as real and actual a battle as that of W aterloo— the only difference is that at W aterloo both forces were on the ground, but, in an air raid, one of the forces is in the air doing its utmost to destroy the per sonnel and property of the force on the ground, which, in its turn, is trying both to defend itself and to destroy as much of the atta ck in g force as possible. N ow no battle can be fought by a Committee, there must be one man in supreme command and one only, how ever m any subordinate commanders there may be acting under him. T h e duty of each of these subordinate com manders is to direct the particular part of the battle over w hich he can exercise control, but it is also his duty to en sure that the Com m ander in Chief is supplied constantly with such information as is necessary for him to be able to co ordinate the battle as a whole and to deploy his reinforce ments where they are most needed. The Comm ander in Chief in the B attle of Britain is the duty officer in the W ar Room of the Ministry of Home Security representing the M inister himself. T he W ar Room is in the closest possible touch with the Cabinet W ar Room, the B .B .C . and with F ighter Command, and from it the entire Civil Defence Forces of the country are con trolled. T h e country itself has been divided into a number of R egions, each of which is under the orders of a Regional Com m issioner actin g directly below the Ministry. Each R egion comprises a number of counties, and each county is commanded by a County Controller. \ G oin g another step downwards, each county is divided into a series of areas which frequently correspond to the divi sions of the County Police. The areas are commanded by Sub-Controllers, each of whom is responsible for any battles which m ay occur in his area. Since each area contains within its boundaries a num ber of fair-sized towns, each of these is controlled by the officer on duty in its own Report Centre, who is also supplied w ith information as to enemy action in surrounding villages through Report Posts in selected places.

RID Appreciate the perfection of the chain and the complete ness of the organisation which permits the fact that a bomb has fallen in a field in South Devon and slain a milch cow to be reported by Bill Sm ith, the W arden— that means Y o u — to the Ministry of Home Security at once, to reach the ears of the Cabinet itself, and to be broadcast next m orning to the world at large by the B .B .C . T h e one important thing to realise is that the Com mander of the Battle in any one area cannot see the battle himself, but has to rely entirely on the reports which reach him from the services on the spot. These reports enable him so to dispose the forces under his command that they m ay be used to the best advantage and allow of his being in a position to deploy his reinforcements where they are most needed. Let us start back now in the other direction and watch the machine actually at work. A bomb falls in a m arket town, certain dam age occurs and casualties are caused. T h e wardens report the facts to the Report Centre, and from there they are passed at once to the Sub-Con troller. T hu s far the incident is purely local and can be readily dealt with by the forces on the spot. Note the fact, however, that know ledge of the incident has already reached the Sub-Controller (the Commander of the Battle), but thus far the situation is too insignificant to warrant his interference. Further incidents occur, fires commence, more bombs are dropped and more casualties are caused, the local re sources are exhausted and help is required. As the attack develops a constant stream of information has been go in g forward to the Sub-control, so that there is alw ays a perfect picture before the Controller of the distant battle, and, w hat is equally important, from the moment of the fall of the first bomb, carefully filtered and condensed information has been passing up the long chain of com munication to the W ar Room of the Ministry of Home Security itself. By this time the Sub-Controller (the Commander of the Battle) is in active w ork, calls for reinforcements are reach ing him from the attacked town, and he has not only to meet the immediate needs but also to prepare for further calls as they m ay arise. At first it will probably be sufficient to move reserves from the neighbouring towns in the area, but at the same tim e it m ust be ensured that no place is depleted too heavily of its own services in case it also becomes involved in the battle. W hen the moment is reached that no more reserves are available in the area the call for help is passed to County Control where the Controller has had throughout a clear picture of the position. T h e despatch of reinforcements is ordered either from other areas in the coun'ty, or, if such are not available, -the request is passed to Region, who may move them from other counties under his command. All the time condensed reports of the battle have been reaching the duty officer in the W ar Room of the Ministry of Hom e Security itself, and when the call for help arrives he m ay decide to order the deployment of reserves from any part of the country to the threatened area. On m any occasions this has proved necessary, and rein forcements were moved to Plym outh, Bristol and Coventry from alm ost all over England. Now I have told you all this not only as a m atter of interest but also to teach a lesson. Appreciate once more the complete dependence of the Com m ander of the Battle upon the reports of Wardens, Police and Specials, and if these reports be inaccurate, it is utterly impossible for him to supply the services and rein forcements required, and, again, one more name may be added to the list of those— died of wounds.

( To be continued.)

*■

FIRST

St.

Joh n

A m b u la n c e

HEADQUARTERS

AND

B r ig a d e

D ISTR ICT

REPORTS.

N o . I (Prince o f Wales’s) District A c t o n 44 /1. — T he inaugural m eeting of this Division was held at their new Headquarters, Baptist Church Hall, Church Road, Acton, on Monday, August 17th. The President, Alderm an Buckett, occupied the chair and was supported by D istrict Staff Officer T . W alsby. Th e N ursing Division attended as guests. Mrs. Sm art (Lady Supt.), Mrs. D awson (Amb. Officer), and Amb. Officer Jones, Ham m ersm ith 44/2 Division, also attended. T h e Local Division was represented by Supt. C. D a w son, Div. Surgeons D r. C. Payne and Dr. L. Vincent, in addition to a large company of the men. Dr. Payne gave an extrem ely interesting discourse on “ T h e Duties of Port Medical O fficers.” Th is was further enhanced by a film loaned by the Medical Officer of Health, Southampton, in which Dr. Payne himself was featured. It is intended to repeat these combined functions every two months, when it is hoped many more enjoyable evenings will ensue. S o u t h a l l , N o . 55 .— T he Mayor (Alderman Mrs. F. S. Amos) presented exam ination awards to members of a first aid class held by the Southall Division at a dance on Satur day A ugust 29 th. In m akin g the presentation, the Mayor said it was a pleasure to her to come and present awards to the successful members who had given up much of their time in attending lectures in order that they m ight qualify in first aid. She expressed her appreciation of the good work perforrfied by the S. J.A. B. during the Council’s holiday-athome programme. Supt. J. E. Taylor proposed a vote of thanks to the Mayor. Charlie Holmes and his band provided the music for dancing, and Corpl. G. Green was M.C. T h e awards consisted of 26 F .A . certificates, 7 vouchers, 6 medallions and 2 labels.

N o . V m (Duke of Connaught’s) District C h i c h e s t e r . — At the annual inspection of the Chichester D ivision, County Commissioner D. Bryce w arm ly congratu lated its members on m aintaining their “ old high-class standards,” despite war-tim e difficulties. H e also referred to the long services of the D ivision’s President (D r. A. M. Barford) who, long before he cam e to Chichester, had done valuable w ork for the Order, of which he had now been made an officer. T h e County Com missioner presented to Supt. H. Bridle a bar to his service medal, award for more than 20 years’ efficient service.

No. EX District There was a large gath erin g of St. John Am bulance and N ursing Divisions from many parts of Devon at a parade in Queen’s Park, Paignton, recently, inspected by Colonel J. L. Sleeman, Chief Com m issioner of the S .J .A .B . Overseas. Follow ing the inspection, Col. Sleem an presented a number of lon g service awards, including medals and fourth bars. Addressing the parade, Col. Sleem an said he wanted to thank them and congratulate them on behalf of the Grand Priory of the Order of St. John and also the W ar O rga n isa tion of the British Red Cross for the good and m agnificent work which they had done since the w ar started. It was quite right that they should set such a h igh exam ple, seeing that they had the honour to belong to the most ancient order

RID

of chivalry in the w orld— the Venerable Order of St. John of Jerusalem , whose crest they wore on their medals, on their badges and buttons. t Continuing, he said this was not the time for words, as they knew w ell ; it was the time for deeds. “ I have seen some of the m agnificent w ork being done by most of these 150,000 who form this great and m agnificent arm y of hum anitarian services,” said Col. Sleem an. “ I have seen so many m agnificent and well-trained formations, which enables me to pay you the great com plim ent that in your turn-out, your drill, your spirit and your appearance and, moreover, your m arching, you-are equal to the best which I have seen.” County Com m issioner V ick thanked Col. Sleem an for inspecting the Divisions and representatives, of those D ivi sions which were not able to parade their full strength. H e would appreciate that, ow in g to transport difficulties and the fact that many of their men and women are on duty to day staffing First Aid Posts, First Aid P arty Depots, am bu lances, am bulance trains and hospitals.

The

N e rvo u s

Sy ste m .

[This is a very interesting subject, and one of which the m ajority of first aiders have little know ledge. In “ Belilios’ H andbook of First Aid and B a n d a g in g ” there appears an excellent chapter dealing with the Nervous System , extracts from which are given herewith.*]

nervous system consists of ( 1) the brain and spinal cord, and (2) the nerves and nerve junctions which form a means of com m unication between these central organs and all other parts of the body. T h e nervous system is the main co-ordinating centre of the body, since every feeling and every m ovement is auto m atically registered in its principal organ — the brain. For exam ple, every portion of the skin has its own special cell in the brain ; this cell is responsible for its welfare. If the skin is pricked by a pin, a m essage (impulse) of pain is instantly conveyed through a nerve junction to one of the strands (fibres) of a nerve and thence to the spinal cord. From here, it travels upwards and ultim ately reaches the cell in the brain which is responsible for the w elfare of the affected part of the skin. T his cell is im m ediately conscious that pain is being experienced, and it therefore sends a m essage to another part of the brain which governs the m ovement of muscles. As a result a further m essage is originated ; this passes down the spinal cord for a variable distance and then leaves it to be conducted along a nerve until it reaches the nearest muscle which is capable of m oving the skin aw ay from the pin. In a sim ilar way, the nervous system is responsible for m aintaining balance. Muscles are constantly pulling first in one direction and then anothter in order to preserve the proper balance of the body. T his mechanism is autom atic and con tinuous because the brain is constantly kept informed of the position of the body in relation to outside objects. For in stance, when one is w a lk in g along a road, m essages are ' received with every step, giv in g inform ation as to the condi tion of the road, and if the brain learns that the road is rough T he

* Reprinted by kind permission of the publishers. Copies of the handbook m ay be obtained from Baillifere, Tindall & Cox, at 7 /8 , H enrietta Street, London, W .C . 2 , or D ale, Reynolds & Co. L td ., 46 , Cannon Street, London, E .C . 4 , price 4/9 post free.

FIRST

and slippery it sends m essages to the muscles of the legs so that extra care shall be taken to avoid slipping. Likew ise, the brain is kept informed as to the position of the eyes so that if an individual turns his vision aw ay from the direction in w'hich he is w alking, the brain im m ediately slows down the rate of progress as a measure of safeguard. From these few exam ples, it will be clear that the brain is the main controlling centre for all the activities of the body. Nerve Tissue.— T h e nervous system is made of a special tissue which consists of cells and fibres. Nerve cells are situated in the brain and spinal cord ; they are grouped together to form the grey m atter of the nervous system. Each cell has a long projection called the fibre or axon and also a number of fine interlacing branches kqow n as dendrites. Nerve fibres naturally vary in length according to the distance which they have to travel. Thus_fibres which carry sensation from the soles of the feet have to travel right up the leg and thence into the lower part of the spinal cord, where-

AID The Nerz'ous System. — T his is divided into two parts : (1) Th^ central nervous system ; (2) the autonomic nervous system. T h e central nervous system controls all the muscles of the head, trunk and limbs ; it is the seat of all sensations, of the intellect, emotions, reason and will-power. The autonom ic system is an offshoot of the central nervous system, and controls the involuntary muscles of the

F i g . 2. — Nerve Cell and its Parts. Note. — T h e cytoplasm is the name given to the special protoplasm contained within the cell.

various internal organs such as the stomach, intestines, bladder and also the tiny muscles of the bloodvessels ; -it also controls the secretions of the liver and kidneys. A person is not conscious of the normal activities of the autonom ic system nor is he able to control them, e .g ., the contractions of the bowel are not norm ally felt by the individual.

Fig. 1. — Side V iew of the Nervous System. as those from the point of the shoulder have only a very short distance to travel before they reach their cells in the upper part of the cord. Th e dendrites-pick up impulses and carry them into the cell, w hile the fibre carries the impusle from the cell. T he fibre ends by dividing into a number of branches which com m unicate w ith the dendrites of another cell or w'ith a tissue such as muscle. Nerve fibres can only carry m essages in one direction. Those which convey sensations to the brain and spinal cord are termed sensory fibres, while those which convey impulses of movement are called motor fibres. Bundles of sensory fibres grouped together form a sen sory nerve, while bundles of motor fibres form a motor nerve. Sometimes both motor and sensory nerve fibres are carried together, in which case the nerve is known as mixed. Nerve fibres are grouped together to form the white m atter of th e'n ervou s sy ste m ; this is found in the brain, cord and nerves. G rey m atter is sim ilarly found in the brain and spinal cord, but not in nerves. It is also found in the ga n g lia, which are sm all isolated masses of nerve cells.

“ H u t t ’s

H a rn e ss.”

M r . A. H u t t of 3, Rectory Lane, D ysart, Fife, sends us a copy of the 2nd edition of a splendidly got up booklet c o n taining illustrated particulars of the uses of his excellent “ Stretcher H a rn e s s” which has been certified by m a n y doctors in E ngland and Scotland as the most outstanding article in first aid and A .R .P . equipment. T h e various illustrations speak for themselves as to the comfort of a patient suffering from many kinds of injuries, when harnessed to a stretcher, and how the patient can be carried in any position. It would take more space than w e can spare to detail all the w ays in which this “ H a rn e s s” can be used, suffice it to say that full instructions are given for its application, which appears to be sim plicity itself. Its use certainly facilitates speed in securing a patient to a stretcher, and the covering must give excellent re-assurance to the patient and a great feeling of security. It can be left on badly injured patients until they arrive at the hospital. Mr. H utt is certainly an expert and readers would do well, before purchasing, to consult him in all matters relating to first aid equipment, including all types of stretchers

FIRST

AID

O U N D S , H EAL

WILL

B U

R N

R A P ID L Y

NOT

TURN IFTREATED

I P

C U T A N E O U S B

E C

V A C CI NE

etc.

S , and

SEPTIC W IT H

O I N T M

E N T

I N

S E

I P

affords rapid relief of C O M M O N C O L D S , IN F L U E N Z A , A N D C A T A R R H . C ontaining the antibodies of the germ s common to infections of the nose and pharynx (Staphylococci, Streptococci, B. pyocyaneus, pneumococci, pneumobacilli, enterococci, M. catarrhalis, B. Pfeiffer), Rhino-Antipeol is not just a palliative, but is a remover of the cause of the infection. D uring epidemics it is the ideal preventive of microbe development.

I P

is a se/ni-fluid ointment, more convenient than the ordinary Antipeol ointment for ocular infections and lesions. Eyes affected by smoke and dust are soothed alm ost im m ediately by the application of Ophthalm o-Antipeol, and the antivirus prevents germ s from developing. C lin ica l Samples on request fro m M E D I C O -B I O L O G I C A L L A B O R A T O R IE S L T D . , C a rgreen Road, South N o rw o o d , Lon d o n , S.E.2S

LO N D O N & N O R TH EASTERN

R a ilw a y

A m b u la n c e

N e w s.

R .I .P . T homas E d w a r d M ein.

GREAT

W ESTERN

B r e c o n . — Presentations to two members of the staff, Mr. Evan E. Jones, station master, and Mr. F. M. Thom as, chief booking clerk, O sw estry, of gold bars for 20 years’ first aid efficiency were made by Mr. T . C. A. Hodson, Divisional Am bulance Secretary, at Brecon at a recent meeting. Mr. Jones was the first secretary of the Brecon Division of the S .J .A .B ., and one of the founders of the Brecon am bulance car service, while Mr. Thom as was Superintendent of the Division for many years. Mr. Hodson thanked the recipients on behalf of the railw ay for their 20 years’ unselfish service.

H o n o u r s . — As a .result of recommendations made by the Central Am bulance Committee, the follow ing members of the staff have received recognition from the Order of St. John of Jerusalem for exceptional services rendered to the movement on the G .W .R . over a long period of years :— Serving Brothers.— W . H. P. M usk, engine driver, Southall ; J. Bridger, signalm an, Kensington, Addisonroad ; R. H. Sullivan, foreman ticket collector, Paddington ; W . H aiber, fitter, Swindon ; A. C. Napper, examiner, W eston-super-M are ; C. F. Gaynor, checker, Paddington ; W . J. N ewdick, clerk, Old O a k Common ; W . H ughes, in spector, Canton, C a r d iff; D. B. Ely, guard, C a r d iff; M. Jenkins, guard, Cathays, Cardiff'; C. R ogers, signalm an, C aerp h illy; R. Pearce, gan ger, W est Drayton. Vellum Vote o f Thanks.— B. Board, clerk, Divisional Superintendent’s Office, Cardiff,

Many of our readers w ill be sorry to hear of the passing of Mr. T. O. Mien at the a g e of 70 years. T h e deceased held the position of hon. secretary of the Great Eastern section of the L .N .E .R . Am bulance section from 1898 to 193 S. H e held many honours in the B rigade in addition to being awarded the medal for “ long and conspicuous service” in February, 1*935 , and being promoted Com mander Brother of the Order. M any of our readers who knew of his great w ork for suffering hum anity will mourn his loss.

Stan m o re

F i r s t A id A s s o c i a t i o n .

S o m e 60 members of this Association spent a very enjoyable and instructive evening at St. L aw ren ce’s Hall, W hitchurch Lane, recently, when D istrict Staff Officer E. T. Milburn, Deputy M .O .H . to St. Pancras, spoke on “ D iagnostic M ethods.” Amb. Officer K . Stallard of the Stanm ore Section of the B rigade announced that a course of lectures on Hom e N urs in g would commence on October 5 th, and that negotiations were in progress with the M inistry of Inform ation for films on first Aid to be exhibited at the November m eeting.

Publishers N ote.— W ill readers please note th a t all back num bers o f “ First Aid ” are now ou t of print and cannot be supplied. W ill South African and oth er C olonial readers please add to th eir rem ittances, “ o r English equivalent, ’

i F

I R S T

Reviews. Rescue Service Manual. js .

H .M . Stationery Office.

Price

6d .

T his m anual is No. 3 of the series, and will be of ser vice to the re-organised L ig h t Rescue Parties. T he 149 pages are full of information and provide the details neces sary for training the Civil Defence personnel in their new task of rescue operations. 2jo A . R . P Ouestions Answered. By R. F. Reynolds, A .R .P .S .,~ R . D. W orm ald, M .A ., L .A .R .P ., and J. M. Y o u n g , M .A ., L .A .R .P . L on d on : Jordan & Sons, Ltd. P rice is . 6d. This 4 th edition has been revised and enlarged. The 250 questions and answ ers deal with H .E ., Incendiaries, W ar Gases and First Aid. The answers have been taken from the various official handbooks and pamphlets and the Textbook of the St. John Am bulance Association. T he book is useful for all those undergoing initial training or as a refresher course for the more experienced. Incendiary Bombs and F ire Precautions. H .M . Stationery Office. P rice 6d. T his is the 2 nd edition of Handbook No. 9 . Additional chapters have been added to include instruction on Structural and General Precautions and on Fire Guard O rganisation. Protection and Salvage o f Food in Wartime. By Leslie Stew art, M .S .I .A ., A .R .P .S . London : Jordan & Sons, Ltd. P rice 2 S . 6d . Lecturers in anti-gas m easures will have felt the need for further information on the methods of protecting food stuffs and the decontamination of foods which have become contaminated by w ar gases. This book comes, therefore, as a welcome addition to the official textbooks. It covers the requirements of producers, m anufacturers, wholesalers and retailers, and should be in the possession of all food squads. War Gases— Learn and Live. By W . F. F. Shearcroft, B .S c., A .I.C . London : Jordan & Sons, Ltd. Price 6d. W ritten in a clear and conversational style, this book w ill appeal to those who find the official handbooks difficult to follow. There is much common sense in the various sec tions, and the author has shown that, provided there is know ledge of the various gases, there is no need to fear them. T he action to be taken to avoid danger is clearly set out. Rescue Work. B y J. K . Law son, A .M .I.S .E . L on d on : By John Crowther. Price ys. 6d. It is noted that all royalties from the sale of this book will be paid to the Lord M ayor’s Em pire Air-raid Fund. In m any respects it is sim ilar to the official'bandbook T rain in g M anual No. 3 , but the author has presented the detail in such a w ay that individual members of the rescue service, as well as instructors, will find it useful. T h e last eight pages are devoted to first aid ; the instruction is too brfef to enable the reader to understand the subject, but enough is said to encourage untrained personnel to deal with casualties in stead of callin g for the trained parties. Handbook No. iy ( is t E dition) . London : H .M . Stationery Office and Branches or through any bookseller. Price is . net. This is a splendid little book written for the guidance of occupiers of factories and other business premises. It con tains 91 pages of most useful information respecting methods to be taken to prevent the spreading of fires and also methods of extin guishin g them. It deals with various classes of buildings, Means of escape, Precautionary measures, Electrical installation, W ater supplies, Sprinklers, & c., Fire figh ting appliances, their operation and maintenance, Safety notes, &c. It is wonderful value for the price asked for it.

R I D

A .R .P . Incidents— Conduct o/. B y T . E. Browne, L .A .R .P . London : Jordan & Sons, Ltd. Price is. T his book will be found of value to those in the Civil Defence Service, and particularly to wardens. It includes sections on reports and communications, training the wardens, standard exercises, Group and Regional assistance, and the duties of the Incident Officer. In a foreword Adm iral Sir Edward Evans recommends this book as a timely gu ide book to all en gaged in Civil Defence.

Letters to the Editor. W e are in no w ay responsible for the opinions expressed, or the statements made, by Correspondents.— E d i t o r .

T O U R N I Q U E T F O R C O M P R E S S IN G T H E F E M O R A L A R T E R Y A T T H E G R O IN . D e a r S ir ,—

In these days of extra danger some of your readers may be interested to hear of the above appliance. I devised it in 1938 and sent one to the St. John Am bulance Medical Com mittee for exam ination and testing, and obtained a satisfac tory report. I do not wish to m ake any money out of it so am sending particulars how to m ake it. T h e appliance is intended for com pressing the femoral artery at the groin when wounded in the upper third of its course ; it can be instantly applied to the righ t or left groin. T h e greatest difficulty with such an appliance is the irregular contour of the buttocks in different people, but by usin g a spring steel holding arm for the tourniquet itself, I have practically overcome it ; someone may be able to improve on my idea. T h e articles required to m ake it are :— 1. A strong brass frame tee-head screw tourniquet with a long pad— screw complete with buckle and webbing. 2 . T w o ft. 8 ins. of spring steel 1 £ ins. wide by 1/16 in. thick. 3 . A piece of wood 8 ins. long by 3 ins. wide by £ in. thick. Bend the spring steel to alm ost a half circle leaving four inches of steel at top end straight, and at the bottom end leave eight inches straight. Rivet the tourniquet securely to 4 ins. of steel at top end, and fasten the 8-in. piece of wood to straigh t piece at bottom end of steel ; well pad buttock wood and steel arm and cover with leather, fix a buckle at top end of steel and a piece of w ebbing at bottom outside end of steel to secure the whole steel frame if found necessary. I made several appliances with the spring steel in two parts so that a thum b-screw would adjust it to fit almost any person, but found it too complicated for use in an urgent em ergency. T h e appliance is more suitable for “ organised” first aid and Brigades where full equipment is carried on a motor am bulance, than for “ individual ” first aiders who have to rely on im provisation.— Yours faithfully, W. H. H i l l . 5 , W hitehall, Stroud, Glos.

H .R .H .

TH E

DUKE

K EN T,

K .G .

Before this issue of F ir s t A id is published, all our readers w ill have heard of the lam entable passing of H .R .H . T h e D uke of Kent, K .G . W e feel sure that all our readers ioin us in our sorrow at this sad event, especially those under the Priory for W ales, of which Priory H is Royal H ighness w as Prior in addition to holding the very high rank of B aliff Grand Cross of the V enerable Order of St. John of Jerusalem v

FIRST

EQUIP

YOURSELF

RID

3 i

FOR W AR E s se n tia l

EMERGENCIES

k n o w l e d g e t o t r e a t s uc ce ss fu lly, A L L p o s s ib l e i n j u r i e s , THE

HOUSEHOLD

PH Y SIC IA N

Describes in SIMPLE L A N G U A G E such necessary i nf orma tion wi th helpful plates and diagrams.

AN D T h e

FOR MORE

C O M P L A IN T S A N D

T h e ir w ith The

O F

M E N ,

W O M E N

C H IL D R E N ,

C a u s e , c o m p le te

PEACEFUL TIMES

T r e a tm e n t in s tr u c tio n s

500 i l l u s t r a t i o n s

and

a n d on

full-page

C u r e

F ir s t

Plates

A id .

makes

the r e a d in g m a tte r m o r e e a s i l y understood. A C C ID E N T S

A fe w o f the S u b je c ts t r e a te d :

WAR EMERGENCIES:— Gas Wa r f ar e First Ai d Bandages Splints Burns Scalds Haemorrhage Fainting

PEACE TIME SUBJECTS:— Influenza, Colds, etc. Measles, Mumps Catarrh Corns and W a r t s Physical Cul t ure W h a t t o Do in Emergencies T r e a t m e n t for all Skin Diseases T h e Lungs, Pleurisy Hygiene, A n a t o m y , Pharmacy The'.Principles of Nursing T h e Eye, t he Ear T h e Throat , t he Nose T h e Chest, t he Heart The^ St omac h, t he Liver T h e . T e e t h , the Muscles Infant We l f a r e Homaepathy, Neurasthenia 375 Prescriptions, etc., etc.

W hat

case

of:

B odily Injury, B urns a n d Scalds, C lo th in g A ligh t. F o r e i g n B o d ie s in Eyes, Ears, N o s e , T h r o a t . M a c h in e ry Accidents, Electricity Accidents. D ro w n in g , Suffocation, Bleeding, Poison, B ro k e n Bones, Fractures, Dislocations, Sprains, F a in tin g, C oncussion, Etc. THE YO U N G W IFE will find just the inform ation she requires. MOTHERS who wish their daughters to develop naturally w ill find exactly the teaching they need. W O M EN O V ER 40 will frankly discussed.

find

their

difficulties

regard in g

health

BEAU TY CULTURE— Com plexion D iets, W rinkle Cures, Care of the Hands, Mouth, Eyes, H air, Recipes, etc. P R E SC R IP T IO N S— 375 proved remedies. T here are hundreds of subjects. T he muscles, teeth, digestion, hair, food values, Ju jitsu, Phrenology. H ow to diagnose diseases from appearance of head, face, neck, tongue, throat, chest, perspiration, etc.

FREE

1 j

MESSRS. VIRTUE & C O ., LT D ., F .A . D ept., C ro w n C h am b ers- U pper P a rlia m e n t Street, N ottin gh am . P le a se sen d m e FREE B ooklet on “ THE HOUSEHOLD P H Y S IC IA N ,” statin g c a sh p rice , a lso m o n th ly te rm s o f p a y m e n t w ithout a n y o b liga tio n to p u rc h a se . NAM E. (Send this form in unsealed envelope stamped Id.) ADDRESS.

FIRST

O u r C O M P IL E D

N u rse s’

RID appreciated. Such members qualify for a special award, a blue star, after a prescribed am ount of help in these institu tions.

Page.

B Y AN A M B U L A N C E S IS T E R . S ocial S ervice C o u r se .

R ank B adges,

S .J .A .B .

New rank badges for officers of the Brigade are as under :— Commissioners Silver Crown and 3 Stars Assistant Com m issioners Silver Crown and 2 Stars District Surgeon ditto Lady D istrict Supt. ditto County Surgeon ditto D istrict Officer Silver Crown and 1 Star Corps Surgeon Silver Crown / Corps Supt. Silver Crown Corps Officer 3 Silver Stars and Bar Divisional Surgeon 3 Silver Stars Divisional Supt. 3 Silver Stars N ursing Officer 2 Silver Stars and T . N. Am bulance Officer 2 Silver Stars Transport Officer 2 Silver Stars and T. Cadet Supt. 1 Silver Star and Bar andC. Cadet Officer 1 Silver Star and C. No. 8 D i s t r i c t , S .J .A .B . C r a w l e y N u r s in g D iv i s i o n . — T he annual inspection of the above Division was held on Saturday, August 1 Sth, at the First Aid Post, Robinson Road, Craw ley, by kind per mission of Dr. S. R. M atthews, Medical Officer in charge of the Post. T h e parade was inspected by Lady County Supt. Miss D. I. Hubbard, S .S .S t.) ., J .P ., who was accompanied by the Countess of Bessborough (Lady County President), Mrs. A. P. Scott (L ady County Officer) and Miss E. M. Trill (Lady County Officer for Cadets). Addressing the nurses at the conclusion of the inspec tion, Miss Hubbard complimented the Division on the sm art ness and correctness of the uniform , and on the high standard of their work. She expressed her wish that more members could be added to the Division, and urged all the nurses to try and get recruits. T h e Countess of Bessborough congratulated the nurses on their work, and thanked them for the services rendered at the First Aid Post and elsewhere, since the outbreak of war. T h e parade was under the command of L ad y Divisional Supt. Miss P. M atthews, R .R .C ., supported by Nursing Officer Miss Bellett (Matron, Craw ley and D istrict Hospital) and L ad y Am bulance Officer Miss A. Sturt. After the inspection, Sister Saunders, in charge of the First Aid Post, took the visitors on a tour of the building, and the nurses then entertained the follow ing visitors to tea : T he Countess of Bessborough, Miss D. I. Hubbard, Mrs. A. P. Scott, Miss E. M. Trill, Mrs. M ontague Bebb and Mrs. Thorpe ( B .R .C .S , W est Sussex Area), Dr. and Mrs. Sidney M atthew s (President, C raw ley Am bulance Division), Dr. and Mrs. Ronald M atthews (Divisional Surgeon, C raw ley Am bu lance Division), Dr. A. Burn (late Divisional Surgeon, C raw ley N ursing Division) who cam e up from Eastbourne for the occasion, Miss Abbott, Mrs. Billington and Mrs. L. Mitchell. Dr. and Mrs. R. H. K n igh t (Div. Surgeon, and Lady Div. President) were unavoidably absent. N ursin g S t a f f pitals.

for

S anatoria

and

T u berculosis

H os

The M inister of H ealth has stated that another 1,200 nurses are wanted to relieve the present serious shortage of staff in these hospitals. Some members of the C .N .R . have already offered their services and their help has been greatly

A Social Service Course for B .R .C .S . and St. John members is beginning on October 1st at 6.30 p.m. at 43 , B elgrave Square, London, S .W .l. T h e number who can take the course is limited. Fee for St. John members is 7/6 excluding the exam ination fee. Applications should be made direct to the L ad y Supt.-in-Chief, 3 , Belgrave-square, London, S .W . 1 . R u g b y E f f o r t for th e R ed C ross.

A first-class variety entertainm ent was presented by Mr. E. R. Shepherd in the Church House, R ugby, on September 2 nd in aid of the Red Cross. T he Mayoress, Mrs. B. M. Sutton, who opened the show in the unavoidable absence of Mrs. E. D . Miller, V ice-Presi dent of the B .R .C .S . for R u gby and D istrict, appealed to a large audience to support the Red Cross which is doing great w ork for the prisoners of w ar by sending them food and clothing. She revealed that over . £ l , 56o had been raised in the last four and a half months in R u g b y and D is trict for the Penny-a-W eek Fund. L ater Mrs. Sut& n thanked Mr. Shepherd for the fine “ m e a l” of Shepherd’s Pie he and his cast had given. D u rin g the interval Mr. Shepherd thanked Miss M arguerite o’ Beirne for her kindness in lending her studio for rehearsals, without which the show could never have been presented. This is the first of a series of entertainments being pre sented by Mr. Shepherd in aid of the Red Cross. S. R .C .S . At a Committee m eeting of this branch of the Scottish Red Cross Society it was disclosed that during the year ended A u gu st 31 st, 1942 , only ;£460 had been subscribed locally to the Prisoners of W ar Fund. This was ;£400 less than had been received in the previous twelve months, and it was felt that an effort should be made to get more regular subscribers to this fund. A food parcel is despatched every week to each prisoner. T he cost of these parcels to the Nairnshire Prisoners of W ar at 10/- per head per week is already alm ost £ 2,000 per year, and it is felt that .£ 460 , much of which is raised by the pro ceeds of whist drives, dances, etc., is too small a proportion to be subscribed locally. N airnsh ire B r anch ,

No. 324 ( H u d d e r s f i e l d ) D e t a c h m e n t , B .R .C .S . An appeal for an increase in membership of this detach ment was made on September 1st by Miss A. Burgess, Associate of the Royal Red Cross Society and a member of the General N ursing Council of England. T h e m eeting, presided over by Mr. L. Crowther, was attended by the Mayor and Mayoress, Alderman and Mrs. A. Gardiner ; Mrs. D. A. F. Holdsworth, Assistant County Director, B .R .C .S . ; Com m andant Mrs. F. Gamm and Lady Supt. Miss Halstead. After introducing Miss B urgess and referring to the need for recruiting women in Huddersfield and district for the detachment, the chairm an described w hat had been done locally for the B .R .C .S . in its many branches, particularly on the financial side and in connection with the prisoners of war. Miss B urgess addressed the assem bly, and said that there was a great need for volunteers to be trained as V .A . D. nurses and Civil Defence workers. She would earnestly recommend the Service to all those who had the time and desire to help their country in its hour of need.

FIRST

AID

S E C U R IT Y W IL L

PEACE

B R IN G

YOU

S E C U R IT Y

\ A / i l l it find you w ith your future assured ? Able to drop into a job right aw ay ? H ave V ” you asked yourself “ W here do I fit i n ? ” “ Is my future secure ? ” “ Can 1 command a professional standard of living or must I alw ays be a w a g e slave ? ” L E A R N T H E A R T O F S C I E N T I F I C M A S S A G E A N D E A R N BIG M O N E Y This is YO UR_ great opportunity to m ake a career and an assured future for yourself. Your knowledge o f F irst A id w ill help you. H ave you realised the scope and prospects for the trained M asseur?— he is called in every day by Doctors, N ursing Hom es, Hydros, Sports and Athletic Clubs, Physical Culturists and Trainers, etc. PLAN

YOUR

P O S T -W A R

CAREER

NOW!

AND

ABSO RBING

IN T E R E S T

Get your copy of “ M A N I P U L A T I V E T H E R A P Y AS A P R O F E S S IO N illustrated book sent F R E E and without obligation.

a 44 -page

And remember that if you are prompt you can still enrol at the very modest pre-War fee. N o.

THE L

SM AE T

IN ST IT U T E A

S U

FIRST

o r bet

letc h er

E xam in ation H ow ler. L .R . (Charlton P ark ).— In a recent exam ination the doctor asked one member of our class to state the general rules of treatment of a case of non-corrosive poisoning. T he candidate hesitated for some minutes and then suddenly blurted out— “ / 'would, g iv e a cosmetic im m ediately!" and he was surprised when the doctor and those within hearing burst out laughing. G ood! N ext, please ! !— N .C .F . B u m s b y E le c tric ity . P.M . (Crayford).— Please tell me w hat are the signs of burn in g by electricity and if the burns are the same as those caused by dry heat. E lectricity m ay cause death from shock without any abrasion of the surface. A gain it m ay cause death from burns which vary in severity with the strength of the current applied and which w ill present the usual signs of any such injury due to dry heat— nam ely reddening, blistering or charrin g of the part where contact takes place. Metals and moisture favour the conduction of the current.— N .C .F . Strongest L ig a m e n t in B od y. W .O . (N orthw ich).— D u rin g a discussion on first aid with colleagues the other day, one of us suddenly asked which w as the strongest ligam ent in the body and where was the sam e situated. W e all gave various answ ers ; and as nobody seemed to be sure I said that I would seek your good advice on the point. It is difficult to give a dogm atic answer because the strength of a ligam en t is dependent on its size and this varies with the development of the individual. A gain difficulty arises ow in g to the sim ilarity between ligam ents (which con nect the ends of movable bones) and tendons (by which muscle is attached to bone). If, however, you are referring

RID to the latter, then the tendon of Achilles (which connects the calf muscles with the heel bone) probably fits the b ill.— N .C .F . Hum our in F irst Aid. A. K. (Haslemere). — Our lay instructor recently mhde an announcement that the doctor who was lecturing was unable to come that evening, and that he (the lay in structor) had been asked to take “ Transport of Patients” for the evening. He ended up by sayin g— “ N ext week the doctor w ill give us p o iso n s!" T o this someone at once asked— “ Is the doctor so fed up with us as that ? ” G ood!

Next, please 1 1— N .C .F .

T ran sport of P atient. D. K. (Isle of Man).— At a recent A .R .P . practice held in this district, w e had to treat a patient suffering from a trans verse wound of abdomen, no bowel protruding. The patient w as treated to the satisfaction of the officials, M .O .’s, etc., and handed over to a rescue squad to con vey over a roof about fifteen feet high to the ridge. W hen ready for lifting I went back to the case (having treated other minor cases while w aiting) and go t on to the roof to look after his injury w hile being transported over. T h e stretcher was kept level from the ground to the ridge, and had to be taken down a lean-to ladder at a reasonably slow gradient. I insisted that stretcher be taken down head first (a matter of about eight seconds duration) ; by so doing, the w eight of the body and the contents of the abdomen would be drawn aw ay from the wound, to prevent any likelihood of the bowel being pushed out. As soon as the stretcher reached the bearers at the bottom, I ordered it to be kept level. Patient’s knees were well trussed and tied up, and head and shoulders raised on stretcher. My action in sliding patient down the ladder head first has come in for much criticism from M .O .’s, Officials and A .R .P . personnel. Did I act properly ? I would very much appreciate your ruling on this incident. T o an injured person the sensation of being lowered head first at a steep angle even for a few seconds only would be most distressing. In these circum stances I feel that the stretcher ought to have been kept level ; and I su g gest that you approach a Rescue Officer for information regardin g the possible methods which will accomplish this object and which are too lengthy for inclusion in this colum n.— N .C .F . T ran sport o f Spinal In ju ry. M .B . (Northern County).— As a surgeon-lecturer I have read w ith much interest your replies to the two queries which were published under the above heading in the June and A u gu st issues of F i r s t A i d . T h e queries and answers would appear to me to have opened up rather a controversial matter in regard to the interpretation of the Textbook instructions. Instruction A (page 73 ) states “ If the patient is un conscious or (not and) if the situation is not clearly de fined, patient should be carried face upw ards.” Does this not give the impression that all cases of fractured spine who are unconscious should be removed face upwards ? My own feeling of the impression given by the paragraph is that face upwards carrying is advised in all unconscious patients and also in all cases of frac tured spine (unconscious or not) where the site of the fracture is in doubt. I think that this impression is deepened by the further detailed instructions given in B (i) and (B) (ii). Please do not think that I am attem pting to criticise your ruling. T h a t would indeed be presumptious on my part. It is the interpretation of the Textbook instruc tions upon which I am venturing to write to you.

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FIRST

In all competitions (colliery, open, W est Riding A .R .P ., etc.) which 1 have had the pleasure of ju d gin g, the m arking sheets have alw ays interpreted the instruc tions for spinal cases in the above manner which, I think, tends to show that my own reading of them is on the same lines as has been also that of the various doc tors setting the tests. As a m atter of fact, surgeons of different hospitals are still not fully agreed upon this m atter(as I know from casss sent from the local collieries to different hospitals) and my own feeling is that the Textbook method of loading a stretcher with the patient in the prone position leaves much to be desired. W hile I agree with you that the T extbook does give the impression that patients— who are unconscious and suspected of having sustained spinal injury— should be removed in face-upwards position, I feel that this instruction should not be interpreted too literally. T h e deciding factor is not the unconscious state but the position of the injury. As you will appreciate, the possibility of a first aider diagnosing a frac ture without some information from the patient is remote since usually there is little displacement of the fragm ents. From this it is clear that the T extbook is trying to bring out the point that when there is doubt (which m ay be due to the fact (1) that patient is unconscious or (2) that his in formation is unreliable) it expects first aiders to treat as for the major injury and to load patient face-upwards. Such is my interpretation of the Textbook instructions on this point ; and in conclusion I thank you for your kind letter which is much appreciated. — N .C .F . F a k in g of In ju ries. D .W . (Andover).— Can you give me any information or guidance as to fa k in g of injuries ? It is not possible to give those whom we train hospital experience ; and it is difficult to think how to reproduce realistic injuries, the know ledge of which I feel should be an integral part of first aid training, particularly in war-time. No articles seem to appear in first aid m agazines, nor does one see any books on this subject. Therefore I should be glad of your advice. Dr. Shirlaw in Casualty refers to “ made-up injuries.” W here can these be procured ? W ith regret I do not know any book devoted to fa k in g of injuries for first aid purposes, nor any place where you can obtain prepared models. Consequently, everything depends on the ingenuity and know ledge of the individual who wishes to reproduce realistic injuries, especially wounds and fractures ! For simulation of wounds plasticine or putty can be used to m ake a false skin ; and after an incision has been made the edges of the “ wound ” can be eased open to represent the various kinds of wounds. Suitable colouring (such as lip-stick or grease paint) can then provide the appearance of bleeding. For sim ulation of fractures a piece of wood the size and shape of the supposed broken bone ran be shaped and tapered as required, and then embedded in plasticine or putty for a simple and partly exposed for a compound fracture. Space does not permit fuller details, but from this com mencement you can proceed to the realistic reproduction ol other injuries. My advice, however, is that, before you show your fakes to the general public, you should get your doctor to pass them as fair copies of supposed injuries.— N .C .F . F ra ctu red C la v ic le and Scapula. L. B. (Slough) — D u rin g a recent practice we had to treat a patient suffering from fractures of left clavicle and right scapula. T here were several different opinions as to the correct method of ban daging ; and so your ruling will be appreciated.

JLI D O f this combination of injuries the fractured clavicle is the more serious and demands preferential treatment. W ere I the first aider, therefore, I would control the fractured scapula by flexing the right upper limb at the elbow and then ban daging the limb to the trunk. Next, I would treat the fractured left clavicle as laid down in the Textbaok. This done I would know that both injuries were properly protected and that the task of the doctor to whose care 1 would pass my patient would be facilitated.— N .C .F . , E thics of F irst Aid. G .N . (New Cross) and O thers.— I am sorry if I offend but I think that in the A u gu st issue of F i r s t A i d you made a little slip when in your reply to a query headed as above you wrote that the T extbook says that alcohol m ay be administered by first aiders in treatment of venomous snake bite. I think that you meant to have named bites by rabid animals as the other condition in which alcohol may be given. Am 1 right ? If 1 am w rong please cane me hard as I am trying to be a good first aider. O f course you are righ t ! T h e error occurred in the transcription of my original rough notes ; and my system of checking replies failed me for the first time in twenty-seven years ! 1— N .C .F . T reatm en t of D og Bite. G .N . (New Cross). — Recently I had to treat a patient who had been bitten by a dog. So I applied a constriction to the limb, washed wound with perm anganate of pot ash, applied a dry dressing and administered a little drop of w hisky before I, took my patient to the doctor. Please tell me if my treatment was in accordance with the Textbook. Now it is my turn to direct attention to a little slip on your part, because in this instance you treated for a bite-by rabid anim al, although cases of hydrophobia are unknown in this island of ours. Nevertheless I shall be surprised if the doctor took serious objection to your treatment of this case.— N .C. F. C .D . In stru ctor’s B ad ge. A .H . (Allestree).— In the A u gu st issue of F i r s t A i d under the above heading reference is made to “ Grade I In structors of St. John.” I shall be obliged if you will' advise me from whom I m ay obtain details of such a course and examination. T he Ministry of Home Security have not yet extended the use of this badge to Grade I Instructors of St. John ; and all that we can su ggest is that you m ake contact with the A .R .P . Authority in your d istrict.— E d i t o r . D efinition of “ P re s su re P oint.” J.R . (Nottingham ). — Please tell me how you would define a “ pressure point.” It is curious that the Textbook does not give any defini tion of a pressure point ; and so I su ggest the follow ing :— A pressure point is the exact point along the course of an artery at which the onward flow of blood through the vessel can be most effectively checked by digital or instru m ental pressure. — N .C. F.

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A BASIC TRAINING MANUAL

EXPLOSIVE - INCENDIARIES

F ro m the F o re w o rd by W in g -C o m m a n d e r E . J . H O D S O L L , C .B . In s p e c to r-G e n e ra l o f C iv il D efence “ The information brought togither under cue cover is that which every single member o f the C iv il Defence Services should know ”

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ECONOM Y “ H U T T ’S and

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A TTEN TIO N

PLEASE !

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A G A IN

in the

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S IM P L IF IE S .

h a n d lin g

Written in response to many requests from members of the B. R. C. S.

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E lim in a t in g S p lin t in g ,

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Ladies and G e n t l e m e n , have you provided Y o ur Org ani sat i on— Y o u r Brigades, Parties, T e a m s and Rescue Squads wi th t he Ar t i cl e t ha t is A d a p t a b l e for First Ai d, Transport, and Nursing Services.

T H E

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FIVE REA SO N S W H Y THIS B O O K IS S O M U C H IN D E M A N D : It i s: i. E n tire ly n e w and up t o d a te . ii. Based o n actu al w a r e x p e rie n c e . iii. D esigned to p r o v id e a c o n cise an d c o m p le te tra in in g . iv. C o v e rs all th e g ro u n d fo r tra in in g re c o m m e n d e d by T h e B ritish Red C ro ss S ociety, T h e St. Jo h n A m b u la n c e A s so c ia tio n , T h e Civil N u rsin g R eserve, an d T h e G e n e ra l N u rsin g C o u n c il. v. S u itab le f o r b o th ad v an ce d and e le m e n ta r y sta n d a rd s .

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IF YO U R K N O W L E D G E IS T O BE UP TO D ATE AND C O M P LE T E YO U C A N N O T A F F O R D T O BE W ITHOUT THIS E X C E L L E N T B O O K .

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Price 4 / 6 , post free. B a illie r e , T i n d a ll a n d C o x , 7 -8 , H e n r ie tta Stre e t, L o n d o n , W .C .2 . Please send......................copies o f Belilios's First A id and Bandaging for ■which I enclose ( j.j6 each, post free) . Nam e :.................................................................................................................... Address :

r a 25

F IR S T

A ID

3 r t 6 e p e n te n f J o u r n a l j o r

r ije A m b u l a n c e E d ito r:

No. 580.— V

o l

. XLIX.

N O T IC E

anb

W A LTER

^ u r j i n i j $ m r ic c s

S C O TT,

F.R.San.l.,

OCTOBER,

1942.

F.R.S.A.

t Entered at 1 Stationers' Hall\

PKJCK

T H K tt F tN C f c

[4/- P br Annum P ost F re e

READERS.

E D I T O R I A L . F I R S T A I D is published on the 3 0 t h o f e a c h m o n t h . A n n ual Subscription is 4 s. post fre e ; single copies 3d.

The

Its aim and object being the advancement of A m bulance W o rk in a ll ils branches, the E d ito r invites R eaders to send A rticles and R eports on subjects pertaining to the M ovem ent and also welcomes suggestions for P ractical Papers. A ll R epdrts, & c., should be addressed to the E d ito r at the address below, and should reach him before the 13 th of each month, and must be accom panied ( not necessarily for publication) by the name and address of the Correspondent. Subscriptions, A dvertisem ents and other business Com m unications connected w ith F I R S T A I D should be forwarded to the Publishers. D A L E , R E Y N O L D S & C o ., L t d . , 46, C a n n o n S t r e e t , L o n d o n , E .C .4 . Telegraphic Address— “ Twenty-four, London." Telephone— City 3710.

CON TEN TS

d it o r ia l

THIS

NUMBER.

—

T h e Shortage of Nurses

Co-ordination of Civil Defence Services

Death of Captain C. Thornes

S .J .A .B . Headquarters and D istrict Reports

The Ven. Order of Activities

St.

John : Its H istory and

Stanmore First Aid Association ...

London and North Eastern R ailw ay

Our N urses’ P age

Reviews

u e r ie s

an d

nsw ers

o r r esp o n d en ts

:—

T h an k s to the Doctor

Performance of Schafer’s Method

Exam ination H ow ler

Treatm ent and Transport

Fractured Forearm and Bleeding Palm

Transport for Fractured Pelvis

Control of H aem orrhage from L e g

...

Roping Patient to Stretcher

Treatm ent of Insect Stings ...

C arriage of Patient Avulsion of H air of Scalp Fracture of Spine ...

...

48 48

U n d e r a variety of headings, such as T h e S ho r t a g e of Nurses, o f u r s e s . Drift from Nursi ng, H o w to Ge t Nurses, Nu r s i n g Co n di tions, and others, a somewhat l e n g t hy correspond ence has occupied the col umns of what is known as the national press. It may be as well at the outset to point out that too much importance must not be attached to this correspondence (much of which is of an a nony mous character), bearing in mind that one letter is i nvariably provocative of others, and that amateur scribes are prone to become discursive upon matters of which they know nothing. It is advanced that the profession has never recovered from the chaotic condition in which it found itself after the last war, and that the steps now being taken are for the express pur pose of b r i ng i ng about a more orderly future, as part, we take it, of that wonderful scheme of re construction which, after the present war, is to secure for all humani ty (nurses included, it may be supposed) a blissful and care-free existence. T h e existing trouble, it is said, arises from a shortage of nurses, in part from that of the domestic staff, which is “ so serious that nurses are h a v i n g to do domestic wo r k . ” . Whatever truth there may be in such allegations, their appli cation is by no means universal, and we should (to use the words of the chairman of the Nu r s i n g Rec rui t i ng Committee) “ beware of us i ng phrases such as the drift from nursing, which are dis proved. by published f igures. ” B e i n g keenly in terested in the matter, we made a tour of a number of hospitals in the Metropolis area, and, as a result of interviews with officials, we could find no substantial proof of the allegations. In cidentally, we note that in the case of a sister advertised for recently, there was a response of 2 0 0 applications, which would seem rather to reverse the situation. T h e best w a y to recruit nurses is, undoubtedly, to i mprove conditions which still leave much to be desired. Th e r e is an old story concerni ng a horse which was daily be c o mi ng more and more unfit for work. Every remedy was tried, veterinary s urgeons were called in, and still the condition of the horse declined. T

h e

S N

h o r t a g e

FIRST A little stabl e-boy was a m o ng those at the last inspection, and he blurted out “ W h y not try o a t s ? ' ’ T h e y were tried and the horse speedily recovered. T h e moral of this story is apparent. W h a t the profession needs is “ more oat s, ” and if they were accorded there would no l onger remain any question of shortage.

C o - o r d i n a t i o n o f C iv il D e f e n c e S e r v ic e s .

S IR

E xtracts from Lectures delivered by H E N R Y L. M A R T Y N , K .C .V .O ., F .R .C .S .

' •

( Continued from page 2 6 .) L

if e

a v in g

th e

ie l d

Thus far I have dealt but little with the actual w ork of services in the field. I have tried to impress upon you, firstly, the importance of collaboration between individual services ; secondly, the extent of the resources which back up and carry on the efforts of those w orkin g in the battle itself ; and, thirdly, how all those forces en gaged are co ordinated and reinforced. No service can be run efficiently under the orders of a comm ittee and leadership by a single individual is of para mount importance. Too often 1 have seen in the course of exercises a party drive up to an incident, a mob of men hurl themselves from the car and throw themselves indiscrim inately upon the job w hatever it m ay be. O f that, as regards casually vvoik, I shall have more to say later, but, for the time being, let me impress upon you that disorderly work, however great the urgency, can never approach in the results that undertaken under the definite orders of a capable party leader. D uring the early months of the w ar there was a curious pha=e of exaggerated democracy prevalent throughout the services. 1 suppose that it was an unconscious reaction of lttttred towards the dictatorships of-our enemies. N ew ly appointed leaders of hastily formed parties were only too easily, and generally qujte w rongly, regarded as “ Little H itlers.” T hat phase has to a large extent passed as the misfits have been eliminated, and the natural born leaders have found their own w ay to the front. But still, deep down in the hearts of m any ot these men lies the fear of the criticism of their fellow s if they really, as they must, take command of the units under them. There are only two collections of individuals that I know of so perfectly trained and so accustomed to w orking to gether that no word of command is necessary for the carry ing out of the most complex w ork — 1 mean the Navy, and a team of Surgeons and Nurses w orking in the operating theatre of a first class hospital. VVe have none of us yet attained to the perfection of team work of either of these, and, until we do so, we must realise that the leader of a party must be prepared to com mand, and I mean command, in no uncertian w ay ; in fact, “ T o speak as one having authority 1” Men must be prepared to lead and, equally important, men must be prepared to obey. I want you now to picture yourselves as members of a First Aid Party ordered as a reinforcement to a town during a heavy attack. L eavin g your base at short notice follows the drive through the night, each one of you keyed up at the thought of w hat is to come, and w ondering anxiously whether your years of training will be forgotten when the

AID great moment arrives. Eventually you find yourselves at the Reinforcement Depot some little distance outside the target area. There, probably with numerous other parties, you will wait, and with any luck absorb a penny bun and a cup of tea w hile you gaze fearfully at the blazing hell spread out below. Y o u can comfort yourselves with one thing, terrified as you most certainly will be, everyone else around you will be equally terrified, and each one of them will be doing his utmost to pretend that he is not even interested. T h at is typically British. Sooner or later you will be ordered on, and you will find your progress halted once more at w hat is known as Sub Battle Headquarters at the very edge of the target area. Here begins your baptism of fire, in reality the worst moment of all because you yourselves will not actually be engaged. A gain you will be sent forward, now accompanied by a guide, and this time into the hell itself with orders to report to some stated Incident Post. Once put to work you will find that your fears are gone, you »will be too busy to think, too busy to fear, .and almost too busy even to be horrified at the horrors around you. Here will come the test of your training, the final re ward of all the hours of w ork which you have put in. If it has been good, you will find that almost autom atically you will do the right thing at the right moment, and that essen tials and non-essentials are as distant as night from day. All First Aid work as it is taught perforce contains much that is theoretical, and is based largely upon the treatment of a single injury ; ycu are taught how to deal with a broken arm , a broken back or a wounded head. In war you will be dealing with wounded en masse, and how you deal with num bers rather than individuals will be the determ ining factor in your success in saving life as a whole. I propose therefore now to place before you certain prin ciples of behaviour— tactics if you w ill— which will stand you in good stead in the supreme moment of trial. In doing so I shall cut out of the picture any question of extraneous dan gers either to yourselves or your casualties, such as fire, gas or falling buildings. T he presence of such dangers must, of course, multiply completely tactics which, in their absence, you would otherwise employ. R

e c o n n a is s a n c e

Y ou have reported to the Incident Officer and have re ceived some picture of the incident with which you are to deal. Either from him or the W arden you will get detailed information of the probable number and position, and, pos sibly, even the nature of the casualties. Now for the first definite step you are to take, preferably with one of your men— do a rapid reconnaissance of 1he inci dent itself. Believe me, five minutes spent in reconnaissance bv a competent leader does more to save life than anythin^ else. T a k e a careful survey of all the casualties, noting in your mind where they are ljin g , the nature of their injuries, and m entally placing them in the right order for treatment, and, what is equally important, in the righ t sequence for evacuation. T h e remainder of the party m eanwhile are g e ttin g out their equipment and covering over every case with blankets. Never allow them to throw themselves pell mell on the first casualties they see ; ten to one the cases they treat will be quite unimportant, and the one case that does need urgent attention will be found hidden round the corner and quite possibly will be dead before anyone finds time to attend to him. D iscourage a tendency w hich I have seen in so many parties, that of blanketing and preparing stretchers while the patients themselves remain uncovered. Cover over the casualties w ith'the blankets, and only transfer the blankets

FIRST to the stretcher when the case is actually ready for evacua tion. T h e leader has now completed his reconnaissance and is in a position to employ his party in the most effective way, and we can now consider the duties which lie before him. For the sake of clarity, w e will tabulate them as follows :— 1 . T o save life which is in immediate danger from (a) Haem orrhage. (b) Asphyxia. (c) Shock. 2 . T o treat the cases in the right order. 3 . T o evacuate the cases in the correct Order and in the right way. ( To be continued. )

D e a t h o f C a p t a i n C. T h o r n e s . We regret to announce the death, on October 2 nd, of Captain Charles Thornes, of 70 , Victoria-road, Dewsbury, one of the staunchest adherents and workers in the St. John Ambulance movement in the Heavy Woollen District. He had been in failing health for 12 months. H is father, Mr. John Charles Thornes, was the master of the old W heelw right Charity D ay School. Mr. John Thornes, his grandfather, was the first headm aster of the D ewsbury Parish Church D ay School, which was founded a hundred years ago in School Street. Captain Thornes was brought up at the last named school, anci was a teacher in the Sunday School for fifty years, until about 12 months ago when his resignation was received with regret. It was, however, in the St. John Am bulance movement that he excelled and was the recipient of many honours throughout his long service on behalf of the sick and afflicted and infirm members of the community. No man in the H eavy Woollen D istrict has been more prominent in the affairs of the Ambulance service. In 1940 lie was honoured with a presentation on relinquishing the secretaryship of the local centre, on which occasion it was stated that he had not missed an inspection or an exam ination of candidates for am bulance certificates since 1896 . H is qualification for the am bulance certificate goes back to the eighties, when his uncle, the late Dr. Fryer, of Batley Carr, was a tutor of am bulance students in the classes. Captain Thornes helped in am bulance w ork in three wars, viz., the South African, the Great W ar, 1914 - 18 , and the present war. H is services in the Am bulance movement were as follows :— Obtained first aid certificate in 1892 , voucher in 1893 , and medallion in 1894 ; admitted Honorary Serving Brother, 1907 ; awarded S .J .A .B . L ong Service Medal, 1912 ; General Secretary, S .J .A .A ., Heavy Woollen District Centre, 1912-1940 ; Corps Treasurer, D ew sbury and District Corps, S J A. B., 1920-1942 ; served in the G reat W ar, promoted Capt. R .A .M .C ., 1914 -20 . T h e interment took place at D ew sbury Cem etery, pre ceded by a service at the D ew sbury Parish Church. Am bu lance Officers acted as pall bearers and numerous members from surrounding districts attended to pay their last respects.

, X O V 11 ' please R E M

give generously :

E M B R A N C E

P A Y

SID

St.

Joh n

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HEADQUARTERS

AND

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REPORTS.

N o . I (Prince o f Wales’s) District Acton, No. 44 / 1.— T h e Acton Division held their second combined m eeting on Monday, Oct. 5 th. L ad y Supt. Miss Sm art and Div. Supt. C. Dawson were both present. Aid. Birkett (President) was in the chair, and Dr. Vincent (Div. Surgeon) gave a lecture on “ A Medical Officer in an Indian General Hospital in the last w a r.” T h e whole was illus trated by a series of lantern slides, which brought back vivid memories to Aid. Birkett, who was in the R .F . C. T he Cadet Section is progressing very favourably, and we are very fortunate in having the co-operation of several head masters of schools in the district, w hich is very greatly appreciated. T h e boys them selves are show ing keenness of a high order. N orw ood and C rystal Palace (No. 23). — Pcnge Scrimp-ers.— T he first annual m eeting of the Penge S alvage O rganisation was held recently and presided over by Sir Edward Campbell, Bart. Sir Edward, who was accompanied by Lady Cam pbell, w arm ly praised the work of the Scrim p-ers, whose aim is to obtain sufficient money with which to build a local St. John Am bulance B rigade headquarters after the war. At the sam e time, the members suggested that it w as for others to . fill the gaps in the ranks resulting from the w a r’s demands and so still further assist the cause. Mr. Sullivan, presenting his annual report as secretary, said that, like any other concern, the Scrimp-ers had had their share of advances and reverses, but there was one dif ference— whereas they had no money dividends, they had dividends of satisfaction, and the more one had helped to swell their total the more dividends of satisfaction one got. T w elve months ago he was proud to hand over the sum of £ 20. Since then they had collected over tw enty times that amount, which was am azing considering the poor measure of manual help they had received. D etails of amounts received for various articles of salvage collected were given. Capt. W hite-K nox, addressing the m eeting, expressed his sense of surprise and pleasure that, follow ing the hand ing-over a year a go of a cheque for £ 2 0 , the total had now grow n to ;£ 500 . T his he regarded as an am azin g result. At the same time, he counselled them not to “ sit b ack ,” but to continue to put their backs into the w ork and produce, if possible, even better results. He suggested that few people, were so busy, even in w ar time, as to be unable to spare a little time and effort for the helping foward of a grand work.

S o u t h a l l ( N o . 55) . — T h e presentation of a vice-presi dent’s badge and framed certificate was made to Mr. VV. F. Billett at a concert held by this D ivision at the Labour H all, Southall, on September 16th. In m aking the presentation, the M ayor (Alderm an Mrs. F. S. Amos) said that the honour of vice-president had been conferred on Mr. Billett for services rendered to the Brigade. H e had put in very fine w ork on behalf of the Southall D ivi sion, and had been secretary of the building fund since its inception. She hoped the public of Southall would alw ays support the B rigade so that eventually they would have their own headquarters. T he St. John Am bulance B rigade had & done a tremendous am ount of good w ork in the borough and its members were alw ays ready to answ er any call to be of service. Mr. Billett, in expressing his thanks, said it would be his constant effort to achieve the object they had in view and

FIRST

to further the w ork of the St. John Am bulance B rigade in the town. H e did not think there was any worthier body or one with higher motives that they could attach themselves to than the Order of St. John with its mission of relieving suffering and pain. T h e hall was filled for the concert. Mr. D avid IJ. Soundy presented “ Rise and Shine,” a variety entertain ment, by the M errym akers Concert Party, assisted by several guest artistes. One of the most enjoyable features were some excellent soprano solos by Miss W hite. N o . II District G

lo u c ester

“ R

o to l

”

m bulan ce

and

u r s in g

T h e annual inspection of the above Divisions w as made by Col. Sleem an, C .D ., C .M .G ., M .V .O . (Chief Com missioner Brigade Overseas). D iv. Supt. Dent com manded the parade and Lady D iv. Supt. P. N . Gerard (S .R .N .) w as in charge of the N ursing Division. There were 42 members present. Col. Sleem an and the officers present then inspected the ranks, the motor am bulances, and the First Aid D em onstra tion that followed. Three incidents were staged, and were as follows :— 1. The removal of an asphyxiated patient from a g a rag e pit by means of the tr ig g lift, artificial respiration with use of the “ Novox ” apparatus, and the treatm ent of a patient suffering from burns. 2 . Four patients had been trapped by large packing cases, and ivere suffering from fractures of the pelvis and spine, lacerated shoulder and crushed feet. 3 . T w o patients on the roof of a 30 foot building, one w as unconscious and the other had a broken leg. After treatm ent these patients were lowered to the ground by means of the “ H utt ” H arness and “ Low Moor J a ck et.” All these patients were conveyed to the First Aid Post by' motor am bulances, and the officers were able to inspect the nurses at work. T he parade then assembled, and Col. Sleeman, address ing both Divisions, said he w as able to give a very excellent report of the smartness and efficiency of the men and women on parade. H e was very impressed by the standard of work he had seen, and of the cleanness and neatness of the uniforms worn. H e admired the courage of the patients who were lowered from the roof, and w as pleased to know that men and women were “ public spirited ” enough to be trained and ready to face any em ergency when called upon. Dr. H. G. D ow ler (Div. Surgeon) then presented Mr. H. J. Lew is (Asst. County Commissioner) with the sum of ^£7112 to be given to “ Mrs. C hurchill’s Aid to R ussia” Fund, the proceeds of a dance organised by the Division. D

iv is io n s

.—

N o . I V District C h e s t e r . — A social evening and concert was held on Saturday, October 3 rd, at B rigade Headquarters, when the boy and girl cadets of Chester Am bulance and No. 2 N urs in g D ivisions arranged and produced an enjoyable evening. T h e show opened with a cinem a display, followed by two sketches and a m usical gam e entitled “ Passin g the P arcel.” D urin g the interval refreshments were served by the girls, of whom Cadet Officer Miss R. Jackson was in charge. After the interval a clever and interesting display of thought reading w as given by “ Senora ” (Mrs. W . Robin son), assisted by her husband, who gave a display of paper manipulation. O ther m usical items and gam es followed. Corps Officer W . Stockton paid tribute to the w ork carried out by Lady Cadet Supt. Miss N. Nield and Cadet Supt. Geo. F. Sperring on behalf of the girls and boys, and thanked all who were g iv in g their time in training the youth of the organisation in the rendering of first aid to the injured.

RID

T h e V e n . O r d e r o f St. J o h n : Its H i s t o r y a n d A c t i v i t i e s . A n address given on September yoth at Gas Industry House, S. W. /, to Lady Officers oj the B ritish R ed Cross Society By N. C O R B E T F L E T C H E R , M .A ., M .B ., M .R .C .S ., Surgeon-in-Chief, St. John Am bulance Brigade. In response to the request that a member of the Ven. Order should address you on its history and activities, the SecretaryGeneral has delegated to me the honour of undertaking this task. In so doing, I pay once again my personal tribute to the wonderful rank and file, members of which, by their devotion to the Order and its objects, have played no small » or mean part in raising the status of the Order in the British Realm from that of a small and private philanthropic body, as it was for many years after its revival, to that of a strong and imperial organisation with worldwide achievements in the cause of hum anity as it is to-day. R

is e

and

a ll

th e

rder

St . J

o h n

At the outset I must speak of the rise, fall and revival of the Order which expresses well in its two mottoes the objects of its foundation— “ Pro fid e " and “ Pro utilitate homium.” T he mottoes— which we m ay translate as “ D e pend the F a it h " and “ Work for the good of mankind ” — are honoured to-day as strictly and sincerely as they were by the K n igh ts of St. John of past generations ; and they provide a tradition which in itself has exerted a rem arkable influence on the success of the English Branch which was revived in 1831 and stabilised in 1877 by the formation of its first special Departm ent— the St. John Am bulance Association. In short, the Order of St. John is the oldest Order of Chivalry in the world ; and it is unique ( 1) in that it admits to full membership only those who accept the tenets of Christianity and is consequently inspired by charitable ob jects, and (1) in that it enrolls under its white cross repre sentatives of all classes of the community, including men and women who, unable to m ake money contributions to charity, give *reely and without reward their services and their off-duty hours to the accom plishm ent of its objects. T he Order took origin from a hospital which, as a place of refuge for pilgrim s to the H oly Sepulchre, was established at Jerusalem in 1050 by certain pious merchants of Amalfi, a small town near Naples. It was well organised when, in 1099 , the first Crusade, under Godfrey de Bouillon, captured the H oly City from the T u rks and established a Latin K in g dom in Palestine. Divided later into eight Langues (L an gu ages or Branches), of which E ngland was one, it gradually developed into a powerful m ilitary organisation which came to acquire w ealthy possessions in the several countries of Europe. Its patron saint is St. Jonn Baptist ; its emblem is a white cross which consists of four arrowheads reversed, which figured originally on the arms of Amalfi ; and its colours are black and white— black for the loss of Jerusalem and white for the pure life— to which is added red in memory of the red cloaks once worn by the K nights when on active service. At its origin and for many years afterwards the Sovereign Order of St. John was composed mainly of French K n ights ; and to its end it was a Rom an Catholic institution which looked to the Pope for its authority and carried on ceaseless w arfare and successful opposition to the onward march through Europe of the Moslem Empire. In brief, the Order was the bulw ark of Christianity again st Mohamedanism. Further, it differed from other Orders of Chivalry in that its members, when figh ting w as over, returned to service in its hospitals where they treated patients without reference to colour, creed or controversy.

FIRST

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one or ot;^er or a " t^le ^ re e races of germ s, Streptococci, Staphylococci and B. pyocyaneus are found in every skin infection common to this country, and A N T IP E O L O IN T M E N T contains the antibodies (antivirus) of these germ s. H ealin g is expedited by the proved ingredients of the ointment, and septic development is stopped or prevented by its antivirus sterile vaccine filtrates. A N T IP E O L O IN T M E N T is unsurpassed for B U R N S and S C A L D S , for it is microbicide and non-adhesive, and dressings do not require to be changed every day.

I N

I P

affords rapid relief of C O M M O N C O L D S , IN F L U E N Z A , A N D C A T A R R H . C ontaining the antibodies of the germ s common to infections of the nose and pharynx (Staphylococci, Streptococci, B. pyocyaneus, pneumococci, pneumobacilli, cnterococci, M. catarrhalis, B. Pfeiffer), Rhino-Antipeol is not just a palliative, but is a remover of the cause of the infection. D uring epidemics it is the ideal preventive of microbe development.

I P

is a semi-fluid ointment, more convenient than the ordinary Antipeol ointment for ocular infections and lesions. Eyes affected by smoke and dust are soothed almost im m ediately by the application of Ophthalm o-Antipeol, and the antivirus prevents germ s from developing. C lin ica l Samples on request fro m M E D I C O -B I O L O G I C A L L A B O R A T O R IE S L T D . , C a rgreen Road, South N o rw o o d , Lond on , S.E.25

Driven by the T u rks from Jerusalem to Acre and thence to Rhodes which it held for two centuries, the Order in 1530 made its home finally in Malta. There it flourished until 1798 when the island was surrendered ignom iniously and without a stru gg le to Napoleon and the m ajority of the K n ights sought refuge in Russia. In this connection it is interesting to note that von Hompesch, who made the sur render, was the first German to hold the high office of Grand M aster and also that a few months later Nelson re-took M alta from the French. R

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Between 1827 and 1831 steps were taken to revive the English L an gue on the understanding that members of the Protestant religion m ight be admitted to the Order in spite of the fact that the other Langues (except those of Brunsw ick and Russia) were composed of Roman Catholic K nights. In 1858 , however, the Order of St. John in E ngland decided to become a national organisation with a policy of its own, to cast off the authority of the Pope and to recognise only its own Sovereign as its head, whence arose the title of Sovereign Head of the O rder.” In 1871 these provisional arrangem ents were confirmed ; and the new constitution assumed the form which has per sisted with little alteration to the present day, though it was not until 1888 that H .M . Queen Victoria granted the Order its first Royal Charter of Incorporation. T he Order published its first Annual Report in 1868 ; and in 1873 it established in the Potteries at Burslem and W olverham pton an am bulance service from which the Am bu lance Departm ent took its origin and later became the prim ary purpose of the Order, controlling as it does the activities of the Association and B rigade. D u rin g this period the Order was increasing in numbers and usefulness,

thanks chiefly to Sir Edmund Lechm ere, its SecretaryGeneral and to W illiam D rogo, D u ke of Manchester, its Lord Prior, each of whom held office for m any years. Next, through the efforts of Sir Edm und Lechm ere the Order in 1874 regained possession of St. John’s Gate, the ga tew ay of the ancient Priory of the Order of St. John ; and so after m any years it returned to its ancient home. In cidentally, Sir Edmund is reputed at the outset to have put up the greater part of the purchase price ; and Cardinal M anning is said to have been his chief com petitor in these negotiations. Further it established as its special charity a system of diets for convalescent patients in hospitals ; and it also sought to promote the provision of trained nurses who should attend poor patients in their own homes. In this connection it later paid for many years the costs of a trained nurse to look after such patients in the vicinity of St John’s Gate. R

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As the rise and progress of the Sovereign Order of St. John w as largely influenced by a movement am ong the nations of Europe, so the revived Branch in E ngland in its turn w as sim ilarly affected. In 1864 two Sw iss gentlem en— Henri D urrant (who dreamed the dream as the result of being present at the Battle of Solferino in the Franco-Austrian W ar of 1859 ) and G ustave Moynier (who made D urrant’s dream come true and was afterw ards President of the Sw iss Republic)— brought about the first G eneva Convention. T his, revolutionised w arfare in that, am ong other matters, it recognised the claim of volunteers— provided that they were recognised by their own governm ents— to g o to the aid of sick and wounded soldiers in time of w ar ; and it established their im m unity from attack and captivity, while so engaged.

FIRST

Consequently a w ave of enthusiasm for this am bulance work spread throughout the nations of Europe ; and National Societies for Aid to S ick and Wounded Soldiers were founded in the various countries. E ngland lag ged behind the other European countries ; and it was not until 1870 that, at the outbreak of the Franco-Germ an W ar, members of the Order of St. John were prominent in establishing the British National Aid Society which despatched surgeons, nurses and orderlies to assist both sides. It is noteworthy that so many hreaches of the Geneva Convention were committed that the V oluntary Aid Movement was believed ter’ have killed itself in this, its first, trial. R ise and P rogress of the Association. Experience gained during this w ar proved that such voluntary aid could avail little, unless(and until) its exponents am ong the general public were properly trained in days of peace. W hen, therefore, at its close the British National Aid Society “ declined this responsibility as too onerous,” the Order of St. John notified the authorities that it was ready to accept their proposals. Accordingly in 1877 the Order inaugurated a special Department which, called the St. John Am bulance Associa tion, began (and has to this day continued) to (1) instruct,, exam ine and certify its lay members in first aid and allied subjects, and (2) foster the spread of am bulance material. T h e enthusiasm of the public for this new and practical form of Christian charity— which owed so much to John Furley, Sir Edward Lechm ere and Major Francis Duncan— is evident in the dry and m usty records which I have twice perused ; and it is clear that this enthusiasm influenced m arkedly'the decision of the Order in E ngland to adopt the am bulance movement as its special method of w orking " i n defence o f the faith ” and “ for the seivice of mankind." W ithin six months 1,000 students had passed through classes in first aid organised by the Association ; and it is noteworthy that at the outset women took up the subject so keenly that the new' cult was cynically called— " a n ephe meralJemine fashion." T he influence of the ladies wras such that in 1880 the Association introduced for them a Nursing Course, which for ten years remained their peculiar preroga tive, and wras only made available to men when the latter demanded the right to qualify for the nursing certificate of the A ssoc'a'ion. At its origin the Association was regarded as a civilian reserve for the arm y, and so it received the active support of the Arm y Medical Departm ent, which delegated two of its medical officers to assist the lay officials of the new organi sation. These w'ere Surgeon-M aiors Peter Shepherd and Francis Falw asser. The latter drew up the first syllabus of instruction in first aid, and the former was the author of the first official textbook of first aid, which was published in 1878 , and in its various subsequent editions has to-day reached a sale of over seven million copies. From 1878 onwrards classes were held annually am ong railw ay men, miners, colliers, policemen, and indeed am ong all classes up and down the country. Q uite early in its career the Association decided to establish Centres where such were likely to be permanent and to control their own classes, and, when this w as not possible, to recognise D e tached Classes. T his system still holds, because it was found that by this arrangem ent freedom and elasticity within certain limits were provided for local governm ent and that the circle of students continued to increase. In 1880 the Association began an extensive ambulance crusade in the Midlands, w'ith the help of Surgeon-M ajor George Hutton, w'ho repeated his visits annually to the rail w ay men and miners in the Midland and Northern Counties and did much pioneer w ork in these parts. T h e year 1895 witnessed the formation of the first Railw'ay Am bulance Centre— the North Eastern R ailw ay ; and within the next ten years most of the other railw ays followed suit.

RID In 1879 the Association put into practice the second object of its existence by opening its Stores Department, which is still flourishing and concentrafes (and has alw ays done) on the m anufacture and sale of equipment necessary for its w ork. In this connection, it is interesting to note that the Association introduced into this country the trian gu lar as the more suitable than the roller bandage for am bulance w ork ; that it invented the first civilian stretcher, litter and horse am bulance ; and that before it began its w ork it was a most difficult m atter to move a helpless patient from room to room and still more so from house to hospital. In 1882 the Association created its Am bulance T ran s port Corps as the natural outcome of its Stores Department, because those requiring am bulance material also required the assistance of men trained in its use. T h e Transport Department has an unbroken record of service to this day ; and it has carried patients not only from home to hospital in London but to and from the Provinces and even across the continent of Europe. Thus, the Association progressed alw ays go in g forward and spreading its influence wider and wider until in 1927 , its fiftieth anniversary, it had established its Centres and D e tached Classes in all parts of the British Empire, and at December, 1941 , it had issued to successful students more than four and a quarter million certificates, chiefly in first aid.

(lo be concluded,.')

S t a n m o r e F i r s t A id A s s o c i a t i o n . On September 14th, at St. Law rence H all, W hitchurch-lane, E dgw are, D istrict Staff O fficer-C . E. Bower, O .B .E ., addressed an enthusiastic and receptive audience on the subject of “ The Art of L earning First A i d ” (including the “ fakin g of in ju ries” ). T he hall was packed, and the subject was dealt with in a lucid and m asterly manner. He offered to answer any questions, but apparently every one was satisfied, for the only question asked w>as— “ W hen will w e have the pleasure of hearing the lecturer again ?” Mr. F. E. Stallard, the chief instructor, thanked Mr. Bower, and the audience expressed their appreciation in the usual manner.

London

a n d N o rth R a ilw a y .

E aste rn .

T h e H ull D istrict Council of the L .N .E .R . North-Eastern Centre of the St. John Am bulance Association held their sum m er competition in “ first aid to the in ju red ” in th e ’ Am bulance Rooms, Paragon Station, Hull, on Sept. 12 th. Dr. N. Jennings and Dr. A. C. Minn were the adjudi cators for an entry of nine team s of five members in each. Dr. Minn judged the team on stretcher w ork in a well set test. All the team s gave a merited performance, and had to improvise a stretcher by use of a board or door to remove the patient to shelter. Dr. Jennings judged all team members individually in the treatm ent of haem orrhage and fractures. H ull Goods w'ere the winners, the members of the w in ning team being B. Fulstow (capt.), J. Patrick, H. Dennett, S. Bond and W. Burley. Mr. L. Ballan, D istrict Supt. and President of the Council, presented the “ John L a r d e r ” Shield and prizes.

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PEACE T I M E S U B J E C T S :— Influenza,Colds,etc. Measles, Mumps Catarrh Corns and W a r t s Physical Cul t ure W h a t t o Do in Emergencies T r e a t m e n t for all Skin Diseases T h e Lungs, Pleurisy Hygiene, A n a t o m y , Pharmacy T h e Principles of Nursing T h e Eye, the Ear T h e Throat , t he Nose T h e Chest, t he Heart T h e St omach, the Liver T h e Te et h, the Muscles Infant We l f are Homoepathy, Neurasthenia 375 Prescriptions, etc., etc.

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B odily Injury, B urns a n d Scalds, C lo th in g A ligh t. F o r e i g n B o d ie s in Eyes, Ears, N o s e , T h r o a t . M a c h in e ry Accidents, Electricity Accidents. D ro w n in g , Suffocation, Bleeding, Poison, B ro k e n Bones, Fractures, Dislocations, S p ra in s, F ain tin g , Concussion, Etc. THE YO U N G W IFE will find just the inform ation she requires. MOTHERS who wish their daughters to develop naturally will find exactly the teaching they need. W O M EN O VER 40 will frankly discussed.

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BEAU TY CULTURE— Com plexion Diets, W rinkle Cures, Care of the Hands, Mouth, Eyes, H air, Recipes, etc. P R E SC R IP T IO N S —375 proved remedies. T here are hundreds of subjects. T h e muscles, teeth, digestion, hair, food values, Ju jitsu, Phrenology. H ow to diagnose diseases from appearance of head, face, neck, tongue, throat, chest, perspiration, etc.

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FIRST

O u r C O M P IL E D

No.

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RID T he letter stated that local hires could not be obtained during the night, and that a request for the use of first aid party vehicles had been refused. At a m eeting of the Council, Provost B e g g explained that the request for the use of first aid party vehicles had been rejected because it was not know n at w hat moment they m ight be required for other purposes. As to the difficulty with local hirers, it was understood that the demands upon them was so great that in order to gain some sleep they had had to refuse night work. Treasurer L ogan referred to the complications which m ight arise if any person urgently in need of a nurse’s attention during the night, were unable to obtain such help. A remedy must be found. The Council finally appointed three members to raise the matter before the Joint M aternity Committee.

Page.

B Y AN A M B U L A N C E

S IS T E R .

District, S .J .A .B .

Cadets Enrolment at Amersham.— An interesting ceremony, witnessed by a large assem bly of parents and friends, took place at Amersham on Septem ber 10th, when 48 girls were enrolled in the newly-formed Cadet Division of the St. John Am bulance Brigade. The enrolment ceremony w as conducted by Major P. G. D arvil-Sm ith (County Commissioner), who w as supported by Miss F. Stokes, Lady Supt. ; Lady Elderton, who has consented to be Vice-President of the Cadet Division ; Mrs. W eaver-Adam s, L ad y County Officer ; Lt.-C ol. R. F. Collins, Assistant County Com m issioner for the Midland Area ; and Mr. H. Alder, Corps Officer. • M ajor D arvil-Sm ith gave a short talk on the history of the Order of St. John, and Mrs. W eaver-Adam s inspired the girls with her helpful chat on their duties and oppor tunities. D urin g the evening it was announced that Miss M. G ray was to be the Cadet Superintendent. She is ably assisted by Mrs. E. Halson and Mrs. I. P ike After a short interval, during which refreshments were served by the Cadets, a most enjoyable entertainm ent was presented by Col. Collins.

Reviews. A id s

T his is the fourth edition of a textbook which success fully covers the whole range of nursing practice as compre hensively as is possible within a small compass. The first ten chapters deal with general basic nursing duties, and the last ten with the more specialised and advanced procedures with which a nurse should be fam iliar at the end of her period of training. Not the least interesting chapter is the first, which gives a short history of nursing and will prove attractive, especially to probationer nurses about to start on their career. The book closes with an appendix containing questions taken from the exam ination papers set by the General N ursing Council, and it should be in the hands of not only of those for whom it was compiled but also of those readers of First Aid who in these days are doing duty in hospitals.

D iscipline in the N ursing Profession. Many correspondents of a daily newspaper have recently pointed out that the discipline to which nurses are subject is far more severe and rigid than in alm ost any other profession open to women. "One writer su ggests that this is possibly a relic of the days when practically the only nurses were nuns. Even now in some parts on the Continent nurses can only be obtained from am ong Sisters of some Order. T h e title of Sister as used in the hospitals in this country m ay be significant of the customs of bygone days. This same correspondent su ggests that until the nursing profession is rid of traditions eulogising austerity for its own sake, modern women will not be attracted to it, however urgent the call. Rochester B .R .C .S . A m eeting for girls interested in nursing and first aid was held at the Belsey Hall on Monday, September 14 th, by the Junior Detachm ent of the B .R .C .S . in Rochester. The speaker w as Miss Clay, Youth Assistant County Director, B .R .C .S ., and the purpose and function of a Youth D etach ment w as explained. F irst A id D emonstration at Monzievaird. L ast month a m eeting w as held at Monzievaird and Strowan, W .R .I . in aid of Red Cross w ork and funds. A talk on first aid and practical demonstrations were given, after which tea w as served. There was a gu essin g competition which realised 12 s. 6d. for the Red Cross funds. N ursing S ervice at F alkirk. A difficulty in providing conveyances for nurses on night duty m ay lead to the complete w ithdraw al of night service in F alk irk . T h is possibility was disclosed in a letter addressed to the T ow n Council by the secretary of the F alk irk Victoria M em orial N ursin g Association.

to Practical N ursing. By M arjorie Houghton, S .R .N ., S .C .M . L on d on : Bailliere, Tindall & Cox. Price 4-s. net.

First A id to Injured and Sick. Revised and re-written by H alliday Sutherland, M .D . E d in b u rgh : E. and S. Livingstone. Price 6d. n et; by post gd.

T h is is the forty-fourth edition of a most useful and deservedly popular little book which can be carried in the w aistcoat pocket, and is im mediately available for reference in em ergencies and for revision before the day of exam ina. tion or re-examination. T h e description of Schafer’s method of artificial respira tion is nearer to w hat Schafer tau gh t than in previous editions ; but it still errs in that both uppgt limbs of the victim are not, as he wrote, “ laid forw ards.” It is strange that the nam e of Silvester is still miss-spelt, and we cannot agree that Schafer’s method is not to be used when the ribs are fractured. C iv il Dejence : A Basic Training Manual. By L t.-C om mander F. A. M. Eden, R .N . London : Jordan & Sons Ltd. Price 2 S. T h is book presents in its 88 pages information which all members of the Civil Defence Services ought to know. It is, in fact, the first stage of their training ; and it is equally important that they should have a sound w orking know ledge of anti-gas measures, elem entary protection against high explosive bombs and measures for dealing with incendiary bombs. Th ou gh prim arily written for members of B .R .C .S ., the book will be of great value to members of the public.

FIRST

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Shows the two stretchers in position.

Shows the top stretcher lowered ready for loading.

Illustrates the same Gear with the top stretcher frame h in g e d d ow n for use when only one stretcher case is carried.

D . Shows the same position as in “ C ’ only with cushions and back rest fitted for convalescent cases.

W h e r e A m b u la n c e s a r e r e q u ir e d t o c a rry f o u r b e d s two Gears are fitted, o n e o n EITHER SID E, and t h e sa m e a d v a n ta g e s a p p ly as d e s c rib e d ab o v e .

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G R E A T P O R T L A N D S T ., LONDON, W .l Phone : Langham 1049.

KARVAUD, WESDO, L O N D O N

FIRST

Queries and Answers toCorrespondents Queries will be dealt with under the follow ing rules :— 1.— Letters containing Queries must be m arked on the top left-hand corner of the envelope “ Q u ery,’’ and addressed to F i r s t A i d , 46 , Cannon-street, London, E .C . 4 . 2. — All Queries must be written on one side of paper only. 3 .— All Queries must be accompanied by a “ Q uery Coupon ” cut from the current issue of the Journal, or, in case of Queries from abroad, from a recent issue. 4 . — T h e Textbook to which reference m ay be made in this column is the 39 th ( 1937 ) Edition of the S.J.A .A . Manual of First Aid to the Iniured. T h an ks to the D octor. Although, ow ing to shortage of paper, coupled with a vastly increased circulation, we have been compelled to curtail the number of our pages, there is one outstanding feature of F i r s t A i d which has not been curtailed and that is the invaluable assistance rendered to individual readers in solving their difficulties, by our friend and Honorary Medical Adviser, Dr. Corbet Fletcher. This feature not only benefits those who subm it queries, but is of great educational value to every reader. W e feel sure that everyone of our readers will join us in tendering to the Doctor our heartfelt thanks for his extreme kindness in im parting from his know ledge and experience, that help which otherwise would be difficult to obtain, and which he has given so w illingly throughout the past twentyseven years.— T h e E d i t o r . P erfo rm a n ce of S ch afer’s M ethod. J.C. (Cumbernauld, Scotland). — Recently I was present at a fatal drow ning accident, concerning which I offer some observations and criticisms, and would value your esteemed opinion. Schafer’s artificial respiration was being applied when I came forward. Patient was lyin g on a cement runw ay with head considerably higher than feet due to slope of ground. His arms were stretched full out at right angles to trunk. There was some w arm th about his loins when 1 came, though I could not be definite that there was a pulse at the wrist. I contend (a) that the patient’s position should have been reversed, head slightly low er than feet ; (b) that his arm s should have been folded loosely above his head, as I judged the full extension of the arms, defeated to some appreciable extent, the effects of respiration ; and (c) that the treatm ent w as not persevered with long enough, the actual time spent being approxim ately 30 minutes. (a) Schafer’s instructions require that patient be placed “ on nearest flat su rface,” this being one which is not uneven but not necessarily horizontal. In these circum stances I do not think that the position of patient’s head, up or down a slope, should interfere with the efficient performance of artificial respiration. (b) Schafer’s instructions require that the patient’s upper limbs should be “ laid forw ards,” each being flexed to a rig h t an gle at the elbow, with the result that the hands are just above the head. So on this point both those whom you criticise and you are at fault. (c) On this point I agree that 30 minutes was too short a period and that the minimum period should have been at least two hours if not longer. Incidentally I note that you were able partially to exam ine patient ; and, this being so, I wonder if you acted on your convictions and persevered with artificial respiration when the other bystanders desisted.— N . C o r b e t F l e t c h e r .

AID E xam ination H owler. D .N . (Rom ford).— At a recent exam ination I asked a can didate how he would diagnose haemorrhage by general sighs and symptoms, where no external haemorrhage was to be seen. T o the amusement of all present he replied :— “ Oh, you mean eternal bleeding ! ” Good !

Next, please ! !— N .C .F .

T reatm en t and T ransport. A .H . (D ysart, Scotland).— I shall appreciate your ruling as to treatment, lifting and placing on stretcher of the patient whom we had to handle in a recent test, the card of instruction of which read as follows :— “ A man is found lyin g on his right side on the roadway, having been knocked over by a motor car. He complains of severe pain in the lum bar region and he cannot move his legs. There is a large haem atom a over the right-parietal region and also a Pott’s fracture on the left side. “ W ith No. S acting as patient, render first aid, load on to stretcher and carry uphill to am bulance. Load am bulance.” A Pott’s fracture involves the fibula only ; and therefore no aggravation of the fracture can result from inclining the stretcher. Consequently transport of patient up-hill feet-first or head-first must be governed by other injuries which may be present. T h e facts as stated are not sufficient for me to give a ruling as to whether or not in accordance with our Textbook the patient should be carried face upwards or downwards. U nfortunately I have not a copy of the latest edition of the St. Andrews’ Textbook and so cannot assist in this direction. — N .C .F . F ra ctu red F o rea rm and B le ed in g P alm . A .T . (Huddersfield). — D uring a discussion am ongst our selves the problem arose as to the method to be adopted when arterial haemorrhage is present from the palmar arch accompanied by a fracture at the wrist. As theTextbook instructions are thatafracture should not be elevated when haemorrhage is present, would it be w rong to apply brachial flexion at the elbow to control the haemorrhage before im m obilising the fracture ? Y o u r advice will be appreciated. First, I assume that when you speak of “ fractured w r is t” you really mean “ fracture of forearm just above the w rist.” H ave you forgotten that the wrist is the heel of the hand and that it is often so-called ? Such being the case, then nothing in your statement of facts precludes the possibility of controlling the bleeding from the palm by pressure on the radial and ulnar arteries while wound is being examined and treated (Textbook Rule 5 , p. 109 ). Should, however, there be some definite contraindica tion, then Textbook instructions in par. 5 on p. 120 would justify you in com pressing the brachial pressure point. N ext, the instructions forbidding the elevation of a bleed in g part when limb is fractured (Rule 2 , p. 108 ) relate to those cases in which movement m ight cause displacement of fragm ents with possible injury to surrounding tissues, especially main arteries, veins and nerves. W ith a fractured forearm, however, the Textbook tells you to treat the fracture and to place the forearm in large arm sling. This being so, I cannot im agine harm resulting from raising the forearm a little higher as part of your treatm ent of bleeding from the palm ar arches.— N .C. F. Transport for F ra ctu red P e lv is. J.C . (R uislip).— I n a recent practice I recommended that a case of fractured pelvis should be considered as serious as a fracture of vertebrae and removed in a sim ilar way by bandages passed underneath and transported on a stiffened stretcher, raising the knees if greater comfort be given to the patient thereby. This method was

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opposed on the grounds that it is not in the St. John Textbook, but my reason is that the unavoidable pressure caused by lifting the patient on to the knees of the team in the usual w ay m ight produce serious complications such as penetration of bladder by splintered end of bone. As opinion is divided on this question, I have under taken to submit it to you for your ruling, and thank you in advance. The Textbook used to recommend the method which you are now suggestin g. T h e treatment of fractured pelvis, however, with side poles and bandages as for fractured spine went out with the 37 th Edition of the Textbook. W hen you remember that the spinal cord ends at the second lum bar vertebra, you will realise that it was a waste of time and energy to treat a fractured pelvis as for a frac tured spine. In these circum stances patients suffering from fractured pelvis are to be loaded on stretcher in the usual w a y.— N .C . F. C on trol of H a em o rrh ag e fro m L eg. E .C . (Sydenham ).— Some doubt has arisen in my mind regardin g the efficiency of a constriction tourniquet in controlling hajm orrhage from the leg when such has been severed in (say) the lower third. I believe that the main arterial vessels are, for at least a part of their course, deeply placed between the tibia and fibula, and are to that extent protected from the effects of constriction. Are they sufficiently well protected to render them incapable ot being adequatelyoccluded by constriction, and in this event what is the best method of controlling h em orrh age, as pad and forced flexion behind the knee does not appear to me to be the best method for such an injury? In practice it is usually found that a tigh t constriction round the limb will obstruct the circulation. Consequently, when this is applied, there is practically no bleeding during surgical operations for am putation of parts of lim bs.— N. C. F. R oping P atien t to Stretcher. A .M . (B lackbu rn).— May 1 first of all express my gratefu l ness for the many interesting replies given in your Queries and Answers colum n? For several years I have found them mo'kt interesting and instructive. I am prompted to write regardin g a question in the July issue of F i r s t A i d from J.C. (Broom) as to methods of roping patient to stretcher with trian gular bandages. I am a member of the B rigade and of a Fii;st Aid Party in the Civil Defence Casualty Service. W e have a method here of roping patient to stretcher with trian gu lar bandages which is very effective and enables the patient to be carried in any position. I refer to the m etal stretcher in use for A .R .P . purposes. Perhaps you could forward me the address of J.C . ; and it will be a pleasure to m ake a rough sketch of our method. In this w ay I may be able to pass on some know ledge which has been of benefit to us. U nfortunately the address of our previous correspondent was not noted. If, therefore, he will com m unicate with Mr. Albert Marsden, 3 , Devonport-road, B lackburn, he can obtain the information which he desired. — E d i t o r . T reatm en t of In s e c t Stings. T. S. (B lackpool).— In reading a M anual of Surgery by Rose & Carless I find no mention of the blue bag for stings, the only treatm ent being an alkaline solution or a freshly sliced onion. Y e t in my 1901 and subsequent T e x t books I find only the blue b ag, and the onion is not mentioned. If it is efficient, w hy is it not mentioned, and should I be in order to mention it am ong the list of home remedies when dealing with stings, as this is the season for a raid on us by wasps and other insects. T h a n k in g you in anticipation. T h e Textbook favours alkaline remedies for insect stings on the grounds that all sting-venom s are acid, this view being

RID based on the fact that the venom of the ant is formic acid, which is the only one so far definitely recognised. Experi ence, however, taught the farm er long years ago that a slice of onion (which is acid) is efficient with wasp-stings ; and modern research has proven that usually w asp venom is alkaline. There is no reason why in your demonstrations you should not refer to the use of slices of onion with wasp-stings. — N. C. F. C a rria g e o f P atient. O.J. (B lackpool).— T h e corridors and staircases of the seven storied building in which I act as a leading first aider are so narrow that it is quite impossible to use a stretcher in the normal way and extrem ely difficult to m anipulate a T riglift Carrier. I am told that there is a safe and recognised way of securing a patient to an A .R .P . (green) stretcher so as to admit of carrying in varyin g positions, but cannot find it described in any m agazine or book I possess. T rian gu lar bandages are used. W ith many thanks in anticipation and best respects. H utt’s H arness (which is advertised in F i r s t A i d ) would seem to meet your requirem ents.— N .C .F . A v u lsio n of Hair of Scalp. O.J. (Blackpool).— I was told a few days ago of a woman who had all her hair torn from her scalp in the machinery of the factory where she was employed. W ondering what I should have done in such a case, I decided upon the application of gauze covered in vaseline and lightly applied, as being more soothing than Dettol or other antiseptic. W as I right, please ? T his injury would result in considerable pain and shock. Personally, if I were the first aider, I would cover the scalp with a clean dry dressing, cotton wool and head bandage. T his done I would treat for shock and remove patient to doctor or hospital. No good would result from sm othering the scalp with vaseline.— N .C .F . Fxactuxe o f Spine. H .B . (W allington).— Ia m a m e m b e r of S .J .A .B . ; and a few w eeks ago, a colleague of mine told me of an interesting case which he had attended. I was so amazed by his statement that I would be glad if you could enlighten me on the subject. My friend was called to attend a man who, as the result of an accident complained of pains in the back. H e suspected fractured spine, but was very surprised when the patient on being asked to raise his legs, immediately did so without apparently any difficulty. A few hours afterwards my friend ’phoned the hospital and w as informed the man had died from a fractured spine. I have alw ays understood that anybody suffering from a fractured spine would have no use or control of the lower limbs. Am I right in this assum ption, and could you give me any idea what, in your opinion, actually happened ? Y o u will note that the Textbook in the first paragraph on p. 73 reads “ with displacement of fragm ents . . . . the spinal cord and the nerves . . . . m ay be injured.” In other words it does not follow that all cases of fractured spine are accompanied by loss of power and of sensation which result only when the displaced fragm ents of vertebrae press on the spinal cord and nerves. As to the cause of death in this case, I cannot venture an opinion on the facts as submitted by you, though this may have been due to secondary shock.— N .C. F.

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a n

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E V E R Y N U R S E A N D F I R S T A I D E R should have a really good Atlas of the human body. BAILLIERE’S two splendid Atlases, the FEMALE and the MALE, fill that need. They show the bones, circulation, muscles, nerves, and all the internal organs. In the FEMALE Atlas the chest and abdomen have lift-up parts, showing each internal organ, its relative size, shape and exact position. Each Atlas is beautifully coloured .and has a fine detailed text accompanying it.

P R I C E 5 / 6 d . each.

Postage 6 d .

The Medical Press and Circular says: “ These two works are faultless to a degree. As an aid to nurses, first-aiders, and ambulance students these Atlases take a place In the foremost ranks.” j B A IL L IE R E ,

T IN D A L L

COX,

7-8 , H enrietta Street, London, W .C .2

Please send m e.........................copies (each) of T he F E M A L E Atlas : T h e M .iL E Atlas for which I enclose 6/- post free each.

A plate from the FEM ALE

ATLAS

much reduced. Note

the

black

a r r o w passing Name

I A ddress ......................................................... ••........................... F.A. 26

under the parts.

lift-up

t i a

l !

FIRST A ID J n ta p e n k n ! J o u r n a lj a r ti)e A m b u l a n c e E d ito r:

No. 5 8 1 .— V o l . X L I X .

N O T IC E

anb

W A LTER

3 $ u r 5 in g

NOVEMBER,

B e r n ic e s

S CO TT,!& F.R ,S an.l.,- F.R.S.A.

1942.

[ Entered ai 1 Stationers' Hall\

PRICE THREEPENCE

[4/« Phr Annum, P o st F re e

READERS.

E D I T O R I A L . F I R S T A I D is published on the a o t h o f e a c h m o n t h . A n n u a l Subscription is 4s . post fre e ; single copies 3d.

The

It s aim and object being the advancement o f Am bulance W o rk in a ll its branches, the E d ito r invites R eaders to send A rticle s and Reports on subjects pertaining to the M ovem ent and also welcomes suggestions for P ractical Papers. A ll R eports, & c., should be addressed to the E d ito r at the address below , and should reach him before the lo th of each m onth, and must be accompanied. ( not necessarily fo r publication ) by the name and address of the Correspondent. Subscriptions, A dvertisem ents and other business Com m unications connected w ith F I R S T A I D should be forwarded to the Publishers, D A L E , R E Y N O L D S & C o ., L t d . , 46, C a n n o n S t r e e t , L o n d o n , E .C .4 .

Telegraphic A ddress — “ Tw enty-four , London." Telephone— C ity 3710.

C O N TEN TS E

d it o r ia l

THIS

NUMBER.

...

—

A National Health Policy

...

Co-ordination of Civil Defence Services ... ... S .J .A B. Headquarters and District Reports ... The Ven. Order of St. John : Its History and Activities ................ ... ... ...

50 51

Railw ay Am bulance N ews Our N urses’ P age ... Review s Q

u e r ie s

... an d

...

nsw ers

... ...

...

o r r esp o n d en ts

Abdominal Wound with Protrusion ... Exam ination H ow ler ... ...

... ...

V ariations in Pulse

...

Iodine Poisoning ...

...

Phosphorus Poisoning

... ... ...

...

H um our in First Aid

...

F a k in g of Injuries

...

Phosphorus Bombs

...

More H um our in First Aid . .. Carotid Arteries M uscular Action

... ...

. ...

...

... .

B lan keting Stretcher

...

Rem oval of L igatu re

... ... .. ...

Fracture of Patella and L e g

...

Grade I Instructor’s Certificate

...

Nose Bleeding in H igh Altitudes

...

Treatm ent of Poisoning

...

58 58 58 58 58 58 S8

...

... ...

Flowers in Sick Room

52 54 56 56

58 60 60 60 60 60 60 60 60 60 60

A h i g h l y inform ative report, containing A N ational proposals for a positive and active health Health P o lic y , policy, has been form ulated by a Sub-Com mittee on the Health Services appointed by the Liberal Party. It is of a revolutionaiy nature in many ways, and opinions upon it will be m any and varied, but it gives food for thought and calls for careful consideration by the powers that be. In the prelim inary “ outline of existin g arrangem ents ” it deals w ith every phase of its subject-matter, including hospital, dom iciliary, m aternity, infant welfare, dental and ophthalmic services, and this is followed by a second part g iv in g proposals for the reform of the health services, while a third part is devoted to that high ly important matter, finance. R ealising as it does (and as we all must do) that the continuance of avoidable ill-health in any section of the com m unity is tragic and wasteful, the Sub-Com m ittee recommends the immediate adoption by the nation of a posi tive and active health policy in respect of all its citizens, w hich will include the development, adaptation and co ordination of all existin g health services and facilities in all areas as the advancem ent of science demands ; that irrespec tive of income the medical services should in future be at the disposal of all citizens free of charge and not m erely to certain insured classes as at present ; that ow in g to the need for a powerful Ministry of H ealth with a well designed health policy and also for expert advice to establish and control a complete health service throughout the country, a Statutory Medical Advisory Com m ittee should be set up to advise the local authorities in respect of their functions relatin g to the publie health services; that the unit of the health service should be a local health centre where all m edical, dental, nursing services, etc., both preventive and curative, should be grouped ; that in order to preserve the h igh tradition and spirit ol service of the voluntary hospitals, assistance from public funds should be made available to those which m ay be in need of it, on the recommendation of the Statutory Medical Advisory Committee. O u r interest is concerned mainly, of course, with the nursing services, and the attention of the public m ight w ell be directed to the follow ing words in the report : “ It is not alw ays realised by the public that, apart from the permanent staff of the hospitals, nam ely the matron and sisters, about whose w ork, in the main, it is impossible to speak too highly, the great m ajority of the nursing care of the sick is provided by student labour, i.e., by nurses in training who receive a totally inadequate salary for the w ork they do, on the assumption that they w ill recoup them selves out of the fees or salaries w hich they can com m and when they become fully-certificated, State-registered nurses. The openings for the services of trained nurses in peace time are not, in fact, sufficient to provide for this expectation, and if it were not for the heavy annual w astage from the profession by the natural exit of m arriage, there would be grave unem ploy ment am ong trained nurses.” A sum m ary is then given of the main openings for those w ho do not m arry, but it is pointed out that in none of the positions enum erated is the present scale of salary and pension adequate to m ake up for

FIRST the years of almost unpaid w ork which must precede appoint ment, and if the present low cost of treatm ent is to be m ain tained the prizes in the form of appointments available to trained nurses m ust be made more attractive. Space pro hibits our sayin g more, although we trust we have said enough to encourage a desire to read the whole report. It may be obtained, price 1/- from the Liberal Publication Departm ent, 8, Gayfere Street, London, S .W .l.

C o - o r d i n a t i o n o f C iv il D e f e n c e S e r v ic e s . S IR

Extracts from Lectures delivered by H E N R Y L . M A R T Y N , K .C .V .O ., F .R .C .S ( Continued from page '}(/.)

angerous

a jm o r r h a g e

T his entails some explanation. W h at constitutes dan gerous haem orrhage ? Y o u unfortunate First Aid Parties have my utmost sym pathy— not in the least for the w ork you have to do, which is the most vitally interesting of all Civil Defence duties, but for the appalling responsibilities which are placed upon your shoulders. W e ask you, quite frankly, to accept responsibilities and to m ake decisions which in m any instances would be hard for a doctor with years of experience. Never be afraid of them, if you do your best, and do it honestly, you w ill never be criticised. It is not the man who m akes a m istake in the heat of battle who is blamed, but the man who does not bother to train. One of your difficulties will be that none of you have probably ever seen a dangerous haem orrhage, and your tendency will be to rush to the rescue of every case that happens to have a lot of blood about it under the impression that it is in danger of imminent death. I have heard a man, fully armed with his first aid cer tificate, asked w hat would happen to a casualty with a radial artery cut if it were left unattended. H is answ er was that it would be dead in three minutes since it was a case of arterial haem orrhage 1 T h at, of course, is rubbish, w hat would happen is that after some time— and I mean some tim e— the victim would faint when his blood pressure had fallen low enough and the flow would alm ost cease, after a time he would recover and the bleeding would increase, and, sooner or later, he would a ga in lose consciousness, and so on, but he would certainly take som etim e to die even if left completely unattended. Sim ilarly, perhaps by the edge of a fallin g tile or glass, half a scalp m ay be stripped com pletely down from the under lyin g skull, the case will probably be found lyin g literally in a pond of blood, the veins still oozing, and the arteries in the flat edge feebly spurting. Even here there is no immediate fear of death. T h e position, however, is entirely different if a wound of one of the large arteries occurs, such as those of the neck or arm pit, upper arm or thigh. Here you are dealing with vessels as large as an index finger, and death does follow with very great rapidity when they are injured. These are the cases which I would dign ify with the nam e of “ d anger ous haem orrh age,” and it is these which demand instant attention if you are to save life. I am not go in g to tell you how to deal with these cases, you have learned all that years ago, but I am go in g to remind you of one or two points. A really b ig arterial haem orrhage is a thin g to daunt the heart of the bravest man. It requires more nerve, cold courage and self control to deal with than any condition 1 know. I have seen even h igh ly trained surgeons, men with names of world repute, who will tackle any m ajor operation,

RID visiblyshaken when a sudden terrific haem orrhage occurs un expectedly in the course of a b ig operation. T o feel yourself struggling-to stop the flow, failing and trying and failing again, know ing that the victim ’s life lies literally in your hands, demands the utmost of any man. T h e nervous strain of those few minutes is tremendous, and when the crisis is over you will find yourself bathed in sweat and as-exhausted as after a hard day’s work. C lin g to one thing. T here is no haem orrhage however severe that— if you can get your finger on to the actual bleed in g point— cannot be completely controlled by the pressure of that finger. Rem em ber that does not hold good when you are deal ing with a wound so sm all that your finger cannot reach the injured vessel itself, but when you can, as for instance in a cut throat, or a wide laceration of the upper arm or thigh, or an amputation, put your finger into the wound itself, press upon or pinch the vessel and stay there until help arrives. Then you can consider whether you can control it permanently by any of the recognised methods, tight pad and bandage, flexure— or tourniquet. One word about the latter, First Aid Parties are apt to regard a tourniquet as their most essential article of equip ment. It has been said, however, and probably truly, that in every hundred cases in which it has been applied, in 99 of these cases its application was either unnecessary or faulty. U se it by all means on stumps of limbs, and elsewhere when it is essential, but realise that its application is much less frequently necessary than you im agine. If you do apply it, remember to see that it is properly applied, that the case is never left, that it is released for a few seconds every twenty minutes, and that the forehead is marked with d “ T , ” and, if possible, with the time of application. A

s p h y x ia

A brief word upon asphyxia, the scond class of case in which life is in immediate danger. Here again I am not go in g to discuss artificial respiration or any of the obvious causes of asphyxia, and I will content m yself by rem inding you of two causes which are apt to be overlooked. First, the unconscious victim who is lying on his back, and in whom the fallin g b ack of his tongue has caused respiratory obstruction. Turn his head on one side, get a bystander to pull for ward the tongue while you give him a few movements of artificial respiration, and, if you have got there soon enough, you will be rewarded by that first shuddering snoring breath which m arks another life to your credit. > Second, the casualty with extensive wounds of mouth or jaw or face is temporarily asphyxiated— drowned if you like — in his own blood. Turn him on his face and try Schafer’s method, you may be rewarded by a bubbling gasp and the life that lay in your hands. ( To be continued.)

Stan m o re

F i r s t A id A s s o c i a t i o n .

Ax a m eeting of the Stanm ore First Aid Association, held in St. L aw rence H all, W hitchurch-lane, E dgw are, on October 12 th, members were privileged to hear a talk by D r. H. C. K illin gb a ck on the subject of “ T he Modern Surgical ' Treatm ent of W ounds.” H e traced the slow development of su rgery through the narrow and dark channels of super stition and com placency, from the first recorded operation under an ana:sthetic to this broader and brighter scientific a g e when surgery has an opportunity, never before afforded to this science, of savin g life and alleviatin g pain and suffering. H e told first aiders how they could be of ser vice to the surgeon by com pletely im m obilising a wounded part and by not “ applying an antiseptic all over the w ound.” A heresy based on sound and logical facts. Am bulance Officer K . Stallard, who attended, thanked D r. K illin gb ack for an interesting evening.

FIRST

St.

Joh n

A m b u la n c e

HEADQUARTERS

AND

B r ig a d e

D ISTR ICT

REPORTS.

N o . HI District. B

r ie r l e y

il l

.—

T h e first competition to be held since

RID

5 1

After the inspection, a dem onstration of first aid and stretcher w ork was given by the cadets and members of the Division, which was favourably commented upon by Supt. Ralph. . O ther officers present were Mr. and Mrs. W . C u n n in g ham, vice-presidents, Dr. R. M arshall, County Surgeon, and Dr. L. D. W oods, D ivisional Surgeon. Am bulance Officer Evan R. G. Cain was in fh a rg e of the parade.

1939 between the North W orcestershire and the Dudley and D istrict Corps of the S .J .A .B ., was held on Saturday, October 24 th. T he trophy at stake was the handsome cup given in 1939 by Am bulance Officer (now Corps Supt.) T . C. Lench for annual competition between the respective winners of the North W orcestershire and the D udley and D istrict Corps competitions. Among- the large crowd of spectators was Assistant Commissioner P. H. Schofield, S. B. T h e two com peting teams were H alesow en (North W orcestershire Corps) and Brierley Hill (D udley and D istrict Corps). T h e ju d ges were County Surgeon Dr. G. C. Cam p bell for the team test and Div. Surgeon J. Ribchester for the individual practical tests. Th e team test consisted of the treatment of two patients, one of whom was h a n g in g head downwards on a ladder and suffering from a fractured spine and sprained ankles, whilst the other patient was asphyxiated and had severe bleeding from the palm of the right hand and splashes of sulphuric acid on his face. At the conclusion of the competition, tea was provided to those present by Mr. Lench after which, the result was made known. County Surgeon Dr. Campbell said that he was very pleased to have been asked to ju d ge the competition. It also gave him pleasure to see such a large number of spectators. This certainly showed that it was the righ t decision to recommence competitions which had been allowed to lapse for the past two years. Corps Supt. T . C. Lench then announced the result of the competition as follows : Brierley H ill, team test, 100 £ marks, individual practical, 179 m arks m akin g a total of 279 |. Halesowen, team test, 61 ^ m arks, individual practical, 162 m arks m akin g a total of 223£. Mr. Lench then presented the cup to the captain of the w inning team, Div. Supt. Northwood, w hilst to each mem ber of the team he gave W ar Savings Stam ps instead of medals which are usually given. H e congratulated the winners on their performance in a very difficult test. N o . IV District No. 1 D o u g l a s ( I s l e o f M a n ) . — T h e first annual in spection of the No. 1 D ouglas Am bulance Division w as held on Monday evening, October 26 th, at Allan Street Hall, D ouglas. T h e County Commissioner Major J. W . Y o u n g , O .B .E ., accompanied by Supt. Ralph, M .C ., the Com m andant Peveril Cam p, Peel, who is a member of the Order, inspected the Division. Tw enty-five members and eight cadets were present. D ivisional Supt. C. A. Kidd reported on the w ork done d uring the year and gave the exam ination results as follows : M edallions.— A. E. Beadle, J. C. Caine, D. Caw te, R. M. Clucas, G. E. Devereau, D. S. Hosie, P. E. Hum phreys, A. E. M organ, A. C. Q u igg in , H. Q u igg in , R. E. Sayle, S. D. W atterson. L ab els.— E. R. G. Cain, R. J. Gill, H. D. K eating, W . J. K elly, D. K. Kneale, C. A. Kidd, R. L . M anning, J. J. Thompson. T he follow ing eight cadets were enrolled and presented with a Cadet badge : A. Bridson, J. R. Cain, B. Crellin, G. H all, D. K eating, R. Kneale, T . Robinson, A. Ventro,

N o . IX District M

il l b a y

a il w a y

iv is io n

.— O n

Saturday, October

24 th, a presentation w as made to Div. Supt. J. A. Ilott, who has resigned from B rigade Active List to Reserve List after

47 years of service. T h e Civic Authorities were represented at the gath erin g by Lord Astor, Lord M ayor ; Mr. W . T . H utchin gs, Chief Constable ; Mr. E. B eckly, Chairm an of Plym outh and D is trict Am bulance Service. T h e G .W .R . representatives included Mr. H all, Locom otive Supt., Newton Abbot ; Mr. Nodder, Div. Engineers’ D ept., North Road ; Mr. H. J. Green, Class Sec., North Road Am bulance Class and Class members. T h e S .J .A .B . were also represented by Mr. H. V . Miller, County Com m issioner ; Mrs. R. Balsdon, Lady County Supt. ; Mrs. V ellacot and Mrs. Modley, vicePresidents ; and Corps Officers, Supts. and members of both male and N ursing Divisions, and Supts. and members of Boy and Girl Cadets. T h e follow ing gifts were presented to Mr. and Mrs. Ilott: Electric table lam p and purse, from Officers and mem bers of male Divisions, S .J .A .B . ; an A rgent pewter biscuit barrel from Officers and members of N ursing Divisions, S .J .A .B . ; a com pact shaving outfit from the members of the R ailw ay Am bulance Class. Mr. Ilott, who is a retired inspector, was employed on the G. W . R. in the Car and W agon Dept. H e w as stationed for m any years at M illbay Station, Plym outh, and durin g the course of his employment went to Swindon and Gloucester. H is numerous aw ards from the railw ay include gold medals and bars, and scores of prizes for R a ilw ay Am bulance Competitions. T he S .J .A .B . movement was founded in the C ity of Plym outh by Mr. Ilott, in the year 1895 , and in 1896 he was appointed Divisional Supt., M illbay Division. H e was made Honorary Serving Brother in 1915 , Officer Brother in the Order in 1940 , and was presented w ith the K in g G eorge Coronation Medal in 1937 . Lord Astor and the Chief Constable and other speakers all paid great tribute to Mr. Ilott for his devotion to duty, not only to the railw ay and to the town, but for w hat it meant to the com m unity in general, and all present heartily endorsed the Chairm an, Lord A stor’s, wish that Mr. and M rs. Ilott will live to enjoy their rest and peace, after lon g years of service in the Am bulance movement. N o . X District C h e l m s f o r d . — T h e Chelm sford, W rittle and Crompton Parkinson Divisions of the S .J .A .B ., under the command of Supt. Barber, Amb. Officer Sills, and Amb. Officer Vow les, respectively, together with Chelm sford Cadet D ivision, under C.-Su pt. Aldous, held their annual inspection on Oct. 17 th, at the Crompton Parkinson sbcial centre. D r. J. T . W hitley, the actin g county com missioner, w as the inspecting officer, and he w as accom panied by B rig.-G en. J. T . W iga n , president of the Chelm sford D ivision ; the Mayor, Councillor Sidney C. T aylor ; M ajor H . S. D oe, A .R .P . sub-controller; County Officer W . E. N orfolk and Corps Officer J. Sm ith, of the B rigade. L ad y Supt. Chaplin and L ad y Am b. Officer H uckle, of the Chelm sford N ursing Division, w ere also present,.

T h e M ayor handed a president’s badge to Brig.-G en. W igan , on behalf of the Chelm sford Division, and a vicepresident’s badge w as presented to Mr. T . H. W indibank, on behalf of the Crompton Parkinson Division. Mr. W indibank also accepted a president’s badge for Lieut.-Col. Hardie, of the Crompton Parkinson Division, who was unable to be present. This w as followed by the presentation of long ser vice ribbons to the follow ing members of the B rigade : County Officer N orfolk, Corps Officer J. E. Sm ith, Supt. E. Barber, Amb. Officer W . R. U nw in, C .-Supt. A. Aldous, Corpls. W . J. Keable and A. R. P. Ellis. Each have 15 years’ service. T ests were then set by D r. W hitley w hich included b an d aging, stretcher drill and am bulance loading. Speeches by the Mayor, Gen. W iga n and Major Doe included thanks for the help given to the town and county by members of the D ivisions during peace and war, and words of praise for the sm art turn-out. D r. W hitley, in presenting a w arrant to Mr. Jas. S. Sm ith as corps officer, said this w as a well-deserved promo tion, as no one had done more for the St. John Ambulance B rigad e in Essex.

T h e

V en .

Its

O rd er

H is to r y

o f

and

S t.

John :

A c tiv itie s .

A n address given on September 'joth at Gas Industry House, S. W .l, to Lady Officers oj the B ritish R ed Cross Society B y N. C O R B E T F L E T C H E R , M .A ., M .B ., M .R .C .S ., Surgeon-in-Chief, St. John Am bulance Brigade. ( Concluded Jrom page 43. R

is e

and

rogress

th e

r ig a d e

Experience a ga in proved that, for the practice of am bu lance w ork in tim es of peace as of war, individual excellence w as not sufficient and that individuals must learn the value of co-operation and combination. Further, the certificated pupils of the Association ardently desired to place their know ledge and skill at the disposal of the public and thereby to m aintain their know ledge and skill. It thus happened that Corps began to be formed, the first being established in January, 1879 , at M argate and the second in April of the same year in Ashford. W ith the former Corps, W . J. Church Brasier w as the leading spirit and qualified to take the pre-eminent position which he after w ards attained in the progress and development of the Brigade. Sixteen years later differences occurred within the M argate Corps which seceded from the Brigade and so the Ashford Corps becam e the senior unit. O ther Corps followed up and down the country, the Invalid Transport Corps (the first in London) being formed in 1882 at St. John’s Gate, which title it afterw ards assumed; and it is still an active unit of the B rigade. T he first N urs ing Corps (or, as it w as then called, Guild) was established in 1885 at Oldham , Lancashire, for the benefit of a m ining district and set an exam ple which w as generally followed at home and abroad. Incidentally, women never obtained in the B rigade the ascendency which they did in the Association in its early days. T h u s it w as that in 1887 these various Corps of the Association were am algam ated as the St. John Am bulance B rigade and recognised by the O rder of St. John as a civilian organisation for dealing with civilian em ergencies wherein it differed from the Association of which it w as an offshoot. T h e pioneers who brought this about were John Furley, Sir Edm und Lechm ere and Church Brasier, their medical colleagues being D r. (later Sir W illiam ) M cCorm ac and Dr. Sam uel Osborn. T h e B rigade is composed of surgeons and certificated lay

persons ; it is a uniformed and disciplined body ; and its objects are (1) the provision of continuous practice in first aid and nursing, with an end to the public good, (2) the render in g of first aid on all public occasions by a body of men and women trained for that purpose ; and (3 ) the maintenance of reserves available to the State in any em ergency. Lord M ayor’s D ay 1886 witnessed the commencement of public duty in the streets of London and later on the occasions of public processions there and in other big cities, and also at National and International Exhibitions. From these begin nings the idea developed ; and the performance of public duties became the raison d'etre oi the Brigade, the services of members being requisitioned for all functions and gatherings where crowds collect and accidents happen. In London street duty has alw ays been the pre-eminent form of public duty, whereas outside London and other large cities, public duty has centred round the am bulances which, as the years passed, were placed in commission in an ever increasing number of towns and urban districts. In 1894 the personnel had increased to such an extent that the old division into Metropolitan and Provincial Corps became obsolete ; and the Brigade was divided into 5 D is tricts on a grouped County basis, the number of the Districts being subsequently increased to 12 as the numbers still increased. Still later a further sub-division was found necessary ; and the D istricts were gradually broken up into their constituent Counties for administrative purposes. By 1897 competitions had assumed an important place in the combined training of members ; and National Com petitions tor the R ailw ays and the B rigade were this year form ally instituted by the Order. T h e outbreak in 1899 , of the South African W ar, estab lished the Brigade as a national institution because the W ar Office at once appealed to it for hospital orderlies. The response was immediate ; and 2,046 (out of some 6,000 male) members served honourably and efficiently during this war. Consequent on the high reputation which these men estab lished and at the request of the W ar Office and Adm iralty, the Brigade in 1901 initiated its Bearer Companies as reserves for the Arm y and its Naval S ick Berth Reserves two years later. Royal recognition cam e to the Brigade in 1909 when No. 1 D istrict was granted the honour of being designated “ Prince of W ales’s C o r p s ” (with the privilege of w earing the plume of feathers as collar badge) by H .R .H . G eorge Prince of W ales— “ as an appreciation of the valuable services rendered by the B rigade generally and especially by No. 1 D istrict.” In 1909 also V oluntary Aid D etachm ents for Men and W omen were inaugurated as part of the Territorial Scheme for action in the event of invasion of the home territory ; and the Order of St. John took its full share in the formation of these units. T hus did the B rigade progress, increasing in numbers and usefulness, and when in 1914 the European W ar started 600 men were at their allotted posts in 24 hours, 6,000 within two months, and before the w ar ended 20,615 (out of a male membership of 43 , 752 ) had served. In 1915 the Brigade Hospital w as opened at Etaples in France ; and before hos tilities ceased 220 St. John Auxiliary Hospitals had been established in E ngland and W ales for the accom modation of 12,500 sick and wounded soldiers. T h e w ar ended, the B rigade resumed its normal activi ties, and in 1922 it opened its ranks to Boy and Girl Cadets, who serve as recruits to the Am bulance and N ursing D ivi sions. In the same year the Reserves for the Arm y and N avy were established, and alw ays had w aiting lists of those who were anxious to serve. T h e new Voluntary Aid scheme of 1923 w as adopted with enthusiasm by the B rigade, and a full quota of Detachm ents was in operation at the outbreak of the Second European W ar in 1939 . Finally, the Brigade in 1935 commenced instruction in the schem e for the protection of civilians from the effects of gas in the event of hostile raids. Consequently when war

FIRST

RID

O U N

D S ,

H E A L

WILL

B U

R N

R A P I D L Y

NOT IF

and

TURN

TREATED

etc.

S ,

SEPTIC

WITH

A I M T I P E O L CUTANEOUS

VACCINE

O I N T M

E N T

one or other or all of the three races of therms, Streptococci, Staphvlococci and B. pyocyaneus are found in every skin infection common to this country, and ANT I P E O L O IN T M E N T contains the """—— an/ibuiiies (antivirus) of these germ s. H ealin g is expedited by the proved ingredients of the ointment, and septic development is stopped or prevented by its antivirus sterile vaccine filtrates. A N T I P E O L O I N T M E N T is unsurpassed for B U R N S and S C A L D S , for it is microbicide and non-adhesive, and dressings do not require to be changed every day.

E C

I N

I P

affords rapid relief of C O M M O N C O L D S , IN F L U E N Z A , A N D C A T A R R H . C ontaining the antibodies of the germ s common to infections of the nose and phar}nx (Staphylococci, Streptococci, B. pyocyaneus, pneumococci, pneumobacilli, enterococci, M. catarrhalis, B. Pfeiffer), Rhino-Antipeol is not just a palliative, "but is a rem over of the cause of the infection. D uring epidemics it is the ideal preventive of microbe development.

I P

is a semi-fluid ointment, more convenient than the ordinary Antipeol ointment for ocular infections and lesions. Eyes affected by sm oke and dust are soothed alm ost im m ediately by the application of Ophlhalm o-Am ipeol, and the antivirus prevents germ s from developing. C lin ica l Sam ples on request fro m M E D I : O . B I O L O G l C A L L A B O R A T O R IE S L T D . , C a rgre e n Road, S outh N o rw o o d , Lon d o n , S.E.2S

w as declared in September, 1939 , it provided the nucleus of the Civil Defence O rganisation at home and overseas from its membership, which to-day totals 150,000 in E ngland, W ales and Ireland, and 50,000 in the British Dominions and Colonies, and which is rem arkable in that no one is paid one penny piece for his (or her) services. Indeed, all are out of pocket 1 O

p h t h a l m ic

o s p it a l

er usalem

. J

oh n

l in ic

I L

C O . ,

H um an O ste o lo g y, A n a to m y, E tc., 18, F IT Z R O Y STREET, F IT Z R O Y S Q U A R E , L O N D O N , W .l T e le p h o n e : M USEUM 2703 .

In 1883 the Order in E ngland opened in Jerusalem an ophthalmic hospital. T his is its special link with the Holy City, and it has attained a worldwide reputation in the treat ment of diseases of the eye which are ram pant in the East. It is m anaged by the Hospitaller and a Com m ittee appointed by the Grand Prior, and in addition to an extensive out patient' departm ent it has accom m odation for fifty in patients. If is staffed by British Surgeons (2 ) and nurses ( 3 ), with a full complement of Palestinian assistant surgeons and nurses. S

Finally, in 1929 the O rder in E ngland took over the St. John Clinic and Institute of Physical Medicine in Ranelagh Road, S. W ., by an arrangem ent made shortly before his death by Louis Cam pbell Johnston, who founded it and partly endowed it. T h e clinic possesses the most up-to-date equipment for dealing with the various forms of ligh t and electric therapy and, seeking to lessen suffering by prevention rather than cure, it does the sam e sort of splendid w ork in V ictoria as the B .R .C .S . Clinic in R egen t’s Park. Publishers N ote.— W ill readers please n ote th a t all back num bers o f “ First Aid ” are now out of print and cannot be supplied. W ill South African and oth er C olonial readers please add to th eir rem ittances, “ o r English eq u ivalen t.”

N E W

JU ST

IS S U E D

M A D E UNDER THE SUPERVISION O F PRO FESSO R C . F . V. SMOUT, B IR M IN G H A M U N IVERSITY. FIR ST

A ID

F R A C T U R E and

D IS L O C A T IO N

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Sizes 28"x40" and 20" x 15" On

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FIRST

RID L O N D O N , M ID L A N D & SCOTTISH

R a ilw a y GREAT

A m b u la n c e

N e w s.

W ESTERN

T h e report of the Chief Medical Officer of the Company on cases of exceptional first aid rendered by members of the staff during 1941 has now been received, and the follotving aw ards have been granted :— Gold Medal: Mr. C. J. H ew lett, Pontypool Road. Silver Medal : Mr. J. A. Neale, Penzance. Bronze M edals: Messrs. S. P. D avy and J. Selfe, Newport D ocks ; Mr. P. J. Vines, Chippenham. Certificates : Messrs. P. J. W alsh and D. G. Thom as (Newport Docks), E. W . Beaucham p (Cogan), S. H. Jenkins (Trow bridge), A. J. Rosew arne (Taunton), A. H. Minett (Abercynon), C. E. Jones (Newport High-street), F. J. Bishop (W estbury, W ilts.).

N e w p o r t ( M o n . ) . — Mr. M. C. Harrison, D iv. D ocks Engineer, presided at a supper and social evening arranged by the Newport Alexandra D ocks Am bulance Class. He stated that the class now has ISO members and by its greatly increased membership had largely contributed to the success of the South W ales D ock Division in w inning the “ Athlone ” Bowl for two successive years. Th e M ayor of Newport (Councillor W . G. Rudd, J .P .) was the principal gu est, and presented long service medals to various members. T h e class aw ards were distributed by Mr. J. Edmonds, J .P ., and Mrs. Edwards. Mr. T. J. Raines (Class Secretary) made a presentation to Dr. G arrow ay Smith, the lecturer, w ho was accompanied by Mrs. Smith.

LO N D O N & N O R TH EASTERN T he annual m eeting of the am bulance class of this Centre w as held early in October. T h e balance sheet was considered very favourable. Items from the Secretary’s annual report were : D uring the year over 400 cases of accident and sudden illness had been attended by members. T h e number of members serv in g w ith the Forces was 6 ; 21 were doing part-time Civil Defence in the Casualty Service, and S in the Am bulance section of the Hom e Guard. A t the annual re-examination of the class SO of the Com pany’s servants passed and 3 failed. Four members qualified for the C o .’s Gold medal ; one qualified for the 20 vear bar and one for the 25 year bar. _ All the hon. surgeons and officers were re-elected. M

ar ch

.—

A very interesting and successful First Aid competition for the “ Childs ” Cup and prizes was brought to a close on October 10 th. Th e semi-final and final was judged by Capt. W . Goodley, O .B .E ., M .C ., Com m issioner No. 1 (Prince of W ales’s) D istrict, and Staff Officer T . E. W alsby. Results were :— Sem i-final— March Nurses, 281 v. March Report Centre, 3 2 1 ; Up well Nurses No. 2 , 149 v. March L N .E .R . “ B ” , 246 . P in al— March Report Centre, 280 v. March L .N .E .R . “ B 236 . T h e chair was taken by H . H. Trum an, Esq., sup ported by Aid. L. Childs, the donor of the cup. T h e cup and prizes (glass honey jars with plated fittings) were presented by Mrs. Trum an. T h e Secretary, Mr. S. W . Atkinson, proposed a vote of thanks to the judges, the U pw ell Division for entering the six team s and so m akin g the competition a success, and asked all concerned with the organisation of the com peti tion to accept his thanks as they were too numerous to /jueriiion personally.

D e r b y . — T h e presentation of aw ards to members of the Derby R ailw ay Offices Am bulance Class for the 1942 exam, w as made by Lt.-Colonel H . R ud gard (D iv. Supt. of Operation) supported by Lt.-Colonel J. W. W atkins, at a well attended m eeting in the Derby R ailw ay Institute on October 8th.

Mr. J. Harris (Div. W elfare Supervisor) presided. The aw ards were as follows :— IS year long service medal, 1 ; 1st year certificates, 12 ; 2 nd year vouchers, 7 ; 3rd year medallions, 7 ; medallion labels, 17 . As a m ark of appreciation of the Class, gifts were pre sented to Dr. C. Penny, and Instructors T. Burnham and G. Dale. T h e Secretary of the Class is Mr. W . Hatch, and he announced .a further series ot lectures would commence on October 14th, and hoped m any new members would enrol.

L.P.T.B. ( M E T .

L IN E S .)

The presentation of the exam ination and other awards gained during the year ended Sept. 30 th last, took place in the D inin g Club of the General Offices, B aker Street Station, on Saturday afternoon, October 24 th. A good number of members and their friends attended. Mr. A. J. W ebb, Chairm an of the Centre, first expressed his regrets that the President, Mr. Evan Evans, could not be present ow ing to a chill, and then after a few opening words called upon Viscountess Robinia M ountgarret, O .B .E ., Lady County vice-President for the W est R iding of Yorkshire, who gave a very interesting address on the foundation and w ork ings of our Ophthalm ic Hospital at Jerusalem. She also told of the Ladies Linen Guild of the Order, of which she was Chairwom an. Colonel A. W . M. Mawby, vice-Chairm an of the Centre, expressed thanks to Viscountess M ountgarret on her most interesting address. T h e Chairm an then called upon the Secretary, 'M r. Gravestock to render his report. This-show ed an improve ment over the previous year. There were 330 aw ards in all, i.e., 232 first aid, 30 home nursing, 30 A .R .P . certificates, certificates for the furtherance of first aid to Mr. W . Skelton and Mr. Edginton, S certificates for the best first aid rendered d uring the year ending Sept. 30 th, 1941 , from over 2,000 reports received, 4 long service aw ards for IS years’ service, 3 for 20 years’ and 2 for 30 years’. Also the “ H ally ” Tablet medals gained by Mr. W m . Tulett, first year ; Mr. John Thurlw ell, second year, and Miss E. Bristor, third year. T h e Secretary thanked the officers of the Centre, lpcturers, class secretaries and all the members for m akin g the year such a success. Mr. V . A. M. Robertson, chief engineer, then presented the awards, giv in g a very personal touch in his remarks to each recipient. He expressed pleasure in being called upon to carry out this duty. H e was thanked by the Chairman for the interest shown in the w ork of the Centre. Silence was observed for absent members of the Centre, those reported m issing, prisoners of w ar and those who have died, namely, Mr. W m . Death and Mr. Charles Bowell. D u rin g tea which followed, the Chairm an announced that a collection on behalf of the Linen Guild of the Hospitals would be taken. T his with a further contribution amounted to £ 5 Ss. Am ong others present were Mrs. V . A. M. Robertson, Mrs. A. J. W ebb, Mr. and Mrs. Ernest Evans, Lady District Officer Mrs. Tapply, Assistant Com m issioner Captain Russel Steel, Doctor Basil Steel, Doctor Ehrm ann, D istrict Officer M cBride, Captain C laridge, C/Superintendent Kersley a Divisional Superintendent Garrad.

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Describes in SIMPLE L A N G U A G E such necessary i nf orma tion wi th helpful plates and diagrams.

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A fe w o f the S u b je c ts tre a ted s

WAR EMERGENCIES:— Gas Wa r f ar e First Ai d Bandages Splints^; Burns Scalds Haemorrhage Fainting

PEACE T I M E S U B J E C T S : — i nfluenza,Colds,etc. Measles, Mumps Catarrh Corns and W a r t s Physical Cul t ure W h a t t o D o in Emergencies T r e a t m e n t for all Skin Diseases T h e Lungs, Pleurisy Hygi ene, A n a t o m y , Pharmacy T h e Principles of Nursing T h e Eye, t he Ear T h e Throat , t he Nose T h e Chest, t he Heart T h e St omac h, t he Liver' T h e Te et h, t he Muscles Infant We l f ar e Homoepathy, Neurasthenia 375 Prescriptions, etc., etc.

W hat

case

o f:

B odily Injury, B u rns a n d S calds, C lo th in g A ligh t. F o r e i g n B o d ie s in Eyes, Ears, N o s e, T h r o a t . M a c h in e ry Accidents, Electricity Accidents. D ro w n in g, Suffocation, Bleeding, Poison, B ro k e n Bones, Fractu re s, Dislocations, S prains, F a in tin g , C oncussion, Etc. THE YO U N G W IFE will find just the information she requires. MOTHERS who wish their daughters to develop naturally w ill find exactly the teaching they need. W O M EN O V E R 40 will frankly discussed.

find

their

difficulties

regard in g

health

BEAU TY CULTURE— Complexion D iets, W rinkle Cures, Care of the H ands, Mouth, Eyes, H air, Recipes, etc. P R E SC R IP T IO N S — 375 proved remedies. T here are hundreds of subjects. T he m uscles, teeth, digestion, hair, food values, Ju jitsu, Phrenology. H ow to diagnose diseases from appearance of head, face, neck, tongue, throat, chest, perspiration, etc.

j----------------- F R E E — ------------1 j

MESSRS. VIRTUE & C O ., LT D ., F .A . D ept., C ro w n C h am b ers- U pper P a rlia m e n t Street, N ottin gh am , I P le a s e sen d m e FREE B ooklet on “ THE HOUSEHOLD | P H Y S IC IA N ,” sta tin g c a s h p rice , a ls o m o n th ly te rm s o f I p a y m en t w ithout a n y o b ligation to p u rch ase. N A M E .......................................................................................................... (Send this form in unsealed envelope stam ped Id.) I

A D D R E S S .....................................................

FIRST

O u r C O M P IL E D

N u rse s’

RID V otes of thanks to the senior officers present were pro posed by cadets, and the little ceremony was concluded by three hearty cheers for the visitors. Then cam e the turn of the senior Division. Members received home nursing certificates from Lady Bradney, after which Lady Tw iston Davies presented certificates of appoint ment to Lady Div. Supt. Mrs. Webb, Lady Am bulance Officer Mrs. Patrick, and Lady Corps Supt. Mrs. T . O. Davies. Capt. Beard said there were 3,400 members of the B rigade in Monmouthshire. When war broke out practically the whole of the casualty service in the county was done by members of the Brigade, who acquitted themselves well. H e wanted to see more members and hoped that soon every one would possess a know ledge of first aid. Ollicers present congratulated Lady Corps Supt. Mrs. T . O. Davies on becom ing the next Mayoress, and wished her a happy and successful year of office. In reply, Mrs. D avies said that though civic matters would take up a con siderable amount of her time, she would not forget her duties as Lady Corps Supt. T he proceedings closed with Corps Supt. M organ con gra tu latin g the N ursing Division on its sm art appearance and excellent work, and Lady Supt. Miss Richards thanking the Monmouth Division for inviting the Llanishen N ursing Division to the function.

Page.

B Y AN A M B U L A N C E S IS T E R .

N o. 1 ( P r i n c e o f W a l e s ’s) D i s t r i c t . H a m p s t e a d S .J .A .B . C a d e t s . — On Saturday, October 24 th, Miss Cleasby (D istrict Officer in C harge Northern Area) officiated at the Enrolm ent ceremony of the Cadets attached to the No. 16 (Ham pstead) N ursing Division). There were present D istrict Officer Mrs. Rayner (formerly Div. Supt. of the Ham pstead Division), Officer in C h arge Miss Finch, County Surgeon Dr. Farm an, Div. Surgeon D r. Mary Fletcher, Miss G regory (former Matron of Ham pstead General Hospital), all the OiLcers of the parent body as well as Officers from other London Divisions, and S/L W. G. Langston, of National Fire Service, H am p stead Area. After the Enrolm ent ceremony the Cadets, whose ages ran ge from 11 to 17 years, demonstrated, under the instruc tions of Amb. Officer Miss Burley and Amb. Sister Miss Paul, drill, stretcher drill, hand seats, fire fighting, first aid, home nursing and dancing. Miss Cleasby said she w as satisfied that the girls had made good progress during the short time the No. 54 Cadet D ivision had been formed, and expressed the hope that still further progress would be made by their keenness and loyalty to the B rigade and by their adherence to its Code of Chivalry. Mrs. Rayner and others also expressed their apprecia tion of the afternoon’s demonstration. Flowers were presented to Miss Cleasby by one of the Cadets, and were much appreciated.

S ilu ria n

C orps,

P ublic N u r s in g .

When the Birm ingham and Three Counties Branch of the Royal C ollege of N ursing resumed its conference in Birm ingham on October 23 rd, Dr. W yndham Parker, M O. H. for W orcestershire, lectured on the Future ot Public Health Nursing. He referred to prejudices against nursing as a vocation, and said there were parents who thought it drudgery, and school mistresses who regarded it from the standpoint of re actions of certain former scholars who had tried the work. Some people spoke ot brutal and harsh matrons and sisters. H e did not agree with this. H e hoped matrons and sisters would do all they could to overcome the prejudice, so that recruits of the right type m ight be attracted to the profession. Dr. Parker said that payments and pensions must be adequate. T h e proper training of the nurse w as by appren ticeship, and he disagreed with the view that there should be any reduction in the three year period of training. He made a strong plea for the recognition of the assistant nurse, who was an essential factor in sm all voluntary hospitals and public assistance institutions.

No. 10 D i s t r i c t , S .J .A .B . I p s w i c h — On O ct. 28 th the enrolment of 12 girls took place in the V ictory H all. Bramford, Lady County Cadet Officer Miss N. R. Botwood being the enroling officer. T h e official ceremony was followed by an instructive talk on “ T h e H istory of the Order ” by Lady County Officer Miss Baldwin, after which the V icar (Rev. C. A. E. Harford) presented prelim inary first aid certificates to the cadets, who had received their instruction from A/S Mrs. Gooderham and A/S Mrs. Peck, the latter being the prospective C .O . A demonstration of first aid was then given by the girls for the benefit of their relatives and friends who were present together with members of the Ipswich Corps.

P rio ry f o r W a le s,

uture

S .J .A .B . M onm outh

N u rsin g

D ivision . — •

Reviews.

Thursday, Oct. 29 th, w as presentation day to the Monmouth N ursin g Division. First cam e the cadets w ho were entertained to tea and then received junior first aid certificates from Lady Tw iston D avies, L ad y County Supt. The Commissioner, Capt. S. T . Beard, O .B .E ., con gratulated the girls on ga in in g their first certificates, and said they were to receive a unique reward. T h e Junior Red Cross of Am erica had sent gifts to various children in England and W ales, and these had been divided between the juniors of the B .R .C .S . and S .J .A .B . T hey had received their share in Monmouthshire. . H e mentioned that some of the g ift boxes contained nam es of schools from which they had been sent, also a letter from one of the children w ishing them success and prosperity. He hoped those cadets who received such letters would ackn ow led ge them and extend good tidings to those Am erican children. These gifts were presented to the cadets by Lady Bradney, a former Lady County Officer.

A id s to Anatomy and Physiology. By K atherine F. Arm strong, S. R. N ., S. C. M. L on d on : Baillierie, Tindall & Cox. Price 4s. net. T his excellent little book has now reached its third edition within two years of its first publication. Clearly it continues to serve the interests of trained nurses for whose benefit it was originally compiled, and also of the extensive lay personnel who in these critical days do part or whole time duty in hospitals. It is very concise and very readable ; and it covers the subjects in a sound and skillul manner. In this new edition suggestions for practical w ork are given at the end of each chapter, and we commend the book to those of our readers who seek a wider know ledge of anatom y and physiology than is required for first aid purposes.

;

FIRST

RID

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de e a r n

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I_TOME study is the short cut to experience and success x and an expert knowledge in Swedish Massage and Anatomy can lead to a congenial occupation and a hand some income. Have you realized the scope and prospects for the trained Masseur ?— he is called in every day hy doctors, Nursing Homes, Hydros, Sports and Athletic Clubs, Physical Culturists and Trainers, e tc , and is of inestimable value to First Aid organizations which is why graduates o f the SMAE Institute are in practice in all parts of the British Empire. TH E

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The SMAE Institute Is the oldest of Its kino In Great B rlt-ln , having been established for over 20 years. Manv of the most successful m ’ sseurs In the country h’ ve been trained by the SMAE Institute and represent the highest paid operators In the realm of massage. SPARE

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You can make Massage a spare time or whole time occupation and remember that with the SMAE Institute you have nothing to lose'as It guarantees to coach you until successful at the examination and your Diplorn- secured, or return your fees in full. W R IT E

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The Book will tell you how you can commence your training in Swedish Massage in your own home without interfering with your pre sent occupation, and how you can start a private practice of your own W rite to the Secretary-50, SMAE Institute, Leatherhead Surrey, •li't* FREE B O O K ‘ Manipulative Therapy as a Profession,” which will be sent free and post free and which Involves you In no obligation whatsoever. *

IN ST IT U T E

LEATHERHEAD,

SURREY.

FIRST

Next, please ! !— N .C .F . V ariatio n s in P u lse. A .E . (R hondda).— W ould you be kind enough to inform me as to how the first aider is able to differentiate the different kinds of pulse in the various conditions ? In S hock we have it “ rapid and fee b le” ; in Concussion “ quick and w e a k ” ; in Compression “ slow and fu ll.” H ow would the first aider be able to distinguish between a feeble pulse and w eak pulse ? A gain, w hat is a “ rapid ” pulse and a “ quick ” pulse ? These questions cropped up recently at Divisional Practice and entailed a few argum ents, the result of which left us wondering. So we decided to forward the query to you for your decision. * T h e use of the adjectives “ ra p id ” and “ fe e b le ” indicates an attem pt to differentiate the degree of alteration of the pulse. If you think of “ rapid as “ very quick ” and of “ feeble ” as “ very w e a k ,” your difficulty w ill be solved. Further, it is only by experience that w e can detect differences in the strength, regu larity and rate of the pulse, these being the three main points on which we concentrate in our exam ination.— -N.C. F. Io d in e P oison ing. A .E . (Rhondda). — In Iodine Poisoning the Textbook tells us that the vomit m ay be yellow or blue. Please tell me w hat m akes the vom it yellow. T h e colour of the vom it in Iodine Poisoning depends on the quantity of starch actually present in the stomach. If there is little or none, the vomit w ill be yellow, but if it is definitely present, it w ill be blue.— N .C .F .

RID P hosphorus P oisoning. A .E . (Rhondda).— In the treatment of Phosphorus Poisoning the Textbook tells us to avoid oil or fat in any form. Y et in Rule 5 of the General Rules of Treatm ent of Poisoning it tells us to give m ilk in all cases of poison ing. As m ilk contains a certain percentage of fat, would it be safe to administer m ilk in Phosphorus Poisoning or should it be avoided ? I thank you for help received in these and past queries submitted by me. M ilk is largely composed of w ater with only 3 per cent, of fat. A sm all quantity, therefore, would probably not pro duce harm ful effects as would be the case with a dose of cod liver or olive oil which act as solvents and facilitate the absorption of phosphorus. Nevertheless, I think that you will be w ise if you stick to the T extbook and avoid all fats with Phosphorus Poisoning ! B y the w ay, there is no discrepancy in the instructions of the Textbook, which first sets out general rules of treat ment and then specifies any exceptions to these general rules. — N .C .F . H um our in F irst Aid. T . P. (W atford).— W e frequently lau gh with you at the howlers perpetrated by nervous candidates who have amused the exam iners. Here is a chance to level m atters up ! At a recent competition the surgeon, who was obviously of great experience in competition work, asked an astonished first aider “ What would you do upon noticing signs o f returning conscientiousness?" Un fortunately the surgeon w as not invited to give the signs and symptoms of this condition. Good !

Next, please ! !— N .C .F .

F a k in g of In ju ries. C .W . (Cam berw ell).— Further to your reply to the query, which w as published under the above title in the Sep tember issue of F i r s t A i d , your correspondent w ill find the subject fully discussed by Dr. A. C. W hite Knox in his F irst A id Competitions published by D ale, Reynolds & Co. W e thank you for your letter and inform ation.— N .C .F . P hosp horu s B om bs. W .S . (H arlesden).— W ith reference to the Circular on phos phorus bombs issued on A u gu st 1st last, by the Ministry of Home Security, I would be grateful for your guidance on the follow ing points :— ( 1) W hat would be the effect of, and the treatment for the inhalation of fumes or sm oke of burntng phosphorus ? ( 2 ) Do you agree that, with phosphorus on the skin, burns will already be present and would it be, in your opinion, advisable to use knives or scrubbing brushes in these circum stances ? (3 ) W hat would be the effect if carbon disulphide or hydrogen phosphide were present and would they.need a variation in treatm ent ? (4 ) W ould w ashing soda be effective w ithout copper sulphate or vice versa ? (5 ) W ould a general antiseptic a gg ra va te the poisoning in phosphorus burns ? (6) W hat are the possibilities of supplying copper sulphate solution for Street First Aid as distinct from Factory First Aid ? (1) I know of no effects other than asphyxia ; and the victim must be removed to hospital for full medical treatment. (2 ) Burns would not be present in every case ; but, if they are, then they must be treated a? laid down in Circular. (3 ) T h e presence of these compounds calls for no varia tion of treatment. (4 ) Either may be used but copper sulphate is not likely to be available at the scene of the em ergency,

A D A M ,

R O U I L L Y

Human Osteology, Anatomy,

Efficient and rapid treatm en t o f ' minor h o i i nils

18, F I T Z R O Y

C O . ,

etc.,

S TR E E T, F IT Z R O Y S Q U A R E , L O N D O N , W .l TE L E P H O N E :

M USEUM 2703.

FIR S T A ID PRESSURE P O IN T, S K E L E T O N , C IR C U L A TIO N CHART

Occlusive wound dressings, because they need fewer changes, allow granulations to form undisturbed. This -method, ap proved in modern surgical practice, is possible with ‘ Elastoplast’ Occlusive Dressings which also economise in materials and time. ‘ Elastoplast’ is widely used in Hospitals, etc., for the efficient and r a p i d t r e a t m e n t of mi n o r wounds.

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Sixth Edition. 44th Thousand. Revised in accordance with 39th Edition of St. John Te xt Book.

Q U ESTIO N S AND A N SW ER S, e t c . , IN HOME NURSIN G.

Made in England by T. J. SMITH & NEPHEW LTD.. Neptune St.. HULL

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FIRST

(5) General antiseptics have such a varyin g chem ical m ake up that first aiders are advised not to use them in these cases. (6) In Factory First Aid there is permanent equipment in store with solutions properly prepared and ready whereas in Street First Aid, equipment is already overloaded and the addition of new ones for special purposes and at present in little demand is not justified. In conclusion, my advice is that first aiders should stick closely to Governm ent guidance as published.— N .C .F . M o re H um our in F irst Aid. O .C . (Low estoft).— In a recent discussion on first aid a friend was asked w hat would be the cause of death if a red hot poker was thrust through a m an’s stom ach. L ike aflash he replied— “ H e would die from central h ea tin g !" G ood!

Next, please ! !— N .C .F .

C arotid A rteries. A .P . (Mansfield W oodhouse),— T o settle an argum ent please tell me how many carotid arteries there are. One of us said that a doctor had told him that there are six but the others said that there were only four. There are two main carotid arteries (right and left). These are called the common carotids. Each divides into an internal and an external branch ; and so there are six carotid arteries. — N . C. F. M u s cu la r A ction . H .D . (Bolton).— Recently we had a discussion on m uscular action in our class. One member stated that every movement of the body has two m uscular actions except the trunk movement ot touching the toes. T his, he said, is not a m uscular action but an action of the sub-con scious mind. Another member denied this, and said that it was gravity which pulled down the body. 1 claim , however, that every movement of the body has two m uscular actions and that there are no exceptions. In all voluntary movements of the trunk and limbs one set of muscles causes the prim ary action (flexion) while another set produces the opposite effect (extension) ; and there is no exception to this rule.— N .C .F . B la n k e tin g Stretcher. M .H . (Astley Bridge)..— D u rin g a practice at our First Aid Depot a discussion arose as to which is the more efficient method of blanketing a stretcher— the St. John or the W oodford-W anstead. In a blitz the patients in most cases wear very little clothing ; and so w arm th is in my opinion most essential to help in reducing the risk of secondary shock. 1 aw ait your decision with the greatest interest. T h e consensus of opinion favours the W oodford-W anstead method which is described in W arw ick and T u n stall’s F irst A id to Injured and Sick. — N .C .F . R e m o v a l of L ig a tu re . A .M . (C am bridge).— A patient has arrived at a First Aid Post with forearm pulped and with a ligatu re applied. T h e latter has been in position for thirty-five minutes, would you or would you not rem ove it ? Y o u r decision will be welcomed by one who has alw ays been interested in your helpful answ ers to queries ever since long years a go he first met you in the com petition arena. If the forearm is pulped then am putation is the only treatm ent. N evertheless, your instructions are to release a tourniquet every tw enty minutes ; and this being so I con sider that you should relax the ligature and see if severe haemorrhage recurs. P ro s it!— N .C .F . F ra c tu re s o f P a te lla and L eg . S .C . (S h irley).— D u rin g a discussion on multiple fractures the correct method of treating sim ple fractures of patella

AID and tibia (both injuries on same limb) came in for lengthy discussion. As agreem ent was not reached your ruling will be greatly appreciated. W ith this combination of fractures it is important to retain the back splint. If, therefore, I had to render first aid in such a case, I would first treat the fractured patella as laid down in the Textbook except that I would not raise the limb. T his done, I should treat the fractured leg, tie both legs together and then raise both lower lim bs.— N .C .F . G rad e I In stru ctor’s C ertificate. A. P. (Ilford). — Will you please inform me how I can obtain Grade I Instructor’s C ertificate? I was Sergeant in the Ilford Division for m any years and have been Superintendent of a private w orks First Aid Station for over 24 years. I am a L .A .R .P . under the local authority, but would also like to hold the S .J .A .B . Certificate. W e su ggest that you write to the Com missioner No. 1 District, S .J .A .B . (97 John S t., E .C .I) under whose authority classes for this certificate are arranged in London and from whom you can obtain full particulars. — Edii© r. N ose B le e d in g in H igh A ltitu des. G .A . (Overseal). — Recently discussion arose as to what makes an airm an’s nose bleed when he reaches high altitudes. My theory is that the pressure inside the body coincides with that outside and that in high altitudes the fact that the pressure outside the body is very low causes the pressure inside the body to burst the capillaries within the nose. Am I correct ? Y e s .— N .C. F. T reatm en t of P oison ing. G .A . (O verseal).— T he T extbook un pp. 173-176 names cer tain remedies for lk Poisons which require Special T rea t ment ” — namely whites of e g g s in unlimited quantities, starch and water, cornflower or arrowroot, perm anganate of potash, brandy, w hisky and sal volatile. All these are difficult to get in most places and impossible in our little village which is six miles from the nearest town. W ill you please tell me w hat can be used as substitutes ? T h e remedies named in the T extbook are recognised antidotes for the particular poisons. If, however, these are not available, you must apply the General Rules for T rea t ment of Poisoning as best you can in the circum stances. Incidentally, copious draughts of cold w ater are useful in cases of poisoning.— N .C .F . F lo w ers in S ick Room . G .A. (O verseal).— T he H ygiene T extbook states that plants and flowers absorb carbon dioxide and give off oxygen, thus m aintaining a balance of pure air. Consequently, instead of rem oving flowers from a sick room, do you not think that it would be beneficial if they were left, provided alw ays that they are fresh ? Cut flowers (and especially those with heavy scent) are removed at eventide from the sick room because (1) they give off odours which m ay m ake the room stuffy and disturb the patient’s sleep, (2) they last longer if removed to a cool place, and ( 3 ) if left they handicap the nurse in her task of tidying the sick room next m orning.— N .C .F .

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Jntepen6<jtf Journal for tlje Ambulance atui p a r s in g ^mriessi N o. 582,

V o l.

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CIVIL DEFENCE: ANTI-GAS - HIGH

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EXPLOSIVE - INCENDIARIES

Written in response to many requests from members of the B. R. C. S.

From the Foreword by Wing-Commander E. J. HODSOLL, C.B. Inspector-General of Civil Defence “ The information brought together under one cover is that which every single member o f the C iv il Defence Services should know.”

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116

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t h e

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C H A N C E R Y L A N E , L O N D O N , W.C.z

W IT H

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A N D

S P E A K S P A T.

TH E

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FROM

OUT

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BE APPLIED

THE

TH E

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T H A N K S NO.

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H ARNESS

T O

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S U IT

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t i a

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F IR S T A ID J n ta p e n ta n f Jfo trm a l f o r rb e A m b u l a n c e E dito r:

No. 582. — V

o l

. XLIX.

N O T IC E

atufr p u r s i n g

W A LTER

S C O TT,

DECEMBER,

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T h e Q u e s t i o n o f D i s c i p l i n e ... C o -o r d in a tio n o f C iv il D e fe n c e S e r v ic e s

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F r a c t u r e o f C la v ic le a n d R ib s E x a m in a t io n H o w le r L o a d in g P a tie n t o n S tr e tc h e r C o r r o s iv e S u b lim a t e P o is o n in g C o m p o u n d F r a c t u r e o f L o w e r L i m b ... T re a tm e n t of S h o ck C o m p r e s s io n S y n d r o m e A v u ls io n of H a ir o f S c a lp .. . S tr e tc h e r E x e r c is e N o .il . .. T re a tm e n t of B u rn s M u l t ip le I n j u r i e s .. . P e r fo r m a n c e o f S c h a fe r ’ s M eth o d S t. J o h n I n s tr u c to r ’ s C e r tific a te L o w e r in g P a tie n t H e a d D o w n T r e a tm e n t o f L a c e ra te d F o re a rm T r e a t m e n t o f F r a c t u r e d S c a p u la T r e a t m e n t o f D is lo c a t e d S p in e D o u b le F r a c t u r e s o f A rm a n d F o re a rm

1942.

[Sta% T J a ^ \

T he

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E D I T O R I A L .

CON TEN TS

F.R.San.l.,

70 70 70 70 70 70 70 70 70 70 72 72 72 72 ' 72 72 72 72

A m o n g the ma ny stories concerni ng the work of the women dur i ng the blitz period is one to the fol l owi ng effect. A girl after be i ng out with an ambulance was g i v en a small car. S h e was told she would be responsible for keepi ng up certain communications. The buildings on each side of the street she passed through were on fire and the firemen tried to stop her, but she told them she would run over them if they did not g e t out of the adjectival way. She could be fluent when occasion demanded, hence her lapse into mild Billinsgate. T o prevent the car from c at c hi ng fire as she drove through, the fire men turned their hoses on it. T h e y g o t to know that girl, for she kept d ri v i ng backwards and for wards down that bl azing street, and the firemen had to play on the car every time. In the morning it was found that the front of the car was smashed in, there were practically no tyres, and the steering lock would onl y operate to the left. T h e picture is a very pretty one, our onl y suspicion be i ng that it may be a “ write up ” in the interests of the work of the sex. H a d the driver been a man, the fire men would have made short work of him, but it was not possible to manhandl e a gi rl — which she doubtless knew ! W i t h the buil di ngs in the street ablaze on either side (and the surface of the street cluttered with hoses, on which the car must have inflicted considerable damage), it was clearly the duty of the firemen to pump on to the buildings and not on to the girl. Her pluck and endurance are beyond praise, and we cannot but admire her as far as that goes ; but she exhibited a sad lack of that discipline which is prejudicial to united effort. W e stand second to none in our belief in the equality of the sexes, but there is a g r o w i n g tend ency abroad to belittle or pass over the achi eve ments of the men and to concentrate on those of the women. W e would have equality in every w a y — in w a g e and salary, in hours and condition of service, in compensation for injury, in sick pay and pensions— but if one of the two sexes is to rise predominant, equality becomes a mere figure of speech. W o m e n have done truly wonderful T he Question of Discipline,

FIRST

work during the war, but they have not yet ex hibited a sense of discipline. T h a t this is so, any factory overseer will vouch for. Hospitals form a notable exception, the work carried out by the trained staff of women in the course of a blitz exhi bi ti ng discipline in its highest and most selfsacrificing form. T h e girl whose story we have sketched had evidently all the pluck of a member of a commando, but it would be a sorry day for the commandos if their ranks contained many like her !

C o - o r d i n a t i o n o f C iv il D e f e n c e S e r v ic e s .

S IR

E xtracts from Lectures delivered by H E N R Y L. M A R T Y N , K .C .V .O ., F .R .C .S ( Continued, from page 39. J

S hock.

W e come to the last on the list of cases requiring pri ority treatm ent— shock, the most difficult of all and the most neglected, but put this golden rule in front of your eyes : ninety per cent, of air raid casualties require treatm ent for it to a greater or less extent. Few of you have ever seen it, and all of you find it alm ost impossible to get a mental picture of w hat shock is. All your training has been concentrated upon the treat ment of injuries, very little has been devoted to that of the patients. Get into your heads once and for all that every man or wom an seriously injured in an air raid is a very ill person. S hock is the illness which accom panies the injury, and if it be sufficiently severe it can kill as effectively as the injury itself. It is to you people in the field that the surgeoTi in the hospital looks, not only to save life from shock, but to pro tect tne patients who later come under his hands as far as possible from its effects which would otherwise delay his w ork when it m ay be most urgently needed. A gain I am not go in g into the routine treatment, all of which you know , but I propose to draw your attention to one or two points of importance. Apart from the injury itself, and the haem orrhage caused thereby, the three great contributory causes of shock are pain, cold and fear. Rem em ber that your own personal attitude to your patients, your bearing tow ards them, is of immense import ance. Y ou have all of you experienced during some illness or other the intangible tonic effect which a dominant reassur ing personality such as that of a good doctor has upon you. Every seriously injured man, as long as he is conscious, is terrified, no m atter how bravely he m ay conceal it, both by w hat he has gone through and by the death which he fears is in front of him. E verything that you yourselves can do to allay pain and relieve fear is of param ount value. Never let any case see that you regard him as otherwise than ligh tly injured, never let him hear you discuss his case save in cheerful tones, lie to him if necessary as to the seri ousness of his condition, and, above all, deal gen tly with him.

AID T he shock associated with air raid casualties is often of a very distinct type. T hey are seldom noiseless or restless, and T ru eta ’s description of the b ig reception hall of the chief hospital in Barcelona with its rows upon rows of stretchers, each one occupied by a silent, grey-faced motion less victim, who, if he was conscious, gazed with wide dis interested eyes upon his neighbours, is an impressive and vivid picture of the condition after a big raid. I have recently had an interesting experience. I was um piring at an incident during an exercise upon which two First Aid Parties were w orking. Both parties did the purely technical part of their work equally well, but the attitude of one of the parties towards their casualties, even though they were perfectly healthy school children, was entirely different to that of the other. It w as extraordinary to hear a burly First Aid Party leader bending over a child, his voice softened, and a quiet, “ Y o u ’ll be all right, old chap ; nothing to worry about.” T hey were dealing with patients— not injuries ! D ram atic, if you like— but first rate doctoring ! And the reason (I only ascertained by enquiry after the exercise)— one party had been in action, the other had yet to receive its baptism of fire. Fear is an am azing factor in shock. I remember well in 1918 ; we were operating in France during the March retreat, as hard as we could go, dealing with case after case which cam e in an endless stream to the tables. W ord was sent to the theatre that a young soldier had been brought direct to the ante-room from a local railway siding where he had been run over by a truck which had partly severed both legs. I went out to see him and found a perfectly conscious lad of about twenty, his right leg was alm ost off through the centre of the thigh, and the left hung by skin and muscle only m idw ay between knee and ankle. He had lost much blood, and there was a tourni quet on each limb. H e was grey and cold and sw eating, desperately ill, and, above all, terrified, frightened alm ost to the verge of insanity, although he complained of no pain whatever. He asked for a priest, and, as usual, a R .C . Padre was on the spot immediately. He was wrapped up, of course, an electric cradle w as put over him, and they were left together. 1 cam e back to see him twenty minutes later and found an almost inconceivable change. T h e boy w as now quiet, composed and quite fearless, with a fair pulse and a good colour, and very shortly afterwards he underwent a double amputation without turning a hair and made a perfect recovery. T h a t is an exam ple of fear as a factor in skock, and it is a factor which the courage and bearing of you people can do more than anything to prevent or cure, One other point, remember that there is a close rela tionship between the treatm ent of shock on the field and your treatment of the injury itself and the evacuation of the patient. W here you are dealing with wounds or fractures, as a broad general rule, the shock will improve as a result of even the simple remedies available on the spot and the short period of warm th and comfort will have rendered your patient far more fit to stand dressing, splinting and trans port. It is for this reason that when we come to con sider the question of priority of treatm ent and evacuation you w ill find that such cases are placed last on the list. If, however, you are dealing with a case of internal haem orrhage, abdominal, chest or head wounds, no treat ment which you can provide in the field is likely to effect very much improvement in the profound shock from which such patients suffer. In hospital treatm ent and early operation lies their only hope, and you will find them there fore placed high on the list of priority.

( To be continued. )

FIRST

RID

No. 44/1 ( A c t o n ) . — T h is Division has been progressingwell since the last report. T he number of cadets is increas ing weekly, and new members are joining the Brigade. A local chemist, Mr. Sam bridge, has given a First Aid Outfit to be awarded to the boy who m akes most progress in three months. In connection with other activities, the boys are anxious to form a football team, and will be pleased to hear from other cadets interested in such matches. T he Division has been very fortunate in having the ser vices of “ T ” Divisional Police Team to demonstrate com petition work. A course on treating dual injuries where the treatment of one upsets that of the other, has been started. T h e mem bers have shown much common sense and originality. Mr. Woodman, Secretary of the local Youth O rgan isa tion, delivered a very interesting lecture on “ Civil Adm inis tration.” T h e detail of w ork carried out by the various departments, particularly the Public Health Departm ent, was an eye opener to most. T he Div. Surgeon, D r. Vincent was in the chair, and afterwards proposed the vote of thanks which was heartily carried by the meeting. On Sunday, Nov. 15th, the Division took part in the Civil Defence Church Parade at St. G abriel’s, North Acton.

Mr. H eathcock said the purpose of their gath erin g was not only the presentation of aw ards, but so that members of the Divisions could meet one another socially and talk matters over. W elcom ing the Mayor, Mr. H eathcock said they were delighted he should come am ong them and give that ga th er ing a civic stamp and recognition. Presenting the annual report, Corps Secretary Jeffery said that 13 past and present members of the Tipton Parish Division had been awarded the B rigade L o n g Service Medal for 15, 20 or 25 years’ efficient service. D u rin g the year six competitions had been organised. T h e medals for the president’s trophy w ere given by Drs. Lloyd and Coutts, and those for the Cadet Competition by Corps Officer F. Jeffery and Div. Surgeon Dr. Kemp, Corps Supt. L akin also subscribing for the medal for the winner of the B aker Rose Bowl. Officers, N .C .O .’s and members of the various Divisions form ing the Corps subscribed to provide a special trophy in memory of the late Colonel H eathcock. T h e result of this competition was : 1 , Tipton Parish Division, 303 points ; 2 , Allens (Tipton) Division, 268 ; 3 , T ividale Division, 257 | ; Revo No. 1 and M .E .C . D ivisions tied for fourth place. Seven team s competed. T h e “ G eorge B a k e r ” Rose Bowl was won by A/S G. Eaves, of the Revo N ursin g Division, Dr. E. P. M cW hirter actin g as judge. E ncou raging and congratulatory speeches were made by Lady H ickm an and the Mayor, and thanks accorded to the donors of prizes, ju d ges and other officials for their w ork and interest in the movement.

No. Ill District.

N o . V District

On Saturday, Nov. 21 st, at the Divisional Headquarters, Messrs. O akley B ros.’ Pavilion, the Cradley Division, S .J .A .B ., held their first competition for the “ O a k le y ” C hallenge Cup, presented by the President, J. O akley, Esq., for annual competition am ong the members. Much hard w ork had been put in by officers and men of this Division in preparation for the competition, and they were rewarded with a good crowd of interested spectators, am ong whom were Asst. Commissioner P. H. Schofield. S .B ., and other notabilities. The team test proved a most interesting case, thoroughly testing the abilities of the four contestant teams. A t the conclusion of the competition, County Surgeon Dr. Campbell said he was very pleased to have been asked to judge the competition and that great credit was due to Cradley Division. H e asked the President to present the cup and small replicas to the w inning team. In his rem arks the President said it was a great pleasure to him to present the cup to the Cradley Division and he hoped it would further the w ork of the members and inspire them to become even more proficient. T h e Assistant Com missioner gave helpful advice for future competitions.

S h a r r o w . — T he N. C. O. ’s of this D ivision have organised whist drives during the past months, £ 6 11 7 having been raised for the M alta Distress Fund. Recently a concert was held in the V ictoria H all, Sheffield, when it was full to capacity, the Chairm an being Councillor H. Cunningham ; several well known Sheffield artistes gave their assistance and a very acceptable sum of ;£18 was realised after all expenses were paid.

St.

Joh n

A m b u la n c e

HEADQUARTERS

AND

B r ig a d e

D ISTR ICT

REPORTS.

N o . I (Prince o f Wales’s) District

C r a d le y .—

T i p t o n a n d D i s t r i c t . — T he canteen of the Horseley Bridge and Thom as P iggott, L td., at which w orks Mr. J. W . Bourne started the first Tipton class in first aid over 50 years ago, w as the appropriate setting, on Sunday, November 15 th, of the first annual presentation of trophies, medals and other aw ards, in connection w ith the Tipton and D istrict Corps, S .J .A .B ., formed last year. Mr. Charles H eathcock (corps president) presided, supported by the Mayor of Tipton (Councillor A. E. Bolton), Brenda Lady H ickm an (county officer), Corps Supt. E. Lakin, Corps Surgeon Dr. D. G. Lloyd, Reserve Corps Officer J. VV. Bourne, Corps Secretary F. R. J. Jeffery and Corps A. R. P. Officer J. W . Plant, and the large assem bly included Coun cillors of Tipton and R ow ley R egis, members of the various Divisions, and friends.

S h e f f i e l d . — The directors and m anagem ent of the Capitol Cinem a, Barnsley Road, Sheffield (Chairm an, M. J. Gleeson), gave a concert-de-luxe on Sunday, November 1st, in aid of the Sheffield Corps, S .J .A .B . Am ongst the artistes who were present were Bert Copley, Beryl Reid, Ronald Frankau, Rob. W ilton and G ay Patrick. Bert Copley made a splendid compere, and a very enjoyable evening was spent by all. T h e members of Shiregreen Am bulance assisted to staff the cinem a and the nurses acted as usherettes.

N o . V I District H e t t o n -le -H o le . ■ — T h e boy cadets attached to the above Division celebrate their 20 th anniversary on Dec. 24 th, h avin g formed their Division in 1922 . W ith their anti-gas, borne nursing and first aid train ing they have proved them selves one of the foremost Cadet D ivisions in the District.

N o . VIII (Duke of Connaught’s) District S a n d w ic h and D i s t r i c t . — W e regret to record the death of Corporal R. D. D avis of the above Division on Sunday, Oct. 25 th. T his cam e after a long illness, at the a g e of 37 years. H e had 12 years efficient m embership in the B rigade, 8 years in the Tilm anstone Colliery Division and 4 years in the Sandw ich and District Division, of w hich he was a mem ber at the time of his death. H e w as laid to rest' at the Eythorne Baptist Church. D iv. Supt. W. J. Bailey and Div. Supt. W . Topliss and

FIRST members of both Divisions were present. There were floral tributes from Tilm anstone Collier}' and Sandw ich Divisions, and from the Tilm anstone Colliery, where he had been employed for the past 20 years. B o g n o r R e g i s . — A parade of nearly 200 members of Bognor R egis Division of the S .J .A .B . was inspected at the Pavilion on Sunday, November 15 th, by Lady Bessborough fD am e of the Order of St. John), Mr. W . J. B. Trotter (Assistant County Commissioner), Mr. C. W . L. Pile (County Officer for Cadets), Miss Hubbard (Lady County Supt.), Mrs. Scott (Lady County Officer), and Miss T ill (County Officer for Girl Cadets). Supt. Thom as was in charge of the parade, Mr. H. T . M ayle in charge of the men, Mr. V . M arlowe in charge of the boy cadets, Mrs. M. Pryde of the nurses, and Mrs. R. B righty of the girl cadets. After the inspection the personnel were put through their paces in ban daging demonstrations and artificial respiration. All the sections then took part in a march past at which Lady Bessborough and Mr. Trotter took the salute. Finally the whole Division was lined up before the county officers when Mr. Trotter congratulated them on their sm art appearance. L ad y Bessborough said she had visited Bognor last year, when the Division was still in its infancy. She, like Mr. Trotter, was thrilled to see how it had grow n. It was par ticularly good that the nursing cadets had grow n in number to 60 during the last six months. Miss Hubbard said how impressed she had been with the high standard of the work. She told the nurses that their officer, Mrs. Pryde, had been promoted to Lady D ivisional Supt.

N o . X District

♦

H a r l o w . — A concert in aid of H arlow S .J .A .B . Cadets w as held in H arlow C ollege gym nasium on Saturday, November 21 st. D urin g the interval Dr. W . N. Booth thanked those who had made the concert a success. He said that there were now 94 girl cadets. T hey learnt first aid, folk dancing, sw im m ing, etc. There were 30 boy cadets, and they were now under the charge of Mr. T . Trist.

L ig h t

T r a ile r

AID Loading.— It is safe to say that two girls of ordinary physique can easily lift a loaded stretcher and place it into position w’ithout strain, because the top of the tray is only 30 inches off the ground and there is no sliding in from the rear to be done ; all that is necessary is to lift the stretcher, step sideways, and lower into slots. Brakes and Springing.— O w in g to the extreme lightness of the am bulance, only parking brakes are necessary ; these autom atically come into operation when the leg of the tow ing beam is lowered and, actin g directly on the tyres, they are most efficient. V ery light and supple leaf springs are pro vided for the comfort of the occupants and are made fairly flat. Wheels, Tyres, and Cover.— Motor-cycle type wire wheels with 26 in. X 2£ in. tyres are suggested. Any suitable canvas anti-gas or other cover may be used, fastened down by press studs and held up by cords and cleats. Towing Attachment.— T he object in providing the simple attachm ent shown on the model is to enable any local black smith to fit the sw an-neck fitting to any car, either to the car frame or bumper bar. (One of the many more elaborate ball joints could be used instead.) Attendant's Seat.— When it is desirable that the attend ant should be in contact with the stretcher cases, a pillion seat is provided with foot rests under the tray. Contact is made by means of the “ lightning fastener ” down the centre of the canvas cover im mediately in front of the attendant, the occupant’s head being next to him. A bell com m unicating with the driver is available to the attendant and to the patients. An interior ligh t run off a dry battery is to be fitted under the ridge board. T w o sloping-lid first-aid boxes are fitted into the rear end of the am bulance within easy reach of the attendant. (A motor-cycle spring pillion seat, three or four inches deep and fitted with a back rest, could be used in place of the plain seat shown on the model. T w o small windows m ight with advantage be fitted into the rear end of the canvas cover, to keep the occupants under continual observation.)

A m b u la n c e .

L i e u t . - C o l o n e l J. L. M o i r , M .B ., Medical Officer, No. 1 Zone, A n glesey Home Guard, writes :

A t my request Mr. D uerr of Bodorgan, a well-known inventor, undertook the designin g of a light trailer am bu lance, especially suitable for the use of the Home Guard in country districts. T he chief features I asked him to incor porate were as follows : E asily man-handled and towable by any light car ; cheap and easy to produce .in quantity ; designed to exclude so far as possible the exhaust gases of the tow ing car ; easily loaded and handled by two persons ; some method of heating provided, and if possible provision for an attendant to travel in contact with the stretcher occupants. Mr. Duerr made a complete model to scale, and the follow ing brief specification shows how well these ideals have been attained. Ventilation and Heating.— Fresh air is drawn in at the highest point through a chute or cowl. It is conducted along the ridge of the am bulance and distributed through a series of holes to the interior to avoid strong draughts, thus creating a slight internal pressure which leaks out at the various sm all openings around the stretcher tray and prevents the adm ittance of exhaust fumes. Provision is made in the tray for four hot-water cans, two under each stretcher, holding about a gallon each.

T he photograph (by Jones-Owen of B angor) shows the canvas cover lifted from one side with one stretcner in place ; the other has been removed to show the two hot-water cans under each stretcher. T h e main features of this “ D u err-M oir” ambulance are : (1) its extrem e lightness and sim plicity ; (2) it can be used either as a trailer am bulance attached to any light car or as a hand am bulance detached from a car, to be used over fields and rough ground ; (3 ) the sim plicity of the heating

FIRST and ventilating systems ; (4 ) it is cheap to produce in large quantities ; (5 ) the cost of upkeep is practically nil. Comment or criticism is invited and the opinion of medical men practising in country districts would be especially welcom ed.— T h e above is reprinted by kind per mission of the British M edical Journal. W e understand that since this article appeared in the B .M .J . Dr. Moir has received appreciative letters from medical men all over Great Britain, statin g how very much such a type of am bulance trailer is needed. One well-known M .P. said he hoped that after the war every village in Great Britain would have a type of am bu lance trailer such as this. W e ourselves would like to point out its double purpose as a hand ambulance, to be pushed through narrow lanes or through gates into fields to pick up casualties, and also as a trailer which can be easily attached to a light car. In fact, where such an appliance is in evidence, several light cars in a village could have the simple attachm ent fitted. It is low from the ground, and the stretcher could be easily lifted the height of some 30 inches by two girls. It fits into slots which do not allow any lateral movement of the stretcher. The heating arrangem ent is sim plicity itself. There is a ventilating cowl and a seat for the attendant with communication to the patients. Also there are two first aid boxes by the attendant’s side. T he cost of upkeep is prac tically nil. W e may mention that Dr. Moir is County Medical Officer and County Civil Defence Officer, A nglesea Branch, B .R .C .S . -

• m 1—

S t. J o h n A m b u la n c e A s s o c ia t io n . S u n d e r l a n d . — D u rin g the last 10 years a total of nearly 7,000 awards have been obtained by students through the

Sunderland Centre of the S .J.A .A . T h e number includes 3,618 adult first aid certificates, 567 prelim inary first aid certificates, 499 vouchers, 517 m edal lions, and 234 labels, and in home nursing 1,213 adult certificates, 231 prelim inary certificates, and 102 nursing pendants. D urin g the year ended September 30 th, according to the annual report adopted by the Sunderland Centre Committee, 45 classes were held — 33 in first aid, 11 in home nursing, and one in hygiene. A total of 518 adult students attended, and of these 265 obtained certificates, 45 vouchers, 99 m edal lions, and 27 labels. N early 500 girls and 29 boys attended prelim inary first aid classes, and only seven failed to obtain certificates. Home nursing classes were attended by 124 students ; and 216 girls attended preliminary classes, all gain in g certificates. T w elve certificates in hygiene were awarded at the one class held.

AID

F r a c tu r e s — S y m p t o m s a n d S ig n s . M .B ., C h .B ., Kirkconnel, Dum friesshire.

B y B owman E d g a r ,

O ne of the chief difficulties en countered in the t e a c h in g of the ab o v e s ubjec t is to g e t pupils to th in k of it in a clear n at ur al order.

O nly on rare occasions do we find a class able to deal with the question m ethodically and sm artly, as if the m em bers could picture to them selves their routine exam ination of the case. T he follow ing story and mnemonic have proved of great value in this area, not only as an aid to m em ory but also, and much more importantly, as a guide to the necessary exam ination of a possible fracture case. It will be noted that the mnemonic gives the three im portant phases in their correct order. (1) W hat the patient tells us ; ( 2 ) W hat we m ay learn on looking at the limb, and ( 3 ) W hat we m ay discover by palpation. T h e chief criticism , perhaps, lies in the fact that “ S ” for Shock comes at the end of the exam ination, instead of at the beginning— as it should do in all serious cases. T h is can easily be pointed out by the teacher. As this method of dealing with the subject has been much appreciated by both junior and senior students here over a long period of years, it m ight, perhaps be of use in a wider sphere. T he S t o r y . 1

One of the K in gs of early E gypt fell and fractured his Fem ur. H is courtiers, who knew little of the art of first aid, could not decide whether or not the royal bone w as broken. T hey clustered about the patient a rg u in g volubly. T h e K in g, lyin g neglected in much pain, cursed them roundly and said, “ From now on let every man rem ember this occasion. I have broken m y H I P — I am more than S A D that no one can help me— and I C U S S the ignorance which is responsible for such a state of affairs. “ Furtherm ore, let the nam e H I P - S A D - C U S S , which I now assum e, serve to remind all men of the symptoms and signs of a broken (fractured) bone.” T he M nem onic.

Keyw ord : “ Hip-sad-cuss.” H — History of accident ) I — Inability (to use injured limb) ) P — Pain. )

. Patient tells us-

S — Swelling. A —/ Abnorm al position (of limb) D — Deformity.

) ) )

C — Crepitus. U — Unnatural mobility( of limb) ) S — Shoitening.

) *vhat Palpation ) tells us-

S — Shock. Dr. James O rr has been appointed Corps Surgeon of the N ortham pton-Corps of the S .J .A .A ., follow ing Dr. Eric S h a w ’s promotion to 'C o u n ty Com missioner. The new Corps Surgeon will have m any divisions under him, including the Northampton H eadquarters, Daventry, Earls Barton, K ingsley, Electric L igh t, Tow cester, Weedon and several N ursing Divisions. It w as shortly after the Great W ar that Dr. O rr first becam e acquainted with St. John, when he becam e D ivi sional Surgeon to the Spencer N ursing Division. In 1937 he became Divisional Surgeon and Supt. of the K in gsley (Men’s) Division, but later, w hilst he retained the position of surgeon, he resigned that of superintendent.

)

Inspection te^s us-

T hat w e should not need to be told.

N ortham pton.—

H .R .H . the Duchess of Gloucester paid a visit to the Prisoners of W ar Exhibition at S elfrid ge’s on D ecem ber 1st. She w as received by the M ayor and M ayoress of St. M aryle bone, Sir Philip Chetwode, L ad y Chetwode, L ad y Louis Mountbatten, Lady Lim erick, D am e Beryl O liver, Sir Ernest Burdon and Sir Richard H ow ard Vyse. After a speech of welcom e by Sir Philip Chetwode, to w hich H .R .H . replied, she made a tour of the Exhibition. Before leavin g it was announced that Her R oyal H ighness had handed in a cheque 'fpr ,£100 to the Funds,

FIRST

R a ilw a y

A m b u la n c e

N e w s.

LO N D O N & N O RTH EASTERN The follow ing are extracts from the Annual Report of the North Eastern Area :— There were 168 classes conducted at various centres in the area during the year. In connection with these the number of students who gained aw ards were :— Certificates, 532 ; vouchers, 359 ; medallions, 450 ; labels, 1751 ; total, 3092 . T h e number is a decrease on the last session, ow ing to the number of members who have joined H. M. Forces. The figures in the report in connection with the w ork during the last nine sessions reveal the great interest taken in the movement by members of the staff in the area. D urin g the year H .M . the K in g has been graciously pleased to sanction the gran tin g of the dignity of Serving Brother to A. Barker, Gateshead ; J. W . H ooker, W est Hartlepool ; W . Nixon, Hull ; H. Roberts, Gateshead. On February 17 th last Mr. C. M. Jenkin Jones pre sented a Meritorious Am bulance Certificate to Mr. Atkinson, dockgatem an at W est Hartlepool, for gallan try and prompt application of first aid know ledge to leading seam an R. Edwards. O w in g to the international situation, the Group and International Competitions were discontinued, but it was agreed that the D istrict competitions be held as usual. Competitions, which took place in all the six districts (D arlington, 5 team s ; H ull, 8 teams ; Leeds, 6 teams ; M iddlesbrough, 5 team s ; N ewcastle, 6 teams ; Y o rk , 4 teams), were a great success and well attended. D uring the year 37 medals, sixteen 20 years’ bars, two 25 years’ bars, eight 30 years’ bars, and one 40 years’ bar have been approved. A suitable certificate has been issued to those concerned, which will be exchanged for the relative gold token as soon as circum stances permit. GREAT

W ESTERN

T h e annual report of the G .W .R . Am bulance Centre for the year ended June 30 th, 1942 , shows that the w ork has been well m aintained, despite the effect of recruitm ent and other w ar activities upon the staff. No fewer than 6,543 members of the staff passed first aid exam inations under the S .J .A .A ., and of these 482 were recruits to the movement. T h e exam ination results of the Centre for the past ten years were as under :— Year

1932-33 1933-34 1934-35 1935-36 1936-37 1937-38 1938-39 1939-40 1940-41 1941-42

Certificates

482 515 657 747 808 797 1,605 570 438 482

Vouchers

Medallions

Labels

T otal

492 379 404 515 553 564 660 795 443 313

565 443 341 350 427 476 543 431 617 333

5,568 5,869 5,989 5,908 5,995 6,142 6,267 5,655 5,460 5,415

7,107 7,206 7,391 7,520 7,783 7,979 9,075 7,451 6,958 6,543

T h e Athlone Bowl, awarded to the division ga in in g the highest percentage of new members in proportion to the total staff employed, w as won by the London “ A ” Division with a percentage of 1 '09 , the runners-up being the Plym outh D ivision with a percentage of 1 08 . Excellent services have been rendered during the year by the Com pany’s trained am bulance personnel, both men and women, in connection with A .R .P . duties, casualty clearing stations and first aid posts, also in the instruction of classes. T he follow ing gold efficiency aw ards have been granted d urin g the year :— 15 year gold medals, 252 ; 20 year gold

RID bars, 276 ; 25 year gold medals, 73 ; 30 year gold bars, 55 ; 35 year gold bars, 11 ; 40 year gold bars, 6. T h e progress of first aid w ork depends very largely on the voluntary services of its divisional secretaries, class secre taries and others, and it is pleasant to report that during the year the follow ing members of the staff received recognition from the Order of St. John of Jerusalem for outstanding services over a period of years :— A s Officer ( from Serving Brother) Mr. J. H. Dee, chief ticket collector, traffic department, Gloucester ; Mr. V . H . O. Harris, foreman, traffic depart ment, Gloucester. A s Serving Brother Mr. A. C. Napper, exam iner, carriage and w agon department, W eston-super-M are ; Mr. W . Harber, fitter, C .M .E . department, Sw ind on ; Mr. R. H. Sullivan, foreman ticket collector, traffic department, Paddington; Mr. W . H. P. M usk, enginem an, locomotive department, Southall ; Mr. J. Bridger, signalm an, traffic department, Addison Road ; Mr. W . J. N ewdick, clerk, C .M .E . department, Old O ak Com mon ; Mr. C. F. Gayner, checker, goods department, Pad dington ; Mr. R. Pearce, gan ger, engineering department, W est Drayton ; Mr. G. E. Holford, station master, traffic department, Bullo Pill ; Mr. W . A. Sm art, storesman, signal department, Frome ; Mr. T . J. Raines, Principal A .R .P . W arden, Newport Docks. Vellum Vote o f Thanhs Mr. B. Board, clerk, divisional superintendent’s office, C ardiff (Divisional Am bulance Secretary).

Reviews. The Nurse's Pocket Encyclopcedia and Guide, 1941. By H ilda M. Gratton, S .R .N . London : Faber & Faber, Ltd. Price 2/6 net. T his useful little book is now in its thirty-seventh year and has long since established a reputation am ong nurses, for whose benefit it was first compiled. In short, it is a pocket refereuce guide for nurses, who will find within its two covers all that they w ant to know with reference to the treatment of their patients. In addition it contains a directory of nursing institutions, a calendar and an appoint ment book for 1943 . Once again, therefore, we commend it to all those readers of F ir s t A id who are en gaged in nursing whether at home or in hospital. A id s to Tray and Trolley Setting. By M arjorie Houghton, S .R .N . London: Bailliere, Tindall & Cox. Price 4I- net. T his book, which is now in its second edition, success fully accomplishes its object as a gu ide to the necessary proficiency in practical procedures w hich are required by the nurse in her daily w ork, and by the probationer pre senting herself for exam ination. It w ill prove most useful and instructive to those readers of F ir s t A id who are doing full or part time duty in hospitals ; and, indeed, these cannot afford to miss the opportunity of acquiring much know ledge at small cost. H er R oyal H ighness the Princess Royal, accompanied by Lord Lascelles, attended a concert at Chelsea Tow n Hall given by Moisiewitsch on Decem ber 1st. H alf the proceeds of which to be given to the D uke of G loucester’s Fund and half to the “ Aid to R ussia ” Fund. H er R oyal H ighness 'w a s received by the Mayor and M ayoress of Chelsea, Lady Lim erick, Mrs. Prentice, Miss Buller, Mrs. Thorold, Mrs. F aw cus and Lady Abraham s.

FIRST

AID

O U N D S , H EAL

WILL

B U

R N

R A P ID L Y

NOT IF

and

TURN

TREATED

etc.

S ,

SEPTIC

W IT H

A N T I P E O L C U T A N E O U S D

V A C C I N E

O I N T M

E N T

II Q p

one ° r other or all of the three races of germ s, Streptococci, Staphylococci and B. pyocyaneus are found in every skin infection common to this country, and A N T IP E O L O IN T M E N T contains the antibodies (antivirus) of these germ s. H ealin g is expedited by the proved ingredients of tne ointment, and septic development is stopped or prevented by its antivirus sterile vaccine filtrates. A N T IP E O L O IN T M E N T is unsurpassed for B U R N S and S C A L D S , for it is microbicide and non-adhesive, and dressings do not require to be changed every day.

I N

I P

is a semi-fluid ointment, more convenient than the ordinary Antipeol ointment for ocular infections and lesions. Eyes affected by sm oke and dust are soothed alm ost im m ediately by the application of Ophthalm o-Antipeol, and the antivirus prevents germ s from developing. C lin ica l Samples on request from M E D I C Q .B I O L O G 1 C A L L A B O R A T O R IE S L T D . , C a rgreen Road, South N o rw o o d , Lond on , S .£.25

T h e C i r c u l a t i o n o f t h e B lo o d . A T he heart is a m u s cu la r o r g a n and it ac ts like a p um p ; it lias four c h a m h e r s — tw o at the top called au ricles or squee z i n g cha mber s, and tw o at the bottom called ventricles or p u m p i n g cha mbers.

Blood commences on its circulation from the left ventricle pumping into the aorta. From the aorta arteries go to all parts of the body ; the arteries divide and sub divide until they become so sm all that they can be seen only by the aid of a microscope ; these small vessels are called capillaries. In these capillaries an inter-change of gases takes place, the blood gives off nourishment to the body and takes up waste m atters and carbon dioxide ; this process turns the blood very dark red. T h e capillaries unite and become larger and larger and form into veins. From the lower part of the body the blood flows up the inferior venae cava:, and from the upper part of the body down the superior v e n a cavae, and enters into the right auricle of the heart. T his is the end of the systemic circulation. Then commences the pulm onary circulation. Blood squeezes from the righ t auricle into the right ventricle, from the righ t ventricle it is pumped up the pulmonary arteries (the only arteries containing impure blood), from the pulmonary arteries the blood enters the lungs and again forms into capillaries, where an inter change of gases takes place ; this time the blood giv in g up its waste matters and picking up oxygen, which turns the blood bright red. From the capillaries of the lungs the blood is forced into the pulm onary veins (the only veins containing pure blood) into the left auricle of the heart, and it is from this point that the circulation commences a g a in .— F. P o w e l l .

C O . ,

H um an O ste o lo g y, A n atom y, E tc., 18, FIT Z R O Y STREET, F IT Z R O Y S Q U A R E , L O N D O N , W .l T e le p h o n e : MUSEUM 2703.

N E W

JU ST

IS S U E D

M A D E UNDER THE SUPERVISION O F PRO FESSO R C . F. V. SMOUT, B IR M IN G H A M U N IVERSITY. F IR S T

A ID

F R A C T U R E and

D I S L O C A T I O N

C H A R T S ,

C O LO U R E D . F IR S T A I D

FR A CTU R E

Size 28" x 40" F IR S T A I D

Price l7/6d.

D IS L O C A T IO N C H A R T

Size 20"x 15"

Two

CHART

Price 7/6d.

Postage

I/- extra.

charts,

caloured,

cloth, with rollers,

FIRST

RID £37 15s. in a period of only 5 months, were rewarded when

O ur

N u rse s’

C O M P IL E D

No. 1

D is t r ic t ,

N o rth e rn

Page.

B Y AN A M B U L A N C E

S IS T E R .

S .J .A .B .

A re a .

E d g w a re

and

M ill

H ill

N u rs in g

D iv is io n .—

A Grand V ariety Concert in aid of the Prisoners of W ar Parcel Fund w as held at John Keble Church H all on Saturday, November 14 th. It had been arranged by the local Am bulance and N ursing Divisions. Am ong those present w ere the M ayor and Mayoress of Hendon (Alderman and Mrs. J. J. Copestake) and D istrict Officer G. H. Hart. D urin g the interval, the Mayor said he felt honoured to be present, it being his first public function as Mayor. He also felt proud to be able to present to Am bulance Officer Mrs. F ox and Am bulance Sister Miss Evershed, Certificates for Meritorious Service. D iv. Supt. Mrs. M cCabe, in a few well chosen words, spoke of the w ork of the Joint W ar Organisation and the great need of funds for the Prisoners of W ar. As the organiser of the Penny-a-W eek Fund in E dgw are, she was pleased to state that from September 1941 to August 1942 , the sum collected was £ 796, and there were great hopes that this amount would be doubled next year. Mrs. McCabe also said that she felt proud that two of her members had gained Certificates for Meritorious Service. In conclusion she thanked the producer of the concert, Pte. Sargent, and the artistes who had so w illin gly given their services to m ake the evening a success. A Dutch Auction of a 10/- note realised ;£ 10 , and to the strains of “ Pennies from H e a v e n ” coins cam e from every corner of the hall. A very happy evening cam e to a close with the N ational Anthem. W o o d G r e e n N u r s i n g D i v i s i o n . — A very successful Sale of W ork w as held at the C ongregational Church Hall on Saturday, November 21 st, in aid of a Medical Com forts’s Depot. T h e hall was crowded for the opening ceremony. T h e Chair w as taken by Mrs. Jack Barratt (President of the Division), and she was supported on the platform by Mrs. Harrison (Mayoress), Mrs. Carter P ag e (vice-President), L ad y D istrict Supt. Miss W alker, Lady D istrict Officer Mrs. Rayner, the Rev. Jack, and officers of the Division. In a happy little speech, Mrs. Barratt introduced the Marchioness of W illingdon, G .B .E ., C .I., County President. L ad y W illingdon said it gave her great pleasure to support the Division on this occasion. H er interest in the B rigad e went back a number of years, and she congratulated the Division on their effort. She had much pleasure in d eclaring the Sale open. V otes of thanks to L ad y W illingdon and Mrs. Barratt were proposed by Div. Surgeon Dr. E. B. W ilson, seconded by D iv. Supt. Mrs. Dearm er. A concert was held in the evening, and as a result of the two events, a sum of ^ 1 4 0 was raised.

No.

S .J .A .B . N u r s i n g D i v i s i o n . — T he members of this Division organised a B rin g and Buy Sale and realised £ 1 0 3s., the N ursing Division raising £ 5 3 s. and the Cadet N ursin g D ivision £ 5. L ad y Corps Supt. Mrs. W indle attended, also Div. Surgeon D. Nelson, the latter presenting the aw ards gained the previous year. S D is tr ic t,

H a n d s w o rth

S ta n n in g to n N u rs in g D i v i s i o n . — T h e very earnest efforts o f Amb. Sisters G . Morris, D . Guest, D . Stenton and J. Stephenson, w ho by w hist drives and dances raised

L ad y Corps Supt. Mrs. W indle presented a skeleton and cupboard on their behalf to Div. Supt. Mrs. M cK ay, Officer in C harge of the Division. Also as a result of their labours, medical equipment to the value of £ 8 has been provided for a Hom e Guard First Aid Post for which some of the mem bers have volunteered in case of hostilities. A dressing trolley was also given by Amb. Sister I. M. Marsh, and a silver cup w as presented by Mr. J. Brand to be competed for annually by members of the Division. Although only 2i years old, this N ursing Division com prises 37 officers and members, with a N ursing Cadet D ivi sion about to be registered, 25 cadets having passed their first aid exam ination, while a further 12 cadets are being trained. W o r s b o r o u g h C a d e t N u r s i n g D i v i s i o n . — L ad y Riverdale presented certificates to 22 members of this Division at the Ambulance H all. She said that it required more skill to be a successful housewife than to w ork a typewriter, for to run a home one must know a great many subjects. L ad y County C ad et, Officer Mrs. Beverley appealed to mothers to induce their children to continue their attendance at the course of lectures arranged for their benefit. She was pleased that 8 girls had qualified for the proficiency badge. W a k e f i e l d C a d e t N u r s i n g D i v i s i o n . — Miss Clinker is the actin g Cadet Supt. and Miss Farrow actin g Cadet Officer of this Division which was formed in July last. It is largely due to their efforts tfiat the cadets now number 40 . Apart from their first aid training, the girls have assisted the W akefield Corporation by collecting salvage. Recently Miss Clinker handed to the W akefield S alvage Dept. 2 tons of books and m agazines, 2\ tons of scrap metal, and 2\ stones of horse chestnuts. T h is voluntary service is greatly appre ciated by the C ity Engineer. Girls are invited to join the Division. Lectures are given at the Church House, South Parade, on W ednesdays at 6.30 p.m. and on Saturdays at 2.30 p.m.

N o. 9

D is t r ic t ,

S .J .A .B .

D i v i s i o n . — V ariety was one of the main attractions of the concert presented by this Division on Friday, November 20 th. T h e compere was D r. Hadfield, Div. Surgeon, and in his ensuing speech he gave a few details of the work of the Division since its formation in 1937 . H e pointed out that am ongst its many duties it had been responsible for the first g a s lecture in the Borough, and at the outbreak of war, trained personnel had manned fixed and mobile first aid posts and ambulances. T h e present membership was 45 , of which 8 were doing full time duty in hospitals and hostels, one was a whole time A .R .P . am bulance driver, and the rest were doing part time w ork at the loeal hospitals and other places where they were needed. A N ursing Cadet Class had been started with 29 recruits and it w as hoped that by Christm as a N ursing Cadet D ivi sion would have been formed. An appeal for more recruits from 12-16 years of a ge was made. T h e concert concluded with ^ Land of Hope and G lory” sung by Mr. Symons, the Penzance N ursing Division, and the B ath in g Pool Choir. Penzance

N u rs in g

St. Colum b V .A .D . fist aid exam ination w as conducted at the First Aid Point, when Dr. Mitchell, Torquay, was the. exam iner. Successful candidates were : First year, Mrs. V, Snell, Mrs. Mitchell, Mrs. R. O ’ H agan , the Misses B. Nail, T . Parkyn and B. Martin, and Mr. J. O ’H ag an ; second year, Mrs. C. W arne, Mrs. C. M. R ogers ; third year, Mrs, Polkinghorne, Miss D . Pratt,

FIRST

f b

RID

f f e

f i n

M assage

P r o fe s s io n

D e m a n d !

SO,

SM AE

IN ST IT U T E ,

L E A T H E R H E A D ,

SU R R E Y .

PATENT

“ PORTLAND” AMBULANCE

GEAR

T h e G e a r illu s tr a te d (A .B .C .D .) c a r r e s t w o s t r e tc h e r s o n o n e sid e o f A m b u la n c e , leaving o t h e r sid e c le a r f o r s ittin g p a tie n ts . T h e UP A N D D O W N a c tio n is q u ic k an d easy f o r lo ad in g o r u n lo ad in g . A.

Shows the two stretchers in position.

Shows t he top stretcher lowere d ready for loading.

Illustrates the same Gear with the top stretcher frame h in g e d d ow n for use when only one stretcher case is carried.

D . Shows the same position as in “ C ” only with cushions and back rest fitted for convalescent cases.

W h e r e A m b u la n c e s a r e r e q u ire d t o c a rry fo u r b e d s two Gears are fitted, o n e on EITHER SID E, an d t h e sa m e a d v a n ta g e s a p p ly as d e s c rib e d ab o v e .

Full catalogue of Ambulance Equipment No. 7Awill be sent on request. GR E A T PORTLAND ST., LONDON, W.1 'Phont : Langham 1049. Telegraphic Address:—

KARVAUD, WESDO. LONDON

FIRST

N ext, please! !— N .C .F .

L o ad in g P atient on Stretcher. F .C . (R oyston).— I have alw ays been taught that the correct w ay to place an unconscious patient onto a stretcher was on his back with the head turned to one side, head up if Hushed face, down if pale face. A few days a go 1 heard a C. D. party told that the proper w ay was to place the patient on his side. I would welcom e your advice on this matter. T h e statem ent is not correct ; and patient must be loaded on stretcher in recum bent position. — N .C .F . C o rro siv e S u blim ate P oison in g. P. N. (Cardiff).— Recently some of us were discussing the “ m etallic poisons ” (Textbook p. 169 ), and the question arose as to whether or not it was correct to administer an emetic in cases of Corrosive Sublim ate Poisoning. As we could not agree we ask your kind ruling. Mercuric Chloride (or Corrosive Sublim ate) is em phatic ally a corrosive poison. Compared with the Corrosive Acids and A lkalies, however, it is slower in action and less intense in its effects. Consequently, it is classified in the Textbook under the Irritants Group ; and in cases of poisoning thereby it is both necessary and safe to administer an emetic at the earliest m om ent.— N .C .F . C om p o u n d F ra ctu re of L o w e r L im b . J.W . (Boston).— In the case of a compound fracture of the low er limb should the bandage round both ankles and feet be used ? I find that many instructors, members of the St. John Am bulance B rigade, contend that when the frac ture is of the compound type the bandage should not pass round the feet as mentioned in the Textbook for simple fractures. I should welcom e your ruling on this point.

AID In all cases of this injury the figure-of-eight bandage should be applied (as the Textbook directs) round ankles and feet. No harm will result to the fracture, provided that the bandage is applied (as the Textbook also directs on pp. 66, 67 ) ( 1) with great care, (2 ) without using force and (3 ) without letting go until the limb is controlled by splints.— N .C .F . T rea tm en t of Shock. A .H . (M ansfield).— Recently I heard an instructor tell his A .R .P . class that a patient suffering from seock should be given a dessertspoonful of salt in a tumbler of warm water. T his advice seemed quite w rong as it is not to be found in any first aid textbook. Y o u r ruling will be appreciated. As you state, this treatment is “ quite w ro n g .” — N .C .F . C o m p ressio n Syndrom e. G .N . (G lasgow ).— I shall be very grateful if you will let me have some information regardin g the above. How is it usually caused, what are the effects of it, and what do you su ggest as the first aid treatment for it ? T h an k in g you in anticipation. T h e term “ syndrome ” merely signifies a combination of symptoms in disease. It seems to me, therefore, that you have heard a doctor speaking of the symptoms in Compres sion of the brain and Apoplexy. T h e latter condition, of course, is diagnosed by the presence of symptoms of Com pression without a history or evidence of head injury.— N .C .F . A v u lsio n of H air o f S calp. l.M . (W elw yn Garden C ity).— I have read with interest the October issue of F i r s t A i d for the first time, and was particularly interested in the Queries and Answers Column. H avin g read this issue, I shall continue to purchase the Journal, as 1 feel that the Journal is of great value to all first aid workers. The query which was published under the above heading caught my eye because recently we had to deal with a sim ilar case in our factory. W e telephoned for the doctor, removed patient on stretcher to first aid room, and applied a plain lint dressing to the scalp. Shock w as so severe that the bleeding soon ceased. In any case of this type, therefore, I should be inclined to treat the shock first. W ith this injury bleeding is rarely and shock is alw ays severe. Nevertheless, it is wise to protect the w’ound at the outset of treatment, as I advised in my answer to the query in the October issue.— N .C .F . Stretcher E x e rc ise No. II. R .E . (Cardiff). — With reference to Stretcher Exercise No. II with Three Bearers, the instructions on p. 219 of the T extbook tells us that the Bearers pass their hands beneath patient in approved manner, and on the com mand “ Lift ” rise to erect position. F ig. 101 , however, shows that Bearers have lifted patient on to their knees before attaining the erect position of F ig. 102 . Please tell me if the bearers should lift patient on to their knees before attaining the erect position and so settle a friendly argum ent between interested first aiders. Y e s .— N .C .F . T reatm en t of B u m s. M .C. (Finchley).— Please tell me why it is that, when the air is excluded, burns cease to be painful. W ith a severe burn the cuticle is destroyed, as are also parts of the true skin. Consequently the tips of the papillae, including the exquisitively sensitive nerve-endings, are laid bare and exposed to the air. T his results in severe pain, which is relieved when the burn is covered and the air ex eluded.— N .C .F .

FIRST

F IR ST

RID A D A M ,

A ID

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C O . ,

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1 *

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M u ltip le In ju ries. T .A . (Shireham pton).— R eading an air pilot’s account of his injuries in a crash, I venture to a sk your advice on the treatment. T hey included four broken ribs, three broken vertebrae, broken left scapula, dislocation of right shoulder, sprain of right knee, incised wound of scalp, broken tooth, concussion and two m arvellous black eyes. He humourously assessed the injuries as “ not in dividually serious,” adding that his righ t arm struck out backw ards and “ w as quite funny if it had not hurt so m uch.” W ith this com bination of injuries it is of paramount importance to treat for shock and to get patient to hospital as quickly as possible. Further, provided that patient is handled w ith extrem e care, no complication is likely to result even if no bandages are applied.— N .C .F . P erfo rm a n c e of S ch afer’s M ethod. D .W . (Stockport). I read with considerable interest your reply to query published under the above heading in the October issue of F i r s t A i d , but with regard to Section A , w hilst I agree that h avin g the head upwards on the slope will not reduce the efficiency of the performance of artificial respiration, it would appear from the in struction I have received that it will reduce the results for the follow ing reasons :— ( 1 ) W ith head high it w ill retard the expulsion of w ater and other foreign bodies from the lungs. Also it would retard the supply of blood to the brain, heart and lungs. (2 ) If the head was pointing straight down it would be ju st as injurious, for although that position would ease the expulsion of water, it would tend to flood the brain, heart and lungs with blood, thereby retard in g recovery. (3 ) Finally, if the body w as placed obliquely with the head slightly lower than the feet it would be easy to expel the w ater and other foreign bodies, and would giv e just the righ t supply of blood to the brain, etc., to facilitate recovery and to combat shock. W hilst 1 agree in principle with w hat you state, I must . remind you that if the act of placing such a patient in the ideal position would result in delaying the com m encem ent of artificial respiration, then the instructions must be modified to suit the em ergen cy.— N .C .F . St. John In stru cto r’s C ertifica te. P. S. (Y o rk ).— W ould you please advise me as to w hat is required of candidates sitting for Grade I St. John Instructor’s Certificate ? I ask because I cannot get any information here as to procedure, i.e., where and whom to apply. I should be pleased if you would let me know. It is not clear from your letter whether you are re ferring to Instructor’s Certificate in Anti-G as or First Aid. In either case, however, you can obtain the facts required if you com m unicate w ith the Com m issioner who is in ch arge of the St. John Am bulance B rigad e in your County. — E d ito r.

L o w e rin g P atien t H ead Dow n. J.S. (W akefield).— D u rin g a recent A .R .P . practice I was in charge of a party rem oving casualties from a threestory building. T h e first man to be lowered was a man w ith a fracture of the femur accom panied with arterial haem orrhage. T h is man w as lowered down a w ire rope (gradient 1 in 3 approx.) head first, the Rescue Leader actin g on my instructions. At a later inquest I was informed that this man should have been lowered feet first. Please give your ruling on this matter, wnicn I a w ait with interest.

RID Frankly, I am of opinion that this patient should have been lowered feet foremost, especially as it is unlikely that the fractured thigh could have been aggravated by such treatment. Also when a conscious casualty is lowered head foremost, it is very disturbing to his mental condition, and the shock associated with the injury is thereby increased. — N .C .F . T reatm en t of L a cera ted F o rea rm . R .H . (Leeds).— At a recent practice of our First Aid Party I w as told to treat a patient for a lacerated forearm. So I dressed the wound and placed the forearm in a large arm sling. T h e observer— a member of the B rigade— told me that the job was improperly done and that all lacerated limbs must be supported on splints. W as he righ t ? On your statem ent of facts your treatment of the lacerated forearm was quite correct.— N .C .F . T reatm en t of F ra ctu red Scapula. R .H . (L eeds)-— At the sam e practice some one else had to treat a patient for fractured scapula. In this case the observer said that the scapula should be supported by 'G ooch splinting or by two short splints side by side. W as he right ? A gain, on your statement of facts the treatment suggested w as not correct, because only fractures of the limbs are treated w ith splints and b an d ages.— N .C .F . T reatm en t of D islo cate d Spine. A .V . (Burton-on-Trent).— W hat would your treatment, method of lifting and loading patient on to a stretcher be if he were suffering (1) from dislocation of spine in the thoracic or lum bar region and (2) from dislocation of spine in the cervical region. At a recent Practice several opinions were expressed and your answer will be much appreciated. Dislocation of the spine is very rare ; and the injury is usually a fracture-dislocation. So if you were to meet with either of the injuries, which you name, you would not be able to recognise them. Rather you would find signs and symptoms as described in the Textbook under fracture of the spine ; and you would have to treat and transport the cases in accordance with its instructions for this injury.— N .C .F . D ou b le F ra ctu res of A rm and F orearm . A. V . (Burton-on-Trent).— H ow would you treat fractures of arms and forearms of both upper limbs ? The treatment which w as most favoured at a recent Practice w as to apply two splints (reaching from armpit to fingers) to each upper limb, and to retain these in position by bandages above and between the fractures of arm and forearm. T his done w e secured both upper limbs to trunk and thighs and removed patient on stretcher in a recumbent position. It is difficult to im agine how this combination of injuries could occur without some associated injury^o the trunk. In these circum stances the decision as to whether the upper limbs should be extended along the trunk and thighs or flexed at elbows depends on the general condition of the patient and on the other injuries which would be present.— N .C . F.

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S.J.A.B. Headquarters and District Reports First Aid Treatment for Fractured Spine Mental Aids to First Aid Railway Ambulance News Ambulance Service Need Part-timers R.I.P.

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u e r ie s

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Elevation of Fracture Examination Howler A.R.P. Quiz Changing Bearers... Figure-of-Eight Bandage ... Improved Treatment of Complicated Fracture An amusing Incident Potts Fracture Colles’s Fracture ... Treatment of Snake Bite Treatment of Nose Bleeding Corrosive Burns of Eye Life Saving Badge Fractured Leg with Bent Limb Artificial Respiration with Burned Back Treatment of Haemorrhage from Nose

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CONTENTS

F .R .S a n .l.,

J A N U A R Y , 1943.

XLIX.

NOTIC E

SCO TT,

82 82 82 82 82 82 82 82 82 84 84 84 84 84 84 84

T h e question has been asked why’ hospital nurses should be treated as if they were girls at a boarding school, and the com parison is a very apt one, because both types of institution, girls’ boarding schools and large train ing hospitals, are subjected to a similar type of discipline characterised by rules and restrictions which appear to the average individual to be at times unreasonable. If asked the question (our correspondent has pointed out) the executive heads would doubtless say that strict rules are necessary because boarding schools and hospitals are highly organised institutions ; but we feel disposed to accept rather the statement that such procedure applies more peculiarly to instances where women are in executive control of girls and younger women, further that both these female communities are ruled by women whose environmental and emotional life is distinct from that of the average adult, and differs in this from similar male com munities where a higher percentage of those in authority are men who have experienced the broad ening effect of family life and of a wider social life. Among the arguments adduced for the exercise of this somewhat harsh discipline is one that the matron stands in loco p a ren tis to the nursing staff, or at least to that portion which is under age ; but surely the parental obligation does not obtain during those hours when a nurse is off duty and expects to have a few hours to herself. The petty restrictions with which the life of a nurse is rounded off do not tend to make the occupation a congenial one. In at ten o’clock is a very customary rule, but surely a nurse who is considered capable of being all night in charge of a ward with up to 40 more or less ill patients might be deemed fit to decide for herself what time to go to bed and how often to stay out late at night. A “ Student Nur se’1 writes “ Nobody would dream of imposing such restrictions on, say, a medical student, or a girl in any other profession. Why, then, on a nurse? Most of us are of age, some have been governesses and teachers and hold universities degrees, a few are married, a fair number have come from overR u le s and R eg u la tio n s.

F I R S T

seas to train at our hospital. All of us have enthusiastically taken up a profession for which intelligent young women are urgently wanted. W h y then should we be treated as if we were at a boarding school ? ” The problem is avowedly a difficult one, and we think that the advice given by a physician offers something by way of its solution. It is for the hospital board of management to set up an advisory committee to take an intimate interest in their nurses, review all aspects of their life as influenced by the hospital, and find out what defects there may be in the organisation and remedy them. This may be not so easy as it seems, but certainly there is much room for improvement in the condi tions under which the nursing profession works.

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o f

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D efen ce

S e rv ic e s.

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Extracts from Lectures delivered by H E N R Y L. M A R T Y N , K .C.V .O ., F .R .C.S

( Continued from page 6 2 .) P r io r it y

o f

T reatm ent.

Tbe First Aid Party has now dealt with such cases as I have described in imminent danger from haemorrhage, asphyxia or shock, and is free to give attention to the treat ment of the remaining casualties. There is always a tendency among parties to treat the most lightly injured first, and I have noted this mistake time after time during exercises. A leader must ensure, from the knowledge obtained from his reconnaisance, that cases are treated in the right order, and, it is this question of priority of treatment that 1 want you now to consider. The first casualties which should receive attention are undoubtedly those with wounds of the abdomen and those with large open wounds of the chest, in the former to pro tect exposed bowel and prevent the escape of more, and, in the latter, to limit as far as possible the free entry of air into the open chest cavity. Next 1 would place wounds of the skull in which brain is exposed, although here I should like to correct some of the ideas which as laymen you most probably hold. The popular idea that a man who has acquired a large open wound of the vault of his skull is necessarily doomed is entirely fallacious. I have repeatedly seen casualties, so labelled during exercises, passed over by a First Aid Party as too hopeless to waste time upon. And yet such cases do recover. During a rush period in France a man was brought to my table three days after the receipt of his wound. It had not been dressed even during the inter val, and when examined proved to be a shell wound a couple of inches across on the top of the head. The injury was widely open with fragments of skull both lying around the edge and driven into the brain beneath. Large pieces of brain tissue protruded, a fragment of. shell lay close be neath the surface, and an army of maggots played happily over all. He made an uninterrupted recovery, and, when last I heard of him, some years after the war, was running a gar age in Surrey with great success.

A I D Returning to the question of priority of treatment next in order I would place extensive burns. Fortunately for you, the vexed question of the best method of dealing with these cases in hospital does not arise, it is sufficient for you to remember certain points. Never attempt to remove burnt and adherent clothing however much your inquisitive mind may urge you to determine the extent and degree of the injury. The charred material is an excellent temporary dressing, which is all that is needed ; wrap the patient completely in blankets, handle him with more than customary gentleness and get him away to hospital. Lastly, attend to cases of ordinary wounds, fractures and minor cases in that order remembering that the two first are left as long as possible in order that they may recover a little from their shock. P r io r it y

o f

T ran spo rt.

Now comes that difficult question of priority of trans port, one of vital importance to those cases which are trembling on the threshold of life and death. The speed with which you can get a case into hospital is of importance in every case, but infinitely more so in some cases than in others. All cases of external dangerous haemorrhage and in ternal haemorrhage have obvious priority immediately followed by all wounds or injuries of the abdomen. You need never have the smallest compunction in dis patching an ambulance with one priority case only if the slightest delay would be occasioned by waiting to complete the load. The sooner you can get an abdominal wound on to the operating table the more chance the victim has of life. He has little enough in any case, but, if you can get him into the surgeon’s hands within half an hour of his injury, at least there is a chance. Trueta, the great Spanish surgeon who worked throughout the siege of Barcelona, records one of the most severe abdominal wounds of his experience which, after operation, made a perfect recovery ; this he attributed solely to the fact that the patient was actually upon the operating table within twenty minutes of his injury. The question of the movement and transport of severe chest wounds is one of great difficulty. In any such case the utmost gentleness in moving it on to a stretcher, and the greatest care in handling it is vital. Anything approaching roughness in the manipulation of a big chest case may readily prove fatal at once, and it may often be wiser to leave it where it is for a time instead of rush ing it to hospital if thereby a smooth and quiet transporta tion is assured. Nevfer be in a hurry with these cases, and if you can get an expert to see the case first, so much the bettter ; in London, as far as possible, a member of a Thoracic Team of. the Emergency Medical Service always endeavours to see such cases personally before they are moved from the incident. Get out of your minds one thing which you have probably been taught. You have been told that chest injuries must be placed on the stretcher in such and such a position. Forget it. Place the patient in whatever position he himself finds the greatest comfort and ease in breathing, never place him— whatever the books say— in any position which increases his distress. Having got him on to the stretcher see that no avoid able jarring occurs either in lifting or loading, and impress upon the ambulance driver that his speed is not to exceed ten miles an hour and that the smoothest possible route is to be chosen. If it ever became necessary to move the patient over any distance, aeroplane transport is preferable to any other method.

( T o be continued.)

•

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S t.

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A m b u la n c e

H EADQUARTERS

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R EPORTS.

N o. I (Prince o f W ales’s) District No. 44/1 ( A c t o n ) . — This Division held a Church Parade at Acton Baptist Church on Sunday, December 13th. The guests were the British Red Cross Nurses and the Boy Scouts. After inspection by Assistant Commissioner S. J. Warren, the whole parade marched to the Town Hall, led by the band of the Hammersmith Civil Defence. The Cadet section continues to grow and it is hoped before long to have more than twenty boys in uniform. Thanks are due to Private Walsby and Private Baxendale, for their great help in training the cadets. Congratulations are accorded to Supt. C. Dawson on his becoming a Serving Brother of the Order of St. John of Jerusalem. No. 83 ( N o r t h e r n H e i g h t s ) . — A Stop Watch Competi tion in aid of the J.W.O. Prisoners of War Fund has been held by the 83rd and 109th Divisions. Over ^/84 was handed over to the fund. The winners of the ladies and gents watches were Mr. R. A. Butler of Grove Lodge, N . 10, and Mr. Adcock of 83, Barrenger-road, N . 10. The prizes were presented to the winners on the stage of the Odeon Cinema, Muswell Hill, by Miss Peggy Dexter the film actress, who was supported by Mrs. Gammans, wife of the local M.P. This grand total was reached by the untiring work by Pte. H. J. Ayton (83rd Division) and Supt. H. J. W. Wedd (109th Division), also Mr. Mitchell of Messrs. Williamsons of Muswell Hill, who received a prize for selling most tickets — his great effort resulting in his total being over 1,000. Mr. Mitchell at once handed back his prize for disposal in which ever way would benefit the fund. Thanks for the use of the stage were expressed to the Manager, Mr. N. Hope Bell.

N o . II District M i n e h e a d . — A signal honour has come to the Minehead Division of the S.J.A.B. by the appointment of its chief, Supt. F. C. Tarr, to be a Serving Brother of the Venerable Order of the Knights of St. John of Jerusalem, for he is the second of its officers so to be appointed. Divisional Surgeon Dr. W. Bain was similarly exalted six months ago. The appointment is in appreciation of Supt. F. C. Tarr’s services to the Brigade over a period of 25 years, eight during residence in Bristol and the remainder at Minehead. That the honour is richly merited is not to be denied, and Supt. Tarr has received the cordial congratulations of those associated with him in the movement In conjunction with others interested he originated the Minehead Division, and later was behind the movement which led to the establishment of the Nursing Division in the town. Subsequently, principally through his active interest, the Bishop’s Lydeard and Watchet Divisions were formed and various sections and classes in the district were organ ised. An interesting point in his record is that he has given up his time during the day, when others could not be spared from their work, to deal with over 1,000 transport duties. During recent years his activity has increased consider ably by virtue of the lectures and instruction he has regularly given to classes in the town and throughout the neighbour hood in connection both with the Brigade and Civil Defence.

N o . I ll District. R o t m w e l i . ( N o r t h a n t s ) . — The first proficiency badges to be won by cadets in the county of Northampton were

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presented to a number of the seniors of Rothwell Cadet Ambulance and Nursing Divisions by the County Commis sioner, Dr. E. H. Shaw, J.P., on November 29th. The Commissioner was supported by County Surgeon Major G. F. P. Gibbons, O .B .E., Lady County Supt. Mrs. I. Jen nings, M.B.E., County Officer C. Curtis, Lady County Officer Hon. Mrs. Macdonald Buchanan and Lady County Cadet Officer Mrs. Remington. The Cadet Divisions were on parade under Lady Cadet Supt. Mrs. E. E. Austin and Cadet Officer J. C. L. Austin. Before the actual presentation Dr. Shaw inspected the divi sions and also set 4 of of the senior cadets a mock accident case, which they successfully treated. A number of the new cadets were enrolled by Mrs. Jennings. The ceremony was attended by many of the Corps and Divisional Officers of Kettering Corps, and a vote of thanks to the Commissioner and Officers for attending the pre sentation was proposed by Cadet Officer Austin and seconded by Cadet Gwen Gilbert. C o v e n t r y . — Sergt. F. R. Poole’s team won the silver challenge cup at the Stoke and Aldemoor Divisional com petition, held on Sunday, December 20th, at the Folly Lane School. Six teams competed, and Corps Supt. G. Oliver, Corps Officer Booth and Div. Surgeon A. G. Dabbs were the judges. The County Commissioner, Major E. S. Phillips, D.S.O., congratulated officers and men on their smart appearance and efficiency, and thanked those who had contributed towards the trophies.

N o . IV District LANCASHIRE. L iv e r p o o l.—

A pleasant ceremony took place on Sunday, December 27th, on the steps of the Liverpool Cathedral ; the occasion being the dedication of the new ambulance which had recently been presented by the patrons of Messrs. Ind Coope & Allsop Ltd. The Bishop of Warrington (Dr. H. Gresford Jones) officiated and paid fine tribute to the S.J.A.B. for their good work— whose tradition has been rrfaintained during the war. About 100 members of the Brigade were present in uniform. Corps Supt. W. E. Searl was in charge of the parade, and many notable personages were present. The Ambulance Detachments represented were : Invalid Transport Service Division, British American Tobacco Divi sion, Princes’ Park Division, Liverpool South Division, Long view Division, B.I. Cables, Central and Liverpool North Division, Liverpool Gas Co. Division. The Nursing Divisions were represented by : Miss M. Bellassis, Lady Public Duty Officer S.J.A.B., Mrs. A. E. Bleases, Nursing Corps Officer, with detachments from the Sefton Division, Liverpool North Division, Princes’ Park and Longview Divisions. After the ceremony the members went into the Cathedral and attended a Carol Service. It is hoped to re-start the Invalid Transport Service. All enquiries should be addressed to the S.J.A.B. Head quarters, 22, Upper Duke-street, Liverpool, 1.

N o. V District • M a p p e r l e y . — At the annual meeting of the Nottingham Corps, held on January 3rd, a letter of appreciation and thanks from Major-General Sir John Duncan (Chief Com missioner) was presented to Cadet Harry Flint, Mapperley Ambulance Cadet Division, congratulating him on his efficient first aid work on September 22nd, 1942, in en deavouring to save the life of an elderly woman found by him in an unconscious condition at Mapperley. Presenta tions were also made to Corps Officer G. W. Dawson and

F I R S T

Div. Supt. H. Peake of certificates of their admission as Serving Brothers of the Order of St. John of Jerusalem.

N o . V I District A N N F t E L D P l a i n . — Dr. E. A. McKinney, Dipton, and Dr. J. Tudor, West Pelton, officiated at the recent examina tion in connection with Annfield Plain Division, S.J.A.B. Dr D. Reid, Nicholl was lecturer and Supt. R. Horsfield was responsible for the arrangements. Awards: Certificates, 17; Vouchers, 10 ; Medallions, 3 ; Labels, 8.

F ir s t

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F ra ctu re d

S p in e . [The following letter is reprinted by permission from the British M edical Journal .] S i r , — The greater part of my time in the last 3 years has been taken up with teaching and examining in first aid and other subjects for the B.R.C.S. and Order of St. John and teaching the Home Guard first aid. 1 have been impressed with the difficulty the first-aid student often seems to have in following and grasping the essentials of the first-aid treat ment of fracture of the spine. For some time past 1 have thought that the instruction on this subject should be simpli fied and Standardized. 1 was therelore interested to read an article in First A id and the M edical Practitioner, one of the Practitioner booklets, on ' First Aid in Fractures,” by H. Osmond Clarke, F.R .C.S ., of Manchester, in which he writes as follows :

“ Fractures of the spine at any level should be trans ported in the supine position on a hard flat stretcher, main taining as far as possible the normal contour of the spine by inserting a small pillow or pad (e.g., a folded garment) b.-neath the lumbar and gervical spines. It is of the greatest importance that an individual wiih an injured spine should be lifted on to the stretcher with his back supported at several points. If the spine is allowed to sag excessively into hyper extension or hyperflexion, as may occur when a man is lifted by his shoulders and legs, irreparable damage may be done to the spinal cord. To summarize . . . . Spine. — Lift the patient with his spine supported at numerous points on to a hard, flat stretcher with a pad behind the lumbar and cervical regions.” This teaching of Mr. Clarke’s appeared to simplify verymuch the first-aid treatment of fracture or suspected fracture of the spine, and to obviate the difficult (for first-aiders) question of the location of the injury, the difficult method of turning the patient on his side, and the stretcher on its side, and placing the patient in the prone position on the stretcher, in the case of fracture or suspected fracture of the dorsal or lumbar region. As this matter is one of considerable importance, I wrote to my old friend Prof. Harry Platt and asked his opinion. He writes as follows : “ With regard to the first-aid teaching of the immediate handling of fractures of the spine, I think there is a tendency — and it is laudable one— to simplify the instructions. The distinction between cervical injuries and those in the dorsal or lumbar region is well enough for the expert, but liable to be confusing to those untrained people who may be called upon to move the injured person. I myself, therefore, would agree with the teaching that all spinal injuries can be safely transported in the supine position, provided (i) the natural contour of the spine is maintained— e.g., by appropriate pillows ; and (ii) no flexion movements— or, indeed, extreme hyperextension movements— are permitted during the lifting

A I D of the patient. I do not think this subject has been debated recently by orthopaedic surgeons, but most of them would be keen on having a simple standardized method laid down for the guidance of the non-expert. I think your scheme is sound.” The scheme to which Prof. Platt refers is one which I suggested should be used as a standardized treatment for all cases of fracture or suspected fracture of the spine at any level by all first-aiders as immediate treatment. In all cases where there is a history of accident or injury to the neck or backbone with pain and shock, even though there is no paralysis of arms and/or legs, treat as follows : (i) Warn the patient not to try to move ; (ii) keep him warm ; (iii) send for the doctor, and if there is any chance of getting medical assistance in a very short time, do nothing more until the doctor comes ; (iv) it there is no chance of getting medical assistance within a reasonably short space of time, and (v) if you have trained assistants with blankets, triangular bandages, and stretcher, (vi) proceed as follows : if the patient is found in any other position except on his back, with great care and all the assistance possible turn him gently on his back ; (vii) tie the lower limbs together by applying broad triangular bandages round thighs and knees, and a figure-of-eight bandage round both feet and ankles ; (viii) five broad triangular bandages are passed under the natural hollows of the body, so that they come to lie under his head, chest, hips, thighs, and calves ; (ix) two strong poles are used and the bandages are looped or tied round the poles, and the patient is slowly and gently lifted on to the stretcher by two or, if possible, three assistants on each side ; (x) the stretcher, which is hard and flat, is prepared by fold ing the blankets as in the Army method, with a small pad or cushion made out of folded garments placed on the stretcher behind the cervical and lumbar regions respectively. It will be seen that this method incorporates the teach ing of Prof. Platt and Mr. Osmond Clarke (to whom I am very grateful), together with other details already in use, and it is for the immediate first-aid treatment of fracture or suspected fracture of the spine at any level. I think not only orthopaedic surgeons but also teachers and students of first aid would welcome some such simplified standardized method of treatment.— I am, etc., J. L . M o i r , M.B., Ch.B., Lt.-Col., Zone Medical Adviser, Anglesey Home Guard ; County Medical and County Civil Defence Officer, Anglesey Branch B.R.C.S.

From the British M edical Journal, Dec. 19th, “ Letters, Notes and Answers.”

1942,

Lieut.-Col. J. L. Moir (Anglesey) in the course of a further letter states that in order to distinguish his method for the first aid treatment of fractured spine (Journal, Oct. 31, p. 529) from others it has been decided to call it the C l a r k e M o i r method, and he will bring it to the notice of the B .R.C.S. and the Orders of St. John and St. Andrew. But before doing this, as the matter is of considerable importance, he is referring the method to the British Orthopaedic Associa tion for their consideration and approval or otherwise. He continues : “ Dr. J. L. McKenzie Brown, First Aid Com mandant, Civil Defence Service, Walthamstow, wrote me that he thought Procedures VI dnd VII in the order of my treatment should be transposed that is the lower limbs should be tied together by triangular bandages before the patient is turned on his back. We quite agree with this, and think this alteration should be made.” Publishers Note .— W ill readers please note that all back numbers of “ First Aid ” are now out of print and cannot be supplied. W ill South African and other Colonial readers please add to their remittances, “ or English equivalent."

F I R S T

M en ta l

A id s

F ir s t

A id .

M r . J. L a w e s of East Winning, Durham, expresses pleasure at seeing the Mnemonic by Dr. Bowman Edgar in our December number and sends us the following with the request to publish it, and further expresses the hope that other students will submit any Mnemonics, etc., which they have coined. With the exception of “ Clomps” and “ Clip ” which were obtained from his instructor, these hints were made by Mr. Lawes with a view to acquiring a quicker knowledge of first aid.

R I D

R a ilw a y GREAT

A m b u la n c e

N ew s.

W ESTER N

At emergency headquarters, Mr. P. W. Pine, the Company’s solicitor, in the presence of Mr. H. Adams Clarke, chief staff and establishment officer, presented Mr. W. H. Teagle, chief messenger, solicitor’s office, with the 40-years gold bar, and in congratulating him on gaining this award, Mr. Pine referred to the excellent work he had performed in the cause of first aid over a long period.

Necessary Qualifications o f a First Aider. O T R D E D P S

bservation act esource exterity xplicitness iscrimination erseverance ympathy

O T R D E D P S

Id ommy obson ied ntering octor arker’s urgery

C T L S C

an ommy uke till ome

Vertebrae. C T L S C

ervical horacic umbar acrum occyx

Shock w ill be increased by E xposure to cold L oss of blood M ental anxiety S evere pain

) ) ) D I M )

General Signs and Symptoms o f Fractmes.

S D I U C

ain oss of power welling eformity rregularity nnatural mobility repitus

C 1 H D C

orrosive rritants ypnotics eliritants onvulsants

P lease L et S ally D o I t ‘U’ C annot

Classification of Poisons. L 1 H D C

an rene ear ora ailing

Hypnotic Poisons. C hlorodyne L audanum ° Piunj M orphia P arogoric S yrup of Poppies

{ C L O M P S

Classification o f Wounds. C L I P

Signs and Symptoms o f Dislocations. F L F D S

am oss of power ixity eformity welling

P a d d i n g t o n . — Mr. W. A. Lambert, goods superin tendent, Paddington, in presenting the 1942 awards to members of the Paddington goods class, thanked Mr. C. F. Gaynor, the class secretary, for his work and expressed the hope that for the next session each member of the class would endeavour to recruit one new candidate.

W o r c e s t e r . — Mr. J. F. M. Taylor, divisional superin tendent, presided at the annual presentation of awards, and was supported by Mr. F. R. E. Davis, secretary of the Company, accompanied by Mrs. Davis, Mr. J. A. Warren-King, district goods manager, Mr. R. J. Arm strong, divisional loco superintendent, and Mr. W. E. Walling, sheet works manager. The class awards were distributed by the respective divisional officers, and Mrs. Davis presented the following long service gold efficiency awards :— Four 15 year medals, two 20 year bars, three 30-year bars, and two 35-year bars. In replying to the welcome conveyed to him by the chairman, Mr. Davis thanked the company for giving Mrs. Davis and himself the opportunity of being present, con gratulated recipients on their continued proficiency, and assured them that at any future occasion it was possible for them to attend a similar function they would be delighted to accept.

L O N D O N , M I D L A N D & S C O T T IS H

C ontused L acerated I ncised P unctured

L i s k e a r d . — The Mayor, Alderman S. Maggs, presided at the presentation of awards, supported by Dr. J. J. Morgan, the leeturer, Messrs. S. J. Pearson and F. M. Davis, assist ant divisional traffic managers, Mr. E. Lake, divisional engineer, Mr. P. G. Miller, station master, and Mr. P. D. L. Moss, class secretary. Several speakers congratulated Mr. A . B. Ford for his splendid work during a recent air raid. In addition to the awards a number of long service gold efficiency awards were distributed, and an enjoyable enter tainment was provided.

| E L M S

Causes of Fracture. irect violence ndirect violence uscular action

Mr. Gilbert Matthews, superintendent of the line, handed the “ Athlone” Bowl to Mr. R. F. Borrough, the divisional ambulance secretary for the London “ A ” Division, who were successful in winning the trophy last year.

P L F D S

ercy eft our ays ince

P e r t h . — Two well-known Perth railway and ambulance officials were married at Stirling on December 28th. The bride was Miss Alice Madeline M’Whirter, daughter of Mr. and Mrs. W. E. M’Whirter, Argyll Avenue, Stirling and the baidegroom was Mr. Alexander Whytock Panton, son of the late Mr. and Mrs. Charles Panton, 87, Scott-street, Perth. Both are members of the staff of the L.M .S. district goods and passenger manager’s office, Perth. Miss M’Whirter is class secretary of the Perth Station Ambu-

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lance Corps, and the bridegroom is secretary of the Perth Railway Ambulance Company. The ceremony took place in the South Church, Stirling. Rev. D. Blades, M.A., Stirling, officiated. Miss Edith A. M ’Whirter, M.P.S., sister of the bride, was bridesmaid, and groomsman was Constable Charles Panton, Leith. The bride’s father was formerly L.M.S. stationmaster at Stirling.

A m b u la n c e

S e r v ic e

N eed

P a r t-tim e r s.

L o n d o n C o u n t y C o u n c i l want more part-time volunteers for their ambulance service. At present 20 per cent, of the personnel are part-timers. There are now 4,210 men and women at London ambu lance stations, made up of 3,330 full-time workers— 2,100 women and 1,230 men— and 880 part-time volunteers—450 men and 430 women. Although thecouncil are reducingthe number of stations, they are losing full-time personnel for the Services and other war work. This means that they will have to recruit many more part-time workers. Thirteen ambulance stations have now been closed and another eight are scheduled, so reducing the number of stations to 100. There were 121 during the Battle of London. The council’s civil defence ambulances’ latest job is the carrying of sick military personnel in the London area from their units to Army hospitals. There are now 650 A.R.P. ambulances in London and 220 cars for sitting cases under the control of the L.C.C.

We regret to report the death of Pte. S. H. White, No. 4 (Leyton and Leytonstone) Division, who was killed in action in North Africa on November 22nd, 1942. He leaves behind memories of a life well spent. He joined the No. 22 Cadet Division in November, 1933, and after excellent service he transferred to the adult division in Sep tember, 1938, where he continued his good work. At the outbreak of war he joined the Civil Defence of Leyton, con tinuing until January, 1942, when he was called into the service of his country, where he again gave of his best. He witl be missed by all who knew him, and should be a shin ing example to all the cadets of to-day. A We regret to report the death of the late S/Sergt. A. T. E. Dale of No. 24, Newington St. Andrew’s Division, S. J. A. B. on December 28th, 1942, at the age of 64. He was one of the few members who started the Division at its present head quarters, in August, 1904. Since he joined he had taken a very active part in the duties connected with the Division, attaining his efficiency every year until he resigned in 1937 owing to ill health. He saw service overseas from 19141918 in the R.A.M.C. being discharged with the rank of 1st class W. O. His service for the cause of humanity was a great inspiration and encouragement to all men and was appreciated by all who came in contact with him. After he resigned he still took a great interest in the work of the Division. He was laid to rest in Lambeth Cemetery on January 5th, 1943, when members of the Division, both past and present, attended.

An ambulance for service in Lanarkshire has been pre sented by the people of Carmunnock and accepted on behalf of the county by County Councillor Peter Shand. The pre sentation was made by Mr. N. Munro Kerr, convener of Carmunnock Ambulance Fund,

A I D

R e v ie w s . The F ire Guard's Pocket Chart,

By T. M. Ross. Jordan Chancery-lane, London, W .C . 2. Price 4-d. each (by post y d .) ; joj- pet 10a (b y post 3o/6J.

and Sons, Ltd.,

116,

This useful chart presents much needed information essential to Fire Guards by means of pictures, diagrams and tables in such a manner that will facilitate training and make revision easy. In addition to dealing with how to tackle Incendiary Bombs, the chart also includes diagrams of Trailer Pumps, notes on the care of Stirrup Pumps, notes on First Aid Duties, together with miscellaneous notes and a compre hensive table of War Gases, etc.

Simple W ar-Tim e First-Aid. Sussex: Author,

16,

By J. A. Trott, A.R.P.S. Hurst-road, Horsham. Price 6d.

n e t; by post jd. In this twenty-two paged pamphlet which was first pub lished two years ago, the author presents the rudiments of first aid in the hope that it will provide the uninitiated with sufficient knowledge “ to enable them to render valuable services in an emergency.” Like the many similar booklets which are now being published under lay authorship, its chief appeal is that it is an expression of personal experience. All profits therefrom go to War Charities.

Hygiene fo r Nurses.

By John Guy, M.D., D.P.H . and G. J. I. Drinkwater, O.B .E., M.D., D.P.H. Edin burgh : E. & S. Livingstone. Price ys. n e t; by post

5 s 5 dThe underlying idea of this useful book, which was first published in 1930, is to provide nurses with a summary of the requisite knowledge of hygiene based on the syllabuses issued by the General Nursing Council. The main structure and arrangement of the book have been preserved in this, its sixth edition, because experience has shown that it fulfills a definite want. Opportunity has been taken to revise the section which deals with food, as the advances in it, especially that part dealing with vitamins make progress at a rapid r; te.

L e tte r s

th e

E d ito r .

We are in no way responsible for the opinions expressed, or the statements made, by Correspondents.— E d i t o r .

U N IFORM D ear

TRAINING

AND

EQUIPM ENT.

S ir , —

Now that so many are interested in First Aid, and are being trained under the various organisations, it magnifies the need for a universal guide book to which all can turn in case of doubt. I recently attended a “ Bee ” and some of the answers which were “ gonged ” under A.R.P. rules would have passed under B.R.C.S. or S.J.A.B. rules. Some members of the Home Guard are being trained under B.R.C.S. and some S.J.A.B., which causes confusion when the stretcher bearers are brought together in exercise. The Home Guard stretchers will not fit some A R. P. ambulances (though they will be working together when the time comes), and many other points are not dovetailed. Why not uniform training and equipment?— Yours faithfully, “ H ome G uard

Str etc h er

B ear er .”

F I R S T

R I D

O U N D S ,

H E A L R A P I D L Y

W IL L

N O T IF

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TREATED

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and

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R o ad , So u th

N o r w o o d , L o n d o n . S .E .2 5 ______________

A id .

medical section of the Home Guard still lacks the support it deserves, and its development thereby suffers con siderably. True, somejjnits are able to produce efficiently trained men who would prove of inestimable value to their Company in an emergency. But too often the officers concerned are too intent in using the limited time at their dis posal in the perfection of drill, weapon training, battle tactics, etc., to realise the necessity of a reliable body of men to deal with the casualties that may arise from that very fighting efficiency. Most of our M .O .’s are overworked practitioners who can ill-afford the time to train their men in first aid, and this work therefore invariably falls on the C . O .’s. Again, why should the War Office allude to the medical personnel as ‘Stretcher Bearers’— the official brassard is marked ‘S .B .’ in large letters. Old Timers remember that this called for no medical skill, and they look with contempt on a unit which they erroneously think is still under the protection of the Red Cross. A badge, similar to the signallers or specialist gunners, would be far more appropriate, and would necessitate a pro ficiency test. Think what their training entails ! They are expected to be efficient in squad and arms drill, and rifle firing ; must do their quota of Guard duties, etc., and on top of this must be proficient M edical Orderlies , not merely Stretcher Bearers. A change in attitude from the high-ups would attract mote support from officers and men. My own section, in an important Middlesex Battalion, have good support and encouragement. They have won the Battalion cup for two years in succession, and have given demonstrations to the Red Cross and C.D. First Aid Units. These dealt with rescue under fire, improvisations, etc. Also the application of the Thomas splint, completed in 3 minutes, in total darkness in minutes,— C. W. S p r e a d b u r y (Sergt.).

L T D ., C a rg ree n

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C o r p s . — All the Nursing and Cadet Nursing Divisions of the S.J.A.B. in the County of Bristol are to be formed into one corps, known as the Bristol Nurs ing Corps. This decision has been made by the Chief Commissioner. The Corps will be on the same footing as that of the men, with its own officers, and still responsible to the County Commissioner, Mr. A. J. Owens Britton. The new Corps Supt. is Miss M. E. E. Sarah, well known for her good work in the Brigade. Mrs. M. N. Farleigh, Div. Supt. of the Clifton Nursing Division, has been appointed Corps Officer to assist Miss. Sarah. Dr. Helen Aldwinckle is the new Corps Surgeon. A new Cadet Nursing Division has been registered at Westbury, with Miss C. H. M. Sellin as Officer-in-Charge. B r is to l

No.

N u r s in g

D is tr ic t,

S.J.A.B.

B r ig h to n N u r s i n g C a d e t s . — A display was given recently by these Nursing Cadets. It included a stall of hand work, practical demonstrations of home nurs ing, first aid, concluding with tableaus of the eight pointed Cross of the Order and mottoes of the Order. After the display, the Corps Chaplain, Canon James, unveiled a trophy (bronze figure of a Knight of St. John, complete with shield, standard, and bearing the eight pointed cross) which has been presented by Corps Supt. Stuttaford for annual competition among the Brighton Corps Nursing Cadet Divisions. The trophy, Canon James stated, had been given to encourage efficiency in service to humanity and to commemorate Peter Stuttaford. The event was also the occasion of the Cadet presenta tion of annual awards, home nursing, first aid and proficiency certificates, and proficiency badges, which were gracefully presented by Mrs. Stuttaford, who expressed her thanks to Cadet Supts. Mrs. Maynard and Miss Bolton for all the splendid work they have done in co-operation with Lady County Officer Miss Trill. P re sto n

B.R .C.S.

and

In s p e c tio n

a t

N u rses.

According to the Minister of Health, some are urgently needed in civilian hospitals.

This shortage has not been produced by war conditions alone. Over 10 years ago the shortage was causing real concern, and two commissions in 1932 and 1939 published reports stating that it was due to the conditions under which nurses worked, such as long hours, poor salaries, especially after years of training, and the restricted life in the hospitals. The most -serious shortage is in the ranks of trained nurses. To meet this situation steps will have to be taken to shorten the period of training. In Industry it has been found possible to “ telescope ” the usual course of apprentice ship and training without detriment to the quality of the work. Medical students are now allowed to take their final examinations three months earlier than usual. So there is no reason why a reduction of about six months could not be effected in the training period of nurses. Something will also have to be done to regularise the position of the thousands of girls who have failed to reach the high standards at present required by the State examina tions, but who are nevertheless competent for much of the routine nursing and ordinary duties. Already Joint Committees have been set up in several hospitals analgous to Joint Production Committees in the factories, with elected representatives of all grades of staff. They discuss the running of the various departments, and are doing much to increase efficiency and eliminate bottle necks and waiting time. The county of Surrey is one which is badly needing more nurses. As in the country generally, there has been an in crease in the incidence of tuberculosis since the war. The Health Committee have been considering a special report by the' Medical Officer, Dr. J. Ferguson. They have informed the County Council that the matter was causing them much concern, as was the shortage of nyrses. Any accommoda tion that could be provided for a larger number of patients than those already under treatment would be of no avail because of that shortage. An instance was the fact that additional accommodation at St. Helier Hospital for 56 tuberculosis patients could not be utilised owing to lack of staff. The Committee expressed the opinion that nursing was so essentially a part of the war effort that the necessity for directing women to serve as nurses in county hospitals ought to be considered. Alderman Elljott observed that if the Government treated the nursing service as it did the A.T.S. and similar services, many of the present acute problems in relation to nursing staffs would disappear.

S toke

H u ll.

Officers and members of East Yorks Detachment 96 were inspected by the County Director, the Hon. Mrs. de Yarburgh Bateson on Saturday afternoon, December 12th, 1942, at their headquarters in Hull. The Inspecting Officer complimented all present on their smartness. She spoke of the activities of the B.R.C.S. in peace and in war, and urged them to equip themselves for the part they would take in reconstruction after the war. Commandant Mrs. P. G. Cooper thanked Mrs. de Yar burgh Bateson for coming, and also Councillor Barney for his kindness in loaning his premises to the detachment. Mrs. Cooper expressed her regret at the absence of Mrs. Andrew, Divisional Secretary, through’ illness. Proficiency badges were presented by the County Direc tor to successful candidates at the recent examination. Among the visitors on this occasion were Miss Goodall (Assistant County Director), Mrs. Harrison (vice-President), Dr. Glover (Divisional Medical Officer) and Cr. Barney.

S h o rta g e

R I D

12,000 nurses

G a b r ie l

N u r s in g

A s s o c ia t io n :

For nearly 30 years, the village has had its own District Nurse, but during the last few years the funds available have not risen in proportion to the increasing expenses, so that, after months of serious consideration, the local committee has felt compelled to end Nurse Dyer’s term of service. Fortunately, Miss Eggins, Hon. Secretary of the Paign ton D.N.A. has shown sympathetic willingness to help, and the four highly qualified nurses under her are ready to fill the gap. The Stoke Gabriel Committee is anxious that the new arrangement shall be given a fair trial with all possible encouragement, financial and otherwise.

A m b u la n c e s ’

B usy

D a y .—

Boxing Day was the busiest

day for accidents experienced in Glasgow last year by the St. Andrew’s Ambulance Association. The services of the Association were required on 101 occasions—71 times for works and road accidents and 30 times for cases of illness requiring treatment in hospital. were fatal.

Four of the accidents

F I R S T

S I D

L e a r n &

e a r n

a s s a g e

b i g

o n e y !

TJTOME study is the short cut to experience and success and an expert knowledge in Swedish Massage and Anatomy can lead to a congenial occupation and a hand some income. Have you realized the scope and prospects for the trained Masseur ?■ — he is called in every day by doctors, Nursing Homes, Hydros, Sports and Athletic Clubs, Physical Culturists and Trainers, etc., and is of inestimable value to First Aid organizations which is why graduates of the SMAE Institute are in practice in all parts of tbe British Empire. THE

O LDEST

T R A IN IN G

CENTRE

GT.

B R IT A IN

T h e S M A E (Swedish Massage A nd Electrical) In s titu te Is th e o ld e st o f its k in d in G r e s t B rit a in , having been estab lish e d fo r o v e r 20 ye ars. M an v o f th e m o st successful m sseurs in th e c o u n tr y have been tra in ed by th e S M A E In s titu te and re p re s e n t th e h ighest paid o p e r a to r s In the re alm o f massage.

SPA RE T IM E

OR W H O LE

T IM E

O C C U P A T IO N

Y o u can m ake Massage a sp are tim e o r w h o le tim e o c c u p a tio n and r e m e m b e r th a t w ith th e S M A E In s titu te y o u have n o th in g to lose’ as it gu a ran te e s to coach yo u u n til successful at th e e x a m in a tio n and y o u r D ip lo m a se cu re d , o r r e tu r n y o u r fees in full

W R IT E

W IT H O U T D E L A Y FO R T H IS B O O K L E T W H IC H W IL L BE S E N T FREE

T h e B o o k w ill te ll you h o w yo u can co m m e n ce y o u r tra in in g in S w e d ish M assage In y o u r o w n hom e w it h o u t in te rfe rin g w ith y o u r p re sent o c cu p a tio n , and h o w yo u can s ta rt a p r iv a te p ra ctice o f y o u r o w n r ,terot? ^ t ! l l i e S retary~501 S M A E In s titu te , L e a th e rh e a d S u r r e y . m i *!!6 ^BOO K ‘ M a n ip u la tiv e T h e r a p y as a P ro fe s s io n ,” w h ich w ill be sent free and p ost free and w h ic h in v o lv e s you in no o b lig atio n w h a ts o e v e r. ,

T H E L

S M A E A

IN S T IT U T E A

S U

r i R S t

Queries and Answers to Correspondents Queries will be dealt with under the following rules :— 1-— Letters containing Queries must be marked on the top left-hand corner of the envelope “ Query,” and addressed to F i r s t A i d , 46, Cannon-street, London, E .C . 4. 2.— All Queries must be written on one side of paper only. 3.— All Queries must be accompanied by a “ Query Coupon ” cut from the current issue of the Journal, or, in case of Queries from abroad, from a recent issue. 4.— The Textbook to which reference may be made in this column is the 39th ( 1937) Edition of the S.J.A.A. Manual of First Aid to the Injured. E le v atio n of Fracture.

W. H. (Derby).— On p. 224 of the Textbook the general rule is laid down that patients should be carried on stretcher feet foremost, with three exceptions. The second excep tion lays it down that patients should be carried head foremost when the lower limbs are fractured. Is not this elevation of a fracture contrary to the General Rules? We welcome your ruling. No ! Elevation of a fracture means raising it out of its natural position. When, however, patient is loaded on stretcher, the whole body is in its normal position and there is consequently no elevation of fracture. — N. C o r b e t F le tc h e r .

E xam in atio n Howler.

W.F. (Torquay).— In a recent examination the doctor asked a candidate what should be done if a person was bit|en in the foot by a venomous snake ; and he was much amused when he received this reply :— “ I would remove the hoot and apply an emetic ! ” Good!

Next, please! !— N.C.F. A.R.P. Quiz.

W.L. (Derby).— One night last week I was listening in to an A. R. P. Quiz, the contestants being teams from Cardiff and Norwich. A member of one team was asked how he would treat a man who was suffering from excessive bleeding from his ears. Imagine my amazement when he replied that he would place a tourniquet round the patient’s neck. My wonderment was increased when the judge failed to point out to him how ridiculous was his answer and when there was no ripple of amusement from the audience ! ! Tut !

Tut !

What next ?— N.C.F. C h a n g i n g Bearers.

T. E. (Winlaton).— At a recent Divisional Practice three new members and I were told to deal with a patient suffering from a fracture of left femur and to remove him on stretcher. I decided to place three Bearers on the right of the patient and to take my position on the left, my decision being based on the footnote on p. 207 of the Textbook. The Divisional Superintendent, however, ruled that I was wrong in so doing. I shall be glad to receive your ruling on this point. To me your Superintendent was correct in his ruling, because changing the Bearers round is likely to lead to con fusion and because in this instance no real harm would result provided that due care was exercised in the handling of patient.— N.C. F. Fig u re-o f-E ig ht B an d age.

P. W. (Kings Cross).— In a recent competition the team test consisted of a patient suffering from compound fracture

R I D o f left tibia wifh protrusion of bone, and a simple frac ture of right femur. In dealing with these injuries the team did not apply the figure-of-eight bandage round feet and ankles, as this bandage, we understand, applies extension to the leg. We lost points however, for not doing so. A year ago we had a similar case and gained points for not applying this bandage, with the bone protruding, but by tying both ankles together. This has led to a very divided opinion in the team, and as we are entering another competition shortly, we would greatly appreciate your ruling on this matter. The figure-of-eight bandage is, in my opinion, essential to the task of properly controlling a fractured leg. General Rule No. 4 on p. 66 of the Textbook affords the solution of your problem, because if you apply the figure-of-eight band age (1) with great care, (2) without using force and (3) without letting go until the limb is secured (in this instance by tying a firm knot) then it definitely cannot cause exten sion.— N.C. F. I m p r o v is e d T reatm ent of C o m p l ic a t e d Fracture.

J.R. (Nottingham).— On a recent Home Guard Exercise no splints were carried and an incident was supposed to occur half-a-mile from the Regimental Aid Post. A soldier sustained a bullet wound in the arm involving brachial artery and complicated by fracture of arm in middle of the shaft. Please tell me the general lines of treatment. First control the bleeding and then secure patient’s upper limb to trunk by broad bondages in the position which gives the patient most relief from pain. This done, arrange for speedy transfer to Regimental Aid Post. — N.C.F. A n A m u s i n g Incident.

J.R. (Nottingham).— During a Home Guard Exercise the mobile platoon, including Stretcher Bearers, was waiting in the village hall for orders. The evening advanced, and the leading S.B. suggested a bit of practice to pass the time, but no one would lend himself as patient, until a sleeping form was discovered in a corner. Some practice kit was found and the snoring patient was treated for fracture of the femur, and left in peace. Shortly afterwards, the ladies of the village brought in hot cocoa for the ‘ 1 brave defenders ” and one pretty damsel took a cup to the “ patient ” and woke him up for his drink. It took him a long while to get over his surprise at finding himself a casualty, but it proved how tenderly the patient was handled. Truth is always stranger than fiction ; and we are in debted to you for reporting the incident.— N.C.F. Potts Fracture.

T. M. (Newcastle-on-Tyne).— Please tell me what exactly is meant by a Potts fracture. The essential features of a Potts fracture are a fracture of the fibula which as the result of indirect violence gives way at its weakest point some 3 inches above the ankle joint, (2) a displacement of the foot outwards and (3) some injury to the lower end (malleolus) of the tibia. The last named may be a tearing away of the internal lateral ligament or even of the extremity of the malleolus.— N .C .F .1 C o l l e s ’s Fracture.

T.M. (Newcastle-on-Tyne).— Also meant by Colles’s fracture.

please tell me what is

A Colles’s fracture is a fracture of lower end of radius about one inch above the wrist resulting from indirect violence due to a fall on the outstretched palm of hand and occurring most commonly in women of advanced years,N .C F ,

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F I R S T

Treatment ot Snake Bite. T.M. (Newcastle-on-Tyne).— Under treatment of snakebite the Textbook (p. 132) tells us that “ it is useless to place a constriction round the forearm or leg.” Please tell me the reason for this warning. The Textbook warning is given because snake venom travels so fast in the circulation that a ligature just above the bite will almost certainly fail in its purpose and that the one chance of limiting the venom to the limb is given by placing your constriction at the union of the limbs with the trunk.— N.C.F.

Treatment of Nose Bleeding. L. M. (Kenley),— A a recent examination a candidate was told by the surgeon-examiner that in the treatment of nose bleeding the patient’s head shoutd be allowed to drop right forward so as to stop the blood going down the throat. As this is not in the instructions on p. 138 of the Textbook I shall welcome your ruling. I suspect that some misunderstanding occurred with reference to the criticism of the surgeon-examiner, because if the head is thrown backwards blood will pass down into the throat and if it is dropped forward the nose will bleed more freely'. So stand by the instructions of the Textbook and tell patient to tilt head slightly backwards which is the middle and most satisfactory position.— N.C.F.

Corrosive Burns of Eye. F.R. (Edwinstone.)— In the treatment of burns on the body the Textbook tells us to mix the neutralising agent with warm water but when quicklime or other corrosive alkali burns the eye to use cold water for this purpose. When instructing a class recently I was asked what was the reason for this difference in treatment ; and I replied that with burns of the eye the cold solution would be more soothing. Please tell me if I was right. Y es.— N.C.F.

Life Saving Badge. T.G. (East Rainton). — Recently one of our wardens came across a class of men and women who were all doing Schafer’s artificial respiration. When he asked what was on he was told that they were being examined for a Life Saving Badge and Certificate. We were all surprised at this because this subject is an important item in the instruction of first aid classes ; and we thought that life saving simply meant bringing a victim out of the water. Please tell me what organisa tion issues a Life Saving Badge. It seems to me that you are referring to the Life Saving Badge awarded after examination by the Royal Life Saving Society. This organisation was founded in 1891 and has ever since devoted itself to the task of minimising loss of life from drowning by teaching lay persons (1) the best methods of rescue and (2) the resuscitation of the apparently drowned. A little thought should convince you that merely pulling a victim out of the sea or river and then leaving him on the beach or river bank would be a poor effort at life saving and that the second object of the Royal Life Saving Society is every bit as important as the first.— N.C.F.

R I D be removed on stretcher without application of splints, which to me is all tripe ! I think that owing to the blitz the compound fracture requires individual attention as the major injury. I would, therefore, lift off the left leg and, with assistance, I would gently bring the damaged leg into as natural a position as possible without causing extension. Then I would control the fractured patella with a bandage and next adjust the sound leg to the new position of its injured fellow ; and this done I would dress the wound and apply the requisite splints and bandages. I have considered the advisability of placing the uninjured in the same position as the injured limb but still have to bear in mind that the patient has to be roped to stretcher which means a “ rough passage.” Your opinion will be warmly welcomed. You do not state the reason why the patient with these injuries has to be roped to the stretcher, though I presume that he has to be lowered from a building. If there is imminent danger of the patient collapsing then it would be better to defer all treatment until the stretcher is on ground level. If, however this is not the case, then— in view of the fact that the patient must be lifted in order that he may be placed on the stretcher— the fracture must be immobilised before the loading is effective. In short, a dogmatic reply to your query is impossible without a full knowledge of all the circumstances of the incident.— N.C.F.

Artificial Respiration with Burned Back. N.P. (Carlisle).— At a recent practice a discussion arose as to which method of artificial respiration should be used if an asphyxiated patient was found to be suffering from severe burns of the back. Two members favoured Laborde, but the majority voted strongly for Silvester. As we could not come to an agreement, we decided to ask you to give a ruling, for which we thank you in advance. The restoration of breathing being much more import ant than the possibility of aggravating the burns, it follows that, when treating such a patient, you should at once commence Schafer, and that as far as possible you should protect the burned parts so that a minimum of aggravation shall be caused.— N.C.F.

Treatment of Haemorrhage from Nose. M.O. (Finchley).— The Textbook, in Rule 1 on p. 138, tells us to raise the patient’s hands above his head when we have to treat him for haemorrhage from the nose. I have asked two doctors and several senior first aiders the reason for this action, but all have failed to give oie a satisfactory reply. So I now turn to you and shall be grateful for the explanation. Elevation of the upper limbs above the head causes enlargement of the chest cavity, and consequently expansion of the lungs. When this happens, pressure on the venae cavae (the large venous trunks) at their entry to the right side of the heart is lowered, with the result (1) that these vessels dilate, (2) that the return of venous blood to the heart is facilitated, and (3) that the bleeding from the nose is lessened. — N.C. F.

Fractured Leg with Bent Limb. W .T . (Kidderminster).— The problem of treating during a blitz a casualty— whois suffering fromcompound fracture of right leg and simple fracture of right patella, limb being bent at the knee to a right angle and being covered by the left le g — has caused controversy in our circle because patient has to be roped to a stretcher. It was argued that the leg should be kept in position as found and tied to the left leg and that patient should

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F IR S T A ID J m !> ep eii 6e n i J o u r n a l f o r rhe A m b u l a n c e a itb p u r s i n g S e r v i c e s E d ito r :

No. 584-.—

ol.

W A LTER

SC O TT,

XL1X.

NOTICE

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Telegraphic Address— " Twenty-jour, London Telephone— City 3710.

THIS

NUMBER.

E d it o r ia l —

Discipline and Obedience

...

Co-ordination of Civil Defence Services Great Western Railway R.I.P.

...

Letters to the Editor

...

Reviews

...

Police Ambulance News

...

... ...

...

.... ...

...

S.J.A.B. Headquarters and District Reports The Circulatory System

... ... ...

...

... ...

St. John Ambulance Association...

. ..

...

Our Nurses’ Page

...

Q u e r ie s

an d

...

A n sw ers

...

85 86 87 87 87 88 90 90 91 91 92

C o r r e s p o n d e n t s :—

Compound Complicated Fracture of Scapula ...

94 94 94 94 94 94 94 96 96 96 96 96 96

Causes of Swelling

Fracture of Humerus

...

Examination Howler

...

Treatment of Cramp

...

Haemorrhage from Lungs . ..

...

Faking Injuries

...

Value of Rocking Chair in Asphyxia Treatment of Fractures

...

... ... ...

Aids to Artificial Respiration

...

Humour in First Aid

...

Life Saving Badge

...

Treatment of Fractured Patella

...

Effects of Oxygen ...

...

... ...

...

f Entered at 1 [^Stationers' H a ll J

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E D IT O R IA L .

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CONTENTS

F .R .S a n .l.,

...

I t is surprising the arguments which arise from the careless or O b e d ie n ce . loose use of words. Above all things, in matters open to dis pute, words and terms should be clearly defined, and it appears from correspondence which we have received that we ourselves in our article “ A Ques tion of Discipline,” have opened ourselves to a charge of falling short of that standard of perfec tion, and in so far have been misunderstood. The fact is that “ discipline” does not, as is popularly supposed, necessarily imply blind, unswerving obedience. A little of latitude must be allowed in the way of commonsense, and Mrs. Hemans’ poem of the boy on the burning deck is regarded now more as an example of a grammatical inadvertance than as typifying an act of heroic obedience to orders. If a man were given an order to light a fire on a certain hearth, and when he arrived at the place he found that, since the order was given, a number of kegs of gunpowder had been stored there it would certainly not be right of him to apply a match. He would, it is .to be hoped, exercise his common sense. Similarly, if the nurses in the lower ward of a hospital were instructed to move some of the patients to a ward on the top floor, and at that precise moment a hail of incendiaries were to be let loose, surely it would be only wise to defer the operation—orders, disciplinary or otherwise, notwithstanding. In our article we commented on the case of a young woman who was ordered to keep up certain communications. The buildings on either side of a street she passed through in her car were well alight, and the firemen had to play upon her car every time she went along it. They endeavoured to stop her, but she threatened to run over them and they contented themselves with the use of the hose, of which she got her share. Now, one or two of our correspondents on the subject have fallen into the common error regarding “ dis cipline.” Says one of them, who has had 31 years experience in first aid, “ the girl was doing as she was ordered to do and therefore was th o ro ugh ly disciplined. The men who tried to prevent her passing were impeding her in carrying out her D iscip lin e an d

F I R S T

A I D

orders.” And here a nice point arises. Whose orders? The men, too, were carrying out their orders, and the one who gave the orders, the chief officer, was there, and had a full grasp of the state of affairs. The girl’s orders were doubtless from some official or another, who may have been miles away, and they were never intended to be blindly followed but only as circumstances would permit. Our remarks do not, of course, apply to bodies of men, such as troops, who would be accompanied by those giving the order, and who would be able to countermand it, should necessity arise.

C o -o r d in a tio n

o f

C iv il

D efen ce

S e rv ic e s.

S IR

Extracts from Lectures delivered by H E N R Y L. M A R T Y N , K .C.V .O ., F .R .C.S

( Continued from page 6j . )

P r io r ity

o f

T ra n sp o rt.— (

maintain that it should be employed far more widely in rural areas where transport over considerable distances Is often necessary. The little extra training required to accustom First Aid Parties to the use of the splint is a very small matter, and the time necessary to apply it with an efficient party is certainly no longer than that needed to apply the Liston long splint. The use of the Millbank clip instead of the oldfashioned clove hitch and Spanish windlass is also a very great economy of time.

Continued.)

You will have appreciated from what I have told you that priority of evacuation of chest injuries will depend upon the particular circumstances. Although it is urgently necessary to get them into hospital as soon as possible, it may be better if a smoother passage can be thereby assured to hold them for a time. No such consideration, however, enters into the ques tion in dealing with cases of cerebral compression. For these the only chance lies in early operation. You will note that I have specified compression as distinct from large open wounds of the skull, and I want you to appreciate that any patient showing signs of com pression, even though there be no visible injury, is infinitely more in need of priority evacuation than is an open wound with protruding brain. You have now got awav, at any rate, your cases requiring urgent operation, deal next with any severe burns, and by this time the ordinary wounds and amputations will have recovered a little from their shock and be ready for transport. Finally, the fractures can be moved, and this brings us to the much disputed question of the best method of hand ling broken thighs. Fracture of the femur is usually associated with a severe degree of shock, and this shock is liable to be increased to a dangerous degree if the patient is either handled roughly or jolted during transport unless the injury is most efficiently splinted. During the last war the Liston long splint was employed at first, but it was very soon found that the control of the fracture which was effected by this splint was quite inade quate, and that men, carried down from the line and often then transported some distance by ambulance, arrived at the Casualty Clearing Station in a state of profound and some times fatal shock. The universal employment of the Thomas splint, even in the front line, resulted in a very great improvement, and it was found possible to transport cases so splinted almost without any difficulty at all. Although it would obviously be foolish to use the Thomas splint in Civil Defence when working in towns with a hospital in the immediate vicinity, I personally

Before leaving the subject of transport, I would like to impress upon you the great value of the newly-introduced Trig-lifts. This very simple piece of apparatus has not re ceived the attention by many Parties which it deserves. At the time of writing it has only been actually issued to Rescue Parties, but a wider distribution is' in progress— and I would urge you to give it your serious consideration. The smoothness and ease with which a patient can be lifted by means of the canvas straps is very much greater than can be effected by ordinary methods. In difficult circumstances, as, for instance, when a casualty is found lying close beside a wall, lifting by Trig-lifts is simplicity itself. There is another point, as the war goes on the number of men available for stretcher parties progressively dimin ishes, and women will have to be employed for this work to an increasing extent. The use of Trig-lifts is of special value to such parties, since the initial strain of lifting the patient from the ground on to the knees is done away with. I have seen, with much amusement, four women, all of whom had previously' maintained that it was impossible, lift a 14 stone man by means of four Trig-lifts with the greatest ease. W h ere

an d

H ow

The problem of where you are to send your casualty and how you are to get him there appears at first sight to be so extremely simple as hardly to be worthy of con sideration. Air Raid Casualties, nevertheless, contain among their number an infinite variety of traps, one of which may serve to defeat the unfortunate First Aid Party Leader’s necessarily limited knowledge, and, in practice, you may find yourselves faced with problems which demand the utmost of your training and, which having been solved to your immediate satisfaction, will occasion you much subse quent anxiety as to whether you did the right thing. You have all of you heard of the standard trap which is invariably impressed upon the budding constable. A man is found at night unconscious in the road smelling strongly of drink. Diagnosing the case as one of drunkenness, he is placed in a cell for the night without bothering the police surgeon. In the morning he is found to be dead, the reason proving subsequently to be that, although he had “ drink taken ” and therefore smelt of alcohol, his unsciousness was due either to apoplexy or to an injury of the brain caused by the fall. The Coroner on such occasions is apt to be sarcastic at the expense of the police, although, needless to say, such a tragedy could never happen here. However often you may have been told to your serious cases to hospital and all the minor to the First Aid Post, or to their homes, sooner you will be caught by some such trap as that have given to you.

send all injuries or later which I

For instance, a man is found in the vicinity of the ex plosion in a slightly dazed condition stating that he was struck on the side of the head by a piece of flying debris. He is insistent, however, that he is perfectly all right and wishes to return home. It is now up to you to decide whether you will allow him to do so, or whether you will do

F I R S T your utmost to persuade him to let you send him to hospital on a stretcher. If you are wise you will adopt the latter course, since, for all you know, in half an hour’s time he may, perfectly possibly, become unconsious with all the symptoms of cere bral compression and be in urgent need of operation. What has happened, of course, is that the blow has been sufficient to rupture a small artery inside the skull, without breaking the bone, and the gradual accumulation of blood pressing upon the brain may readily prove fatal unless relieved by trephining. Let it be a standing rule always to send such a case for observation either to hospital or First Aid Post.

( To be continued.)

G reat

W e ste rn

R a ilw a y .

A b e r c y n o n . — A large gathering af railwaymen attended the social and musical evening held at the Junction Hotel, when ambulance awards were presented to members of this class. Mr. F. J. Gibbon presided, and was supported by Mr. M. Morgan, stationmaster ; Supt. Jackson, S.J.A.B. ; Messrs. E. J. Livesey, P. Lang, Inspector G. Hawkins, W . J. Parr, class instructor; and A. Minett, class in structor. The certificate recently awarded to Mr. A. Minett for exceptionally efficient first aid rendered was presented to him, and two members of the class received gold bars for 20 years’ service to the movement.

P e n z a n c e . — Mr. A. W . H. Christison, divisional locomo tive superintendent, Newton Abbot, presented a certificate to Mr. J. A . Neal, chargeman examiner, Penzance, for ex ceptionally efficient first aid rendered to a soldier who was lying seriously injured in a mine field.

Mr. Neal has been awarded the Company’s silver medal, but this cannot actually be presented to him until the Board of Trade Restriction Order on the manufacture of such articles is removed. Mr. P. Thomas, divisional ambulance secretary, mentioned that seven people who had entered the mine field were killed, and six others, including Mr. Neal, badly injured.

W e s t b u r y ( W i l t s ) . — Mr. R. G. Pole, divisional traffic superintendent, Bristol, presented the certificate recently awarded to Mr. F. J. Bishop, yard inspector, Westbury, Wilts, and congratulated him on the good work he had performed in rendering first aid on this and several other occasions.

R .I.P . W e regret to announce the passing, at the age of 67, of Miss Mary Ann Pasquill, Lady Superintendent of Atherton Nursing Division. Death was due to an accident— falling down the stairs at her own home.

Miss Pasquill joined the Division in 1912, and during the first two years of the war trained 386 people in first aid. She will be greatly missed by her fellow workers, not only in F.A. but at the Howe Bridge Mills, where she worked for SC years.

R I O

S t.

«7

J o h n

A m b u la n c e

H EADQUARTERS

AND

B r ig a d e

D IS T R IC T

REPORTS.

N o . I (Prince o f W ales’s) District No. 163 ( W a n s t e a d a n d W o o d f o r d ) . — A very success ful concert was given by the Hackney Police “ J ” Division Concert Party recently, at the South Woodford Senior School, St. Barnabas Road, Woodford, in aid of the newly formed Cadet Section of the S.J.A.B., 163rd Wanstead and Woodford Division. The Police, who appeared by kind permission of Supt. E. Brazier, put on an excellent show, every item of which was well applauded. The hall was crowded and the audience insisted upon numerous encores. During the interval, the Mayor, Aid. H. A. Southam, J. P., thanked the Supt. for his presence, and congratulated the Police on their talent. The Supt. in reply, said it gave him great pleasure to help such a good cause. The Div. Supt. of the Brigade, Mr. R. D. Browse also thanked Supt. E. Brazier, mention ing that the Cadet Section was doing good work, and had a membership of 200 boys between the ages of 11 and 17 undergoing training with 40 seniors. A large number of municipal and other influential guests attended the function. No. 84 ( T w i c k e n h a m ) . — The annual general meeting was held on Monday evening, February 1st. Among those present were the Assist. Commissioner, Mr. S. J. Warren (Western Area), Councillor C. W. Beckett (President), Mrs. W. D. Van Troostwyk (Div. Sec., B.R.C.S.), Dr. H. L. Rayner (Div. Surg.), L/Dw. Supt. Mrs. M. Attwooll and officers of the 63 N (Twickenham) Division. After confirmation of the minutes, the Secretary pre sented the annual report, which showed a decline in member ship, drills, duties and casualties treated ; there were now 127 members of whom 40 were in the Forces. Six first aid classes had been held, at which approximately 230 candidates had been successful. Sympathy was expressed with the relatives of Sergt. Observer R. L. Norris, R.A. F., killed on active service, and Pte. H. A. Atkins who died after a short illness. The A/O in charge (Mr. Geo. Ewer) said that the public classes were a small part of the work done by the Division. Members formed the nucleus of a Light Rescue Party in the district. Joining with the Nursing Division and B.R .C.S., they had helped to organise the appeal week for the Duke of Gloucester’s Prisoners of War Fund and raised over ^ 72, 000, apart from the flag day collection. Councillor C. W. Beckett said that ambulance work was more than an emotion of the moment, it was an inborn desire to assist one’s fellow’s. After presenting the annual awards for re-examination, the Assist. Commissioner said he thought that the slight decline was general and did not mean that the Division was breaking up. He thanked the. townspeople for their support of the Prisoners of War Fund. Dr. Rayner expressed his pleasure at the appointment of Councillor Beckett as President, and as a Capt. in the Home Guard, had been asked to express his battalion’s thanks to the Division for training their stretcher bearers. On February 8th, the Division held an inter-section competition w’hich was kindly arranged and judged by Supt. Partridge assisted by Sergt. Smeed and S.-C. Buttle of Teddington Special Constabulary. Teddington Section were first with 134 points, Whitton second w’ith 112 and Twicken ham third with 101 points out of a possible 175. Members of the winning team were :— Pte. Stanton (leader), Cpl, Winter, Ptes. Spalding and Taylor,

F I R S T

No. II District S a r is b u r y .—

This Division of the S.J.A.B., and cadets were inspected recently, Corps Supt. O. F. Francis and Corps Officers Hawkes (Secretary) and Hedges representing head quarters, Gosport Corps. The parade was in charge of Divisional Supt. Lockyer, Ambulance Officer Silvester, Acting Officer Wade (Divisional Secretary), and Corpl. Sanford, with Divisional President A. C. Elmore in attendance. The Divisional Corps Supt. presented certificates to Cadets D. Fielder, I. Tuck and H. Fay.

No. IV District S t o c k p o r t . — Lady Louis Mountbatten, Supt.-in-Chief of Nursing Divisions of the S. J. A. B., inspected East Cheshire units of the Brigade at Stockport Town Hall on Saturday, January 16th. She had previously visited first-aid posts staffed by brigade personnel. At the Town Hall Lady Mountbalten was received by the Mayor, Alderman J. Randles, and accompanied by Captain P. Reay, M .C ., the County Commissioner, and Mrs. Demetriadi, the County Superintendent of Nursing Divisions, and other county officers. She inspected some five hundred members of St. John units— ambulance men, nurses and cadets— and con gratulated them upon their appearance. Referring to secondary school girls who had witnessed the inspection from the gallery, she stressed the importance of getting the interest of young people in the movement. Although members carried on their own work they were able to render great service to the Brigade and so to the com munity. They showed the true commando spirit of courage, tenacity, and confidence which my husband has in the men under his command, she said “ St. John stands for every thing that is chivalrous and public-spirited.”

No. V District S h i p l e y a n d D i s t r i c t . — Good progress is maintained by the Shipley and District Corps, S.J.A.B., composed of ambulance, nursing, and cadet Divisions. In the ambulance Divisions are 22 officers (ambulance and medical) and 315 N .C .O .’s and men. The nursing Divisions have 34 officers, with 356 ambulance sisters and the cadets, six officers and 109 members. Members serving with the Forces comprise : Navy, 26 men and 2 women ; Army, 62 men and 18 women ; Air Force, 24 men and 7 women. In the Civil Defefice there are 30 full-time and 286 part-time volunteers. In Ihe Civil Nursing Reserve 98 members are engaged on full-time and 40 on part-time services. Over 8,000 cases of accidents have been attended to by members, with many others not reported officially. The full membership now is 850, as against 827 in 1941 and 805 in 1940.

No. VHI (Duke of Connaught’s) District A d d i s c o m b e . — There was an excellent attendance of members and friends at the annual general meeting of the Addiscombe Division, S.J.A.B , in the Addiscombe Methodist Hall on January 18th, when main items included the adoption of the 22nd annual report and balance sheet, and the unveil ing of the Divisional Roll of Honour. Relatives and friends of the two members who had been called to higher service on active duty were present. The ceremony was one of sim plicity and of reverence. On a pre-arranged signal, every one stood to attention as the Commissioner, W. Geo. Pape, O .B .E ., K. St. J., cut the string of the veil. Thus was the Roll of Honour unveiled. The Roll formed the focal point in a beautifully arranged draping of white and black, surmounted by letters of red— “ Remembrance.” Floodlights illuminated the frame so that all could clearly read the names therein : P/O. A. A. Aldred, R.N., A,/B. D. Lewis, R.N.

A I D With officers at the salute, the Guard of Honour on the stage (attending by kind permission of Lieut.-Col. Hughes, D.C. M., 33rd Queen’s Surrey Regiment Home Guard), gave the Royal Salute, and the Commissioner feelingly spoke those words familiar to Legion men : “ They shall not grow old as we that are left grow old . . . .” Then followed one minute of silence. The annual report, read by Sgt. Botting, hon. secretary, provided a splendid record of Divisional activities during the past year. During 1942, 2,034 cases of first aid were treated. The annual report relative to the Addiscombe Motor Ambulance Service indicated continued need for this most important activity. During the past year 503 patients had been transported over a mileage of 11,110. The Commissioner spoke of the sacrifice of time by the members, to the spirit of friendship, and their efficiency. He looked forward to the future with confidence.

No. IX District I l l o g a n . — Members of Illogan Division of the S.J.A.B. met at the headquarters at Pool on January 30th, on the occasion of the retirement through ill-health of Supt. W. H. Kevern, who has been a member of the Division for 20 years and Superintendent for the past four years. Mr. A. Pascoe (chairman of the committee) presided, and Mrs. B. J. Mayne (vice-president) presented Mr. Kevern with an illuminated address and a cheque subscribed by members of the Division, officials, and committee. T r u r o . — Coun. H. R. Jennings, sub-chaplain of the Order of St. John, dedicated Truro S.J A .B .’s new ambu lance on January 16th, at the Regent Theatre. The service was conducted by the Rev. F. H. Pritchard, chairman of the Cornwall Methodist District. The Lady Supt., Mrs. Tresidder, named the new ambulance, and it was accepted by the County Commissioner, Lieut.-Col. W. Blackwood.

The

C ir c u la to r y

S y ste m .

[The subject of the circulation is one to which first aiders pay great attention. The vessels through which the blood flows and the action of the heart, are well-known, but the parts which-make up blood and the functions of blood are not so well-known by the average student. We are, therefore, publishing this month, extracts from Chapter XXI of “ Belilios Handbook of First Aid and Bandaging” which sets out clearly and correctly the required knowledge.*] i i e circulatory system consists of the heart, the bloodvessels and the blood contained therein. Each time the heart con tracts (beats) blood is forced along the vessels of the body ; it is therefore kept in a state of continuous motion. By this circulation, oxygen and food products, both of which are carried by the blood, are constantly being brought to the tissues ; and the waste products, formed by tissue action, are constantly removed. Blood is a thick red fluid, a little heavier than water. It is of a brighter red colour in the arteries owing to the presence of oxygen which is being carried to the tissues ; in the veins it is of a darker hue. There are approximately 11 pints of blood in the body. Blood is made up of two parts— a fluid portion called the plasma, which represents about two-thirds of the total bulk, and a solid portion called the corpuscles.

* Reprinted by kind permission of the publishers. Copies of the handbook may be obtained from Bailli^re, Tindall & Cox, at 7/8, Henrietta Street, London, W .C . 2, or Dale, Reynolds & Co. Ltd., 46, Cannon Street, London, E .C . 4, price 4/9 post free.

F I R S T The plasma is a straw-coloured fluid such as is found beneath a blister. It is composed mostly of water and con tains salts, food products after digestion, and waste sub stances including carbon dioxide which are being removed from the tissues. The corpuscles are very minute cells and are divided into red corpuscles and white corpuscles. The former are minute, disc-shaped bodies. They are very numerous— no less than 5, 000.000 would be found in that amount of blood which would rest on the head of a pin. The red corpuscles contain a coloured pigment called haemoglobin ; this is a yellow substance which colours the corpuscles, but it gives the blood a red colour because the cells are so numerous. Haemoglobin possesses the power of combining with

F ig .

1. — Red

A I D

The clotting, or coagulation of blood as it is termed, is the natural method of arresting haemorrhage. When a small bloodvessel has been cut, a clot of blood forms in its wall and seals if, preventing further loss. Were it not for coagu lation a slight wound might cause death ; indeed, some people are born with blood which is deficient in clotting power (haemophilia) and are liable to die from haemorrhage as a result of even a small scratch. T h e H e a r t . — The heart is the chief organ of circulation and is responsible for driving blood to all parts of the body. It is a hollow muscular organ lying in the centre of the chest between the two lungs, rather more to the left side than to the right. It is about the size of a clenched fist and weighs about 10 ounces. It is roughly cone-shaped with its base facing upwards and to the right, and its apex pointing down wards, forwards and to the left.

Blood Corpuscles.

a, Showing how they tend to run together when a drop of blood is allowed to settle ; b, c, d, different views of a single red corpuscle. oxygen while the blood is circulating through the lungs ; it then carries the oxygen .around the body to the tissues. The red corpuscles are therefore the oxygen carriers of the body. The white corpuscles, or leucocytes, are larger than the red cells but less numerous— only 6,000 in each tiny speck of blood. White corpuscles are typical animal cells, consisting of protoplasm and a nucleus ; they are thus capable of move ment and can pass out of the smaller bloodvessels into the tissues. The white corpuscles are often called “ the defenders of the body” because they attack and attempt to devour germs which enter the tissues. During this process, white corpuscles may be destroyed and their dead bodies, together with liquefied dead tissues, form the pus or matter which is always found in a boil or abscess. F u n c tio n s

o f

th e

B lo o d .—

These are as follows :

. ( 1) It carries oxygen, food and water, salts and other substances to the tissues. (2) It carries waste products from the tissues to organs which excrete them. (3) It distributes heat and maintains a uniform tempera ture (98'4 degs.) in all parts of the bod}'. (4) It fights germ infection through the white corpuscles and also by various substances (anti-toxins) which the body itself manufactures to neutralise the toxins (poisons) produced by germs. (5) By its power to clot, it aids the arrest of haemorrhage.

a. F ig .

2.— Varieties

of White Blood Corpuscles,

a, Polymorphs which form 70 per cent. ; b. lymph ocytes which form 25 percent. ; c, large lymphocytes which form about 2 per cent. The remaining 3 per cent, are formed by other varieties.

F ig ,

3 . — Diagram

sh o w in g of th e

t h e Structure and Function Heart.

N ote .— (1) The auricles (R.A. and L.A.) and the

ventricles (R.V. and L. V .); (2) the chief blood vessels; ( 3 ) the valves, the edges of which are joined by strong tendinous cords to projections of heart muscle. The arrows show the direction of the circulation through the heart.

The apex of the heart lies on the diaphragm and can usually be felt beating against the chest wall just below the lef nipple in the space between the fifth and sixth ribs. This beat is known as the cardiac impulse, and is of considerable importance in first aid because it can be felt or heard even when the pulse has become imperceptible. Failure to feel the cardiac impulse, however, does not indicate that the heart has stopped, because sometimes the heart is separated from the chest wall by the left lung. The heart is divided from base to apex into two distinct halves, the right and left sides of the heart respectively. These have no communications with each other. Each side of the heart is divided into two chambers : (a) The auricle, o r receiving chamber, forming the base o f the heart. (b) The ventricle, or discharging chamber, which term inates at the apex. Each auricle communicates by an opening with its corresponding ventricle. The heart works like a pump, the right ventricle pump ing impure blood to the lungs to be purified and the left ventricle driving pure blood to all parts of the body. It will be appreciated that the left ventricle has to work harderthan its fellow, and for this reason its wall is three times thicker than that of the right side.

F I R S T

R I D D ear

L e tte r s

th e

E d ito r .

We are in no way responsible for the opinions expressed, or the statements made, by Correspondents.— E d i t o r . SUGGESTED D ear

M NE M ON ICS.

S ir ,—

I have read with great interest the mnemonics submitted to you by Mr. Lawes of Durham and published in your January issue. These are interesting and helpful, and many readers will doubtless make a note of them. May I venture to offer three of my own use T The necessary qualifications of a first aider I remember by think ing of the “ red spot” in billiards, spelling it R E D D SPOT. I find Mr. Lawes’s mnemonic for the signs and symptoms of fractures a little difficult to remember compared with the good advice “ Pay £ s. d. if you can.” This latter is easily changed into “ Pay L S D if you can,” giving you the initial letters for the signs and symptoms. As an addition to the splendid list Mr. Lawes has sub mitted, may I suggest the following :—

DeUria nt Poisons. B. Belladonna S. Stramonium A. Alcohol C ompany Chloroform Everyone has heard of B.S.A. bikes, etc., and the mnemonic has always proved a welcome one in my experi ence. I am sure that many readers will sincerely thank your correspondent for his helpful suggestions.— Yours faithfully, B. T h o m p s o n (Div. Supt.).

S ir ,—

In the January issue I notice a query from T.G. (East Rainton) re Life Saving Badges. Whilst agreeing entirely with your answer, I feel that the information given was inadequate. T.G. evidently refers to the Respiration Service Badge which is awarded to the R.L.S.S. to candidates who suc cessfully pass a test in (a) Physiology, (b) Artificial respira tion and shock, (c) Special cases of artificial respiration and after-treatment. There is no “ water work ” in this examination, so nonswimmers can join the classes. I would advise T.G. to get in touch with the R.L.S.S., asking for the A.R.P. handbook (price 8d.). The address can be obtained from any Public Baths.— Yours faithfully _______ ___ J. E. T. ’ F I R S T A ID T R E A T M E N T F O R F R A C T U R E D SPINE. D e a r

S ir ,—

Thanks for your reprinting that very interesting letter from the B .M .J . on “ First Aid Treatment for Fractured Spine.” There are two points I humbly comment on :— ( 1) “ Fracture of the spine should be transported in the supine position on a hard fiat stretcher.” This would mean that the Stretcher Parties would have to carry boards or some other appliances to make the stretcher hard and flat, and extra kit means more to carry for the Stretcher Party, for you cannot always find a gate handy. (2) In vii “ tie the lower limbs together by applying broad bandages round the thighs and knees and a figure-ofeight bandage round both feet and ankles.” I suggest that the feet and ankles be tied together first.— Yours, J a m e s E. R u s h t o n .

S ir , —

While not exactly a mnemonic, I have found the follow ing to be of help to new students of first aid who find a diffi culty in rembering which is a Colles and which is a Potts fracture :— The Coat (sleeve) covers a Colles. The Pants (leg) ,, Potts. Once they have been told this, they have not the slightest doubt about which is which. Hoping this will be of some help to the new beginner.— Yours, &c., W. T a y l o r . LIFE D ear

S A V IN G

BADGE.

S ir , —

With reference to the question raised by “ T . G . ” (East Rainton) in the January number of F i r s t A i d , may I offer the probable explanation to his enquiry. The Royal Life Saving Society some years ago introduced their Resuscita tion Certificate. This is granted to those people who pass a satisfactory examination in the theory and practice of the Schafer method of resuscitation. Possibly the class which the warden saw at work was receiving instruction for this certificate. ‘ The holders of this certificate are not entitled, by gaining such award, to wear the registered badge of the Royal Life Saving Society. The badge can only be .worn by holders of the Society’s awards following examination in the art of life saving from drowning, which includes practical work in the water. The only exception is that the Badge is sometimes awarded by special vote of the Central Executive to certain personages as an honour and not the result of examination. While on this subject, I would like to express an opinion which I have long held. This is that life saving from drown ing is a complementary science to first aid to the injured and as such, I would very much favour the inclusion in our manual of the methods taught by the Royal Life Saving Society. I write as a member both of the Brigade and the Society.— Yours faithfully, B . B k n s o n (Div. S u p t .) .

R e v ie w s . Artificial Respiration. Royal

A re you prepared? London : The Life Saving Society, 8, Bayley-street, W.C. 1.

Price 8d. net.

This is the thirteenth edition of a booklet which the Royal Life Saving Society first produced in October, 1939. Beyond doubt, it is the most informative booklet ever pub lished on artificial respiration, and every first aider should possess and carefully study his copy. As is well known, the Society in 1931 was instrumental in securing Professor Sharpey-Schafer’s approval of certain modifications of the method of artificial respiration which he originated in 1903; and it has consistently striven to per suade all first aid organisations to teach the method exactly as Schafer approved it. The present edition bears signs of a complete overhaul with many improvements ; and among the changes we note with interest that the Society has adopted the method of turning the patient face downwards as is taught in the St. John Textbook, and that to comply with this it has modified its previous instructions for turning the patient face upwards, which, truth to tell, were not easy to under stand without a demonstration. This is a decided step forward, and it proves that the Society is sincere in its efforts to secure uniformity of instruction.

C iv il Defence.

By Lt.-Commander F. A. M. Eden, R.N. London : Jordan & Sons, Ltd. Price 2I-.

"In our issue of last October we reviewed this basic training manual, and we whole-heartedly commended it to those of our readers who are engaged in Civil Defence Services. It has now been re-issued with a Supplement on Incendiary Bombs, which cancels the information on pp. 80-88. Those who have already purchased the book can bring their copy up-to-date by sending 7d. to the pub lishers, who will post them this Supplement.

F X R 8 T

9 i

A I D

O U N D S , H E A L

WILL N

CUTANEOUS

T U R N

TREATED

VACCINE

e tc .

R A P I D L Y

O T

B U R N S ,

S E P T IC

WITH

O I N T M

E N T

B E C A U S E

P o lic e

M E D IC O - B IO L O G fC A L L A B O R A T O R IE S

A m b u la n c e

M ETROPO LITAN

S P E C IA L

N e w s .

CONSTABULARY.

The No. 1 District Competition, a new event, was decided at Trenchard House, on January 31st, 1943. The judges were Sub-Divisional Inspector Farthing (individuals) and Inspector Wheatley (teams). The result was as follows :— “ V ” Division (Putney); 335, “ T ” Division (Ealing), 278, “ A ” Division (Cannon Row), ' 259£1 “ C ” Division (West End Central), 256, and “ F ” Division (Hammersmith), 221| ; “ B ” Division (Chelsea) did not compete. The num ber of marks possible was 413. The winners hold the challenge certificate, given by Commandant A. W. Blott, “ A ” Division, for one year. Major P R. Margetson, M.C., Deputy Assistant Com missioner, No. 1 District presented the awards and referred to the services of the judges, “ than whom,” he said “ there are no better first aid experts in the Metropolitan Police.” The judges commented briefly on the performances of the teams. Mr. Farthing remarked that first aid is part of police duty, and Mr. Wheatley that the first aid work of the M.S.C. is really good. Staff Inspectors (M.S.C.) Ludgate and Opie arranged the staging with their usual efficiency, resulting in a perfectly co-ordinated competition. Commandant E. B. Brown, L.D .S ., R.C.S., Director of A.R.P. and Ambulance, complimented No. 1 District on being the first to have its own first aid competition, and thanked the judges and staff. Commander Sassoon, O. B. E., M.C., thanked the D. A.C. for his presence and interest in the competition.

L T D . , C a r g r e e n R o a d , S o u t h N o r w o o d , L o n d o n , S .E .2 5

Major Rogers, D.S.O., O.B .E., M.C. (Staff Officer) and Senior Officers of the Divisions in the district attended. A challenge cup has been offered by Major Rogers, to be known as “ The Staff Officers Cup,” to be competed for annually by the winning teams in each of the four Districts.

S t.

John

A m b u la n c e

A sso c ia tio n .

P l y m o u t h a n d D i s t r i c t . — A talk on the work of the boy and girl cadets of Plymouth and District S.J.A.A., was gfiven to members of the local branch of the Electrical Association for Women at Emmanuel Church Hall, Mannamead, on January 25th, by Mrs. R. Balsdon, Lady County Supt. Mrs. C. Daymond presided. Mrs. Balsdon referred to the work the girls were doing at the Prince of Wales’s and City Hospitals after school hours and during week-ends, and said they were maintaining the ancient creed of the Order of St. John, namely, the service of men and women which for nine centuries was the basis of the ambulance work. It was on such a basis that they, the youth of the city, would shape the future world. The cadet work was started in 1922, Mrs. Balsdon added, and some of the Divisions shortly would be celebrating their coming of age.

B ir m in g h a m C o u n ty C e n t r e . — Classes held by the Birmingham County Centre of S.J.A.A. during the past year numbered 261, compared with 190 the previous year, and 5,102 certificates were awarded, against 4, 385. Although the increase is due partly to the larger number of men’s classes, there have been increases in the classes in preliminary first aid, home nursing and home hygiene. This interest is attributed to the pre-service training organisations which are growing up in the city.

F I R S T

O u r COM PILED

No.

P a g e. SIS TER .

S.J.A.B.

D is tr ic t,

N o rth e rn

N u rses’

B Y AN A M B U L A N C E

A rea.

E d g w a re

and

M ill

H ill

N u r s in g

D iv is io n .—

This Division joined with the men’s Ambu lance Division in giving a party for families of Prisoners of War at the Cornwall Rooms, Edgware, on January 9th. Among the visitors were the Mayor and Mayoress of Hendon, Lady District Supt. Miss Workman, Lady District Officer Burns and Cr. Mrs. Grey Skinner. Each child received a present from the Christmas tree and a merry afternoon was spent by all. Div. Supt. Mrs. McCabe expressed thanks to all who helped to make the party such a success.

S o u th e rn

A rea.

B o ro u gh

o f

L e w is h a m

N u r s in g

D iv is io n .—

Officers and members of this Division and of Hither Green Section laboured untiringly on January 20ih, and subsequent days, when the Sandhurst School was bombed in daylight. Two of the first on the scene were N/O Bevisand A/S Beare. They found Div. Surg. Dr. T. Meyrick already on the spot and doing what he could for the little ones being taken from the debris. Div. Surg. Helen Meyrick soon arrived, and later undertook to visit children who had been taken home for treatment and advise transfer to hospital where necessary. More members came speedily, and all got down to the work on hand, giving first aid here, sending serious casualties quickly to hospital and others to St. Andrew’s Hall, where the Mobile Unit had arrived. It is interesting to note thal? many of the volunteers who came forward to help in the rescue work had gained first aid certificates at classes organised by the Nursing Division. At the mass funeral of the little victims, six members of the Section, accompanied by Dr. Helen Meyrick and N/O Bevis, attended at the Church, and then joined Lady Div. Sup. Miss Pearce and other members at the cemetery, where they were giving sympathetic attention to parents and those bereaved ones who collapsed. One of the Nursing Cadets had a very narrow escape, but she bravely turned up at the Divisional meeting held on the day of the funeral. On this occasion the cadets stood in silence for one minute in memory of their little comrades. The code of chivalry was recited with great fervour, and the cadets filed out with the words of their Superintendent ringing in their , ears— “ Be determined to learn this good work with sin cerity, for you never know when you may be called upon to render service to others.” W e m b l e y (No. 3) N u r s i n g D i v i s i o n . — At the conclu sion of the annual general meeting held on Thursday, Jan. 21st, a very pleasant surprise was announced, when District Officer Mrs. S . C . Goodwin presented a silver cup as a souvenir of her long association with the Division, also as an incentive to competition work. Mrs. Goodwin joined the Wembley (No. 3) Nursing Division in 1923, was promoted Ambulance Officer in 1940, and in May, 1942, was promoted to District Officer ; her special section being the cadets. Mrs. Goodwin has just received a star to her bar.

No.

(E a ste rn )

D is tr ic t,

S.J.A.B.

Peterborough.— The St. John Cadets(Holmes Division) Peterborough, made a splendid effort at No. 4 F.A. P. on Saturday, January 23rd, for the Prisoners of War Fund.

R I D Lady Cadet Supt. Mrs. V. Gillett was in charge, and the visitors included Lady Corps Supt. Mrs. A. E. Holmes, Lady Div. Supt. Miss Burton and members of Brigade and parents of cadets. Mrs. Hemmines (Post Liaison Officer) served tea and the cadets gave a drill display and demonstration of practical work. “ Bring and B u y ” stalls were managed by ambulance sisters and cadets, and Joyce Vincent presented flowers to Mrs. Holmes ; ,£10 10s. resulted for the fund. S a l a r ie s

N u rses.

o f

In the coming series of House of Commons sittings, Mr. Brown, Minister of Health, will make an important state ment on the salaries and status of the nursing profession following the report of the Rushcliffe Committee. It is understood that the committee has advocated a national scale of salaries for State-registered nurses in voluntary and other hospitals, the public services, the dis trict nursing service, and student nurses in private hospitals. These scales, allowing for local variations on the lines of the Burnham scale for teachers, would mean substantial increases in the lower grades and generally make the pro fession more attractive.

A c c id e n t

P e r t h s h ir e

N u rses.

A party of nurses from an emergency hospital had a miraculous escape from serious injury when an ambulance in which they were travelling was struck by a heavy motor lorry. The nurses were returning from duty in a hospital train at a nearby station when the ambulance, in negotiat ing a crossing leading to the hospital, was struck by the lorry. The ambulance was overturned and completely wrecked, several of the nurses being thrown into the road way. Three of them suffered from bruises and shock. The driver escaped injury. R edbrook

N u r s in g

A s s o c ia t io n .

Over two hundred attended a whist drive and dance arranged in aid of Redbrook and St. Briavels Nursing funds. Mr. E. R. Evans acted as M.C. for whist and Mr. S. Ashton for the dancing. Competitions were held, and at the end of a very pleasant evening, Mrs. S. Ball kindly presented all the prizes won. S l a it h w a it e

N u r s in g

A s s o c ia t io n .

Dr. R. N. Kirk acted as chairman in the absence of Dr. Naismith, at the inaugural meeting of the Slaith waite Nursing Association held at the Town Hall on January 27th. The chairman pointed out the pressing need for a nurse for the two districts of Slaithwaite and Linthwaite, especi ally just now when women were fully occupied in war work. Actually, it was stated, two nurses were needed, one for each place, but owing to present conditions, one would have to suffice. Mr. Adey, Secretary of the Royal Infirmary Contribu tory Scheme, assured the meeting that help would be received from the Contributory Scheme. A committee was formed, with Dr. Naismith as chair man and Mrs. Sykes as secretary, to organise a further public meeting with the object of calling together representa tives of churches, chapels, clubs and other bodies with a view to enlisting the services of collectors. Among those who attended the meeting were Councillor Armitage, Miss Greenwood (County Nursing Association), and Mr. Hoyle, secretary of the Contributory Scheme in the Slaithwaite district.

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F I R S T

R I D tendency to gout or rheumatism are often associated with attacks. Forcibly straightening the limb and vigorous rub bing are the best means of cutting short the attacks.— N.C.F. Haemorrhage from Lungs. E.J. (Weston-super-Mare).— Would you be kind enough to answer the following questions :— (1) Is haemorrhage from the lungs caused by the ribs penetrating the lungs, classified as internal haemorrhage or otherwise ? (2) Should a patient suffering from haemorrhage from the lungs, be given hot or warm sweet tea ? Please answer thesequestions and so settle a friendly argument between some of our lads. (1) The Textbook classifies this variety of bleeding as haemorrhage from an internal organ or in other words as a form of internal bleeding. Personally I regard it as partly external (and seen) and partly as internal (and concealed) bleeding ; and I remember that the internal bleeding maybe much more severe than the external. (2) Since no one can be sure at the outset that the bleed ing has been controlled, warm and hot drinks (which might stimulate and cause further bleeding) are definitely contra indicated.— N.C.F. Faking Injuries. G.O. (Stafford).—1 have been trying to get some plasticine and grease paints for faking injuries but have not been successful. In the circumstances what can I do please ? If you get some ordinary putty and work into this a small quantity of boiled linseed oil you will have a suitable base as substitute for plasticine. As an alternative to grease paint, I can only suggest dark red lip stick.— N.C.F.

F le tc h e r .

Examination Howler. M.R. (Cannon St.).— In a recent nursing examination the doctor asked one of the candidates why in taking a patient’s temperature the thermometer was placed under the tongue. He was profoundly amused when the fellow replied— “ To stop the lady talking ! " Good !

Next, please ! !— N.C.F.

Treatment of Cramp. W.J.F. (Torquay).— Is it not curious that no first aid is given either in the S.J.A.A. or B.R.C.S. handbooks, for the very common and painful malady of cramp when not specifically associated with strain ? Belilios’ handbook refers to its cause by reason of acids being produced too suddenly in the muscles. No remedy is suggested, how ever, and no explanation is given of its arising when the muscles are in repose as is commonly the case when the sufferer is in bed. Discussion by members of a First Aid Party brought forth various panaceas— standing on cold lino, applica tion of warmth, massage, and lastly, exercise. Will you kindly tell us, Sir, the cause of the sudden onset of the trouble when a person is at rest and the means of alleviating it. Since an attack of cramp carries with it no danger to life, to limb or to part, its treatment is, in fact, outside the scope of first aid. Consequently your opening question is based on a misapprehension ! Nevertheless here goes ! Cramp is a painful spasm of the muscles. The calves of the legs are most often affected ; and attacks tend to come on at night on the occasion of some slight movement of those parts. Attacks rarely last more than a minute or two, though they may speedily recur. Irritation of the stomach and intestines is probably the most frequent cause, especially in children and delicate nervous persons. Prolonged exposure to cold, excessive fatigue and

Value of Rocking Chair in Asphyxia. M.D. (Chester).— During a talk on Artificial Respiration the subject of the Rocking Chair Method cropped up. This is the placing of patient face downwards on a stretcher which is resting on a trestle, and then rocked. It was maintained that this method is more efficient than Schafer’s method. May we have your kind com ments, as there appears to be no reference to this method in any textbook ? The rocking method of artificial respiration is being pressed to-day in certain official quarters but it cannot be efficiently reproduced without suitable apparatus. On the contrary this or even a stretcher in imitation thereof, is not always available ; and further Schafer’s method can be started on the spot by one individual and without any assistance. — N. C. F. Treatment of Fractures. M.G. (Stanmore).— At a recent Divisional Practice a differ ence of opinion arose over Rule 4 of the General Rules of Treatment of Fractures (Textbook p. 66). The supposed casualty was lying on his back with his right leg drawn up and suffering from fractures of both tibia and fibula, the fragments protruding. “ A ” acting strictly in accordance with Rule 4, placed his left hand under the limb, above the fracture, his right under the limb and below the fracture, then carefully placed the limb in juxtaposition to its fellow, after which he proceeded to apply splints in the usual manner. “ B ” immediately applied splints, by securing them with bandage above and below fracture thus ensuring comparative immobility, whilst the limb was being placed in the most natural position. Will you please let us have your ruling or comments on this question ?

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F I R S T

In my opinion an attempt to apply splints and bandages to the leg before placing the limb in its natural position might result in further damage being caused when the limbs are placed together ; and it could easily convert a simple or com pound into a complicated fracture. It is better, therefore, to carryout the instructions of the Textbook and to apply splints and bandages after the limb has been placed in correct alignment.— N.C. F. Aids to Artificial Respiration. P.S. (Clapham Junction).— In view of the fact that carbon dioxide stimulates the respiratory centre and that it has been used successfully in resuscitation by various apparatus held to the mouth, would breathing into the mouth of the patient during performance of artificial respiration serve the same purpose when other ways of administering carbon dioxide are not available ? Your kind comments will be much appreciated. Mouth-to-mouth insufflation has been used down the years, the first historical reference known to me being the raising of the widow’s son by Elijah (1 Kings XVII, 21). In my student days we were advised not to use the method on new born infants in view of the risk of distending the stomach through the forcing of air down the gullet. Further, it is well nigh impossible to apply it when the patient is in the prone position. Consequently in the circumstances named it would seem to me better to persevere with Schafer’s method and not to bother with any other aid to resuscitation.— N.C.F. Humour in First Aid. B.T.

(B irm in g h a m ).— H a v in g

a lw a ys

en jo yed

the

w h i c h y o u s o o fte n i n c l u d e in y o u r c o l u m n o f F

hum our ir st

I venture to submit an amusing article published in a recent issue of The Methodist Recorder, as follows :— “ ‘ I suppose you know everything ’ a pert young miss said to me the other day'. 1 Well not quite ’ I said modestly. ‘ What do you want to know ? ’ ‘ Not much,’ she said, ‘ Only whether a man who’s broken his shoulder blade should go to a cutler’s for a new one ? ’ 1 Certainly not ! ’ I replied ' no more than he ought to go to a hatter’s for a knee-cap, or to an ironmonger’s for a key for a lock of his hair. Is there anything more you want to know ? ’ “ For a moment she thought and then said ' Yes. Can a man get dates from the palms of his hands ? ’ ‘ No ’ I replied ‘ and if anything goes wrong with the roof of his mouth he can’t repair it by using the nails of his toes. Anything more ? ’ “ Again she thought and came to the charge with another question : ‘ Are my eyes teachers because they have pupils ? ’ ‘ Not any more than your ebrs are bands men because they have drums ’ I replied, adding : ‘ And is that all for to-day ? ’ ‘ I think so ’ she replied, ‘ except that I’ve always wondered why I can’t pack my clothes in my chest and why I can’t see with my eye teeth.’ And then she laughed merrily, and said ‘ We are clever, aren’t we ! ’ I agreed that we were.” Good !

Next, please! !— N.C.F. Life Saving Badge.

A.O. (Hull).— Several members of my Division hold the Life Saving Badge of the Royal Life Saving Society. We are told that they can wear this on their Civil Defence uniforms but we cannot obtain information as to the correct position in which it should be worn. We shall therefore be obliged if you will enlighten us on this point. The woven Badge issued by the Royal Life Saving Society to personnel who have passed their examination in

artificial respiration should be worn on the right breast pocket of the Civil Defence uniform.— N.C.F. Treatment of Fractured Patella. J.F. (Rickmansworth). — Please tell me what are the reasons for the pad which raises the heel off the splint in the treatment of fractured patella. I know that it makes it easier for the bandage to hold the foot firmly but what effect has it on muscles and tendons ? The pad has the effects of assisting in the immobilisation of the leg the foot of which has a tendency to sway when the limb is placed on the splint and also of rendering the fracture less uncomfortable. Incidentally, never once have 1 seen the heel raised off the splint in a long series of examinations ! !— N.C.F. Effects of Oxygen. G.R. (Blaydon-on-Tyne). — During a discussion on oxygen between F.A.P. men at our Depot it was asserted that an individual can live indefinitely in pure oxygen. This statement seems to me at variance with our training and scientific textbooks whicb suggest that in such atmo sphere the temperature would rise to dangerous degree and death quickly take place. We await your ruling which is our law ! In the air which we breathe, 79 per cent, of its volume is nitrogen. The effect of this gas is to dilute the quantity of oxygen inspired to the quantity suitable tor maintaining life. From this it follows that it is impossible for a human being- to live in an atmosphere of pure oxygen. — N.C.F. Compound Complicated Fracture of Scapula. W. B. (Garforth).— Please give treatment of a compound, complicated fracture of scapula caused by a piece of shrapnel entering through the scapula and penetrating the lungs and leaving a gaping wound right down to the lungs. Also, how would you transport such a case? With this combination the lung injury demands preferen tial treatment and the fractured scapula is relatively unimportant. You should, therefore, concentrate on the former whilst protecting the latter from aggravation. As such a case would require early treatment on arrival at hospital it would be better to load patient face-downwards on stretcher so that thewoundcan be readily treated.— N.C.F. Causes of Swelling. W.B. (Garforth).-— Will you kindly explain “^swelling” which can be caused in so many different ways ? The question cropped up at an A. R. P. meeting but no one could give a definite answer. We awaft your answers to our queries with much interest ; and I would add that we devote one night each month to your replies to our queries. By the term “ swelling ” we signify a morbid and un natural enlargement of any part of the body and limbs. This may be due to a displacement of a bone at a joint, the projection of the fragments of a fracture, the escape of blood beneath the unbroken skin due to injury to bloodvessels, and the accumulation of serum from the blood in dropsy, or in the process of inflammation.— N.C.F.

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NUMBER.

E d it o r ia l —

Report of the Nurses Salaries Committee ...

The Home Guard and First Aid..

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S.J.A.B. Headquarters and District Reports Great Western Railway

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Q u e r i e s a n d A n s w e r s t o C o r r e s p o n d e n t s :—

Fractured Cervical Spine

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Examination Howler

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Asphyxia with Fractured Ribs

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Artificial Respiration

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Performance of Artificial Respiration

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Diagnosis of Apoplexy

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Foreign Body in Eye

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Roping Patient to Stretcher

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Effects of Blow o n Thigh

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Compound, Complicated Fracture of Ribs

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Insensibility with Fractured Skull

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Holger Nielson Method

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Treatment of Fractures without Splints

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Treatment of Fractures Rate of Circulation

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First Report of the Nurses Salaries Committee lies before N u r s e s S a l a r i e s us, and whatever may be its C o m m itte e , ultimate fate it is a document which appears to have given great general satisfaction, and that not only to those who are immediately concerned by it but to the great mass of the public at large. It deals with salaries, emoluments and conditions of service of female nurses in hospitals, and the Minister of Health welcomes the recommendations in the Report, and states that, while recognising that the adoption of the proposals will mean an increase in the expenditure of most hospital authorities on the salaries of their nursing staff (and after consultation with representatives of the Associations of Local Authorities and the London County Council) he is prepared, pending the settlement of the post-war hospital arrangements, to assist local authorities in giving effect to the proposals by undertaking to pay from the 1st April, this year, a grant equivalent to half the additional expenditure involved. It seems that there will be no loophole for evasion of the findings of the Committee, for the Minister, in the Circular (No. 2769) which he has issued, says specifically that “ to qualify for this assistance it will be necessary for local authorities to adopt the Committee’s proposal as a whole. Grant will not be payable if they are adopted only in part, nor will the payment of any amount in excess of the scales recommended by the Committee rank for gr ant .” A concession of a somewhat unexpected nature is embodied in the following clause in the Circular referred to. It says “ the Minister has also been in communication with the Associations of Local Authorities and the London County Council as to the financial assistance to be given to local authorities who increased the salaries of their nursing staff after the issue of Circular 2340, in accordance with the suggestions he made. Follow ing these consultations, the Minister is prepared, in respect of the period beginning 1st August, 1941, and ending on 31st March, 1943, to pay a grant equivalent to one half of any additional expenditure incurred by local authorities in increasing the salaries of their hospital nursing staff to the levels T h e

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CONTENTS

F .R .S a n .l.,

F I R S T

suggested in that Circular, and he is also prepared to make a similar contribution in respect of con sequential increases made at the same time to staff holding positions sehTor to that of staff nurse.” It is unnecessary to enter upon details here. The matter is one which has been very efficiently tackled by the Press in all parts of the country, and it has been universally recognised that the nursing pro fession is one that has for far too long a time remained “ outside the p a l e ” and that the day is long overdue when matters such as hours of work, salaries, uniform, night duty, holidays with pay, off-duty days, and sick pay called for action on the part of the Government. It really looks as if some thing is to be done and that some of the grievances and disabilities from which the profession has suffered are to be redressed. The full text of the Report, which includes particulars of the salaries and emoluments recommended, classified according to the various categories of nurses, may be obtained through any bookseller, at the published price of 9d. ret.

C o -o r d in a tio n

o f

C iv il

D efen ce

S e rv ic e s.

S IR

Extracts from Lectures delivered by H E N R Y L. M A R T Y N , K .C.V .O ., F .R .C.S

( Continued from page S y .)

W h e re

and

How ?— ( Continued)

Another type of casualty which may prove to be a dangerous trap is the individual who has received a blow, not necessarily severe, over the spine. Of this I shall have more to say later when discussing Rescue Work, but, be it noted now, that such a case must be regarded with due con sideration and should be transported on a stretcher for observation. Do not be tempted in a moment of pressure to deal with it as a sitting case lest there be present some mere crack of a vertebra which, by such handling, may be easily converted into an irreparable injury. Any patient whom you may find with one or more tiny, and apparently quite insignificant, wounds of the abdomi nal wall or flanks should always engage your very careful attention. The discoloured edges suggest that they have been caused by minute bomb fragments, probably of the anti personnel type, but beyond local discomfort there may be very little complaint of pain. The temptation will be to evacuate such a case in a sitting car rather than upon a much needed stretcher. What you yourself, however, are not in a position to determine is whether one of the tiny fragments has not in actuality almost penetrated into the abdomen itself. The muscular movement entailed upon the casualty by sitting transport may easily convert an “ almost ” into an “ actually penetrated,” in which the outlook is entirely different............................................... ......................... Never allow yourselves to be misled by the existence ot symptoms, however vague, suggesting the presence of an injury to some internal organ, by the absence of any

R I D wound in the immediate vicinity. Remember that the penetrating power of tiny fragments travelling at high velocity is very great indeed, and that a piece of metal enter ing the thigh or buttock may easily reach the interior of the abdomen, or one striking the shoulder may be found eventu ally in the chest. The number of casualties which may be allowed safely to go direct to their homes is very limited indeed, and is almost confined to cases of obvious hysteria and minor bruises. Even sprained ankles should be sent as sitting cases through the First Aid Post since not even the most skilled surgeon is prepared to state definitely that a small fracture may not also be present. I am strongly adverse to the tendency seen at times of allowing minor walking cases making their own way to a First Aid Post unaccompanied. There is such a thing as delayed shock, and it is distinctly upsetting to the dignity of a Party Leader, when he is under the impression that his casualties have been safely disposed of, to receive a message advising him that one of them is lying uncon scious just round the corner. There is almost always to be found some intelligent bystander who can be relied upon to take charge of a convoy of lightly injured en route to the Aid Post. Delayed shock is a very definite entity, and I have clear recollections of a motor smash in which I was in volved, without personal injury, producing this condition. Subsequent to the smash I was engaged in salvaging the car and making numerous arrangements, and it was not for well over an hour that I returned to my house, where I eventually awoke to find myself on my consulting room floor after what had evidently been a fairly prolonged faint, for which no other reason than delayed shock existed. Now that you have considered it, I think you will appreciate how difficult is the problem of determining correctly even such apparently simple matters as the desti nation and means of transport of air raid casualties. There is much to be said in favour of sending a doctor out with every party, not only as a means of taking some of the responsibilities off the shoulders -of leaders, but also to ensure the early administration of morphia. This practice is now largely being adopted, but unfortu nately the supply of doctors is too small to meet the demand. The other alternative, employed wherever possible in Spain, was to place -the large First Aid Posts in the receiv ing rooms of the chief hospitals, using throughout the rest of the target area only small points cited in well pro tected shelters. To these large Posts all cases of every sort came direct from the incidents and a staff of doctors was permanently on duty engaged solely in diagnosing and directing casualties to the correct destinations, whether these were to be resusci tation wards, theatres, ordinary wards, X-ray rooms, casu alty rooms or to home. By such a system only is it possible to ensure that the fewest mistakes are made, and that undue responsibilities do not fall upon the shoulders of those who cannot be trained sufficiently to bear them. It must be admitted that under the present system we are asking our First Aid and Rescue Parties to accept responsibilities and to make decisions, many of which re quire a very high degree of surgical training. Unfortunately, in England, few of our major hospitals are built of the immensely strong reinforced concrete of the Barcelona Hospitals, and in London, at any rate with one exception, the newly-built Westminster Hospital, it would have been impossible to use them for this combined purpose to any large extent. While I am upon a subject less directly concerned with the actual saving of life, perhaps I should say a few words upon the subject of the dead.

F I R S T Many of you are, I know, concerned with the difficulty which you fear that you may experience in deciding- whether or not death has actually occurred. In the vast majority of cases you need have no anxiety whatever since the fact is only too obvious. In a few in stances, however, especially in death from blast, the body may be quite unmarked and appear to you as only as one unharmed and sleeping. The best rule to adhere to is that in no case should definite action be taken until the fact of death had been con firmed by at least one other member of the party. When death has been confirmed, ensure that the body is disposed decently and covered at once. There is nothing more shattering to the morale of both workers and bystanders than the sight of exposed bodies. If actual and certain identification can be effected on the spot, fasten a label to the body with the name and place of finding. In no case should a body be searched for any pur pose whatever, except in the presence of a competent witness, a special constable or a policeman.

( To be continued.)

The

H om e

G uard

T r a in in g

an d

and

F ir s t

A id .

E q u ip m e n t .

appears to be a good deal of misconception as to the type of training necessary to a H.G. Medical Unit. Too often it is along purely C.D. first aid lines. In last month’s issue, “ H.G. Stretcher Bearer” (how I dislike this term !) complained of the need for uniform training and equipment. I agree to a certain extent, but there are snags. With regard to equipment, the only real difficulty that I see, is the one he mentions— that of fitting H. G. stretchers to A. R. P. ambulances. Surely some interchangeable fitment could be evolved to overcome this difficulty. Certainly, I would not care to see A.R.P. stretchers issued to the H.G. They are far too cumbersome for field use. As to the training, surely the most important guide book is the R.A.M.C. handbook (obtainable through booksellers, or direct from H M. Stationery Office, price 3/6). There is a comprehensible section on first aid, the nursing of casualties — very important, this— and many things not contained in ordinary text-books, but of vital importance under army con ditions. This applies particularly to country or outlying defence areas. In town areas, of course, where street fight ing may take place, further instruction is needed in rescue methods from buildings, etc. This can always be obtained through the local A R.P. Officer. I do not believe, however, in relying solely on any text book, or in learning it word for word, as so many people do. Training becomes too stereotyped and it does not encourage initiative. When a good general knowledge has been obtained, especially of physiology and anatomy, the firstaider should find treatment methods come more or less naturally. Remember, that text-book methods are often im practicable under the special conditions of war time. Take fractures for instance. Splints would not often be. readily available, therefore it is important to know first of all how to use the body and opposite limbs as a natural support. Again, a most important section of the training curricu lum should be methods of rescue under fire ; how bearers in the prone position lift their patient on to stretcher ; how to strap a patient to stretcher for surmounting obstacles ; a sound knowledge of war wounds and their special treatment, and many things seldom included in text-books. I would be pleased to exchange views on these subjects with any unit interested.— C . W. S p r e a d b u r y (Sergt.). T h e re

S t.

J o h n

A m b u la n c e

B r ig a d e

HEADQUARTERS AND DISTRICT REPORTS. Brigade Headquarters Cordial congratulations to Colonel Charles Joseph Trimble, C.B., C.M.G., L .R .C .P ., D .P .H . and G O.M. of the Brigade who passed his 87th birthday on March 16th. One of the original Deputy Commissioners, Colonel Trimble rose from Divisional Surgeon to O.C. No. IV District ; and during the War of 1914-18 he was O.C. of the Brigade Hospital in France. He is among tbe most efficient and popular surgeons in the Brigade of which he is still on the active list as Inspecting Officer for Lancashire.

No. I (Prince of Wales’s) District No. SS (Soutiiall-Nurwood).— The S.J A.B. has now been in existence in Southall for 32 years and throughout that time it has maintained a fine record of service to the community. Though now there are no less than 40 of its members serving in various branches of tbe Forces there are still 84 men left with the local Division to carry on this great tradi tion of service. Many of these are playing their part in Civil Defence, but yet find time to perform the normal voluntary obligations they have undertaken to the public to render aid to the sick or suffering. Many tributes have been paid to the work of the S.J. A. B. in Southall. Perhaps no finer testimony has bten paid than that unconsciously uttered by the secretary, Sergeant G. Cox, when he said at the annual general meeting of the Division that in spite of all present-day difficulties, “ at no time had they been unable to accept a duty.”

Photo by\

[Wakefields, E alin g. S ergt.

J im

C orke,

R . A . F.

(Reported missing after an operational flight over Germany.) Sergt. Corke is the eldest son of Mr. and Mrs. Corke, Brent-road, Southall, his age being 21 years. He took a keen interest in the above Division, of which he was a member, and volunteered for service in the R.A .F. in Septem

90,

/ IOO

F I R S T

ber, 1940. He received his training as a Sergt. Observer in South Africa. His father served in a cavalry regiment, as an N.C.O. during the last war, and is now a member of the Home Guard. No. 120 ( B e x l e y ) . — On February 24th, the Bexley Division of the S.J.A.B. held their 11th annual general meeting. Div. Supt. F. G. Ellis was in the chair (in the absence of Dr. C. Morgan, Div. Surg.) and Ambulance Officers A. E. Aylott, A. Gibbins and E. Goodall were pre sent, together with a large number of other ranks. The Treasurer’s report given by the Treasurer, Amb. Officer Aylott, showed that in spite ot increasing difficulties, the Division had still maintained progress in its funds. The Secretary (Hon. Sgt. Wheble) reported that the roll at the end of 1942 was 130, comprising 7 officers, 5 corporals and 118 privates, an increase of 8 over the previous year, and included 18 new members ; 3,289 cases were dealt with by members during the year ; 65 members are in the Forces, 8 in the Navy, 45 in the Army and 10 in the R.A. F., whilst another is working for the Ministry of Supply in East Africa. Thirteen members are working full-time in A.R.P. services and 17 are doing all-night duties with Mobile First Aid Units or at First Aid Posts as part-timers, and 3 are in the Home Guard ; 1,479 duties had been covered by the Division’s members at the five cinemas and swimming pool ; 572 night duties were put in by part-time A. R. P. members, and shelters in the district were visited on 43 occasions. Special mention was made by Supt. Ellis of the good work done by Cadet Supt. Goodall and Cadet Officer Gravett, the average attendance for the boys being about 40 a week. Supt. Ellis poin ed out that the work done among the boys could not be stressed too much and he had received excellent reports of some of the lads who had gone into His Majesty’s Forces. The training given by the Cadet Officers not only helped the lads in leading healthy and useful lives, but also in becoming good citizens. Supt. Ellis also thanked the Treasurer and Secretary for the work they had put in.

No. Ill District. C r a d l e y . — A very enjoyable evening was spent at the Divisional Headcjuarters (Messrs. Oakley Bros. Pavilion) on Saturday, February 6th, the occasion being the Annual Meeting and Presentation of Awards. Among those present were J. Oakley, Esq., President; E. HodgeUs, Esq., VicePresident ; W. B. Southall, Esq., Vice-President ; County Officer D. M. Chapman, S.B., Corps Supt. T. C. Lench, Corps Secretary F. Lightfoot, S.B., Corps. Sergt. Major Preece, Amb. Officer Willetts, E. Littlewood, Treasurer; E. E. Dodd, Secretary, and 28 members of the Division. A light supper was served, after which the County Officer presented the awards of labels, medallions, vouchers, first aid and home nursing certificates to the members. The County Officer, in his remarks, made reference to the great help the Division were receiving from the President and Vice-Presidents, and asked all members to carry on the work of the S.J.A.B. as they had done in the past years. The President thanked the Division for the kind invita tion extended to himself and his fellow visitors. The Rev. Yaxley, in support, said he always enjoyed himself when he came among the Cradley Division and appreciated the kindness very much. He referred to the Church Parade which is to be held on April 11th, and, as last year, the offertory will be devoted entirely to the Red Cross and St. John Ambulance Fund. The annual meeting immediately followed, and was very satisfactory. The Division have increased their num ber by five during the past year. The annual meeting closed with thanks extended by the Secretary to the President, Vice-Presidents, County Officer,

R I D Corps Officers and all the Division for their help and co operation during the past year.

No. VI District B r o u g h a n d D i s t r i c t . — The third Divisional meeting of the Brough and District Division of the S.J.A.B. was held at the headquarters, Elloughton Road, Brough, February 26th, 1943. In the absence of Asst. County Commissioner Edwards, Dr. G. Thompson, Divisional Surgeon, presided supported by H. Rankine Divisional Supt., Ambulance Officer W. J. Howforth, Hon. Sergeant B. Briggs, Divisional Secretary, Sergeant A. Hessel, and other officials and members. Apologies for absence were presented on behalf of Arnold Reckitt, Esq., Divisional President, and E. W. Shoebridge, Divisional Treasurer. The Chairman opened the meeting by thanking all members for their enthusiasm and work, and in the absence of the Treasurer, an abbreviated financial statement was sub mitted by the Superintendent which revealed a satisfactory condition. In the Superintendent’s report it was stated that the strength of the Division was 33 of whom 5 were absent in H.M. Forces. As a result of various classes held during the year for instruction in first aid and gas, 34 awards had been gained in first aid examinations, 24 certificates had been awarded for “ gas ” training and 3 members of the Division had passed for the first home nursing qualifications. With the full support of the members of the Ambulance Division, a Nursing Division had been formed, and they had also contributed extensively in the area to the training in first aid, of Civil Defence personnel, Special Police, Home Guard and other interested parties. Very succcessful flag days have been held, and thanks were due to the public in the district for their interest and assistance. Gfeat stress was laid on the fact that during the year, considerable expenditure had been incurred in the establish ment of a Medical Comforts branch at headquarters. These sundries which may be hired locally at a very low charge may be obtained by the public on application to any of the officials or members of the Brigade, who are continually helpful.

The meeting closed with the appointment of various committees and representatives, and with a vote of thanks to the Chairman for his interest and services.

No. IX District H a y l e . — On Saturday, February 13th, County Officer A. V. Baker visited the St. John Ambulance Cadets of Hayle Division for the purpose of promoting suitable Cadets as N .C .O.’s of the recently-formed Division. Before conduct ing the examination, the County Officer pointed out that N .C .O .’s were the backbone of any disciplined body, because upon them fell the responsibility of setting the ranks a high example of efficiency. They must earn the respect of the Cadets in their charge, and be able to correct any faults solely by means of precent. St. John Ambulance Cadets being a body held together by voluntary discipline, methods suitable fora compulsory form of discipline could not always be employed. Cadets must be made to think correctly for themselves, and not have their thinking done for them, and it is in this that voluntary discipline has such a great advantage over other forms. The County Officer then asked all Cadets to remember that the new N .C .O .’s would have a difficult task, which would only be properly done if the Cadets themselves gave their new officers whole-hearted support. If all worked together they would really have what all of them wanted— a division unequalled in the county for efficiency. Concluding, the County Officer complimented the Div.

F I R S T Supt. (Mr. J. R. Bond) and Cadet. Supt. (Mr. F. Williams) on the number and evident keenness of the Hayle Cadets. The two successful candidates for the rank of corporal were Peter Cretney and Leslie Couch.

io i

R I D

L e tte r s

th e

E d ito r .

We are in no way responsible for the opinions expressed, or the statements made, by Correspondents.— E d i t o r . F I R S T A ID T R E A T M E N T F O R F R A C T U R E D SPIN E.

G reat

W e ste rn

R a ilw a y .

P o n t y p o o l R o a d . — Mr. W. E. Baines, divisional loco motive superintendent, Newport, in the presence of a number of the staff, presented a certificate to Mr. C. J. Hewlett, engineman, Pontypool Road, for exceptionally efficient first aid rendered. The case was a very difficult one, as on arrival at a neighbour’s house he found a man and his wife suffering from severe throat wounds, also a child of five years of age in the room. The situation was rendered more difficult as the electric lamp had been removed. The woman’s injuries included a severed windpipe, and Mr, Hewlett immediately arrested the haemorrhage by indirect digital pressure, which he maintained until arrival of the doctor, and arranged for the child to be removed to his own home, also instructed the police how to arrest haemorrhage on the male patient. The woman lived for three weeks, which the doctor stated was due to the efficient first aid treatment. Mr. Hewlett has been awarded the Company’s gold medal, but this cannot actually be presented to him until the Board of Trade Restriction Order on the manufacture of such articles is removed. Engineman H. Critchfield and T. Davies were also thanked for the assistance they rendered.

D e a r

S ir ,—

In reply to Mr. Rushton’s letter re the above in your February number, I am very glad he raised the two points as they are most important. 1. I consider that the A R P. wire stretcher which is used by the Stretcher Parties, is in most cases sufficiently rigid to transport such a case on, where it is not possible to procure boards. In the case of the canvas and wooden stretcher, boards would have to be used. 2. I quite agree with Mr. Rushton, that the feet and ankles should be tied together first, before the thighs and knees, and am very grateful to him for the suggestion. It is interesting to see that in No. 10 A. R. P. Handbook (2nd ed.) “ Training in First Aid for Civil Defence Purposes,” no mention is made of turning a patient over on his face for transport, in the case of a fracture of the spine in the middle of the back.— Yours truly, J. L.

oir

M.B.Ch.B. (Lt.-Col.).

Anglesey. VARIATIONS D e a r

IN T R E A T M E N T O F

FROSTBITE.

S ir ,—

Mr. E. M. Lewis, brake examiner, Swindon ; Mr. W. F. Burrett, signalman, Saltney ; Mr. J. Green, oil gas maker, Exeter.

For business reasons I have had occasion to make a study of the Government pamphlet “ A Guide to the Preser vation of Life at Sea after Shipwreck” (M R.C. War Memorandum No. 8), published recently. Apart from the particular purpose for which I required this publication, I have been interested, as a first aider, in certain paragraphs dealing with the treatment of various injuries, condition*, etc. In reading up concerning Frostbite I was immediately7 struck by the recommendations contained in the pamphlet. There are such fundamental variations from the treatment described in our 39th Edition Handbook and in the B. R C. S. Manual that I have made some comparisons of the main points of the three methods as under :—

Vellum Vote of Thanks.

M .R .C . Memorandum , No. 8, (page

H o n o u r s . — As a result of recommendations made by the Central Ambulance Committee, the following members of the staff have received recognition from the Order of St. John of Jerusalem for exceptional services rendered to the move ment on the G. W. R. over a long period of years :—

Serving- Brothers.

Mr. F. E Saunders, acting dock fireman, Swansea. Mr. A. H. Cheek, signalman, Bristol, has also been admitted to the Order as a Serving Brother on the recom mendation of the St. John Ambulance Brigade. He is Supt. of the Shirehampton and Avonmouth Division.

S t.J o h n Handbook , (page S t.

A n d rew ’s

A m b u la n c e

A sso c ia tio n .

D y s a r t . — The annual social presentations and dance was held on February 13ih when over 200 took part. Councillor Cook the Section President occupied the chair, and in his remarks praised the work that had been done by its members and the high efficiency obtained. Provost Wilson presented Mr. A. Hutt the Section Com mandant with a Voluntary Medical Service Medal with two clasps, for his 32 years efficient and loyal service, and said that Mr. Hutt had acted as layman lecturer with great suc cess and had now won every available ambulance cup in Scotland and had captained the team that had won the championship of Scotland in 1925. Mr. Hutt was also very well known for his very fine invention the “ Hutt’s Harness ” which was now being used all over Great Britain and in other parts of the world. Provost Wilson then presented 49 certificates to the successful students. A very enjoyable dance then followed.

21).

" 1. Thaw the part in cold (not warm) water. If pain is severe on thawing, cool the part again for a little while with cold water, ice or snow. 2. Rubbing with snow or otherwise— or any kind of massage— is dangerous. 3. Keep body warm, but the damaged part cool.

182).

1. 2.

Avoid the application of moisture in any form. Apply mild friction and the application of dry, gentle warmth. 3. When circulation is restored bring patient into a warm room.

B .R .C .S . Manual , No. /, (page

188).

Rub the affected part gently with snow or a cold wet handkerchief 2. Continue rubbing gently until some colour returns to the part. 3. If no colour returns cover part with improvised dressing. Prevent further exposure to cold. If sleep ing under exposed conditions, the parts should be rubbed gently as often as possible. These divergent instructions are apt to confuse the lay mind and I wonder if, in the happier years to come, there will be a unification of opinion. The Memorandum also speaks of the local application of acriflavine, gentian violet jelly or sulphanilamide to wounds, burns, etc., to prevent their becoming septic. It has to be

102

F I R S T

realised, of course, that such treatment, although in unskilled hands, is intended for shipwrecked people in their tragic surroundings for whom professional attention is not available. On page 14 of the Memorandum there are two excellent sketches of the position of the operator performing Schafer’s method of artificial respiration. The diagram showing the application of pressure to induce expiration makes it very clear that the pressure is directly downwards. So many pupils, as well as some instructors, persist in having their arms at such an angle with the prone patient that the pres sure is made in an upward direction towards the chest. The drawings, incidentally, were loaned by the Royal Life Saving Society whose instructions also have been adapted for inclusion in the Memorandum.— Yours faithfully, B. Hoylake.

B en son

(Div. Supt.).

• LIFE

S A V IN G

BADGE.

C au ses

and

T rea tm en t

S ir ,—

Like Div. Supt. B. Benson, I too, am a member both of the Brigade and the Royal Life Saving Society, and am interested in the last paragraph of his letter in February issue. However, I feel that the inclusion in first aid manuals of the life saving methods taught by the Society would hardly be practical, if those manuals were to continue to be the basis of recognised first aid examinations. Nevertheless, I agree that life saving from drowning is very closely allied to other first aid work and the first aid organisations would do well to do all they can to foster its study in the same way that they do with home nursing, hygiene, &c. Authorising the wearing of a special badge on their uniform by Brigade members holding the Society’s certificate might act as a fillip.— Yours faithfully, E.

Tulse Hill, S . W . 2. D ear

H in e .

S ir , —

Readers must have been rather puzzled by the two letters on the Life Saving badge in the February issue. J.E.T. is right; Div. Supt. B. Benson is mistaken. A woven badge, in red and blue, is issued by the R.L.S.S ., and the Minister of Home Security has given permission for it to be worn on the uniform of Civil Defence personnel who pass the Society’s examination (p. 7, Artificial Respira tion, R.L.S.S . 13th edition). The British Red Cross Society also recognises the badge and has given permission for it to be worn on the right sleeve of its members’ uniform. Ex amination for this badge does not include any rescue or release methods in water, or, in fact, any swimming at all. The registered emblem of the Society is shown on the badge and has been incorporated all along. It is on my own badge (No. 377), and should be widely known, as over 13,000 can didates have now passed. So far from its being correct that “ the badge can be worn only by holders of the Society’s awards following examination in the art of life saving from drowning,” the fact is that, though one may hold also the bronze medallion, the instructor’s certificate, and the award of merit, which all, in a life saving (from drowning) sense, rank higher than the respiration certificate, it is the ‘ ‘ respiration service ” badge only that may be worn on one’s Civil Defence uniform. May I express my agreement with Divisional Superin tendent’s view that life saving is complementary to first aid. Yours faithfully, J.

U n con

s c io u sn e ss. B y

J. L. MOIR, M.B.Ch.B. (Lt.-Col.).

I n teaching first aid, one finds that the student often has difficulty in understanding and grasping the rather difficult subject of “ Unconsciousness,” anything that will make the subject easier to understand or remember, is therefore useful. I have found from considerable experience that the following memorisers (I do not like the word mnemonics, it is difficult to spell and difficult to pronounce) are helpful ; I have come across them in various books and have amplified them some what. . I was asked recently by some members of the Order of St. John, if they could be more widely known. C au ses

D ear

o f

U n c o n s c io u s n e s s .

The vowels of the English language and 3 D ’s and S. A Apoplexy, Asphyxia, Alcohol. E Epilepsy and other fits. I Injury to the brain. O Opium and other poisons. V Uraemia, a disease of the kidneys. D (i) Death, the unconsciousness which precedes death. D (ii) Destitution, exposure to cold ; starvation, etc. D (iii) Diabetes, coma. S Sunstroke, Heatstroke. G eneral

R u les

for

th e

T reatm ent

U n c o n s c io u s n e s s .

A B C D E F G H I . A Air plenty of air. See that breathing passages are clear, remove false teeth or F. B. in throat, turn head to one side so as to avoid the tongue falling back and causing suffocation. B Bleeding ; stop bleeding at once. C Clothing ; undo any tight clothing round neck or waist. D Doctor ; send for the doctor. E Elevate the head if face flushed ; if not, keep fiat. F Fracture look out for fracture of the skull, a common cause of unconsciousness. G Give nothing by mouth. Guard the person from harm. H Help ; get help as soon as possible. / Insist on the person being kept warm.

R e v ie w s . A id s to Surgical N ursing. S.R.N., S.C.M.

by Katherine F. Armstrong, London : Bailliere, Tindall & Cox.

Price 4-S net. The third edition of this excellent textbook contains certain small additions and alterations which were necessary to bring it into line with the many advances resulting from medical progress and war-time experience. Apart from these, changes have been reduced to the minimum necessary to keep the book thoroughly up-to-date owing to the war time shortage of labour. The continued success and popu larity of the book are assured, and the third edition will be as warmly welcomed by readers of F i r s t A i d as it was on first publication.

H ig g in ,

Chairman Accrington Amateur Swimming Club. Publishers Note.— W ill readers please note that all back numbers of “ First Aid ” are now out of print and cannot be supplied. W ill South African and other Colonial readers please add to their remittances, “ or English equivalent.”

T h e F i g h t i n g F o r t y - F o u r t h . — We hear that L/Cpl. Williams, E. H. (of Dartford Division, S.J.A.B.), has been congratulated by Major General N. P. Hughes upon a report he had received of his very good w'ork as a Stretcher Bearer during an important action at a place we, of course, cannot mention in print.

F I R S T

103

SLID

O U N D S , H E A L

e tc .

B U R N S , and

R A P I D L Y

W IL L

N O T T U R N IF

TREATED

S E P T IC

WITH

A N T I P E O L CUTANEOUS

VACCINE

O I N T M

E N T

B E C A U S E

M E D lC O - B IO L O G iC A L

L A B O R A T O R IE S

L T D . , C a r g r e e n R o a d , S o u t h N o r w o o d , L o n d o n , S .E .2 5

ADAM,

ROUILLY

& CO. ,

Human Osteology, Anatomy, Etc.,

18, FITZROY STREET, FITZROY SQUARE, LONDON, W.l Telephone : MUSEUM 2703.

NEW !

JU ST

IS S U E D !

MADE UNDER THE SUPERVISION

PROFESSOR C. F. V. SMOUT, BIRMINGHAM UNIVERSITY.

FIRST 106

A ID

F R A C TU R E and

d r e s s in g s ,

r e a d y

a p p ly

‘ Elastoplast ’ Dressings are the readiest means of protecting minor injuries. After cleaning the wound it takes but a few seconds to select a suitable size of dressing, apply the antiseptic pad and press down the adhesive. The “ Doctors’ Set ” illustrated comprises 106 flesh-coloured dressings of various sizes, in a metal case.

D IS L O C A T IO N

C H A R TS ,

C O LO U R E D . F IR S T

A ID

FRACTU RE

Size 28" x 40" F IR S T

A ID

CHART

Price

D IS L O C A T IO N

Size 20" x 15"

Price

l7/6d. CHART

7/6d.

Postage I/- extra. TPAO6MARK

A id

M a d e p y T . J. S m ith & N e p h e w L t d ., N e p tu n e S treet, H u ll.

Two charts, coloured, on cloth, with rollers,

F I R S T

104

O u r

N u rses’

COM PILED No.

AMBULANCE

SIS TER .

S.J.A.B.

D is tr ic t,

BY AN

P age.

D i v i s i o n . — On January 30th, follow ing an accident, Div. Supt. Miss Pasquill suddenly passed away at the age of 67, very much to the regret of her Division and all who knew her. Miss Pasquill joined the Atherton Nursing Division in 1912 and was promoted to Ambulance Officer in 1922 and Divisional Supt. in 1929. During the last war she assisted at the Convalescent Home at Woodlands. For the past three years she has served in a full time capacity at tne First Aid Post. < Much of the progress made by the Atherton Nursing Division is due to the untiring efforts of Miss Pasquill and to her splendid example of service to others. In the first two years of the war she trained 386 people in first aid, and at a meeting held on Tuesday, February 2nd, the Medical Officer of Health paid warm tribute to her untiring devotion and service to the needs of her fellow townsfolk. For 50 years Miss Pasquill was employed at the Howe Bridge Mills where she will long be remembered for her life of serving for others. The funeral took place on February 3rd at Howebridge Church, when members of the Brigade and many others attended to pay a last tribute to one they had loved and respected. A th e rto n

No.

N u r s in g

D is tr ic t,

N u r s in g

C ad et

of all present.

D is tr ic t,

A m b u la n c e

N e w s .

M ETROPOLITAN. Ten teams took part in the finals of an inter-station first aid competition held by Z Division at St. Christophers School, Norbury, on Saturday, February 27th. Consisting of an individual test and a team test, the contest was gov erned by the rules of the S.J.A.B. In the team test the competitor had to treat a man suffering from a fractured elbow', burns of the hand, an enter and exit wound of the leg and severe shock. Time allowed for this was twelve minutes. Mrs. Quincey, deputising for Sir George Abbiss, O.B .E., who was unable through illness to attend, pre sented the prizes. The Croydon Cup and a set of medals for the winners went to Streatham Special Constabulary. The Norbury Cup for the runners-up was won by Croydon Regulars. The “ P Q ” Cup for most improved team was awarded to South Norw'ood Auxiliaries. The judges were Dr. M. M. Scott, Div. Surg., S.J.A.B., and District Officers Stratton and Hipkins, S.J.A.B. The trophies were presented by Mr. Arthur Bull (Croydon Cup), Norbury Police Athletic Club (Norbury Cup), and Command ant Phillips, O.B .E. and Supt. H. C. Quincey(“ P .Q .” Cup). The medals for the winning team w'ere presented by Sir George Abbiss, Assistant Commissioner of Police.

S.J.A.B.

C o u r s e . — By invitation of the County President, the Lady Blanche Cobbold, a training week end for Superintendents and Officers of Suffolk Cadet Nursing Divisions of the S.J.A.B. was held at Glenham Hall, Woodbridge. Twenty-four officers attended, represent ing fourteen Divisions. There were lectures by specialists on various subjects connected with cadet work, and a demon stration of competition work was given by Nursing Cadets. S u ffo lk

F i f t y Y e a r s A g o . — On January 23rd, 1 8 9 3 , a meeting was held at St. John’s Gate, Clerkenwell, to discuss the formation of a Nursing Division in connection with the St. John Ambulance Brigade then in existence. It was decided the Division should be called “ St. John s Gate Nursing Division.” To commemorate the fifty years of unbroken service, some of the present members attended Evensong at St. Paul’s Cathedral on January 23rd, as an act of thanks giving and re-dedication. The Arch-Deacon, Dr. Sharpe (a Chaplain of the Order) spoke to the members after the Service, and congratulated them on their golden jubilee.

D iv is io n .—

All enjoyed a splendid tea, provided by Miss Clinker, whom Lady Div. Supt. Miss Howard Hall thanked on behalf

No.

Instruction in drill, was given by Company Sergt.-Major Norton. Miss Cunard, Staff Officer and Chief Officer for Nursing Cadets, presented Cadet Jean Lesquereux with the first cadet war service badge to be won in Suffolk. Lady Dunbar Nasmith, Chief Officer for Nursing Cadets, who expressed her satisfaction of the work done in Suffolk, was among the visitors, also the County Commissioner, the Earl of Cranbrook, and Mrs. Lachlan Porter, Officer of the Order of St. John. Others present included the County Supt., Miss Parker, County Officer Miss Miller and County Cadet Officer Miss Botwood, Miss Gurney, psycho-therapist, Miss Haward, N.F .O ., Miss Watson, Sec. Suffolk Youth Committee, Miss Shannon, Miss Prickett, Head Mistress, Mills Grammar School, Franlingham.

P o lic e

S.J.A.B.

On Saturday, February 27th, Asst. Com. Dr. K. Harold Beverley and Lady County Cadet Officer Mrs. Beverley visited Chevet Park to inspect the work of the Nursing Cadets there and to present first aid certificates. _ _ Under the supervision of L. Cadet Officer Miss Farrow, the girls presented a wonderful tableau of the Maltese Cross, a Cadet in turn explaining the symbols of each of the 8 points of the cross— Observation, Tact, Resource, Dexterity, Explicitness, Discrimination, Perseverance, Sympathy. Nurs ing Cadet Audrey Butter worth recited the Cadet “ Code of Chivalry.” With L. Cadet Supt. Miss Clinker in command the cadets gave a good demonstration in hand-seat drill and later treated ‘ ' cases ” of fractures and haemorrhage. Dr. Beverley inspecting their work expressed his pleasure at the result. He reminded them of the parable of the Good Samaritan and that the motto of all members of the S.J.A.B. was “ For the Service of Mankind” and that their practice of first aid helped to fit them for this service. Nursing Cadet Audrey Butterworth sang The Lost Chord,” Nursing Cadets Barbara Hall and Eleanor Waddington a duet “ Nymphs and Shepherds” ; Mrs. Lifton, who has promised to instruct in physical training, gave a W a k e fie ld

R I D

T r a in in g

M N F M O N 1C S .— Since we commenced publishing mne monics kindly sent to us by readers for general information and instruction, we have received an enormous number from other readers. These we shall publish as space permits.f We would, however, ask readers kindly to refrain from sending further mnemonics for a time until we have been able to publish those we have in hand.— E d i t o r .

f i r s t

a i d

* °5

L e a r n &

e a r n

a s s a g e

b i g

o n e y !

JJTOME study is the short cut to experience and success and an expert knowledge in Swedish Massage and Anatomy can lead to a congenial occupation and a handsotne income. Have you realized the scope and prospects for the trained Masseur ?— he is called in every day by doctors, Nursing Homes, Hydros, Sports and Athletic Clubs, Physical Culturists and Trainers, etc., and is of inestimable value to First Aid organizations which is why graduates of the SMAE Institute are in practice in all parts of the British Empire. TH E

O LD EST

T R A IN IN G

C EN TRE

GT.

B R IT A IN

T h e S M A E (Swedish M a s sage A n d E l e c t r i c a l ) In s titu te Is th e o ld e s t o f its kin o In G r e a t B r it a in , having been estab lish e d fo r o v e r 20 ye ars M an y o f th e m o st successful n r s s e u r s in th e c o u n tr y have been tra in ed by th e S M A E In s titu te and re p re s e n t the highest paid o p e r a to r s In the re alm o f massage. SPARE

T IM E

W H O LE

T IM E

O C C U P A T IO N

Y o u can m ake M assage a sp are tim e o r w h o le tim e o c c u p a tio n , and r e m e m b e r th a t w ith th e S M A E In s titu te yo u have n o th in g to lose as it gu a ran te e s to coach yo u u n til successful at th e e x a m in a tio n and y o u r D ip lo m a se cu re d , o r r e tu r n y o u r fees In full. W R IT E

W IT H O U T W H IC H

D ELA Y W IL L

FO R

T H IS

SEN T

BO O KLET

FREE

c T I ? ? ? 1* wMI tel1 you h o w y o u can co m m e n ce y o u r tr a in in g In S w e d ish Massage In y o u r o w n h o m e w it h o u t in te rfe rin g w ith y o u r p re se n t o c cu p a tio n and h o w yo u can s ta r t a p r iv a te p ra ctice o f y o u r o w n W r i t e to th e S e c r e t a r y - 5 0 , S M A E In s titu te , L e a th e rh e a d S u r r e y ' ill'k ' ^ .B O O K M a n ip u la tiv e T h e ra p y as a P r o fe s s io n ," w h ich w h a ts o e v e r

T H E

S M A E

P ° St

and w h lc h in v o ,v e s

in no o b lig atio n

IN S T IT U T E

L E A T H E R H E A D , SU RREY.

io 6

F I R S T

C o rk e t

F le tc h e r .

Examination Howler. S.G. (Bourne)— At a recent examination the doctor asked one candidate what he would do first if he came across a man hanging by a rope from a nail on the wall of his bedroom. He was much amused when the candidate replied — “ / would empty his pockets and so take the weight off his neck ! ” Good!

Next, please ! !— N.C.F.

Asphyxia with Fractured Ribs. J.A. (Manchester).— At a recent Divisional Practice I was told to deal with a patient suffering with asphyxia and simple fracture of the ribs. I considered Schafer’s method of artificial respiration to be the best treatment, but one member favoured Laborde and a few Silvester. So we decided to ask you for an explanation as your opinion will be welcomed.

R I D 45 degs. (head down) be sufficient to raise the diaphragm to cause expiration without artificial assistance ? ” Your valued opinion will be gratefully appreciated. Your letter is not very clear and gives the impression that the patient is stationary. If so, the effects of the move ments of the internal organs on the diaphragm would be minimal. To obtain full effects you would have to rock the patient or, in other words, to raise the head and shoulders and to lower the legs alternately.— N.C.F. Performance of Artificial Respiration. p.S. (Plymouth).— On p. 144 the Textbook, with reference to the performance of Schafer’s method of artificial respira tion, tells us “ not to waste time by loosening clothing.” On p. 149 in its instructions on performance of Silvester’s method it tells us to “ undo all tight clothing.” This difference in the instructions has always puzzled me ; and so 1 venture to ask your kind explanation. With the Schafer method the prone position of the patient protects him from the added risks of suffocation which may result from his tongue slipping backwards and from pressure on his air passages. It is, therefore, quite correct to start operations at once and not to waste time by loosening clothing ; and these were Schafer’s own instructions. With the Silvester method the supine position of the patient and the backward tilt of his head definitely exposes him to these added risks. It is, therefore, necessary that steps be taken to avoid these, by controlling the tongue and by loosening the clothing before you begin operations.^ N.C.F. Diagnosis of Apoplexy. N.B. (Chelsea).— To its description of Apoplexy on p. 166 the Textbook adds this cryptic sentence— ” Signs of injury are not necessarily present.” At any rate 1 have always been puzzled by it and I shall be grateful for your explanation. As the sentence follows a statement that Apoplexy is due to rupture of diseased blood vessel causing haimorrhage into the brain tissue, the sentence under discussion ought to read “ Signs of injury to head are not necessarily present.” As a fact, doctors diagnose Apoplexy by the presence of signs and symptoms of Compression of Brain which are not accompanied by history and/or signs of injury to head.— N.C.F. Foreign Body in Eye. M.N. (St. Pancras).— Recently 1 saw a first aider use his tongue to remove some grit from a fellow workman’s eye. As this is not mentioned in the Textbook I wonder if you will commend such action ; and I await your ruling with interest.

1 do not ! Rather hensible trick.— N.C.F.

1 condemn

it as a dirty and repre

Your decision is correct because Schafer’s method, properly performed, exerts pressure on the loins and would not cause aggravation of the fractured ribs. On the other hand, Laborde’s method does not give satisfactory results, whilst Silvester’s method pulls on the upper limbs and would result in aggravation of the fractured ribs.— N.C.F.

Roping Patient to Stretcher. A.H. (Thorton).— Last October I put forward in this district a method of roping patient to an A.R .P. stretcher, which all here think better than that in A .R .P . Handbook No. io (2nd Edition). The tying is done slightly under the patient and therefore allows no movement whatever. The tying of the feet is firmer and one bandage less is used. The tying of the feet is started under the instep, crossed over the instep in front of the ankles down through the mesh of the stretcher, brought back and tied in front of the ankles. Please give your comments.

Artificial Respiration. A.F. (Holloway).— After a recent first aid lecture to a party of B .R .C.S . members, the discussion of artificial respira tion arose, and there was one point that no one could answer. This is it :— “ Would the weight of the contents of the abdomen of an asphyxiated person reclining at an angle of

With regret I cannot commend your suggestion because experience has shown that the wire mesh of the A.R.P. stretcher is not strong enough to take the weight of a patient in the way suggested by you. Consequently there is a risk of one or more of the wires breaking under the strain and a possibility of the patient being thrown off the stretcher.— N.C.F.

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Effects of Blow on Thigh. O. (Stafford).—1 am a medical orderly in the Home Guard. Recently one of our officers gave a lecture on unarmed combat. He stated that by striking a person on the inside of the lower limb just above the knee joint and by driving the femoral artery sharply against the femur, you could make that person temporarily unconscious We welcome your comments.

It seems to me that there was some misunderstanding on this point because I do not know any effects of a blow on the thigh which would produce unconsciousness.— N.C.F. Compound, Complicated Fracture of Kibs. H.D. (Quinton). — Please tell me if a fracture of ribs with injury to the lungs but without an external wound can be called a compound, complicated fracture in view of the chance of. harmful germs gaining access to the seat of injury via the air passages and damaged lungs. The Textbook (p. 62) defines a compound fracture as one in which (1) the fractured ends may protrude through the skin and (2) the wound may lead down to the fracture. On this definition, therefore, it follows that if air can get through the damaged lungs to the broken rib (or ribs), the fracture may become both compound and complicated.— N.C.F. Insensibility with Fractuxed Skull. C.M. (Hammersmith).— Will you please tell me if it is possible for a person to receive head injuries to the extent of a fractured base of the skull associated with a fracture of head or brow and yet remain conscious and able to sp eak ?

Such a patient may be fully conscious ; and he may be able to speak provided that the speech centre in his brain is not affected by the injuries. Once again I point out that of all the causes of insensibility named in the Textbook, Epilepsy is the only one in which the patient suffers from sudden and complete loss of consciousness and that in all the others the patient may be either fully conscious or partially or completely unconscious. — N.C.F. Holger Nielson Method. K.O. (Glasgow). — Please tell me what is your opinion of the new Holger Nielson method of artificial respiration. The Holger Nielson method of artificial respiration was first put forward by Colonel Holger Nielson of Copenhagen at the Fourth Congress of Life Saving and First Aid. It was described in detail in the May and June 193S issues of F i r s t A id . Briefly, the patient being placed in prone posi tion with forehead resting on his flexed forearm, the method consisted of pressure on both shoulder blades in imitation of expiration followed by a “ lifting movement” which was produced by the operator grasping both armbones midway between shoulder and elbow joints and raising the elbows off the ground in imitation of inspiration. Experience proved that it was less efficient and more difficult to carry out than Schafer’s method ; and, to the best of my knowledge, it was for these reasons— never approved by the experts.— N.C.F. Treatment of Fractures without Splints. J.E. (Port Talbot). — During a lecture on treatment of frac tures our surgeon-lecturer laid stress on the fact that with any fracture of the limbs— whether splints were available or not, and whatever other bandages were used there must always be one above the fracture (to he p ut on first) and one below the fracture. On the other hand the Textbook tells us that with a fracture of the leg, when no splint is available, feet and ankles, knees and thighs should be tied together. Could you tell me please the reason why the bandages above and below the fracture are omitted ? Surely the addition of these would secure the immobility of the fractured limb more than would be the case without them

A I D and even though the uninjured limb is being used as a splint, for when we have a splint the above and below bandages are the first to be applied. Your comments would be appreciated. On this point I agree with your surgeon-lecturer. What he said, however, was that of the two bandages above and below the fracture the upper one must be applied first. He could not have stated that the bandage above the fracture must be the first to be applied in all cases. Thus with frac tured thigh and with fracture of leg (single-handed treatment) the Textbook tells you first to apply a bandage as figure-ofeight round ankles and feet. With reference to the Textbook instructions at foot of p. 92, it seems to me better to follow these and to omit the bandages above and below the fracture of leg because these might cause displacement of fragments owing to the outward bend of the tibia, a risk which does not arise when the leg is tied to a splint on the outer side.— N.C.F. Treatment of Fractures. H.E. (Forest Hill).— May I be allowed to pull to pieces the query published under the above heading in the February issue of F i r s t A i d . The case to which your corre spondent refers seems to me to be full of blunders regarding treatment. The fractures of the right tibia and fibula are obviously compound. So why was “ A ” allowed to apply any form of extension to this injured limb ? The Textbook obviously and rightly forbids such action. Further, Rule 4 on p. 66 does not say anything about placing one hand under the limb above fracture and the other under limb below fracture. Yet we are told that “ A ” strictly in accordance with Rule 4 applied exten sion to a compound fracture and on top of this applied it in a totally wrong fashion. Your correspondent seems to be concerned only with whether it is correct or not to apply splints to the injured limb before or after it has been put in correct alignment with its fellow. He surely misses the fundamental errors to which I have referred. Thanks a lot for your help month after month in the Queries column but I wish that some of the queries were as intelligent as your answers. From your letter it would seem that you are confusing the words “ juxtaposition” (as used by my correspondent) and “ extension.” Also you misinterpret Rule 4 in accordance with which Candidate “ A ” held the limb in such a way that he could control the limb (1) with great care and (2) without using force. Irj short, your criticisms are not substantiated. — N.C.F. Rate of Circulation. R.W. (Walton-on-Naze).— During a recent discussion in our Depot the question arose as to how long it takes the blood, after leaving the left ventricle of the heart, to travel round the body and back to the left ventricle. A colleague produced a newspaper in which the same question had been asked, and the reply given was fifteen seconds. From my studies of first aid I understand that it takes about thirty seconds. Is this correct ? Would you be kind enough to give your ruling on this point, which like many other questions from month to month, is awaited with interest. Thirty seconds is correct.— N.C.F.

“ FIR ST AID ” QUERY and REPLIES COUPON. T o be c u t o u t a n d e n c lo s e d w ith a l l Q u e r ie s .

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By MARGARET E. HITCH. TH E

LATEST

AND

TH E

BEST

PAGES of essential information • Hundreds of illustrations • W ords defined, explained and pronounced • Invaluable to the first aider Special illustrated sections on First Aid T r eatm en t.

Bandages and Bandaging.

Antiseptics and Disinfectants.

Gases Used in Warfare.

Blood Transfusion.

C om m o n

Poisoning.

Methods of Giving Drugs.

Av era g e W eig h ts and

Drugs and Doses.

Heights. T her momet er s.

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F IR S T A ID JntapenAen! ^ a m ^ j o r th e A m b u l a n c e a n b l u r s i n g B e r n i c e s E d ito r :

No. 586.— V

o l.

W A LTER

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THIS

NUMBER.

E d it o r ia l —

The Nurses’ Bill

109

...

Co-ordination of Civil Defence Services

...

110

The Home Guard and First Aid...

111

S.J.A.B. Headquarters and District Reports

111

First Aid for Fractured Spine

113 114 114 116 116

Railway Ambulance News St. John Ambulance Association... Letters to the Editor

...

Stanmore First Aid Association... Q u e r ie s

and

A n sw ers

C o rre sp o n d e n ts

Functions of Spleen

...

Examination Howler Sulphanilanide Powder Faking of Fractures Rate of Circulation Wound of Finger ... Shock from Abdominal Injury Faking Injuries

...

118 118 118 118 118 118 118 118

Calcium Carbide Poisoning...

120

Humour in First Aid

120

Priority in Ambulance

...■»

at H a ll .J

PR IC E (4 /- P e r

TH R E E PE N C E

Annum , P o st

F rh e

Nurses’ Bill, which has now passed its third reading, has for its avowed object the protection of the profes sion by the weeding out of the incompetent and the substitution in their place of those trained and fully qualified. The Bill proposes that the grade of “ assistant n u r s e ” (for whom hitherto there has been no accepted definition) should be given a recognised status and placed on a roll under the control of the General Nursing Council ; that employment agencies for the supply of nurses, commonly known as “ Nurses’ Co-operations” , should be controlled by a system of licensing and inspection ; and that the use of the title “ nurse ” should be restricted to registered nurses and en rolled assistant nurses with certain exceptions. So called assistant nurses come in for an excep tional large share of obloquy despite the much good work which they have performed, and in this connection the following extract from the Report of the Athlone Committee will not he considered out of place. Said the Re port: “ A large body of women, varying greatly in age, skill and ex perience, who are not trained nurses or training J o r admission to the profession, are engaged in nursing the sick, and, in so far as they are em ployed in hospitals or institutions, are usually known as ‘ assistant nurses.’ . . . W e are satis fied that if these assistant nurses always worked in hospitals and other institutions under trained supervision, their employment would be of great help to the community, but we are equally con vinced that their uncontrolled employment consti tutes a definite danger to the patients under their care, and tends to lower the status of the whole nursing profession.” Under the provisions of the new measure a roll of assistant nurses will be kept by the General Nursing Council, which will draw up rules for their appointment and control, pre scribing training, examinations and so forth. They will, however, it is to be noted, be repre sented on the Committee of the General Council. Among other provisions is one to the effect that an agency supplying a nurse, midwife or other person must provide a statement in writing of the qualifi T h e

Sub scription s, A dvertisem en ts and other business Com m unications connected w ith F I R S T A I D should he forw arded to the Publishers.

S tre e t,

f Entered L S ta tio n in '

The

A ll R epo rts, & c ., should be -addressed to the E d ito r at the address b elo w , and should reach him before the 8 t h o f each m onth, and m ust be accom panied ( not necessarily for publication) b y the nam e and address o f the Correspondent.

46, C a n n o n

F .R .S .A .

E D IT O R IA L .

CONTENTS

F .R .S a n .l..

A P R I L , 1943.

XLIX.

NOTICE

SCO TT,

120

Lung Injury from Blast

120

Mouth-to-Mouth Insufflation

120

Complicated Fracture of Femur

120

The N u r s e s ’ B ill.

110

F I R S *

cations of the person supplied ; and that agencies must be carried on under the supervision of a doctor or State registered nurse. It is scarcely necessary to add that there are the customary prescribed penalties for infringement of any of the clauses of the Bill, especially as regards the mis use of the title of nurse or any title likely to imply registration. That there will be evasion, or attempt at evasion, is certain, that there will be individual cases of hardship is also certain, but the measure is a salutary one, and will operate in the public interest. May we hope that the suggestion made by a correspondent that the expression “ Nannie ” might be used to distinguish children’s nurses from the professional will not be adopted. It is humiliating to a degree, in our opinion, to call any woman a she-goat, however humble the occupation she follows.

C o -o r d in a tio n

C iv il

D efen ce

S e rv ic e s.

SIR

Extracts from Lectures delivered by H E N R Y L. M A R T Y N , K .C .V .O ., F .R .C.S

( Continued from page q q .)

T he

P roblem s

o f

G a s.

There are few certain things in this world, but one fact is unquestionable— namely, that we shall never be the first to employ gas in this war. The Germans may or may not decide to do so ; if they do, we must be ready for it, and we shall assuredly retaliate. If gas be used by the enemy it will be employed sud denly and unexpectedly, and will be distributed by bomb or spray over wide areas simultaneously. Once it has actually been employed half the anxieties will have gone. By that time all services in the battle area will work • automatically in protective clothing, the decontamination centres will be doing their jobs smoothly, the housewives’ services will be functioning and the hospitals will have be come accustomed to the handling of gas casualties. The one dangerous period will occur during the few hours immediately following the first attack. There is no fear of panic among the trained services, but there is a definite fear of it among the civil population— not from those who have actually been gassed, but from those who imagine that they have been gassed. First Aid Posts, Points and Hospitals will be flooded with two distinct crowds of people— the Foolish Virgins who have left their gas masks at home once too often, and the far larger crowd of those who, having smelt something, imagine that they have been involved, with probably fatal results to their silly selves. Personnel of all services in the target area, and for considerable distances around, will have to be especially aware of this possibility and be prepared to cope with the position when it does arise. It is unfortunately a fact that at the present moment most First Aid Parties, composed of part time personnel, have not heen sufficiently practised in the handling of casu alties contaminated with a persistent gas.

A I D Although they show themselves to be well drilled in ordinary casualty work, ^vithout constant training they find it difficult to adapt the technique which they know so well to that which they must perforce employ when handling these cases. Even in exercises in which every possible condition stimulating the real thing is present— such as the libera tion of C.A.P. and G 2 D, and the splashing of casualties or sacks with creosote, or lubricating oil, parties still con tinue to be extraordinarily casual in this respect. Apart from the question of panic, there will occur that difficult hour when a persistent gas is present round incidents with casualties lying-amid contaminated surround ings while the services themselves will, for the moment, be unprotected with the exception of masks and gloves. The first thing that they will have to appreciate is that if they find, themselves involved unexpectedly in a persistent gas cloud of any concentration, it will not be possible for them to put on protective clothing and then carry on. To do so would merely be to enclose gas and possible spots of contamination beneath an almost air-tight waterproof envelope. The chances of being able to withdraw suffici ently rapidly out of the cloud before such has occurred and then to protect themselves is very unlikely, and the pro bability is that they will have to carry on until relieved by a protected party. Provided they keep their heads and have been well trained, nothing is to be feared from such a situation. A party wearing gum boots, masks and possibly though not even necessarily, gloves can continue to work in any reasonable concentration of persistent gas for at least half an hour provided that, at the end of that time, they can themselves be cleansed and their clothes and equipment decontaminated. Even were they to be involved in a spray attack, unless it were delivered from very much less than 10,000 ft., it is unlikely that any one of them would receive more than two or three drops of liquid, and at least two hundred drops are necessary to produce dangerous effects. As regards the party itself, therefore, there is no reason why it should not continue to work with reasonable impunity until relieved by protected personnel. Provided careful attention be paid to detail the handling and treatment of the contaminated casualty should be equally safe and effective. The party may have the chance of putting on gloves, but if the hands have been exposed to gas rub them over with No. 2 ointment before doing so. If they have joined the ranks of the Foolish Virgins and left their gloves at the depot, 'coat the hands thorougly in ointment before touching the case. At the outside this should not take more than a few seconds if No. 2 is carried in the mask haversack. Wipe the excess from the finger tips before touching the patient’s eyelids. Deal first with the casualty’s eyes and flush them out from the water bottles available. Remember that it is the eyes themselves and not the eyelids that must be washed, and that this can only be ensured by holding open the eye lids firmly while the water is poured in. This, naturally, must be done before putting on the casualty’s mask, but again it must be-appreciated that, in a reasonable concentration of mustard, the urgency of masking is not so great as was originally thought to be necessary, and it Is certain that two or three minutes additional ex posure without a mask would not be so serious in its effects as the inevitable loss ot the eyesight which would follow the failure to give immediate treatment to a contaminated eye. A second or so must also be spared to mop spots of liquid gas from the face and rub in a little No. 2 before applying the mask. At this point I have seen repeatedly in exercises a curious difficulty which many First Aid Parties appear to

F I R S T experience, that of how to deal with a casualty suffering from a wound of the head or.face when it is necessary to put on a mask. It has been constantly impressed upon them that a dressing must be applied to all wounds as soon as possible, and that they must avoid handling any injury if such can be prevented. They find themselves therefore faced with the diffi culty that they must either put a dressing upon the wound and so render it impossible to put on a mask, or put the mask directly in contact with the wound without any dressing. The answer is, of couse, obvious. If the mask cannot be applied over a dressing without impairing the efficiency of the mask, then the dressing must come off and the mask be applied in direct contact with the wound. The con tamination of the patient’s lungs with gas is far more serious than the contamination of the wound by contact with the mask.

( To he continued.)

The

H om e

G uard

R escu e

and

U nder

F irst

A id .

F ir e .

A p p a r e n t l y some interest has been aroused, by my remarks last month, on methods of rescue under heavy fire. In response to requests, therefore, I will endeavour to outline one or two methods which may prove of use to H.G. stretcher crews. Perhaps a description of a recent demonstration by my own section will be the best means of illustration.

( 1) Rescue hy Squad o f Four .— The squad were approach ing a casualty with a “ broken leg ” when they came under heavy fire (signal by whistle). All bearers immediately fell prone and crawled'quickly to patient, No.’s 2 and 4 dragging their stretcher. When near enough, the latter prepared and blanketted stretcher, whilst 1 and 3 proceeded to dress wound and thoroughly immobilised the legs, all lying close to ground while working. Patient was then turned on to his side, bringing him and No. 1 (also lying on his side) facing each other. No. 1, after getting as close to him as possible and grasping him firmly, fell backwards on to his own back, bringing patient face down on top of him, No. 3 assisted where necessary. No.’s 2 and 4 then dragged stretcher close up to No. 1, who allowed patient to roll over on to it, again assisted by No. 3 on the other side. When ready to move off, all bearers crawled to their usual positions with the stretcher handles about in line with the head. Taking the time from No. 1, stretcher was pushed forward to full arms length, No.’s 1 and 2 using a somewhat lifting movement while pushing. Bearers crawled forward and repeated movements until “ under cover.” (2) One Man Rescue .— The rescuer crawled rapidly to patient, who was “ unconscious ” and lay on his side facing him. Removing patient’s belt and linking it with his own, he passed it under and round both patient and himself. Then turning his back to patient and pulling him on to his side, he tightened belt as much as possible. This brought them in close contact, facing the same way. Finally, he brought patient’s arms round his own neck, fastening the wrists with a handkerchief. The bearer now rolled over with a jerk, face downwards, bringing patient on to his own back, and crawled away with him, keeping flat the whole time.

More methods next month. C.

S p read b u ry

(Sergt.).

School House, Noel Road, W , 3,.

A I D

S t.

J o h n

A m b u la n c e

B r ig a d e

HEADQUARTERS AND DISTRICT REPORTS. Brigade Headquarters The resignation of Major-General Sir John Duncan, as Chief Commissioner of the Brigade At Home, has been accepted with regret. During his term of office the personnel of the Brigade rose from 65,000 to 167,000 at the end of 1942.

No. I (Prince of Wales’s) District 5 8 / 5 t h ( W e s t e r n P o s t a l a n d St. M a r y l e b o n e ) . — On Thursday evening, March 18th, a ceremony of no small importance took place at the Training Headquarters, 30, Gloucester-place, W .l, of the above Division. The occasion was the presentation of the Badge of vice-President, County of London, to Lord Nathan, while Sir George Abbiss, Assistant Commissioner, Metropolitan Police, was presented with the Badge of vice-President, 41st St. Marylebone Cadets and Lady Abbiss with a similar Badge as vice-President, 72nd St. John’s Wood Nursing Cadets. The chair was taken by Captain W. Goodley, O .B .E ., M.C., Commissioner, S.J.A.B., No. 1 District, who in the presence of the Mayoress, Mrs. Timmins, praised the splendid team spirit practised in the Borough. Congratulating Divi sional Supt. W. V. M. Allen and Lady Divisional Supt. M. M. Allen on their fine work, he said he thought it proper to regret the absence of this lady through sickness, and felt sure all would wish her a speedy recovery. In accepting office, his Lordship said how proud he felt to be actively associated with the Brigade, and hoped (as far as his other duties allowed) to be able to give proof of his sincerity. Sir George Abbiss said he too felt proud to accept the honour bestowed on him, and made it known that between twenty to thirty thousand policemen under his command had a thorough knowledge of first aid. Alderman R. Stiles Allen, D.L., L.C.C., in the absence of His Worship the Mayor, thanked His Lordship, also Sir George and Lady Abbiss, for their kindly interest in what he considered a goodly cause on behalf of humanity. An award of preliminary certificates to 21 Nursing Cadets was made by Miss Walker, Lady District Supt. No. 1 District. Prayer was offered by the Rev. Harold Morris.

No. Ill District. C i t y o f C o v e n t r y . . — There was a large attendance at the Ambulance Hall, Parkside, Coventry, recently, on the occasion of Parents’ Night in connection with the City of Coventry Ambulance Cadet Division of the S.J.A.B. County Lady Supt. Miss C. Orton presided, and pre sented 36 certificates in the preliminary first affi class, handi craft certificates and service awards. Cadet Officer A. Smith received the officer’s warrant. Displays of individual first aid work, team work and test cases were watched with great interest, and the keenness of the hoys and the soundness of their training were manifest and won well deserved applause. Cadet Staff Officer A. Jennings, in the course of an address, looked forward to the time when summer camps would again be possible, and referred to the good work accomplished by Cadet Supt. Goddard and the support given to him by Mrs. Goddard. He appealed to the boys who were growing up to continue in the movement. Cadet Supt. Goddard said they had old Cadet boys scattered all over the world doing their work efficiently in

F I R S T

A I D

many spheres. He also spoke of the great work done by members of the Cadet Division during the raids on Coventry.

supervision of Lady Cadet Supt. Miss Bolton and Cadet Officer Miss George, was staged during the evening.

No. IV District

No. IX District

Presiding at the annual meeting of Lytham Ambulance Division on March 23rd, Coun. C. H. Riley, the chairman, said that should any emergency arise, the ambu lance and nursing Division, like other members of the Civil Defence, would be able to meet it. Congratulations were tendered to Ambulance Sister M. Lazonby and Supt. George Webster on being elected Nursing Serving Sister and Nursing Serving Brother of the Order respectively. Reference was also made to the presumed death on active service of Dr. C. A. Bingham, the Divisional Surgeon, and on the chairman’s suggestion the meeting decided to send a letter of sympathy to Mrs. Bingham. Sir William Edge, Bart., M.P., was re-elected President. L y th a m .—

No. V District The report of the S.J.A.B. for 1942 states that during that year members of the Brigade reported having treated 27,096 cases in Yorkshire alone. The senior personnel num bers 11,010 officers, nurses and men, under the command of County Commissioner H. L. Thornton (Huddersfield). The report shows the Cadet Divisions in Yorkshire have a membership of 2, 206. The Cadet Divisions number fiftytwo Nursing and twenty-five Ambulance Divisions. The ages of the cadets are from eleven to seventeen years. They are trained in a number of subjects in addition to first aid and nursing, such as fire fighting, physical exercises, signal ling, home craft, handicraft, camp and rambles, public services, natural history and other subjects. The attendances of the nurses at hospitals number 16,302 and at clinic and welfare centres 5, 100. This is voluntary work, and shows the keenness and enthusiasm of the St. John workers. The vehicles belonging to the Brigade have travelled 97,648 miles carrying 8,344 cases of accident and invalid transport.

No. VI District N e w c a s t l e a n d D i s t r i c t . — There was a very good attendance at a meeting of the above Corps of the S.J.A.B., held at the Barracks, Newcastle, on March 23rd. The newly appointed Corps Supt., Dr. A. P. Spark,* presided. The Chairman said he was anxious to make the New castle Corps the strongest in the area. It comprised three Divisions— at Newcastle, Chesterton and Wolstanton. Each Division also had a Cadet Nursing Division and a Cadet Ambulance Division. An appeal was made for volunteers to join the Corps. A Cadet Division recently started at Chesterton now had 24 members. The girl cadets were taught first aid, home nursing and physical training, and the boy cadets first aid and physical training, including swimming.

No. Vin (Duke of Connaught’s) District R o e d e a n . — The Roedean Nursing Division fpent an enjoyable social evening on Wednesday, March 25th, at St. Mark’s Infant’s School, Kemp Town. A large company was welcomed by the Lady Divisional Supt. Mrs. Rose, which included the Corps Surgeon and Superintendent, Dr. F. H. Stuttaford (who was accompanied by Mrs. Stuttaford), Corps vice-President, and Lady County Cadet Officer Miss Hill and Mrs. Hill. Mrs. Stuttaford kindly presented 15 first aid certificates and 1 medallion to members. A special display by the Brighton Cadets, under the

P ly m o u th N ew C e n tre O p e n e d . — Mrs. Reginald McKenna, Assistant Superintendent-in Chief, St. John Nursing Corps and Divisions, when she opened the new Central Headquarters for Nursing and Ambulance Cadets at Staddon Terrace Lane on Saturday, April 3rd, delivered a message from Lady Louis Mountbatten, Supt.-in-Chief. Lady Mountbatten sent good wishes to the Cadets and hoped that the new premises would be the scene of many happy activities. Mrs. McKenna deputised at the ceremony for Lady Dunbar-Nasmith, the Chief Officer for Nursing Cadets, who was unable to open the Hall as arranged owing to illness. Mrs. McKenna said : “ I have never known anything which has made me so proud of my country as the splendid spirit of the people of Plymouth. It is a spirit which I respect, because it has overcome with determination all likely obstacles. “ When the history of this City is written, the work done by St. John will go on the record. Whenever there is difficult and harrowing work to be done, the Brigade is always on the scene, and that has been proved again and again in Plymouth. “ Like the Royal Navy, it is a silent service, but it is none the worse for that, and its records will be shining and glorious, and I am very happy to be associated with it.” Mrs. McKenna began her official day with a visit to the large Central Ambulance Station for Plymouth and District, and inspected the St. John Ambulance fleet which has played such a notable part in the war effort. ' Afternoon proceedings began with an Inspection and March-past of a large assembly of boy and girl Cadets in Plymouth, South-West Devon and East Cornwall. Mrs. McKenna’s deep and sympathetic interest in the boys and girls made a great impression. The new Cadet Central Training Headquarters are to replace the accommodation at the City Centre St. John Am bulance Station, which was totally destroyed by enemy action. Thanks to a grant from the Plymouth Youth Committe and the hard work of Cadet Leaders, adult Unit members and the Cadets themselves, excellent premises were obtained and prepared. Received by a smart Guard of Honour of St. John Cadets, Mrs. McKenna was accompaned by the Deputy Lady Mayoress of Plymouth, Mrs. W. J. Modley, who presided over a large gathering. Mrs. Modley wore her St. John Uniform as County Vice-President, together with her Civic Chain of Office. Prayer was offered by Rev. E. Marshall Moyle (Ambu lance Service Chaplain), and the Lord Bishop of Plymouth impressively dedicated the premises. Arrangements for the various Cadet functions were made by a Cadet Leaders’ Committee, the Hon. Secretary of which' was Supt. A. E. Perkin, of the County Staff and Plymouth Co-operative Division.

T o p s h a m . — Twelve months ago a decision was reached by certain members of this Division, that a new section of the S.J.A.B. be formed to meet the need of Topsham and District, and, taking advantage of an increasing number of personnel of qualified first aiders, this Division was created. At its fiiiji meeting held in April, 1942, the County Officer of the Brigade, B . . B o w d e n Esq., of Exeter, attended at the election of Officers, etc. With a commencing m e m b e i s h ’ P of 1 8 , not only have practically all the personnel been retained,.but the number has increased to 24 despite the demands of war. One ^ e m ber has been called to Military Service, and for some time the services of the Hon. Sec. were lost.

F I R S T The year has been one of steady consolidation with the Division’s energies directed to the calls of war instead of the claims of peace, and it is noteworthy that all members have contributed to the National War Effort by service in the Civil Defences of the country. Each one has contributed service to the home town in the capacity of Warden, Ambulance, First Aid or Rescue. Other than this, the scope of the Division has been limited, due to the causes of war, but a number of incidents have been attended to with entirely satisfactory results. The services of the Division are becoming known to the people of the town and district and many donations have been received to mark and acknowledge an appreciation of services rendered. Finances stand to-day at nearly ^jlOO. A further noteworthy effort was the complete success of members in the 1942 examinations ; all members passed. Dr. Paget of Exeter was the lecturer for the first year. The end of 1942 records : 10 first year certificates, 9 second year, vouchers, 2 third year medallions, and 2 members possessing label awards marking over three years qualifications. The Division enters its second year with every confidence of sustained effort, ready at all times to give of its aid when needed. Through the good graces of the local Civil Defence authorities, the Division is permitted in some degree the use of their accommodation, etc. It is, however, the ambition of the Division to acquire its own Headquarters when circumstances permit.

F irst

A id

fo r

F ra ctu re d

S p in e .

[The following letter is reprinted by permission from the British M edical Journal .] S i r , — I have read with much interest the letters on the above subject, and 1 am also indebted to Mr. Thos. Stowell for very full details of his method of turning cases of this type. As a general practitioner in a busy colliery village (blessed with an excellent first-aid personnel) I would ask the experts, Why is it necessary to turn the patients at all ; why not do them up as they lie ? This colliery has its share of accidents, and as the nearest hospital is 30 miles away transport of serious cases calls for fairly efficient first aid. The following is the method of dealing with cases of fracture or suspected fracture of the spine as carried out by the colliery team under Mr. Robt. McCormick. So far no complaint has been received from any patient, and the .surgeons have at one time or another been quite complimentary. K ir k c o n n e l

M eth od.

Personnel : 4 first-aiders, whom we will number 1, 2, 3, and 4. Materials : 1 strong rug or blanket ; 2 splints to extend from head to feet ; 2 splints to extend from armpits to feet ; 1 rug to make a pad between the legs ; 7 triangular bandages and 1 short splint to pass the bandages. Bearers 1 and 3 take up position at the sides of the patient, No. 4 is at the head, and No. 2 at the feet. The rug is pleated up from top to bottom and is placed at the patient’s head. Nos. 2 and 4 apply extension and counter-extension, while Nos. 1 and 3 pull down under the injured man in the following manner. Placing their inner hand against the patient’s side, they grasp the edge of the rug1 with the outer hand and pull downwards and outwards, so that, besides pulling down, they are also pulling against each other. This prevents the' edges from being turned up and thus increasing the friction ; in addition it maintains a minimum 'of thickness between the patient and the ground. The first pull is made to the waist, and by successive pulls the whole

A I D rug is drawn down to this hollow, the upper edge remaining at the level of the head. By a similar movement it is pulled into the hollow below the buttock and, in successive stages, to the feet. The rug is now “ straightened out ” and turned over the patient while bandages are passed as follows : under the neck, armpits, upper chest, lower ribs, hips, above the knees, and under the ankles. The covering rug is again spread out on the floor and the folded pad made with No. 2 rug is placed between the legs : it should reach from the crotch to the feet. The two short splints are now placed on each side edge of the rug, the top level with the head. They are then rolled inwards in the rug and traction is exerted on them till they come tight up against the patient’s body with the part under his back perfectly taut. Bearer No. 1, standing at the head, grasps the rolled-in splints at the level of the shoulders. No. 3 astride over the patient grips opposite the hips and No. 2 grasps the rolled-up rug at the ankles. All lifting carefully together, the patient is slowly raised a couple of inches from the ground, just sufficiently to allow the two long splints to be slipped under the patient on top of the bandages, so as to lie along either side of the spinal column. The patient is carefully eased back to the ground and the short splints are rolled out of the rug and re-rolled in it so that their upper ends are now at the level of the axilla. In tying the bandages, starting at the top, the first and second are tied to each other close to the seams of the jacket and the long ends tied together over the chest in the middle line. The remaining bandages are tied firmly in the middle line, except that at the ankles, which forms a figure-of-eight around the feet. Loading on to a stretcher is performed by the same lift as was used to pass the long posterior splints. For a long journey the back splints may be padded with rugs folded lengthwise, and the side splints can be padded with tow, etc., if desired. Pads of wool may be placed under the bandages on the chest to prevent friction. For the prone position a similar procedure may be adopted, the splints being placed either down the back or under the abdomen. Owing to the absence of natural hollows when lying prone, a modified method of rug passing will be called for. A pull of six inches only is made from the head, and then, by a series of 6-inch waves, the rug is passed to the feet. This assures that there is only a small area of folded rug under the patient at any one time. This latter method can also be used for supine patients whose “ natural hollows ” are not much in evidence. For fractures in the cervical region the following addi tional equipment is required— 2 bandages, 2 short splints and 2 large pads. The procedure is the same as for trunk fractures, but the extra bandages are placed under the head and neck. The two pads are used to steady the head, and are supported by the short splints, which, in the final roll-in, are used from the shoulder to the top of the head. The final result obtained by this method is: (a) the patient runs no risk of further damage by being moved unnecessary; (ih) he is comfortably encased in an “ orange-box ” which allows of safe and easy transport ; (c) he can, on arrival at hospital, be placed, if desired, directly on the x-ray table, the back splints can be slipped out, and he can still be safely handled for removal to bed after the desired exposures have been made. It may be emphasised that the technique is very much easier to carry out than it is to describe in detail. Theoretic ally it may be all wrong : in practice it yields satisfactory results. I am much indebted to Mr. McCormick for assist ance in detailing the various steps in the above description. — I am, etc., B ow m an

M.O., Kirkconnel.

4th

E d gar,

Battn., Dumfriesshire H.G.

H 4

F I R S T

R I D

S t.

R a ilw a y

A m b u la n c e

John

A m b u la n c e

A sso c ia tio n .

N ew s.

LONDON, MIDLAND & SCOTTISH B ir m in g h a m N ew S t.— A pleasing presentation and concert took place at the Crown Inn, Broad Street, on March 10th, to Mr. F. G. Hewitt, Station Master, New St., who has recently been transferred to St. Pancras, London. Mr. Hewitt had been President of this Centre for the last two years, and since his election he has shown a great deal of interest in the class affairs. He also gave considerable assistance in the re-organisation two years ago. Present at the concert were T. H. Jones, vice-President, A. R. Thompson, District Controller, New St., and G. S. Hill, L.M.S. General Ambulance Secretary from Manchester. The presentation was made by W. H. Andrews, H. S. B. Chairman of the Centre, who remarked on the good work done by Mr. Hewitt. Mr. Hewitt returned his thanks to the entire class for all they had done to strengthen the class and for all the work they rendered during the air raids on Birmingham. He also thanked Mr. Andrews and Mr. Morris (Secretary of the class) for their fine work. He congratulated Mr. Morris on his grand organisation in connection with the social work. Variety turns were given by “ The Darwoods ” and Billy Day. An enjoyable evening was had by everyone.

LONDON & NORTH EASTERN The growing public interest in first aid was reflected in the increased attendance of spectators from Cambridge at the L .N .E .R . Cambridge District Officers’ annual ambu lance competition, held in Houghton Hall, on Saturday, March 27th. Owing to other calls on spare time, the num ber of teams competing showed a slight decrease this year. The results were as follows :— 1, March “ A ” , 208 ; 2, March “ B” , 196 ; 3, Cambridge “ A ” , 187. The highest individual score was that of Mr. H. Sproston, of March “ A” , with 34 out of a possible 40. Once again the competition was staged with as much realism as possible, thanks largely to the efforts of the Dis trict Engineer (Mr. E. D. Robinson). The teams on this occasion were called upon to treat a man found lying in a country road, having apparently’ been knocked down by a passing vehicle. Peter Chalkley acted as the patient, and Mr. Jack King (no stranger to Cambridge audiences) brought a touch of humour to the proceedings as a country “ yokel ” involved. Capt. W. Goodley (Commissioner, S.J.A.B.) and Mr. W. Walsby (Divisional Officer, S.J.A.B.) again acted as judges. Mr. G. Sutcliffe, District Supt., was chairman, and Mr. R. A. Taylor again carried out the duties of com petition secretary. Mr. Sutcliffe announced the results and congratulated March “ A ” on their success. He also recalled that it is 60 years since railway examinations started in the railway service, the Great Eastern Section being foremost in the ambulance work. Thanks to the judges were voiced by Mr. A. H. Rees (District Loco. Supt.), and in acknowledging his remarks Capt. Goodley pointed out several little weaknesses in the teams’ work. He complimented them on their efforts, how ever, and expressed satisfaction with the general high standard shown. In presenting the shield to March “ A ”, with medals for the individual members, Mr. Sutcliffe paid warm tribute to the secretary, the stewards and other helpers, particularly Mr. King, for their efforts. Mr. F. Oglethorpe, who thanked the chairman, referred to the encouragement which the district officers always gave the ambulance work by their interest.

B r i s t o l C e n t r e . — Dr. H. G. Kyle presided at the 62nd annual meeting of members of the Bristol Centre, S.J.A.A., at the Grand Hotel, Broad-street, on March 19th.

The annual report showed that over 2,000 people attended the various classes during the year. Although all did not take the examinations, the actual awards gained were 2, 299, a slight increase over last year, due to preliminary certificates, which was indeed a healthy sign, as the citizens of future were already showing an interest in those things which would render them valuable members of the com munity. Up to the end of September, 1938, the total awards issued through the Centre since its formation amounted to 22, 808. During the four years just ended 13,703 received awards. Juvenile organisations, including the Junior Air Force and other new groups, had been instructed by Brigade and Associarion members, and several examinations for the Pre liminary First Aid Certificate had been held. Groups of wardens and several N.F. S. units had had valuable pre liminary training. The accounts showed a balance in hand of ;£45 10s. 4d. compared with £ 6 3 6s. 9d. last year, and the hon. treasurer (Mr. VV. G. Hawkins) said that for the first time in his ex perience he had received the necessary donation (£ 5 and upwards) under the life membership. The report and accounts were adopted, and the officers were re-elected, with the addition of Dr. Helan Aldwinckle as junior vice-president. Although competitions have been postponed on account of the war, it was decided to run an event for the Weaver Trophy.

D eath

o f

M r.

C e n tr e .—

John

R o berts.

We regret to announce the death of Mr. John Roberts (Commander of the Order) and who, since 1912, was Honorary Secretary of the Liverpool Centre of the S.J.A.A. Mr. Roberts joined the Liverpool Corps in 1902, and held the long service medal. On the outbreak of the first world war, he volunteered and went to France in March 1915, with the Merchant’s Mobile Hospital, returning to England in May 1918. He had been complimented by the late Sir Douglas Haig. Mr. Roberts had also been a great organiser of flag days. The funeral took place at Anfield Cemetary on Wednes day, March 31st. The oak coffin containing the remains of the deceased was draped with the St. John Brigade Flag, military decorations of the deceased, and also the Masonic Emblems. Mr. Roberts belonged to The Royal Victoria Lodge 1013. The coffin was borne throughout by six bearers from the Liverpool Gas Co. Ambulance Division in charge of Divisional Supt. T. Taylor. The Cortege was met by a large contingent of Brigade members from the various Divisions of Liverpool Corps, together with representatives of the Brigade from Birken head, Wallasey and Bootle, who formed into procession at the Cemetery Gates. The Police were represented by con tingents from Liverpool, Bootle, Birkenhead and Wallasey. County Surgeon W. Murray Cairns, C.B.E., M.D., C. M. (Commander of the Order) gave the Salute at the graveside. Lord Brocket (Kn'ght of Justice) President of the Liver pool Corps, S.J.A.B., and Lady Brocket (who were repre sented) sent messages of sympathy. The Dowager Countess of Sefton (Dame of Grace) and Major A. J. Macphail (Officer of the Order), Chairman of L iv e r p o o l

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SU RREY.

F I R S T the Finance and Co-ordinating Committee, S.J.A.B., were represented, as also were the Joint War Organisation and the British Red Cross Society. Many other well-known personalities were also present.

L e tte r s

th e

E d ito r .

We are in no way responsible for the opinions expressed, or the statements made, by Correspondents.— E d i t o r . ROPING D ear

PA TIE N T

STRETCHER.

S ir , —

In the March issue of F i r s t A i d , A.H. (Thornton) refers to a method of roping a patient to a stretcher. Eighteen months ago a rope harness was made by R. Butler (Sitting bourne), which has been tested by securing a patient on a stretcher and lifted from a ship’s hold at a large dock. It proved very satisfactory and efficient and can be adapted for securing a child, and also to fit any stretcher The harness consists entirely of rope and no buckles, and after a little practice a patient can be secured and ready to be lifted or lowered in about three minutes or less.— Yours faithfully, R.B. & W.C. Sittingbourne.

LIFE D ear

S A V IN G

BADG E.

S ir ,—

My Committee have noted with pleasure the letters from Messrs. E. H. M. Hine and J. Higgin appearing in the March 1943 issue of F i r s t A i d , and we are very grateful to Mr. Higgin for the explanation which he has given relative to this Society’s Artificial Respiration badge which, as he says may be worn on Civil Defence uniform, permission for this having been granted by the Ministry of Home Security, but he has made considerable error when stating that the emblem of the Society should be widely known as over 13,000 candidates have now passed the examination. I think Mr. Higgins must be quoting from a very out of date figure, as the correct number of candidates who have successfully passed this examination has reached the enormous figure of 67, 641, not 13,000 as quoted by your coriespondent. I should be grateful if you could find space to correct the error, which has appeared in Mr. Higgin’s letter and whilst conveying our thanks to him we do desire to make it known that we will gladly send information regarding this examina tion and our book on the subject to anyone who cares to communicate with me as the Chief Secretary.— Yours faith fully, A l w y n E. B i s c o e (Chief Secretary), The Royal Life Saving Society.

11, Thetford Road, New Malden, Surrey. D ear

S ir , —

May I please be allowed to revert to the correspondence on this subject in your March issue. Mr. Higgin, of Accring ton, says I am mistaken but to this I cannot agree. My statement was that the “ registered ” badge of the R.L.S.S. can be worn only by those who have qualified in the whole subject of Life Saving (that is, land, water drills, etc.). The 11 registered ” badge is of white and blue enamel or of silk woven on cloth— also white and blue. The red and blue badge which the B.R .C.S. and C.D. personnel are permitted to wear is of war-time origin and signifies that the wearer

A I D holds the Resuscitation Certificate of the R.L.S.S. This covers a useful though limited portion of life saving training. With so many badges in evidence nowadays, I am of the opinion that the “ red and blue ” one ig superfluous. A B. R. C. S. member’s uniform should be sufficient evidence that he has a satisfactory knowledge of resuscitation methods. For C.D. personnel, who are not members of the B.R.C.S. or S.J.A.B., there may be some satisfaction in displaying the badge on their uniform but as Red Cross and St. John personnel are permitted to wear the badge of their organisa tion on C. D. uniform I consider the addition of the ‘ ‘ red and blue ” is rather trying to “ gild the lily.” I am pleased to observe that both Messrs. Hine and Higgin support my opinion of the close alliance of Life Saving from Drowning with First Aid to the Injured.— Yours faithfully, B.

B en son

(Div. Supt.).

Hoylake.

S ta n m o re

F irst

A id

A sso c ia tio n .

A “ Wings for Victory ” whist drive was held by this Association on March 11th, at which there was a good attendance of local residents. Mrs. Penny and Mrs. Grey were jointly responsible for the management of this success ful function, which raised ;£12 14s. The Lounge in the Corner House, Canons Corner, Stanmore, was kindly lent by Mr. and Mrs. Webber, and as a token of appreciation for this and other kindnesses Mrs. Penny presented a bouquet of flowers. On March 15th the usual monthly meeting of this Association was held at St. Lawrence (Small) Hall, Whitchurch-lane, Stanmore, when a talk was given by Dr. W. L. Templeton on “ Mustard Gas ” ; the effects of burns; the standardised methods of protection and treatment, and new methods still in the experimental stage whereby it is hoped to minimise or neutralise the poisonous effect by the admini stration of a drug by the mouth either before or after the occurrence. Comparative photographs were exhibited of the limbs of subjects who had submitted to being burned, some of whom had been treated with a drug and others whohad not. Two members of the audience exhibited burns which they had received 24 hours before the meeting. Members agreed that they had enjoyed a very instructive evening. A vote of thanks to the Doctor was moved by Mrs. G. Penny.

P r i o r y f o r W a l e s . — The Rt. Hon. D. Lloyd George, P.C., has accepted the position as Prior in the Priory for Wales in succession to His Late Royal Highness the Duke of Kent. Mr. Lloyd George has been Chancellor for the Priory for many years. Sir John W. Beynon, Bart., C.B.E., who has occupied the position of Librarian for some years, succeeds the Earl of Plymouth as Sub-Prior.

O r d e r o f S t . J o h n . — Following the resignation of the Sub-Prior (Earl of Scarbrough) and the Secretary-General (Sir Percival Wilkinson), and the death of Sir Joseph Byrne, the following appointments have been made :— Sub-Prior : The Earl of Plymouth, P.C. Secretary-General : Brigadier William B. G. Barne, C.B.E ., D.S.O. Director of Ambu lance : Lieut.-General Sir Clive Gerard Liddell, K.C.B., C.M .G., C.B.E., D.S.O. Secretary : Major Douglas Mackenzie Gordon, M.C.

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_________________ KARVALID, W ESD LO N D O N O,

F I R S T

R I D Rate of Circulation.

Queries and Answers to Correspondents Queries will be dealt with under the following rules :—

1.— Letters

containing Queries must be marked on'the top left-hand corner of the envelope “ Query,” and addressed to F i r s t A i d , 46, Cannon-street, London, E .C . 4.

2.— All 3.— All

Queries must be written on one side of paper only.

Queries must be accompanied by a “ Query Coupon ” cut from the current issue of the Journal, or, in case of Queries from abroad, from a recent issue.

4.— The

Textbook to which reference may be made in this column is the 39th (1937) Edition of the S.J.A.A. Manual of First Aid to the Injured.

YV.V. (Worthing).— In your reply to-a query which was published in the March issue of F i r s t A i d , you state that the blood travels the complete circulation in thirty seconds. When putting down this fact in my note book I find that in an article, which Dr. A. C. White Knox contributed in the March,. 1940, issue, it is stated that the time for the circuit is twenty-three and a half seconds. Please tell me which is correct or if the speed varies. „ Why worry about split seconds— especially when we remember that the length of the journey in a circuit depends on the part of the body which is being supplied with blood. In my letures I always say that the circulation can be com pleted in thirty seconds.— N.C.F.

Wound of Finger. Functions of Spleen. B.O. (Stafford).— At a recent class meeting the anatomy and physiology of all the internal organs were discussed. Doubts were raised as to the functions of the spleen. I have looked up several medical books concerning this organ, but not one is definite in its description. All stale that the spleen is a solid organ richly supplied with blood but without any known functions. 1 greatly re spect your assistance in all queries and would appreci ate your kind help in this matter. » The spleen is the great blood filter and purifies the blood in its passage by taking up particles of foreign matter and worn-out red blood corpuscles ; and it may serve as a reservoir of red corpuscles. Another function attributed to it is the formation of the red corpuscles, but the evidence is not conclusive that such process occurs normally in the spleen.— N. C o r b e t F l e t c h e r . Examination Howler. F.E. (Shrewsbury). — In a recent home nursing examination I asked a candidate how she would sterilise sharp in struments. To my surprise and amusement she replied -— “ Soak them in ivatm beer!" Good !

Next, please ! !— N.C.F.

W.R. (Exhall).— Recently I was called to treat a man’s hand of which the tip of the index finger had been torn off at the first joint. After putting on a dry dressing I sup ported the forearm in a St. John sling, my object in using this instead of the large arm sling being to keep the hand raised and to ease the pain when the numb ness passed pff and feeling returned. On the way to the first aid room I met a responsible official who criticised the St. John sling, took it off and replaced it with a large arm sling. All this was done in a coal mine ! Would you kindly say (1) if this was really neces sary, (2) if I was right in anticipating that there would be throbbing pain when sensation returned, and (3) if the St. John sling would help to ease the pain by keep ing the hand elevated ? With regard to choice of sling, your official acted strictly in accordance with the instructions of the Textbook, which tells you to use a St. John sling when there is arterial bleeding from the palm of hand. Further, with the injury named there is not likely to be profuse bleeding ; and, as the distal phalanx was amputated, I doubt if there would be throbbing pain as you suggest. At the same time the St. John sling could do no harm, and on your statement of facts I wonder if it was worth while to change the sling, an action which might cause mental distress to the patient and make him wonder if the rest of your treatment was correct.— N.C.F.

Sulphanilanide Powder. E.H. (Tulse Hill). — Do you recommend the use of Sulphani lanide powder (or paste) by first aiders in their treat ment of wounds ? If so, is it readily available ? Your reply will be appreciated. The use of this powder should, in my opinion, be re stricted to the treatment of wounds by doctors and trained nurses. For this reason it is available at hospitals and first aid posts.— N.C.F.

Shock from Abdominal Injury. W. M. (High Wycombe). — I should be glad if you would give the answer to the following question which appeared in an examination paper some months ago: “ A heavy blow below the sternum causes collapse. 1. What has happened? 2. What is the first aid treatment ?*’ I take the opportunity of expressing my appreciation of your Query Column, which I have found interesting and helpful.

S.H. (Kingstanding).— I think that a good way of faking compound fractures is to take an old piece of cloth, to paint it red and to fasten two piecss of bone with ends protruding through its centre. If the fake is placed on the site of the supposed fracture, cadets and newcomers will get used to the real job.

In the upper part of the abdomen there is an important part of the sympathetic nervous system which is known as the solar plexus. Consequently a sharp and sudden blow in the “ pit of the stomach ” may produce a condition of shock which is popularly known as “ winding” and which may cause a temporary or even a fatal failure of the vital func tions resulting in death. Treatment is as laid down in Chapter IV of the Textbook.— N.C.F.

Red cloth was used in the early days of competitions for faking injuries before modern methods had been developed. Consequently, far more realistic results are obtained by the use of plasticine and putty, which can be modelled to repre sent the injury and stained with reddish brown colouring matter if bleeding is supposed to be present,— N.C.F.

ILL. (Munderley).— With further reference to your reply, which was publisned under the above heading in the February issue of F i r s t A i d , I would add that for faking

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F I R S T blood on wounds there is nothing better than red beet root (not sugar beet !) A squashed or mushed beet root placed on arm or leg looks uncommonly like a raw wound. Your letter is much appreciated. — N.C.F.

Calciu m Carbide Poisoning. H.F. (Pembrey Carius).— At at recent competition a com petitor was asked what he would do if called to a child who had accidentally swallowed some calcium carbide. We cannot agree as to treatment and ask your kind help. Little is known about the treatment of poisoning by calcium carbide (which may prove fatal in three or four hours) except that treatment must be immediate and prevent the production of acetylene gas. The subject has been under discussion in first aid circles during the past ten years. The net results of these discussions is that glycerine (which absorbs water) is regarded as the ideal antidote for use by first aiders who should administer it freely and then take steps to make the patient vomit and so empty the stomach. If glycerine is not available, then medicinal paraffin might be used for the same purpose, although, of course, this remedy is insoluble in water and alcohol.— N.C.F.

Humour in First Aid. B.R. (Cross Keys).— The class was putting a triangular bandage on the hand to control arterial haemorrhage ; and the junior member was not getting on very well owing to the pad falling from the patient’s palm. So the instructor, encouraging, and leading him, said that the patient was conscious and could assist if asked. Further he asked what junior would ask patient. To this question the junior quickly replied : “ I would ask him for his advice ! ” Good !

Next, please ! !— N.C.F.

Priority in Ambulance. D.E. (Caldicot).— To settle a recent discussion will you please give me your decision on the problem as to which should take priority in an ambulance— a case of internal injury or fractured spine ? During the discussion I stood by the internal injury being priority, so am anxiously awaiting your ruling and the reason for same. Your decision is correct because a case of internal injury is more likely to become rapidly worse than a case of frac tured spine as the latter can only be aggravated by careless movement during treatment and transport. Further, in the former case, operation at the earliest possible moment may afford the victim his only possible chance of recovery.— N.C.F.

Lung Injury from Blast. A. FI. (Gravesend).— One of our Officers in the Brigade has told us that the treatment for blast to the lungs is mouth breathing. We have a Sparklet Resuscitator, I wonder if this would do in place of mouth breathing. We thank you for the great help which we have received through your answers to queries. In cases of injupy to the lungs by blast which have come under observation, it has been found that the diagnosis of

R I D this condition is extremely difficult. At the outset the patient may continue to breathe without evidence of distress ; and often he collapses only after removal to hospital. Con sequently should an instance occur in which breathing has ceased entirely, I very much doubt if it would be possible for a first aider to diagnose this as due to. blast. Personally, I believe ( 1) that if Schafer’s method of artificial respiration is used for such cases further damage is not likely to result ; (2) that the suggested mouth-to-mouth insufflation (which is not taught officially or described in A .R .P . Haudhook No. 10) would have little effect because it can only produce changes in the tidal air ; and (3) that the Sparklet Resuscitator can produce no effect if the victim is not making some attempt at breathing, without which the gas from the machine could not find its way into the lungs. — N.C.F.

Mouth-to-Mouth Insufflation. A. H. (Gravesend).— Please tell us the history of mouth-tomouth insufflation and the proper way to carry out this operation. Mouth-to-mouth insufflation was one of the oldest methods of artificial respiration used by laymen in Europe and England. It was practised for the greater part on new born infants who were unable to breathe at birth, and the medical profession of those days deemed it a vulgar act ! It is claimed that the prophets Elijah and Elisha both used this method of resuscitation as is recorded in Holy Writ in I Kings XV II, 21 and in II Kings IV, 34. The mouth of the operator was placed directly over that of the victim with or without a piece of lint or a handkerchief separating the lips of operator and victim ; and the breath was blown into and sucked out of the lungs. In later years the air was breathed into the mouth of the victim while the nose was kept closed by pinching with the operator’s fingers. Still later compression was made on the victim’s chest to aid expiration.— N.C. F.

Complicated Fracture of Femur. C.T. (Birmingham). — If a simple fracture of the femur is, by careless handling, complicated by severance of the femoral artery, (1) how long would it be before signs and symptoms of internal hasmorrhage became appar ent ? Also (2) would the patient have any additional symptoms ? Finally, unless medical aid is immediately available, would death result or would an internal clot be formed after a short time? Your kind reply to my three queries in one will be welcomed by us. (1) In an actual case of fracture of femur complicated by tearing of the femoral artery it was found that within two or three minutes the swelling resulting from escaping blood into the tissues had extended below the knee, and within eight minutes involved the whole limb. The patient died en route to hospital. (2) The usual signs and symptoms internal (that is con cealed) bleeding as detailed on p. 136 of the Textbook were present within a few minutes. (3) When the femoral artery is severed death usually takes place in a few minutes, especially when there is an external wound. Consequent on the rush of blood escaping from the vessel, clo'tting is not likely to take place.— N.C.F.

“ FIR ST AID ” QUERY and REPLIES COUPON. T o be c u t o u t a n d e n c lo s e d w ith a l l Q u e r ie s .

April, 1943.

IN T R O D U C T IO N

F IR S T A ID

by John

R. M.

V V h igh am , M .C ., M .S ., F . R . C . S . A n e w a n d u p to d a t e m a n u a l on th is s u b je c t b a se d on le c tu re s g iv e n to St. Jo h n A m b u l a n c e cla s s e s o v er a p erio d of ye ar s. W ith m an y illu stratio n s. P r i c e l s . 3d. p o s t a g e 2 d . ___

B y C o l. R . J. B L A C K H A M , C .B ., C .M .G ., C .I.E ., D .S .O ., M .D .

t m

m A SEPTIC

O IN T M E N T

A IR

R A ID

F IR S T

A ID

A S e rie s o f 15 C h a r ts c o v e r i n g all the d u t ie s o f a F i r s t A i d W o r k e r , g i v i n g fu ll in stru ctio n s as to A i r R a id effects a n d p r e c a u tion s, re c o g n it io n and t r e atm e n t o f injuries. T h e I d e a l W a ll C h a r t. S i z e 2 2 £ in . x 1 4 £ i n . , h a s b e e n p r e p a r e d fo r u se in A i r R a id S h e lte r s , R e d C r o s s a n d St. J o h n ’s A m b u l a n c e S t a t i o n s a n d C l a s s e s , a n d a ll p la c e s w h e r e F i r s t A i d a n d N u r s i n g a r e r e q u i r e d . P r i c e Zs. 6d. P o s t a g e 6 d T h e H o m e C h a r t. S i z e 1 3 in . x 1 \ i n . , h a s b e e n s p e c i a l l y p r e p a r e d f o r u s e in t h e H o m e o r s m a l l g r o u p s , p r i c e l s . 6d. po st 3d. A l s o in B o o k l e t F o r m . P r ic e 9d. ; p o s t I d .

P r in te d o n s t r o n g p a p e r a n d m o u n te d o n r o lle r f o r h a n g in g .

Second Impression.

By A. E. JOHNSON. P O IS O N G A S.

A c o m p le t e fo ld e r o n th e d e te c tio n , e ffe cts a n d t r e a t m e n t of g a s w ith c h a r t a n d a d v ic e o n d rill a n d p a r t ic u la r s of d ec o n ta m in a tio n a n d c a re of resp irator. I n v a l u a b l e ! a n d t h e m o s t c o m p r e h e n s i v e l i t t l e f o l d e r b e i n g s o ld .

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No. 587, Vol. XLIX.]

3 fiu r s m

c j

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| » m

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CIVIL DEFENCE: WITH

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N u m b e rle s s

L a s t A id .

w h ich

suspended

re ce iv ed in

th e

tim e s

have

such

w itn esse d

term ed

THIS

m ust

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p resen t,

d it o r ia l

:—

121

C o -ord in a tion of C ivil D e fe n ce S erv ices

122

...

F ir s t A id for B u r n s

123

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...

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been

re n d e rin g o f

sa id — th at

a id

such has

126

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F i r s t A i d in W a r T i m e . . .

126

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R ev iew s

126

T h e H o m e G u a r d a nd F irst A id ...

128

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sa id —

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E f f e c t s o f O x y g e n ...

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in c o m m o n w it h th e p r e v e n t i o n it

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“ M i llb a n k ” H e e l C lip ...

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R e s c u e P a r t y w o r k is a lt o g e t h e r too s p e c ia lise d a n d c o m p le x a j o b for th e m e r e a m a t e u r to v e n tu r e to d is c u s s a t a ll b u t a fe w c o m m e n t s m a y b e of v a lu e a t th e poin t a t w h ic h

A I D a c tu a l re scu e h a s b een co m p le te d a n d the c a s u a lt y h a s been exposed. O r i g i n a l l y th e R e s c u e P a r t y w a s d e s ig n e d o n ly to re le a s e the tra p p e d c a s u a lty , a n d , w h e n th is h a d b een do n e, the F i r s t A id P a r t y w a s s u p p o s e d to t a k e o ver. N o w - a - d a y s t h e r e a r e f e w R e s c u e P a r t i e s in w h i c h s o m e a t l e a s t o f t h e m e n , if n o t a l l , a r e n o t f u l l y t r a i n e d in f i r s t a i d a n d t o w a t c h a r e a l l y fir s t c l a s s p a r t y a t w<?rk i s a m i r a c l e of o r g a n is e d sk ill. F o r th o se w h o s e m is g u id e d e n th u s ia s m m a y lead th em in to efforts a t a s s is t a n c e I w o u ld g i v e on e or t w o w a r n i n g s . ' N e v e r w a l k on th e top of a n y stru c tu re or d eb ris beneath w h ic h th ere m a y be c a su a ltie s or people sh e lte rin g . T h a t is th e first g o ld e n rule. B u rie d c a su a ltie s a re fa r m o re sa fely a p p ro a c h e d b y tu n n e llin g th a n b y d i g g i n g fro m a b o v e since th e lin e o f a p p r o a c h fr o m a b o v e a lm o s t in v a r ia b ly c a u s e s su b sid e n ce of d eb ris u p o n the c a s u a lty befo re he c a n be r eleased. B e s p e c ia lly w a r y of th e fli g h t of s to n e s te p s s o com m on lyfou n d le a d in g u p fro m th e stre e t to a fron t door, g e n e r a lly o v er an a re a , a n d often h a v in g a co a l ce lla r b eneath. T h e ste p s, e a c h f o r m e d of a n o b l o n g b l o c k o f sto n e , a r e u s u a lly su ppo rted on b ric k s a t e a c h end. E x p e rie n ce h a s s h o w n th at the steps th em selv es a re v ery fr e q u e n tly c r a c k e d a c r o s s b y b la s t b u t re ta in th eir p osition, a n d , b e in g co v e re d w ith d ust, a p p e a r u n in ju re d . T h e e n t h u s i a s t i c a m a t e u r d a s h i n g b r i s k l y u p t h e s t e p s is a p t t o fin d h i m s e l f p r e c i p i t a t e d i n t o t h e c e l l a r b e n e a t h t o t h e in e v ita b le a n n o y a n c e of th o se s h e lte r in g there. B o m b sto ries a r e u s u a ll y c o m m o n p la c e b u t th is illu s tr a t i o n o f t h e d a n g e r o f w a l k i n g o v e r c e l l a r s in w h i c h p e o p l e a re t a k i n g co v e r m a y s e rv e to im p re ss th e ris k s u p on you . D u r i n g o n e of th e L o n d o n b litz e s a s e r io u s c h e s t c a s u a lt y w a s re p o r te d to t h e T h o r a c i c T e a m of t h e E m e r g e n c y M e d ic a l S e r v i c e a n d a s u r g e o n w a s s e n t o u t t o d e a l w i t h it. H e fo u n d h is c a s e s h e lt e r in g w it h s e v e r a l oth ers, i n j u r e d a n d u n i n j u r e d , in t h e c o n c r e t e c e l l a r o f a l a r g e pu b lic h o u se w h ic h h ad been a lm o st co m p le te ly d em o lish ed . A lth o u g h th e ce ilin g of th e c e lla r w a s d a n g e r o u s ly in se c u r e th e c e lla r itself w a s in tact, a n d , h a v i n g co n ta in e d a n u m b e r of h o g s h e a d s of b eer w h ic h h ad been b u rst open b y th e e x p lo s io n , w a s flooded to th e d e p th o f n e a r l y a foot b y beer. W h ile he w a s e x a m in in g the case, w h ich , fortu n a tely for h im , w a s ly in g clo se a g a i n s t o n e w a ll, so m e too e n th u s i a s t ic r e s c u e r s s ta r te d to w a l k o v e r the d a m a g e d c e ilin g . W i t h o u t a s e c o n d ’s w a r n i n g t h e e n tire s t r u c t u r e d e s e n d e d en m a s s e u p o n th e p e o p le b e lo w f o r c i n g th e m to the c o n c r e te f lo o r a n d d r o w n i n g t h e m a j o r i t y — in b e e r ! P rotected by th e w a ll, th e s u r g e o n a n d h is c a s u a lt y w e r e a lm o s t the o n ly su rvivo rs. N o m o r e d i f f i c u l t fir s t a i d w o r k e x i s t s t h a n t h a t w h i c h h a s to be h an d le d b y R e s c u e P a rtie s. N e a r l y a ll b u r i e d c a s u a lt ie s a r e m o r e or less s e r io u s l y in ju re d , a n d m a n y of t h e m a r e e i t h e r u n c o n s c i o u s l y o r t o o s e v e r e l y s h o c k e d t o be a b le to g iv e a c o h e re n t a c c o u n t of th eir sy m p to m s . T h e s t a n d i n g r u l e , t h e r e f o r e , is v e r y w i s e , w h i c h o rd ain s th a t e v e ry c a s u a lty a c tu a lly d u g o u t from ben eath d e b r i s s h a l l b e h a n d l e d a n d t r e a t e d f r o m t h e fir s t a s t h o u g h h e w e r e s u ffe r in g fro m a fr a c tu re d spine. If th a t ru le is in v a r ia b ly o b e y e d b y R e s c u e P a rties, m a n y a c a s e w ill be sa ved not o n ly fro m d ea th bu t fro m a life of p e r m a n e n t p a r a ly s is . F e w R e s c u e P a rtie s realise the d e lic a c y of the verteb ral c o lu m n o r p ic t u r e th e f r a g i l e s p i n a l c o r d u p o n w h i c h so m u c h d ep en d s ly in g w ith in th e v arte b ra l ca n a l. R e m e m b e r t h a t th er e is a n a p p r e c ia b le s p a c e b e tw e e n t h e b o n y w a l l s o f t h e c a n a l a n d t h e c o r d w i t h i n it , a n d t h a t g r a v e in ju ry m a y h a v e b een c a u s e d to th e v e r te b ra e th e m se lv e s w it h o u t ir r e p a r a b le d a m a g e h a v i n g b e e n d o n e to th e a ll-im p o r ta n t cord. O n c e , h o w e v e r , th e co rd itself is d es tr o y e d th e victim , e v e n if l i f e b e s a v e d , w i l l b e p a r a l y s e d f o r e v e r b e l o w t h e

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l e v e l o f t h e i n j u r y , a n d n o o n e w h o h a s l i v e d in t h e n e i g h b o u r h o o d o f a n y o f t h e h o s p i t a l s in w h i c h s t i l l r e m a i n t h e u n fo r tu n a te s w h o s u rv ive d the la st w a r w ith sp in a l in ju ries co u ld b e ar, b y h is o w n c a r e le s s n e s s , to a d d o n e m o r e to th eir num bers. H a n d le , th e r e fo r e , e v e r y c a s e a s t h o u g h it w e r e m a d e o f e g g sh ell, a p p r e c ia t in g th a t b y th e s lig h t e s t r o u g h n e s s a n in ju ry, h itherto o n ly in v o lv in g bon e, m a y b e c o m e o n e also c o m p lic a t e d b y g r o s s in ju r y to th e cord.

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T h e s e r u l e s n e e d t o b e m o d i f i e d in t h e c a s e o f p h o s p h o r u s b u r n s f r o m t h e n e w t y p e o f fi re b o m b u s e d b y t h e G e r m a n s . P h o s p h o r u s s p la s h e s fr o m th is b o m b a n d g o e s on b u r n in g , a n d t h e f i r s t t h i n g t o d o is t o p u t t h e a f f e c t e d p a r t i n t o w a t e r . If y o u h a v e w a s h i n g s o d a h a n d y a d d a little to th e w a t e r for th is h e lp s to n e u tr a lis e th e h a r m f u l p r o d u c ts w h ic h a r e form ed by b u r n in g ph osph oru s. I f t h e w a t e r is w a r m it is still m o r e e ffective. A f t e r b a t h i n g th e b u r n t p a r ts for a f e w m in u te s , a p p ly a c l o t h s o a k e d in t h e s o d a s o l u t i o n t o t h e b u r n t a r e a b u t d o n o t w r in g ou t the w a te r. F a s t e n it w i t h a b a n d a g e a n d h u r r y the p a tie n t to the n e are st h o sp ita l.

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T h e S e ctio n of th e B e v e r id g e R e p o r t d e a lin g w ith S t a t e M e d ic a l S e r v ic e s a p p e a r s to h a v e c a u s e d th e m ed ic a l p ro fessio n s o m e c o n c e r n a n d not a little a n x ie ty . T h e y s e e in it t h e e n d o f t h e G e n e r a l P r a c t i t i o n e r a n d t h e fi n i s h o f “ H a r l e y S t r e e t ” f o r p r a c t i s i n g in a p r i v a t e h o u s e is a p p a r e n t l y n o t a llo w e d for. P r a c tis e s a n d all th a t h a d b een p u t in to th e b u i l d i n g u p of t h e m w o u l d h a v e to b e s a c r ific e d , a n d t h e in d iv id u a l d o c to r m e r g e d in to t h e p u b lic s e r v ic e w it h set h o u r s a n d d uties. F o r th e p u b lic th is w o u ld m e a n th e en d of all p r iv a c y , a n d for th e v o lu n t a r y n u r s i n g o r g a n i s a tio n s, p r o b a b le e xtin ctio n . T h e a b o v e w a s stated by A sst. C o m m is s io n e r R u sse ll V . S teele, M . B . , B . S . , w h e n a d d r e s s in g a m e e t in g of officers of t h e C e n t r a l A r e a , S . J . A . B . , a t 30, G l o u c e s t e r P l a c e , W . l , o n A p r i l 8t h . T h e m ee tin g w a s m ad e m ore in te re stin g by the in tro d u c tio n of t w o n e w d e v ic e s , t h e first of w h i c h w a s a n e ffic ien t type of n e w a r m s lin g , d em o n stra ted b y A m b u la n c e S iste r M iss B a te , K e n s in g t o n D iv isio n . T h e seco n d a series of fo u r s h o r t l i f t i n g s lin g s , d e s i g n e d s p e c ia lly to f a c ilit a te th e l i f t i n g of a p a tie n t fr o m t h e p ro n e p osition to th e s tre tc h e r. T h is w a s d e m o n stra te d b y A m b u la n c e O ffice r M r. S h e e n , 13 th F in sb u ry P a r k D ivision . C

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L a d y D is t r ic t O ffic e r M rs. T a p l e y b r o k e th e s e rio u s sid e b y s i n g i n g t w o s o n g s f r o m t h e p i a n o in a m a n n e r w h i c h l e f t n o d o u b t a s to h e r h a v i n g a b il it ie s o t h e r t h a n o r g a n i s i n g . T h e C o u n t y S u r g e o n w a s th e n in v ite d to s h o w a t r a v e l film e n t itle d “ T h r o u g h F r a n c e a n d I t a l y . ” In m in ia tu re a n d t e c h n i c o l o u r it w a s a f e a s t o f a r c h i t e c t u r e a n d g o r g e o u s p a n o r a m a , b e i n g w e l l b a l a n c e d in e v e r y d e t a i l . T h e C h a i r m a n , D i s t r i c t O f f i c e r T . M c B r i d e in w o r d s s u ite d to th e o c c a s io n , t h a n k e d all p r es en t for h a v i n g m a d e th e e v e n in g possible, a n d m o v e d a v o te of t h a n k s to D iv . S u p t . W . V . M . A lle n , 58/5th D i v i s i o n a n d L a d y D iv . S u p t . M. M . A llen , 1 1 5 N u r s i n g D iv is io n , for th e loan of th eir tra in in g headquarters. T h i s w a s a c c o r d e d b y th e officers present w h o num bered ap p ro x im ately one hundred.

N o. 11 ( B o r o u g h o f W e m b l e y ) . — T o m a r k the ju b ile e of th e N o . 11 A m b u la n c e a n d N o . 3 N u r s i n g D iv isio n s, a s o c ia l a n d d a n c e w a s h e ld a t T e r r y ’s R e s t a u r a n t t o w a r d s t h e en d of A p ril. N o le ss th a n 95 m e m b e r s a n d old fr ie n d s of the B r ig a d e en joyed excellen t re fresh m en t d espite ra tio n in g d ifficu lties. A fte r M r. A . M in to n h a d p erfec tly re n d ered a solo “ I T r a v e l the R o a d ,” th e C h a ir m a n , D iv . S u p t. W . T h o m p s o n , op en ed th e m e e t in g w ith a m e s s a g e of r e g r e t from th e C o m m issio n er N o. 1 D is tric t (C a p t. W . G o o d ley) th at he w a s u n a b le to b e presen t. M r. H . R . S ta n le y , w h o h a s b een a s s o c ia te d w it h the D i v i s i o n f o r 48 y e a r s , w a s c o n g r a t u l a t e d u p o n h i s a p p o i n t m en t b y H .M . the K i n g a s O fficer (B ro th er) of the O rd er. A short h istory of the D iv isio n w a s g iv e n d u r in g w h ich m a n y m eritoriou s activities w e re reco u n ted . A s s t . C o m m i s s i o n e r S . J. W a r r e n w h o t h e n r e a d a l e t t e r of c o n g r a t u la t io n fr o m C a p t. W . G o o d le y , la id g r e a t e m p h a s is on th e fa c t t h a t th is c e le b ra tio n w a s a r a r e o c c u r re n c e , a s no o t h e r A m b u l a n c e a n d N u r s i n g D i v i s i o n s in t h e L o n d o n a r e a c o u ld c la im t h a t t h e y h a d w o r k e d t o g e t h e r for h a lf a c e n t u r y . A fte r n a m in g th e D iv . Su pts. A la n P a u l, B a m b e r g , C a p t. C la r id g e , a n d p a y in g w a r m trib u te to M r. H . R . S ta n le y , a ll of w h o m h a d so a b l y g u id e d N o. 1 1 , h e e x p re s s e d th e h o p e t h a t th o s e p r e s e n t w h o h a v e th e g o o d f o r tu n e to

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A sst. C o m m is s io n e r W a r r e n w ish ed th e D iv isio n s every s u c c e s s in t h e n e x t f if t y y e a r s a n d e x p r e s s e d t h e h o p e t h a t t h e y m a y b e e v e n d o u b l y a s u s e f u l a s in t h e p a s t . L a d y D is tric t O fficer M iss W e s t s p e a k i n g for L a d y D i s trict O ffic e r M is s W o r k m a n a n d herself, sin c e re ly c o n g r a t u la te d N o. 1 1 a n d N o. 3 D iv is io n s on r e a c h i n g s u c h a m ilesto n e in h isto ry . L a d y S u p t . M is s M . E . D u l i g a l l , w h o h a s b e en S u p t . of N o. 3 N u r s in g D iv is io n fo r 22 years, a n n o u n c e d th a t sh e h ad receiv ed c o n g r a tu la tio n s fro m se v eral L a d y S u p ts. w h o w ere u n a b l e to be p r e s e n t, a n d a ls o p a id e lo q u e n t t r ib u te to th e la te D r . C. E . G o d d a r d a n d M rs. G o d d a r d w h o s e g o o d w o r k p a v e d th e w a y fo r th is h is to ric o cca sio n . D r . R . T u d o r E d w a r d s , D iv i s i o n a l S u r g e o n s in c e 1928, a l s o s p o k e in a c o n g r a t u l a t o r y m a n n e r . C a p t. C l a r i d g e ( C o u n ty O fficer for M id d le se x ) e xp re sse d h is c o n g r a t u la t io n s , a n d m en tio n e d s e v e r a l p io n e e rs w h o had r e n d e r e d lo y a l a n d v a lu a b l e s e r v ic e in th e e a r ly d a y s . A fte r v otes of th a n k s h a d been p a ssed , d a n c in g and social g o o d fe llo w s h ip to o k u p th e re m a in d e r of a th o ro u g h ly en jo yab le even in g. W e r e g r e t th a t p ressu re on sp a c e p reven ts us m en tio n in g the n a m e s of m a n y oth er n o tab le perso n s co n n e cte d w ith th e V e n e r a b le O r d e r , th at w e r e present.

16 N ( H a m p s t e a d ) N u r s in g D iv is io n . — -T w o C a d ets of th is D iv is io n h a v e a lr e a d y q u alified fo r W a r S e r v ic e B a d g e s in u n d e r s i x m o n t h s , h a v i n g c o m p l e t e d o v e r 300 h o u r s v o l u n t a r y s e r v i c e in H o s p i t a l s a n d F i r s t A i d P o s t s . O n e C a d e t , a g e d 1 6, h a s b e c o m e a f u l l - t i m e m e m b e r o f a H a m p s t e a d W a r t i m e D a y N u rs e ry , w h e r e sh e w ill u n d e r g o a c o u rs e la s t in g IS m o n th s for the N a tio n a l S o cie ty of D a y N u r s e r ie s C e r tific a te , q u a l i f y i n g h e r to o b t a in a p ost as N u r se ry A ssistan t. S e v e ra l g ir ls b e tw e e n the a g e s of 11 a n d 1 7 a re h e lp in g in D a y N u r s e r i e s , H o s p i t a l s , F i r s t A i d P o s t s , a c t i n g a s p a t i e n t s in G a s C l e a n s i n g S t a t i o n s , a s w e l l a s a i d i n g t h e a d u l t D i v i s i o n in v a r i o u s p u b l i c d u t i e s . A n o t h e r C a d e t h a s t h e c a r e ot F i r s t A i d B o x a t a l a r g e p r in tin g w o r k s , a n d h a s b een a b le to tre a t se v e ra l m in o r in ju rie s s a tisfa cto rily . A C a d et, a g e d 12, w h o h as o b tain ed F .A . , H .N . and F ir e F i g h t i n g C ertificates, h a s a lr e a d y m a d e g o o d u se of h er k n o w l e d g e b y tr e a tin g tw o c a su a ltie s correctly, the second b e in g sp ecia lly co m m e n d a b le . ( a ) C o n c u s s i o n ( fa ll f r o m s w i n g ) in H i g h g a t e p l a y i n g f ie ld s . (b) W h i l e on h e r w a y to a p a rty , th e C a d e t p a ssed a s m a ll g ir l w h o a p p e a r e d to h a v e in ju re d h e rs e lf w h ile s k i p p i n g . U p o n exa m in a tio n s h e fo u n d h e r n u r s i n g h e r left e lb o w a n d h e a d in c lin e d to l e f t s i d e ; the g ir l c o m p la in e d of b ro k e n n e ck . T h e in ju ry w a s c o rrec tly d ia g n o s e d a s a fra c tu re d c la vicle, an d , after t r e a t in g for sh o c k , th e C a d e t se n t o n e b y s ta n d e r fo r the g i r l ’ s o w n d o c t o r ( a s h e l i v e d c l o s e b y ) a n d a n o t h e r to e n q u ire w h e th e r a n y fo rm of t r ia n g u la r b a n d a g e s w e re a v a ila b le ; one tria n g u la r b a n d a g e and a sca rf w ere pro duced. T h e g i r l ’s b e re t w a s u se d a s a p a d u n d e r th e a r m pit, t h e b a n d a g e u s e d a s a S t. J o h n s l i n g , a n d th e s c a r f placed rou n d the elb o w a n d tru n k so a s to lever out and d r a w b a c k th e sh o u ld er. B y th is tim e the d o c to r a rriv e d a n d the C a d e t e x p la in e d w h a t h a d h ap p en ed . T w e n ty -fiv e C a d e ts h a v e a lr e a d y p a ssed F .A . ; 10 of th ese h av e a ls o p assed H . N . a s w ell, a n d 1 7 th eir F ire F ig h t in g exa m in a tio n . B a d g e s u b je c ts to be t a k e n d u r i n g th e y e a r in clu d e C h ild W e lfa re , H y g ie n e , H a n d ic ra ft, H o m e craft, C le rica l A b ility a n d H is to ry of the O rd er.

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A I D a s s o c i a t e d , w a s o f s p e c i a l i m p o r t a n c e t h i s y e a r b e c a u s e it w a s m a d e the o c c a s io n for th e p r es en ta tio n of a G r a n d P r io r B a d g e to o n e of t h e c a d e t s a n d t h e a n n o u n c e m e n t t h a t a se c o n d c a d e t of the s a m e D iv is io n h ad qu alified fo r th is c o m p a r a t i v e l y r a r e a w a r d , a c i r c u m s t a n c e t h o u g h t to b e u n i q u e — a t a n y r a t e in n o r t h L o n d o n . T h e e ven t to o k place at S p rin g fie ld H a ll, N e w S o u t h g a t e , o n t h e e v e n i n g o f W e d n e s d a y , M a y 5 t h , a n d a b o u t 300 m e m b e r s a n d fr ien d s a s s e m b le d to h o n o u r th e p r iz e - w in n e r s a n d e n j o y a n e v e n i n g ’s g a i e t y . D istin g u ish ed g u e sts in c lu d ed the R t. H o n . th e C o u n te s s of L y tto n , C . I . , D .S t .J ., tb e M a y o r of S o u t h g a t e (C o u n cillo r C. W m . S k in n e r) an d the M a y o re ss , D is tric t O fficer F. H . C o llin s, L a d y D is trict O f f i c e r s M r s . D . R a y n e r a n d M r s . 1. B u r n s , L a d y D i s t r i c t C a d e t O fficer M iss K . C le a sb y , D iv is io n a l S u r g e o n s D . W . R eid a n d L o u is a M. W e s t la k e a n d D iv . S u p ts. a n d O fficers f r o m th e S o u t h g a t e , P a l m e r ’s G r e e n , M ic h e n d e n , C h u r c h E n d (F in c h le y ) an d B a rn e t D iv isio n s. B o u q u e ts w e r e presen ted to th e C o u n te s s a n d the M a y o r e s s b y t h e G r a n d P r i o r C a d e t s , a n d a f t e r a p e r i o d of d a n c i n g a n d g a m e s to th e s tra in s o f th e G r e m lin s d a n c e b an d , D is tric t O fficer C o llin s w e lc o m e d the C o u n te s s an d in v ite d h e r to p r e s e n t th e p r o fic ie n c y c e r tific a te s a n d b a d g e s w h i c h , in a d d i t i o n t o t h e G r a n d P r i o r B a d g e , i n c l u d e d a lo n g s e rv ic e ribbon e a r n e d b y A / S iste r M rs. B . B a r r e ll of the 7 4 th D iv is io n for IS y e a r s ’ s e rv ice . P r o u d recipien t of the G ra n d Prior B a d g e w a s C a d et S e r g e a n t P a tricia H a le s and w h e n C a d e t S e r g e a n t E d n a S a y w e n t u p to r e c e iv e s e v e r a l p roficien cy certifica tes, sh e w a s c o n g r a tu la te d by the C o u n te ss on h a v i n g w o n a s i m i la r a w a r d , w h ic h w ill be p r e s e n te d to her on a la ter occasion . In t h a n k i n g th e C o u n t e s s fo r a t t e n d i n g to p e r f o r m th is p le a s a n t d u t y th e M a y o r m e n tio n e d t h a t his d a u g h t e r b e in g a m e m b e r of th e S t. J o h n o r g a n i s a t i o n , g a v e h im a sp e c ia l in te r e s t in th e m o v e m e n t. O t h e r i t e m s in t h e e v e n i n g ’ s c h e e r y p r o g r a m m e i n c l u d e d s in g in g a nd d a n c in g tu rn s a nd a d ra m a tic sk e tc h w ith a s t r o n g St. J o h n in terest b y s o m e o f th e c a d e ts , a n d r e fr e s h m en ts w e re served d u r in g th e in terval. G u id in g the pro c e e d in g s efficien tly a u d w ith in fectio u s e n e r g y w a s C a d e t O ffic e r S. C . A n d r e w s of th e 28th ( S o u t h g a t e ) D iv is io n .

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K ir b y N u r s in g D iv is io n . — T h is D iv isio n c e le b ra t e d i t ’s s e c o n d b i r t h d a y o n S a t u r d a y e v e n i n g , M a y 1 s t . A b o u t 120 m e m b e r s a n d g u e s t s w e r e present. L a d y C o u n ty S u p e rin te n d e n t M rs. D e m e tr ia d i, L a d y C o u n t y O ffice r D r. M a r y P la c e a n d C o u n t y O ffice r R . E. A n t h o n y w e re the p rin cip al g u e s t s of th e e v e n in g . Corps a n d D iv is io n a l O fficers from B ir k e n h e a d a n d W a l la s e y w e re also present. T h e p a r t y t o o k t h e f o r m o f a c a fi ch a n ta n t , t h e t o p t a b l e w a s p l a c e t ! in t h e s h a p e o f a V f o r V i c t o r y . The h all w a s tas te fu lly d ec o ra te d w ith m a n y different flo w ers. L a d y D i v i s i o n a l S u p e r i n t e n d e n t M i s s J. E . D u n c a n th a n k e d th e g u e s t s for th eir p resen ce, a n d sa id th at d u r in g th e past y e a r the m em b e rs h a d d on e e x c ellen t w o r k , th ey had p u t i n w e l l o v e r 2 , 6 0 0 h o u r s a t h o s p i t a l , d o n e o v e r 1,000 p u b lic d u tie s a n d s o m e 350 p e o p le h a d re c e iv ed in stru c tio n in f ir s t a i d , h o m e n u r s i n g a n d h y g i e n e . M u sical item s w ere presented d u r in g the refresh m en ts. L a d y C o u n t y S u p t. M rs . D e m e tr ia d i c o m p lim e n te d the D i v i s i o n u p o n i t ’s w o r k a n d w i s h e d i t e v e r y s u c c e s s in t h e future, sh e a lso c o n g ra tu la te d L a d y C a d et Supt. M rs. C r a w ford on th e sp len d id n u m b e r of c a d e ts w h o w e r e p resen t h e l p i n g to h a n d th e r e f r e s h m e n t s a n d l o o k i n g v e r y s m a r t a n d b u s in e s s lik e in th eir u n ifo rm s. W est

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F I R S T ferred u p o n M r. R e g i n a ld G . W in d e r , S e c r e t a r y of the B r i g h t o n C o r p s , in r e c o g n it io n o f th e m a n y s e r v ic e s h e h a s p e rfo rm e d d u r i n g th e p a st 21 y e a r s. M r. W i n d e r jo in ed t h e B r i g a d e i n 1 9 2 2 , a n d is n o w C o r p s O f f i c e r a n d S e c r e tary. H e is a l s o w e l l k n o w n in C i v i l D e f e n c e c i r c l e s a s St a f if O f f i c e r o f t h e B r i g h t o n C a s u a l t y S e r v i c e s , a n d is t h e a u t h o r o f a r e c e n t l y p u b l i s h e d m a n u a l , “ F i r s t A i d in C i v i l D e fe n c e .”

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T reatm ent. T h e a n n u a l In te r-S ta tio n F ir s t A id C o m p e titio n of the “ T ” D iv isio n , M etro p o lita n S p e c ia l C o n s ta b u la r y for the “ O ’ R o u r k e B o w l ” a n d o th er a w a r d s w a s held on S u n d a y a fte rn o o n , A p ril 4th, a t th e c a n te e n of M essrs. A. a n d F. P e a rs factory, L o n d o n R o a d , Isle w o rth , befo re an a u d ie n c e o f a b o u t 10 0 s p e c t a t o r s . T h r e e S tatio n s entered the c o m p etition r o o m — B re n tfo rd , H o u n s lo w a n d T e d d in g t o n . T h e te a m test w a s j u d g e d b y C o m m a n d a n t E. B. B r o w n , L . D . S . , R .C .S . (D irecto r of A .R . P . and A m b u la n c e T r a in in g , M . S . C . ) ; th e in d iv id u a l te st for N o s. 1 a n d 3 b y S t a f f I n s p e c t o r J. L u d g a t e , a n d f o r N o s . 2 a n d 4 b y S t a f f I n s p e c tor S. C. O pie. C o m m a n d a n t B r o w n in th e c o u r s e o f h is r e m a r k s , t h a n k e d I n s p e c t o r E s l i c k ( D i v i s i o n a l F i r s t A i d O ffic e r ) for th e pe rfec t a r r a n g e m e n t s m a d e for th e s m o o t h r u n n i n g of t h e c o m p e t i t i o n , a n d in p a r t i c u l a r , f o r h i s s t a g i n g o f t h e t e a m test. C om m andant E. W . Roe, O .B .E . (Com m andant “ T ” D iv isio n ) w e lc o m e d th e n e w C o m m a n d a n t-in - C h ie f (M a jo r V i v i a n R o g e r s , D . S . C . , O . B . E . , M . C . ) o n h is first visit to “ T ” D iv is io n a s C . - in - C ., a n d a ls o t h a n k e d th e j u d g e s for th eir services. T h e a w a r d s w e r e th en presen ted b y th e C o m m a n d a n tin -C h ie f. T h e re s u lt w a s a s fo l lo w s : 1, B r e n tfo r d 2 12 m a r k s ; 2, T e d d i n g t o n 1 8 3 ; 3, H o u n s l o w 1 7 0 . T h e f o l l o w i n g w a s t h e t e a m t e s t :— C a r d . — I t is a h o t s u n n y d a y , a n d y o u f o u r a r e w a l k i n g t h r o u g h s o m e m a r k e t g a r d e n s on y o u r w a y to th e sta tion 1 m ile d istan t. Y o u see an eld erly m a n a n d a w o m a n h o e in g , th e m a n fa lls to the g r o u n d fa c e d o w n w a r d s . S c e n e .— M a rk e t g a rd en , c o tta g e n earby, tw o hoes, tw o s a c k s , t w o p ieces o f w o o d , b r o k e n b r a n d y b ottle. F ir s t aid m a t e r i a l in c o t t a g e . (T e le p h o n e , h a v e r s a c , b la n k e ts , cold w a t e r a n d h o t w a t e r bottles). W ife w ill su p p ly a n y th in g a s k e d for. P a t ie n t .— E ld e r ly m a n (flushed face) a p o p le x y , fr a c tu re le ft c la v ic le (sim p le ), b le e d in g fr o m left p a lm (arte rial). T i m e .— IS m inu tes.

W a r n i n g a t 12 m in u tes.

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P u b lis h e rs N o t e .— W ill re a d e r s p lea se n o te t h a t all back n u m b e rs o f “ F irst A id ” a r e n ow o u t o f p rin t and c a n n o t be su p p lied . W ill S o u th A fr ic a n and o th e r C o lo n ia l re a d e rs p lea se add to th e ir re m itta n c e s , “ o r E nglish e q u iv a le n t.”

F I R S T

R I D

Reviews.

“ Millbank” Heel Clip. S in c e S i r H e n r y L . M a r t y n m e n t i o n e d t h e “ M i l l b a n k ” h e el c l i p in o n e o f h i s l e c t u r e s , w e h a v e h a d n u m e r o u s e n q u i r i e s f r o m r e a d e r s f o r p a r t i c u l a r s o f, a n d w h e r e t h e a p p l i a n c e c a n be obtain ed .

S u th e r la n d 's F i r s t A i d

to I n ju r e d

a n d S ic k .

H a llid a y S u therlan d , M. P. E d in b u r g h : stone. P r ic e g d ., hy p ost i s .

E d ited by E. & S. L iv in g

T h i s p o p u l a r l i t t l e b o o k , w h i c h w a s fir s t p u b l i s h e d in 188 7 b y th e fa t h e r of th e p r e s e n t e d ito r, c o n tin u e s its s u c c e s s f u l c a r e e r a n d is n o w in its fo rty-fifth ed itio n . It is b a s e d o n t h e s y l l a b u s of i n s t r u c t io n of th e S t. A n d r e w ’s A m b u la n c e A sso ciatio n , a n d p ro vid es a c le a r an d con cise a c c o u n t o f fir s t a i d w i t h i n t h e s c o p e o f a v o l u m e w h i c h c a n b e c a r r i e d in t h e w a i s t c o a t p o c k e t .

Y ou a n d Y o u r C om rad es.

B y th e M e d ica l O ffice r to M id lo th ian B a tta lio n H o m e G u a rd . E d i n b u r g h : E. & S. L ivin gsto n e. P r ic e y<7., by p ost 6d.

W e a r e n o w a b le to illu str a te the clip b y th e a c c o m p a n y in g d im en sio n ed sketch. I t is m a d e o f s t e e l w i r e a n d is u s e d f o r a t t a c h i n g t o t h e h e e l o f a p a t i e n t ’ s b o o t in o r d e r t o a p p l y exten sion . It c a n be o b ta in e d fr o m M e s srs. A lle n & I l a n b u r y ’s L t d . , B e t h n a l G r e e n , L o n d o n , E .2 .

First Aid in War Time. M o d e r n m e t h o d s o f first a id w e r e d e s c r ib e d b y R o t a r i a n D r . H e rb e rt T o m lin at a recen t w e e k ly m e e tin g of the H u d d e r s f ie ld R o t a r y C l u b . R o ta ria n T o m lin , w h o w a s w e a r i n g the u n ifo rm of a H o m e G u a r d M a jo r, said th at s in c e the la st w a r th ere h ad b e e n a t r e m e n d o u s c h a n g e in p u b l i c o p i n i o n , a n d h e w a s n o t a l t o g e t h e r s u r e w h e t h e r it w a s f o r t h e b e n e f i t o f f i r s t a i d . F irst A id at th e presen t tim e, h e th o u g h t, h a d b e co m e a c u lt a n d w a s o v e r g r o w i n g itself. M a n y people h a d been o v e r t r a i n e d in t h e s u b j e c t , a n d h a d t o o m u c h t h e o r y a n d n o t e n o u g h practice. A c t u a l l y , t h e y n e e d e d to k n o w v e r y little a b o u t t h e s u b j e c t , in f a c t , in h i s o p i n i o n , a l i t t l e k n o w l e d g e a n d a l o t o f c o m m o n s e n s e w a s b e t t e r t h a n a lo t o f k n o w l e d g e a n d a little c o m m o n sen se. It w a s not b e y o n d the b o u n d s of p o ssib ility th a t a n y one of th e m m ig h t be w o u n d e d as a resu lt of e n e m y action. T h e y w o u ld h a v e se v era l co m p lic a tio n s to co u n te r— b le e d in g , s h o c k a n d blood p o iso n in g . O n e w a y o f s t o p p i n g b l e e d i n g in a n e m e r g e n c y w a s t o o b lite ra te th e in ju re d s u rfa c e b y eith e r a h a n d k e rc h ie f or a d r e s s i n g , in f a c t , a c o m p r e s s o f a n y t h i n g c l e a n . T h e clea n i n g o f th e w o u n d co u ld be d o n e later. T r e a t m e n t f o r S h o c k . — S h o c k he w e n t on, in vo lved a n a l t e r a t i o n in t h e a m o u n t o f s u g a r in t h e b l o o d , a n d w a s a very serious th in g . T h e m a in t h in g w a s to k e e p the p atien t warm . D u r i n g th e la st w a r th ere w a s a h ig h d e a th -ra te f r o m s h o c k in t h e c a s u a l t y c l e a r i n g s t a t i o n s , d e s p i t e t h e f a c t t h a t t h e p i c k o f t h e c o u n t r y ’ s d o c t o r s w e r e in a t t e n d a n c e ; a n d n o so lu tio n w a s fo u n d until y e a r s of p e a c e h a d in te rve n e d . F in a ll y , d u r i n g th e L o n d o n blitz s o m e b o d y h it u p o n th e id ea th a t the c a s u a ltie s m i g h t b e cold, a n d to -d a y p eo p le w e r e “ p r o p e r l y c o o k e d ” in s p e c i a l r e s u s c i t a t i o n w a r d s a n d h a d fa r b e tte r c h a n c e s of re c o v e r in g from b le e d in g a n d sh o ck . D e a l i n g w ith b lood p o is o n in g , th e s p e a k e r said th a t o n ce the p atien t w a s u n d e r th e a n a e s th e tic a ll d irt w a s c le a re d out of th e w o u n d , th e d e a d tissu e s re m o ve d , a n d th e c a v ity stitch ed. P o i s o n i n g — t h e g r o w t h of g e r m s in th e w o u n d — w a s co u n teracted by the d r u g M . a n d B. T e ta n u s w a s d ealt w ith b y a n a n t i- t e ta n ic s e r u m in jectio n . It h a d b een le a rn ed th at rest w a s not a lw a y s th e best t h i n g , a n d t h e p o i n t h a d b e e n r e a c h e d w h e r e it w a s r e a l i s e d th a t rest after a n in ju ry w a s h a rm fu l. T o - d a y people w h o r e c e i v e d a w o u n d w h i c h i n c o n v e n i e n c e d t h e m in a n y w a y le a rn e d h o w to u se th e d a m a g e d part. T h is w a s k n o w n as

reh ab ilita tio n .

P r o b l e m s o f f i r s t a i d in f a c e o f t h e e n e m y d i f f e r in m a n y r e s p e c t s f r o m t h o s e m e t w i t h in c i v i l l i f e o r in C i v i l D e f e n c e w h e r e d o c to rs a r e u s u a lly m o r e or less q u ic k ly at h an d . T h i s little b o o k , th e r e fo r e , h a s b e en c o m p ile d fo r th e benefit o f m e m b e r s o f t h e H o m e G u a r d , t o w h o m it s h o u l d b e of in e stim a b le v alu e. I t is t h e o u t c o m e o f p e r s o n a l e x p e r i e n c e , a n d it s e t s o u t t h e w a y in w h i c h s o l d i e r s c a n h e l p e a c h o t h e r in t h e a b s e n c e o f m e d i c a l a i d .

B a illie r e ’s N u r s e s ’ C om p lete M e d ic a l D ictio n a r y . by M a r g a r e t E. H itch , S . R . N . T ind all & Cox. P r ic e j s . 6d.

London:

R evised Bailli^ re,

T h i s j u s t l y p o p u l a r d i c t i o n a r y i s n o w in it s 1 0 t h e d i t i o n , w h ic h h a s b een c a re fu lly rev ised a n d e n tire ly re-set ; a n d the l a r g e a m o u n t o f i n f o r m a t i o n w i t h i n i t s p a g e s is t r u l y rem ark able. P r i m a r i l y d e s i g n e d f o r s t u d e n t n u r s e s , it w i l l b e f o u n d o f i n v a l u a b l e a s s i s t a n c e t o a l l fi r st a i d e r s , a n d e s p e c i a l l y t o t h o s e w h o in t h e s e d a y s , o f w a r a r e d o i n g f u l l o r p a r t t i m e w o r k in h o s p i t a l s , b e c a u s e t h e d i c t i o n a r y d o e s n o t c o n f in e i t s e l f m e r e l y t o d e f i n i n g m e d i c a l t e r m s , b u t p r o v i d e s , in m o s t c a ses, b rief e x p la n a t o r y in fo r m a tio n ( in c lu d in g p ro n u n c i a t i o n ) r e g a r d i n g t h e m . I n a d d i t i o n , it i n c l u d e s t w e n t y o n e a p p en d ices, w h ic h set ont a b o d y of u sefu l in fo rm a tio n n o t s u i t a b l e f o r i n c o r p o r a t i o n in t h e a l p h a b e t i c a l s e c t i o n , b u t w h i c h n e v e r t h e l e s s is d e s i r a b l e t o h a v e a t h a n d f o r i m m e d i a te reference. “ I n c id a r p s " I n c id e n t C o n tr o l T r a in in g M o d e ls. B y T . E. B r o w n e . L o n d o n : J o r d a n & S o n s , L t d . P r ic e 2s. 6d .,

by p o st 2 S . gd. In tr a in in g w a r d e n s a n d o th er s to a c t a s in cid ent officers th e t a c tic a l ta b le h a s p r o v e d of g r e a t v a lu e , but w h i l s t it h a s b e e n p o s s i b l e t o h a v e a l a r g e s c a l e m a p , t h e n e c e s s a r y m o d e ls of m e n , a m b u l a n c e s , c a r s , e tc ., h a v e been difficult to o b tain , e s p e c ia lly a t th e p r es en t tim e w h en m e t a ls a r e w a n t e d for th e w a r effort. T o m ee t th is d ifficu lty t h e a u t h o r h a s d e s i g n e d f o u r s h e e t s o f p r i n t e d m o d e l s on b o a r d r e a d y fo r c u t t i n g o u t a n d g i v i n g s o m e 75 m o d e ls of m e n , c a rs , etc. W h e n a s s e m b le d , th e m o d e ls s h o w the p r in t in g a n d c o l o u r i n g o n b o th sid es, a n d th is is of v a lu e se e in g th a t o n lo o k ers a re u su a lly g ro u p ed rou nd the m ap. T h e m o d e l s s h o u l d p r o v e o f g r e a t a s s i s t a n c e in t h o s e c a s e s w h e r e th e m e ta l m o d e ls c a n n o t be o b tain ed .

F ir s t

A id

C iv il

D efen ce.

Lond on : T h e F ou n tain

By Press.

R e g in a ld G . W in ter. P r ic e / / ? n e t ; by p est

t/ST h i s b o o k s h o u l d p r o v e o f g r e a t v a l u e in v i e w o f t h e re c e n t re d u ctio n of th e p e rso n n e l of th e C ivil D e fe n c e S e r vices a n d of th e n e ce ssity for t r a in in g m a n y part-tim e m e m b e r s t o fill t h e g a p s t h u s c r e a t e d . It d ea ls w ith every a s p e c t of w a r - t i m e first a id in a p r a c t ic a l a n d c o n c is e m a n n e r ; a n d its o p e n i n g c h a p t e r s o n P r o c e d u r e a t A i r R a id In c id e n ts a n d T y p e s of In ju rie s a r e p a r tic u la r ly in te re stin g . I n s h o r t , it c o n t a i n s m u c h e s s e n t i a l i n f o r m a t i o n w h i c h d e s e r v e s th e clo s e a tte n tio n of a ll m e m b e r s o f th e Civil D e fe n c e S ervices,

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one or ° ^ ler or th ree races of g e r m s , S tre p to co cci, S ta p h y lo c o c c i a n d B . p y o c y a n e u s a re f o u n d in e v e r y s k i n i n f e c t i o n c o m m o n t o t h i s c o u n t r y , a n d A N T I P E O L O I N T M E N T c o n t a i n s t h e a n tib od ies ( a n t i v i r u s ) o f t h e s e g e r m s . H e a l i n g is e x p e d i t e d b y t h e p r o v e d i n g r e d i e n t s o f t n e a a d . s e P t i c d e v e l o p m e n t is s t o p p e d o r p r e v e n t e d b y i t s a n t i v i r u s s t e r i l e v a c c i n e f i l t r a t e s . A N TIP E O L O I N T M E N T i s u n s u r p a s s e d f o r B U R N S a n d S C A L D S , f o r it is m i c r o b i c i d e a n d n o n - a d h e s i v e , a n d d r e s s i n g s d o n o t re q u ire to be c h a n g e d e v e ry d ay.

R H I N O - A N T I P E O L a ffo rd s ra p id relief o f C O M M O N C O L D S , I N F L U E N Z A , A N D C A T A R R H . C o n ta in in g th e a n tib o d ie s of the g e r m s c o m m o n to in fe c tio n s of th e n o s e a n d p h a r y n x ( S t a p h y lo c o c c i , S t r e p t o c o c c i, B. p y o c y a n e u s , p n e u m o c o c c i , p n e u m o b a c i l l i , e n t e r o c o c c i , M . c a t a r r h a l i s , B . P f e i f f e r ) , R h i n o - A n t i p e o l is n o t j u s t a p a l l i a t i v e , b u t is a r e m o v e r o f t h e cause o f t h e i n f e c t i o n . D u r i n g e p i d e m i c s it is t h e i d e a l p r e v e n t i v e o f m i c r o b e d e v e l o p m e n t .

O P H T H A L M O -A N T I P E O L is a s e m i - f l u i d o i n t m e n t , m o r e c o n v e n i e n t t h a n t h e o r d i n a r y A n t i p e o l o i n t m e n t f o r o c u l a r i n f e c t i o n s a n d l e s i o n s . E y e s a ffected b y s m o k e a n d d u s t a r e so o th ed a lm o s t im m e d ia te ly b y th e a p p lic a tio n of O p h th a lm o -A n tip e o l, a n d th e a n tiv iru s preven ts g e r m s fro m d e v e lo p in g . C lin ic a l S a m p le s o n r e q u e s t f r o m

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P R E S C R IP T IO N S — 375 p r o v e d rem ed ie s.

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p |e a s e s e n d m e P r o s p e c tu s o n T H E o b lig a tio n to p u r c h a s e .

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S i n c e l a s t m o n t h ’ s i s s u e it h a s b een s u g g e s t e d th at the r e s c u e m e t h o d s d e s c r i b e d b y m e w o u l d , in m a n y c a s e s , t e n d to a g g r a v a t e th e in ju r y . It s h o u ld b e fu lly realised th a t t h e s e a r e w h a t m a y be te r m e d “ life a n d d e a th ” m eth o d s . M e d i c a l O r d e r l i e s in t h e f ie ld h a v e l i t t l e c h a n c e t o p r a c t i c e t e x t b o o k m e t h o d s , p a r t i c u l a r l y w h e n u n d e r fi r e. W h ile e v e r y c a r e s h o u l d b e t a k e n , a c e r t a i n a m o u n t o f r i s k is in evitab le. B u t b e t t e r l o s e a l i m b t h a n l o s e y o u r life. W h y is it s o m a n y f i r s t - a i d e r s b e c o m e o n l y “ t e x t b o o k m in d e d ” a n d n e ve r u se th eir in it ia t iv e ? I t is t r u e , d o c t o r s a n d e x a m i n e r s o f t e n fa i l t o e n c o u r a g e t h i s . A typical e x a m p l e a p p e a r e d in l a s t m o n t h ’ s “ Q u e r i e s a n d A n s w e r s , ” w h e n W . R . ( E x h a l l ) a s k e d if a n o f f i c i a l w a s c o r r e c t in c r it ic is in g h im fo r p u t t i n g t h e a r m in a S t. J o h n s li n g w h e n th e d is ta l p h a l a n x of a n in d e x fin g e r h a d b e en torn o ff a n d c h a n g i n g to a la r g e a r m slin g . O f course he w as not correct ! T o s a y t h e l e a s t , s o m e p a i n is i n e v i t a b l e w h e n t h e n u m b n e s s w e a r s off, a n d e l e v a t i o n is t h e m o s t c o m f o r t a b l e p osition. H a v e yo u ever w a tch e d a person w h o h as b ad ly inju red a fin g er ? H e a u t o m a t i c a l l y r a i s e s h i s h a n d , e v e n if it is n o t s l u n g . B u t t h e t e x t b o o k g i v e s o n ly t h r e e u s e s for th e St. Jo h n s lin g . Y es, H o m e G u a rd s m ust advance b e y o n d t h e t e x t b o o k to b e efficien t. F ield co n d ition s an d t h e d e a r t h o f e q u i p m e n t w i l l t e s t t h e i r i n i t i a t i v e t o t h e fu l l . A n d n o w f o r a f u r t h e r m e t h o d o f r e s c u e u n d e r fir e.

T w o bearers only. — P a t i e n t can be approached, d r e s s e d , a n d lifed on to s t r e t c h e r a s fo r fo u r b e a r e r s , e x c e p t t h a t m o r e w o r k i s i n v o l v e d f o r N o . 2. E a c h b e a re r th en s h o r t e n s a s t r e t c h e r s l i n g r i g h t u p a n d p l a c e s it r o u n d h i s n e c k a l l o w i n g lo o p s to h a n g f o r w a r d o v e r h is s h o u ld e r s . T a k in g u p p o s itio n on h a n d s a n d k n e e s , a t h e a d a n d fo o t of s t r e t c h e r , b u t J a c in g e a c h o t h e r , t h e y b e n d r i g h t d o w n a n d slip loops o v er h a n d le s. I f p r o p e r l y a d j u s t e d , t h e y c a n li ft s tre tch e r cle a r of g ro u n d , t a k i n g w e ig h t lo w d o w n a t the b a c k of t h e n e c k a n d c r a w l on h a n d s a n d k n e e s to c o v e r N o. 1 m o v in g b a c k w a r d s a nd No. 2 forw ard s. C.

p r e a d b u r y (S e rg t.), S c h o o l H o u s e , N o e l-ro ad , W .3 .

P . S . — A s a p oin t of in terest, I h a v e j u s t h a d th e h o n o u r of b e in g p r e s e n te d w i t h a C e r tific a te of M e r it b y the C . - i n - C . H o m e F o r c e s in c o n n e c t i o n w i t h t h e K i n g ’ s b i r t h d a y h o n o u r s .— C. W . S.

Great Western Railway. S w in d o n . — D r. R . B . H ic k presided at th e p r e s e n ta tion of a w a r d s to m e m b e r s of the S w in d o n A m b u l a n c e C la s s e s on A p ril 1 1 th , a n d w a s su p p o rte d b y M essrs. G . C u llin g , C h a ir m a n of C o m m itte e , L . G . B re tsc h , D iv isio n a l S e c r e t a r y , J. W . S u t t o n , A s s i s t a n t D i v i s i o n a l S e c r e t a r y , M r s . A . M o rris, S e c r e ta r y L a d ie s section , a n d m e m b e rs of the

com m ittee. D r. H ic k e n c o u r a g e d th e m e m b e rs w h o h a v e o b tain ed c e r t i f i c a t e s t o k e e p u p t h e i r i n t e r e s t in t h e w o r k b y c o m i n g a l o n g e a c h y e a r to q u a lif y fo r a d d it io n a l a w a r d s . H e said t h e r e w a s a l w a y s s o m e t h i n g t o l e a r n in f i r s t a i d , a n d r e f e r r e d to th e lo y a lty of th e l o n g se rv ice m e n w h o a tte n d e d the c la s s e s y e a r a f t e r y e a r to m a i n t a i n t h e ir effic ien c y . Four h u n d re d a nd seven m em b e rs h a v e su cce ssfu lly passed an e x a m i n a t i o n d u r i n g t h e p a s t y e a r , w h i c h w a s a n i n c r e a s e of

R I D F o w l e r , w h o h a d b e e n a s s o c i a t e d w i t h t h e m o v e m e n t f o r 29 years. H e h ad been g ra n te d the G . W . R . Q u a r te r C e n te n a ry M e d a l , a n d w o u l d t h i s y e a r h a v e q u a l i f i e d f o r a b a r f o r 30 y e a r s efficient service.

Letters to the Editor. W e a r e in n o w a y r e s p o n s i b l e f o r t h e o p i n i o n s e x p r e s s e d , o r the sta tem en ts m ad e, b y C o rre sp o n d e n ts.— E d it o r .

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In p e r u s in g y o u r A p r il issu e of F ir s t A i d , w e n otice u n d e r “ Q u e r i e s a n d A n s w e r s to C o r r e s p o n d e n ts ” a r e a d e r a s k s — “ W e h a v e a S p a r k l e t s R e s u s c i t a t o r — I w o n d e r if t h i s w o u l d d o in p l a c e o f m o u t h b r e a t h i n g . ” In a n s w e r i n g th is q u e s t i o n , D r . C o r b e t F l e t c h e r s a y s , “ (3) T h e S p a r k l e t s R e s u s c i t a t o r c a n p r o d u c e n o e f f e c t if t h e v i c t i m is n o t m a k i n g so m e attem p t at b r e a th in g .” W h i l e t h i s is p e r f e c t l y t r u e w e fe e l t h a t t h i s q u e s t i o n m i g h t h a v e b e en a n s w e r e d a little m o r e fu lly . T h e general r e c o m m e n d a t i o n is t h a t a r t i f i c i a l r e s p i r a t i o n s h a l l i m m e d i a t e l y b e a p p l i e d in c o n j u n c t i o n w i t h C 0 2 in c a s e s w h e r e b r e a t h i n g has ceased. W 'e c o u l d , o f c o u r s e , d e a l w i t h t h i s m a t t e r b y a m o r e l e n g t h y d i s c u s s i o n b u t fe e l it w i l l s u f f i c e if w e d r a w a tte n tio n to p a g e 233 of th e “ B ritish R e d C r o ss S o c ie ty F irst A i d M a n u a l N o . 1 , ” f r o m w h i c h t h e f o l l o w i n g is e x t r a c t e d :— “ A d m in is tr a t io n o f C arbon D io x id e . “ I n a l l c a s e s in w h i c h b r e a t h i n g is d i m i n i s h e d o r sto p p e d o w i n g to d r o w n i n g o r p o i s o n i n g b y g a s e s s u c h a s c a rb o n m o n o x id e from c a r e x h a u s ts , coa l g a s or co k e f u m e s , t h e a d m i n i s t r a t i o n o f c a r b o n d i o x i d e ( C 0 2 ) is a u s e fu l a d d i t i o n to th e first aid t r e a t m e n t a lr e a d y in d icated . “ C a r b o n d i o x i d e m a y b e g i v e n e i t h e r d i r e c t l y in c o m b in a tio n w ith o x y g e n , or in d irectly b y a d d in g a g e n t l e s t r e a m of c a r b o n d io x i d e to th e in s p ir e d a i r a t a b o u t a n i n c h in f r o n t o f t h e p a t i e n t ’ s n o s e a n d m o u t h . In d r o w n i n g , a s so o n a s th e a i r - w a y s a r e c le a r, w h iffs of c a r b o n d io x i d e s h o u ld b e a d d e d to a r tific ia l r e s p ir a tio n . I f t h e p a t i e n t is p o i s o n e d b y c o a l g a s o r “ f u m e s , ” h e m u s t be b r o u g h t into th e fresh a ir a n d artificial r e s p ir a tion p e rfo rm e d w it h th e a d d itio n of c a r b o n d i o x i d e .” I t w o u ld b e p o s s ib le to q u o te n u m e r o u s c a s e s w h e r e a rtificial resp iratio n a n d C 0 2 h a v e b een ap p lied w ith g r e a t satisfa ctio n w h e n b re a th in g h a s been p res u m e d a b s e n t— as, fo r in s t a n c e , t h e c a s e of e le c t r o c u t io n w h i c h w a s m e n t io n e d in “ T h e E l e c t r i c a l T i m e s ” o f M a r c h 1 7 t h , 1 9 3 8 , w h e n , s u b se q u e n t to m ed ica l e x a m in a tio n , th e “ b o d y ” w a s sen t to the m ortuary. A fi r st a i d e r in t h e a m b u l a n c e , o n h i s o w n in itiative, c a rrie d ou t a rtificia l re sp ira tio n a n d a p p lied C 0 2 w i t h t h e r e s u lt t h a t t h e m a n c a m e to life e n ro u te . T h e o b je c t of th e S p a r k l e t s R e s u s c i t a t o r is to p r o v id e the fi r st a i d e r w i t h a s i m p l e m e a n s o f g i v i n g C 0 2 w h i l e a p p l y i n g a rtific ia l re sp ira tio n , p a r t ic u la r ly in s e v e r e c a s e s of a s p h y x i a a n d , a s D r. C o rb e t F le tc h e r , u n d e r (1), h a s s u g g e s t e d “ th at if S c h a f e r ’s m e t h o d o f a r t i f i c i a l r e s p i r a t i o n is u s e d f o r s u c h c a s e s , f u r t h e r d a m a g e i s n o t l i k e l y t o r e s u l t , ” it w o u l d h a v e b een a n a d v a n t a g e to h a v e r e c o m m e n d e d th a t C 0 2 fr o m the S p a r k le t s R e s u s c ita to r be g iv e n w h ile th is w a s b e in g c a r r ie d out. I n cid en tally, a p p a ra tu s su ch a s the S p a rk le ts R e s u s c ita to r w a s in tr o d u c e d a s a d is tin c t b enefit o v e r th e o ld e r m eth o d of m o u t h b r e a t h i n g . M o u t h b r e a t h i n g is r e f e r r e d t o in H o l y S crip tu re s as “ th e b re ath of life .” I t is t h e w r i t e r ’ s i m p r e s sio n t h a t th e b enefits of m o u t h b r e a t h i n g a r e l a r g e l y d u e to t h e e x h a l a t i o n f r o m t h e fir s t a i d e r t o t h e v i c t i m o f C 0 2 to s tim u la te the re s p ir a to r y c e n tr e .— Y o u r s faith fu lly,

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A c tio n w ith M a te r n ity C a s e . F . C . ( H a s t i n g s ) . — If a first a i d e r s h o u l d c o m e a c r o s s a w o m a n w h o h as been su d d e n ly confined, w h a t c a n he d o s u p p o s i n g t h a t t h e r e is n o c h a n c e o f g e t t i n g i m m e d i a t e m e d ic a l aid ? M e a n w h i l e I t h a n k y o u in a n t i c i p a t i o n o f y o u r kin d replies to m y tw o queries. T h e s u d d e n d e l i v e r y o f a p r e g n a n t w o m a n is a n a t u r a l , t h o u g h p r e c i p i t a t e , e v e n t ; a n d it is n o t u s u a l l y a c c o m p a n i e d by severe h rem orrh age. I n t h e s e c i r c u m s t a n c e s , a fir s t a i d e r s h o u ld b e c a r e fu l to a v o id in te rfe re n c e , t h r o u g h w h i c h th e d a n g e r s of sep tic in fection a re e n o r m o u s ly in cre a se d . As l o n g a s t h e w o m a n is m a d e c o m f o r t a b l e a n d c o v e r e d u p w a r m l y a n d a s lo n g a s th e c h ild is p r o te c te d fr o m a s p h y x ia a n d a l s o k e p t w a r m , a l l t h a t is n e c e s s a r y is a c c o m p l i s h e d ; a n d t h e fir s t a i d e r c a n w i t h e q u a n i m i t y a w a i t t h e a r r i v a l o f the d octor or m id w ife .— N .C .F .

R a te o f C ir c u la tio n . E ffe c ts o f O x y g e n . R .F . (V a n c o u v e r, B .C .) .— W h e n d e a lin g w ith a q u ery w h ich w a s p u b l i s h e d u n d e r t h e a b o v e h e a d i n g in t h e F e b r u a r y issu e of F ir s t A id , y o u g a v e a n a n s w e r w h ic h im p lies t h a t it i s i m p o s s i b l e f o r a h u m a n b e i n g t o l i v e in a n a tm osp h ere of pure o x y g e n . T h e f a c t t h a t it is p o s s i b l e is p r o v e n b y t h e u s e o f m i n e r e s c u e o x y g e n b r e a t h i n g a p p a r a t u s in w h i c h p u r e o x y g e n is u s e d f o r p e r i o d s a s l o n g a s 2 h o u r s . T h is 2 h o u r l i m i t is n o t a p h y s i o l o g i c a l l i m i t i m p o s e d b y^a h u m a n b o d y, b u t a m e c h a n ic a l lim it im p o se d b y the m a x i m u m efficien t w e i g h t o f th e a p p a r a tu s . T h e s u b stitu tio n of m o re o x y g e n for a n o rm a l h ig h p e r c e n t a g e o f n i t r o g e n in t h e a t m o s p h e r e , d o e s n o t f o r c e t h e b o d y t o t a k e in a d d i t i o n a l o x y g e n t h r o u g h t h e l u n g s . T h e s u r p l u s is m e r e l y b r e a t h e d o u t a g a i n , o n l y t h e req u ired a m o u n t b e in g retained. Y o u w o u ld se e m to h a v e m isse d the q u e r y an d of m y re p ly ; a n d I can o n ly im p o s s ib le for a h u m a n b e i n g to liv e a tm o s p h e re of pu re o x y g e n . — N. C o r b e t

m a in p oin t of th e r e p e a t t h a t it is i n d e f i n i t e l y in a n F letcher.

E x a m in a tio n H o w ler. F . E. ( S h r e w s b u r y ) .— In a recen t e x a m in a tio n I a s k e d one c a n d id a t e to tell m e w h a t im p o r t a n t s t r u c t u r e p a s s e s th ro u g h the sp inal co lu m n . Y o u m ay im ag in e m y su r p r i s e a n d a m u s e m e n t w h e n h e r e p l i e d — “ T h e A m b r o s ia l A r te r y !" T o t h i s I w a s t e m p t e d t o a d d “ C a r ry in g food fo r the g o d s ? " b u t I r e f r a i n e d . Good!

N e x t , p l e a s e ! !— N . C . F .

A s p h y x ia w ith B le e d in g . F .C . ( H a s t in g s ) .— A t a recen t D iv isio n a l P ractice I w a s a s k e d h o w I w o u ld tre at a patient w h o w a s su fferin g fro m b le e d in g from th e r ig h t fe m o ral, fro m b u rn s on the left a r m a n d a t th e s a m e tim e w a s not b r e a t h in g . I r e p l i e d t h a t I w o u l d t r e a t t h e h a e m o r r h a g e fi r st a n d t h e n c o m m e n c e a rtific ia l r e s p ira tio n ; a n d th a t w h e n his b re a th in g w a s restored I w o u ld treat for sh o c k , le a v in g th e tr e a tm e n t of th e b u rn s la st. P l e a s e t e l l m e if w i t h s u c h a c a s e t h i s is t h e c o r r e c t p r o c e d u r e . Y o u r a n s w e r w a s not q u ite correct b eca u se w ith a n in s e n s i b l e p a t i e n t w h o is n o t b r e a t h i n g t h e r e w o u l d b e l i t t l e b leedin g. In th ese c ircu m sta n ce s yo u w o u ld ta k e preven tive a ction on ly by ra p id ly p la c in g the to u rn iq u et w ith te m p o ra ry d r e s s i n g for th e w o u n d so th a t w h e n p a tie n t b e g in s to b r e a t h e a n d b l e e d i n g is l i k e l y t o r e - s t a r t y o u c a n t i g h t e n t o u r n i q u e t im m ed iate ly. T h i s d o n e y o u w o u l d a t o.nce r e s o r t t o a r t i f i c i a l resp iratio n r e m e m b e r in g th a t o p e ra tio n s m u st be c o m m e n c e d a t t h e first p o s s ib le m o m e n t . T h e n w h e n b r e a th in g h a s been re-started you w o u ld d ress th e w o u n d a nd b u rn s ca re fu lly a n d a s l a i d d o w n in t h e T e x t b o o k . — N . C . F .

W . C . (S h e ffie ld ).— Y o u r re p ly to th e q u e r y w h ic h w a s p u b l i s h e d u n d e r t h e a b o v e h e a d i n g in t h e M a r c h i s s u e o f F i r s t A id s e e m s to ca ll fo r f u r t h e r e x p la n a t io n . Your a n s w e r o f “ T h i r t y s e c o n d s is c o r r e c t ! ” s e e m s f a r t o o a b r u p t to settle th e m atter. O n p a g e 1 7 3 ( 3 6 t h e d i t i o n ) P h y s io lo g y a n d B io C h em istry b y H a l l i b u r t o n a n d M a c D o w a l l , t h e f o l l o w i n g s e n t e n c e o c c u r s :— “ S i n c e t h e t o t a l b l o o d in t h ^ b o d y a n d t h e o u t p u t o f t h e h e a r t p e r m in u t e a r e a b o u t t h e s a m e , i .e ., 5 litres, it c a n b e c o n s i d e r e d t h a t a l l t h e b l o o d m a k e s o n e c i r c u i t - per m in u te, at r e s t.” O n th is s a m e p a g e , th e a u t h o r s c a r e fu lly poin t ou t t h a t S t e w a r t c a l c u l a t e d t h a t t h e t o t a l c i r c u l a t i o n t i m e in m an w a s IS seconds. F u r t h e r , it is p o i n t e d o u t t h a t t h e v a r y i n g ro u te s b y w h i c h a n y p a r t ic u la r p a r tic le of blood m a y t r a v e l a l s o i n f l u e n c e i t s t i m e r a t e in m a k i n g a c o m p lete circu it. It w o u ld s e e m r th en , th at o n e ca n h a rd ly d ism iss t h e q u e r y in a f o u r w o r d a n s w e r , a n d t h a t s o m e q u a l i f i c a t i o n is n e c e s s a r y . I a w a it y o u r fu rth e r rep ly w ith in terest. Y o u w i l l p r o b a b l y h a v e r e a d e r e t h i s in t h e A p r i l i s s u e th e re p ly w h ic h I g a v e to a n o th e r c o rre s p o n d e n t a n d w h ic h d ea ls w ith y o u r m ain a rg u m e n t. B o th of y o u a re w o r r y i n g y o u r s e lv e s o v er a m a tte r to w h ic h no p o sitive a n s w e r c a n be g i v e n a n d w h i c h is o u t s i d e t h e s c o p e o f p r a c t i c a l f i r s t a i d . I n s h o r t m y f o u r w o r d e d r e p l y in t h e M a r c h i s s u e st ill s t a n d s !— N . C . F .

T r e a tm e n t o f F r a c t u r e d N o se. P . O . ( E d i n b u r g h ) . — P l e a s e t e ll m e w h a t is t h e c o r r e c t fi r st a id tre a tm e n t for fra c tu re of the n o se c o n c e rn in g w h ich t h e T e x t b o o k is silen t. I h a v e d is c u s s e d th is p oin t w ith t w o fr ie n d s a n d a s w e c a n n o t a g r e e w e d e c id e d to a s k y o u r k in d ru lin g . W ith a fractu re of nose the tw o co m p lica tio n s w h ic h m a y n e c e s s it a t e a c ti o n b y first a i d e r s a r e h a e m o r r h a g e fr o m n o se a n d c o n c u ss io n of brain. C o n s e q u e n t l y l o c a l t r e a t m e n t of t h i s i n j u r y m u s t b e o n t h e l i n e s o f t h e i n s t r u c t i o n s s e t o u t in t h e T e x t b o o k u n d e r “ H a e m o r r h a g e f r o m t h e N o s e ” (p. 1 3 8 ) . W h e n b l e e d i n g h a s b e e n c o n tr o lle d th e p a t ie n t s h o u ld be a d v is e d to s e e k m e d ic a l a id a t th e e a r lie s t m o m e n t . — N . C . F .

H u m o u r in F ir s t A id . W . J . ( C h e a d le H u l m e ) . — T h e f o l l o w i n g a m u s i n g in cid ent w a s re la te d to m e b y o n e of m y a m b u la n c e sisters w h o i s g i v i n g i n s t r u c t i o n in fir s t a i d t o a c l a s s o f s m a l l b o y s in c o n n e c t i o n w i t h t h e Y o u t h M o v e m e n t . S h e h a d b een te llin g the b oys a b o u t th e treatm en t of b u r n s a n d s c a ld s , g i v i n g d e ta ils in th e u s e o f b i c a rb o n a te of sod a, w h e n su d d en ly a h an d sh ot up and

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a s m a ll b oy said : “ P le a se , M iss, w h a t w a s th e n a m e o f t h a t s t u f f w e h a v e to u s e ? ” “ B i- c a r b o n a te of s o d a ,” said th e in stru cto r. “ O h ! ” s a i d t h e s m a l l b o y , t h o u g h t f u l l y , “ a n d if 1 h a v e n ’t a n y b i-c a rb o n a te of so d a, w ill lim e ju ic e an d soda do ? ” A m id s t m u ch la u g h te r , the in stru cto r th a t lim e ju ice a n d s o d a w o u ld not do. Good !

exp lained

N e x t , p l e a s e ! !— N . C . F .

R e s u lt o f I n ju r y to F e m o r a l A r te r y . N . Y . ( P l a i s t o w ) . — I f , a s t h e r e s u l t o f a w o u n d in t h e t h i g h , th e fe m o r a l a r t e r y is c o m p le t e ly s e v e r e d , w h a t h a p p e n s ? D o e s t h e a r t e r y r e s u m e its fu n c t io n s a f t e r t r e a t m e n t ? Y o u r r e p l y t o t h i s q u e s t i o n is a w a i t e d w i t h i n t e r e s t . I f t h e f e m o r a l a r t e r y Be c o m p l e t e l y s e v e r e d , t h e o n l y p o s s i b l e t r e a t m e n t is t o l i g a t u r e t h e t o r n e n d s , w h i c h m e a n s t h a t its fu n c t io n s a r e e n d e d . F o rtu n ately, h ow ever, there is a c o l l a t e r a l ( o r “ b a c k d o o r ” ) c i r c u l a t i o n t h r o u g h c e r t a i n v e s s e ls w h ic h g r a d u a l l y e n l a r g e a n d t a k e on t h e w o r k of th e d estroyed m ain a rtery. T h is re -e sta b lish m en t of the c i r c u l a t i o n t a k e s a l o n g t i m e ( p r o b a b l y m o n t h s ) f o r it s c o m pletion — N . C. F .

is “ w i n d e d ” a s t h e r e s u l t o f a v i o l e n t b l o w in t h e p i t o f the sto m ach . A s w e c o u ld n ot a g r e e , w e d e c id e d to s u b m it o u r p r o b le m to you . T h e c o n d i t i o n o f “ w i n d i n g ” is o n e o f s h o c k r e s u l t i n g fr o m a b d o m in a l in ju ry. T h i s c a u se s irritation of th e s y m p a t h e t i c n e r v o u s s y s t e m , a n d e s p e c i a l l y t h a t p a r t o f it w h i c h is c a l l e d “ t h e s o l a r p l e x u s , ” a n d is s i t u a t e d in t h e r e g i o n o f t h e pit o f t h e s t o m a c h . I n o t h e r w o r d s , it is ( a s t h e T e x t b o o k t e l l s y o u o n p. 4 3 ) “ a c o n d i t i o n o f s u d d e n d e p r e s s i o n of th e n e r v o u s s y s te m r e s u lt in g fro m a n d o c c u r r i n g a fter e v e r y c a s e o f a c c i d e n t o r s u d d e n i l l n e s s ” ; a n d it m a y la st for o n ly a fe w m o m e n t s o r it m a y d e v e l o p i n t o collap se. c o n d i t i o n o f “ w i n d i n g ” r e s u l t s f r o m a sharp b lo w on the a b d o m in a l w a ll, a s b y a fast t r a v e l l i n g fo o tb a ll, a n d c a u s e s a t e m p o r a r y s t o p p a g e of b r e a t h i n g , w h i c h ( f o r t u n a t e l y f o r f o o t b a l l e r s ) is u s u a l l y transient. T h e l a t t e r is a r e f l e x e f f e c t o f t h e a b d o m i n a l i n j u r y ; a n d , a s t h e m o s t m a r k e d s y m p t o m , it g i v e s i t s n a m e to t h e c o n d i t i o n , w h i c h m a y v a r y f r o m a t e m p o r a r y i n c a p a c it a t io n to a fa ta l s y n c o p e , th e la t te r o fte n w i t h o u t a n y a p p a r e n t lesio n . In th ese c ir c u m s t a n c e s t r e a t m e n t sh o u ld be fo r s h o c k as l a i d d o w n in C h a p t e r I V o f t h e T e x t b o o k . — N . C . F . The

and

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T o ta l L e n g th o f B lo o d v e s s e ls . W . T . ( B ir m in g h a m ) .— L a s t w e e k a d a ily n e w s p a p e r stated in i t s “ R e p l i e s t o C o r r e s p o n d e n t s ” c o l u m n t h a t if y o u c o u ld c o n n e c t all th e a r te r ia l a n d v e n o u s blood vessels i n t o o n e l o n g p i p e l i n e it w o u l d m e a s u r e 3 5 t h o u s a n d m iles. I s t h a t c o r r e c t , S i r ; it s o u n d s a d i c k e n s o f a l o n g w a y to m e. T h a n k i n g y o u v e r y s i n c e r e l y in a n t i c i p a t i o n o f y o u r reply. A m o n g m y t r e a s u r e s i s a fo e t a l l o w e r l i m b w h i c h h a s b e e n in je c te d to s h o w th e m a in a r t e r y fr o m t h i g h to fo o t a n d its in n u m e r a b le off-sh oots. L o o k i n g a t th is a n d re m e m b e r i n g t h a t it r e p r e s e n t s t h e a r t e r i a l v e s s e l s o f o n e l i m b o n l y , I c a n w e l l i m a g i n e t h a t if w e c o u l d s t r e t c h o u t in l i n e "all t h e b l o o d v e s s e l s o f a n a d u l t w e s h o u l d p r o b a b l y fi n d t h a t t h e t o ta l l e n g t h w o u l d a p p r o x i m a t e to t h e s t a te d f ig u r e , w h ic h , a f t e r a ll, is o n ly g u e s s w o r k . — N . C . F .

C a r b o lic A c id P o is o n in g . M . N . ( P l y m o u t h ) . — I t is n o t e d t h a t , w h e r e a s t h e T e x t b o o k t e l l s u s t o w i t h h o l d a d m i n i s t r a t i o n o f a n e m e t i c in t h e tre a tm e n t of C a rb o lic A c id P o is o n in g , ce rta in oth ers re c o m m e n d the e v a c u a tio n of the sto m a c h co n te n ts by th is m ea n s. In v ie w of th is d ifferen ce of op in io n w e sh all be g r a t e fu l fo r y o u r k in d help. C a r b o l i c A c i d is n o t a c t i v e l y “ a c i d ” ; a n d c o n s e q u e n t l y it is n o t s o l i a b l e t o b u r n t h r o u g h t h e g u l l e t a n d s t o m a c h a s a re the oth er C o rro siv e A c id s a n d A lk a lies. In oth er w ords, it is l e s s l i a b l e t o b e a s s o c i a t e d w i t h u l c e r a t i o n a n d p e r f o r a tion of th e w a lls of th es e p a rts w h e r e b y th e a c t of v o m it in g m a y p r ec ip ita te p erfo ratio n. C o n s e q u e n t l y , s o m e a u t h o r it ie s r e g a r d it a s p e r f e c tly sa fe t o g i v e a n e m e t i c in s u c h c a s e s . P e r s o n a lly , I a m of the o p i n i o n t h e t t h e T e x t b o o k is r i g h t in a d v i s i n g t h e w i t h h o l d in g of a n e m e tic .— N . C . F .

A s p h y x ia a n d C a r b o n D io x id e . H . E . ( F o r e s t H i l l ) . — A s p h y x i a , a s I u n d e r s t a n d it, is d u e to th e d e ficie n cy of o x y g e n a n d not to th e e x c e s s of C 0 2 in th e blood . Y e t , a l t h o u g h th e b lo o d t e n d s to b e c o m e sa tu r a te d w ith C 0 2 (h en ce the d ee p er b r e a th in g b y p a t i e n t b e f o r e i n s e n s i b i l i t y p r e v a i l s ) , w h y i s it t h a t i n r e s u s c i t a t i o n it is a d v i s a b l e t o i n t r o d u c e C 0 2 i n t o t h e b l o o d s t r e a m in o r d e r t o s t i m u l a t e t h e r e s p i r a t o r y cen tre ? I realise th a t the b od y c a n n o t g o on p ro d u c in g C 0 2 fo r lo n g , o w i n g to th e la c k of o x y g e n n e ed e d to c o m bin e w ith th e c a rb o n . A s , h o w e v e r , th e r e is a n in itial e x c e s s o f C 0 2 in t h e b l o o d , I p r e s u m e t h a t t h i s g a s is a b s o r b e d in s o m e w a y a s t h e n a t u r a l s t i m u l a t i o n o f t h e r e s p ir a t o r y c e n tr e c e a s e s in th e e a r ly s t a g e s of a s p h y x ia . I sh a ll a p p r e c ia t e v e r y m u c h y o u r r e p ly on th is poin t ; and I th a n k you. Y o u a r e q u ite r i g h t in y o u r c o n c lu s io n s . P ro bab ly w h a t h a p p e n s is t h a t t h e e x c e s s o f C 0 2 h a s b e e n t h r o w n o f f in t h e p e rio d j u s t p r io r to t h e o n s e t of in s e n s ib ilit y w h e n th e b r e a t h i n g is v e r y l a b o u r e d . T h i s b e in g so, th e v a lu e of th e s u b s e q u e n t a d m in is tra tio n of C 0 2 ca n be m ore rea d ily u n d erstoo d . — N . C . F .

S h o c k fr o m A b d o m in a l I n ju r y H . P . ( W a t f o r d ) . — S o m e o f u s t h e o t h e r d a y w7e r e d i s c u s s i n g w h a t h a p p e n s a nd h o w w e sh o u ld treat a p a tient w h o

E ffe c ts o f D r o w n in g . I . C . ( P a d d i n g t o n ) . — R e c e n t l y I h e a r d it s t a t e d t h a t t h e e f f e c t s of d r o w n i n g a r e d i f f e r e n t w i t h m e n a n d w o m e n a n d t h a t a d r o w n e d m a n flo ats “ fa c e d o w n ” a n d a d r o w n e d w o m a n “ face u p .” C a n y o u p l e a s e t e l l m e if t h i s is a true sta tem en t a nd sta te the reason s ? I n a f a t a l c a s e o f d r o w n i n g t h e b o d y is s u b m e r g e d u n t i l t h e g a s e s o f p u t r e f a c t i o n a c c u m u l a t e in s u f f i c i e n t q u a n t i t y to m a k e t h e s p e c if ic g r a v i t y of t h e b o d y le s s t h a n t h a t o f th e w a t e r in w h i c h it lie s . T h is u su ally occurs w ith in one w eek, a fte r w h ic h perio d th e b o d y rises to th e su rfa ce. T h e b o d i e s o f m e n , u n l e s s t h e r e is a n e x c e s s o f a b d o m i n a l f a t , u s u a l l y f l o a t in t h e p r o n e p o s i t i o n , w i t h h e a d a n d l i m b s b e l o w t h e l e v e l o f t h e w a t e r — t h a t is “ f a c e d o w n . ” The b o d i e s o f w o m e n h o w e v e r , o n a c c o u n t o f t h e f a t t y t i s s u e in b r e a s t s a n d a b d o m e n , u s u a l l y f l o a t in t h e r e c u m b e n t p o s i t i o n — t h a t is “ fa c e u p . ” — N . C . F .

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Jmkpemkut Journal Jw tljc Ambulance ami Jftursing perukes; No. 588, Vol. XLIX.]

JUNE, 1943.

, l

ByJ Lt.-Com. F. A. M. EDEN ,7 R.N.

^s., by post 2s. 2d. (In c lu d in g S u p p le m e n t)

Instructor, Ministry of Home Security School, York

CIVIL DEFENCE: WITH

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SUPPLEMENT

I NCENDI ARY

B OM BS

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J O R D A N & S O N S , L IM IT E D , 116 C H A N C E R Y L A N E , L O N D O N , W .C .2 .

BIOLOGICAL ( M B t ) PREPARATIONS A

T I P

a r e s E,°Nui O

I N

O n e o r o t h e r o r all o f th e three races o f g e r m s , S t r e p t o c o c c i, S t a p h y lo c o c c i a n d B . p y o c y a n e u s a re f o u n d in e v e r y s k in in f e c t i o n c o m m o n to this c o u n t r y , and A N T I P E O L O I N T M E N T con tain s the antibodies (an tiv ir u s) o f these g e r m s . H e a l i n g is e xp e d it e d b y th e p r o v e d ^ i e,nJ S ° f -the o in t m e n t > and se ptic d e v e lo p m e n t is s t o p p e d o r p r e v e n te d b y its a n t i v i r u s sterile v a c c in e filtrates. A N T I P E O L O I N T M E N T is u n su rp a ss ed f o r B U R N S and S C A L D S , f o r it is m ic r o b ic id e a n d n o n -a d h e siv e , a nd d r e s s in g s d o n o t r e q u ir e to b e c h a n g e d e v e r y d ay . W O U N D S , B U R N S , etc., W I L L N O T T U R N S E P T I C i f tre ated w i t h A N T I P E O L O I N T M E N T .

- A

I P

is a semi-fluid o in t m e n t , m o r e c o n v e n ie n t than the o r d in a r y A n t i p e o l o in t m e n t f o r o c u la r in fe ct io n s a n d lesion s. E y e s affected b y s m o k e and d u s t are s o o t h e d a lm o s t im m e d ia t e ly b y the appli ca tio n o f O p h t h a l m o - A n t i p e o l , and the a n t iv iru s p r e v e n t s g e r m s f r o m d e v e lo p i n g .

I N

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N o.

W A LTER

5 8 8 .— V o l . X L I X .

N O T IC E

SCO TT,

F .R .S a n .l.,

J U N E ,

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1943.

READERS. The

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•

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th e

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Subscriptions, Ad ver tisemen ts and other business Co mm unications connected with F I R S T A I D should be forwarded to the Publishers.

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O r d e r of St. Joh n

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S .J .A .B . H e a d q u a rte rs and D istrict R ep orts

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...

142

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142 142

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140

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137

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It m a y se e m s o m e w h a t a n o m a lo u s th at, a c c o m p a n y

n a tio n a l

CONTENTS

T h e B ir t h R a t e . in o ff ic ia l q u a r t e r s a t t h e f a l l i n g

A l l Reports, & c . , should be addressed to the Editor at the address b e low , and should reach him before the 8 t h of each month, and must be accompanied ( not necessarily for publication) by the name and address o f the Correspondent.

S tre e t,

. J

E D IT O R IA L .

F I R S T A I D is published on the a o t h o f e a c h m o n t h . An n u al Subscription is 4 s . post free ; single copies 3 d.

46, C a n n o n

5 S S

reasons

and

a lle g e d

q u o ta tio n . to w h e t h e r

h a v e a la rg e fa m ily

Sch afer, S ilvester or H o w a r d

...

144

tio n s o v e r c ro w d e d

T re a tm e n t of B u rn s

...

144

m a te rn ity

S ta g e s of E p ile p sy

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144

a n a e sth e tics

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D r.

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use

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134

A I D a s h e c a n b e p e r s u a d e d to t a k e . S u c h m o r p h i a a s is n e c e s s a r y to re lie v e p a in w ill be g i v e n a t o n c e , a n d , m e a n w h i l e , t r a n f u s i o n o f b l o o d in s o m e f o r m w i l l h a v e b e e n started.

a u th o r itie s te a c h th e ir m id w iv e s h o w to u se g a s a n d a ir

a p p a ra tu s ,”

carry

need

“

g e ttin g

d reary

round

to s c r u b , w a s h

w ith o u t p e rio d

th e

re lie f

fo r

of life .”

e v id e n ce

th e

and

m uch

th e as

th e

p o st-w a r

to th e

days a w eek

In the m e th o d s n o w a d o p te d for tr a n s fu s io n w e h a v e o n e o f t h e g r e a t e s t a d v a n c e s in t r e a t m e n t w h i c h h a v e b e e n m ad e sin ce 1918. D u r i n g t h e l a s t w a r it w a s u s e d t o a c o n s i d e r a b l e e x ten t, b u t its u s e fu ln e s s w a s lim ite d b y t h e fa c t t h a t a t t h a t tim e o u r m e t h o d s for p r e v e n t i n g th e c lo t t in g of b lood a n d o t p r e s e r v i n g it f o r u s e w h e n a n d w h e r e it w a s n e e d e d h a d n o t re a c h e d the p resen t s ta te of perfectio n.

ch ild -b e a rin g

a s is t h e p ic t u r e ,

e x a g g e ra tio n ,

th at

days

housew ork, and

w o r k i n g - c la s s e s a t le a s t, a l t h o u g h in d ica tio n s

ten

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G lo o m y

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a p p lie d

it b e a r s to

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th ere a re d istin c t

p e rio d

w ill

in fu se

in th e w a y o f b r i g h t n e s s in th e liv e s o f t h o s e

to w h o m

T h e d o n o rs of b lood , m o re o ve r, w e r e n ot o r g a n is e d as t h e y a r e n o w , a n d , a s it w a s t h e n n e c e s s a r y t o b r i n g t h e d o n o r a s n e a r to th e r e c ip ien t a s p o ssib le, blood tra n s fu s io n a s a m e a n s of s a v i n g life n e v e r a p p r o a c h e d to t h e p o s itio n of v i t a l i m p o r t a n c e w h i c h it a t p r e s e n t o c c u p i e s .

D r . S u m m e r s k i H ’s s t a t e m e n t s p a r t i c u l a r l y

a p p ly .

Co-ordination of Civil Defence Services. E x tr a c t s fro m S IR

H EN RY

L e c tu re s d elivered

M ARTYN,

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by F .R .C .S

( C o n tin u e d from page 1 2 3 . )

R e scu e

P a r t y

W o r k

. — ( C o n tin u e d )

M o v e th e v ic tim o n to a s t r e t c h e r e it h e r b y m e a n s o f a b la n k e t , or, w h a t I c o n s id e r p e r s o n a lly to be e v e n b etter, b y th e u se of h a lf a d o ze n T r ig g lif t s . T h e latter, w h e n sk ilfu lly used, a vo id s th e p re lim in a ry m o v e m e n t of the ca se n e c e s s a r y to g e t the b la n k e t b e n e a th it, a n d b y t h e i r m e a n s t h e p a t i e n t c a n n o t o n l y b e l i f t e d b u t s i m u l t a n e o u s l y ro lled in to th e fa c e d o w n p o s itio n on th e s t r e t c h e r p la c e d r e a d y o n e d g e to r e c e iv e h im . O n c e y o u r p a t i e n t is s a f e l y o n t h e s t r e t c h e r b e p r e p a r e d t o g o t o a n y t r o u b l e t o e n s u r e t h a t i t is c a r r i e d h o rizo n tally th ro u g h o u t. N e v e r a tte m p t to t a c k le a n a w k w a r d c o r n e r o r s t a i r c a s e , b u t , i f y o u a r e r e m o v i n g it f r o m a b o v e e i t h e r r i g a j i b , o r , i f t h a t is i m p o s s i b l e , r u n th e str e tc h e r d o w n a stra in e d rope. If y o u a re r a is in g the ca se from a ce lla r or a re a r ig a g a n tr y , u s in g p erh ap s one s i d e o f y o u r lo r ry ' a s t h e o u t e r s u p p o r t . S u c c e ssfu l w o r k b y a n y R e s c u e P a r ty d e m a n d s the m o s t c a r e f u l r e c o n n a i s s a n c e b y t h e P a r t y L e a d e r , s i n c e it w ill be o b v io u s fr o m w h a t 1 h a v e sa id to y o u th a t h e not o n ly m u st d e te rm in e m a tte rs of prio rity of tre a tm e n t a n d p riority o f e v a c u a tio n , b u t also th e m e a n s by w h ic h the latter c a n b e effected . T

h e

a s u a l t y

o s p it a l

W e h a v e n o w c o n s id e r e d a t s o m e l e n g t h th e w o r k of the s e r v ic e s d u r i n g th e b a t t le itself. I h a v e t r i e d t o t e l l y o u in b r o a d o u t l i n e o f c e r t a i n p r i n c ip les to be fo llo w e d , a n d , la stly , I s h o u ld lik e to t a k e y o u a little fu r th e r u p o n th e ro a d w h ic h y o u r c a s u a lt y w ill tr e a d a n d s h o w y o u b riefly th e r e a s o n s w h y th e s e p r in c ip le s h a v e b een g i v e n to you . W h e n th e pa tien t a rriv e s a t th e h o sp ita l the m o re s k il fu lly y o u h a v e h a n d le d hrm th e less w ill be th e s h o c k . I f i t b e s t i l l s e v e r e h e w i l l n o t b e in a fit c o n d i t i o n to to lera te a n y fu rth e r tre a tm e n t w h a te v e r u n til so m e im p ro v e m e n t h a s b e en effected in h is c o n d itio n . W r a p p e d in b l a n k e t s , a n d w i t h o u t a n y a t t e m p t b e i n g m a d e to u n d r e s s h im , h e w ill be p la c e d a t o n c e in bed in w h a t i s k n o w n a s a r e s u s c i t a t i o n w a r d . A cradle c a r r y in g a n u m b e r of e le c tric lig h t b u lb s w ill be pu t o v e r h i m , a n d , e x c e p t in t h e c a s e o f a n a b d o m i n a l w o u n d , h e w ill be in d u c e d , to a b s o r b a s m u c h g l u c o s e a n d fluid s

U n d o u b t e d ly m a n y th o u s a n d s of lives w o u ld h a v e b een s a v e d in t h e l a s t w a r , a s t h e y h a v e b e e n in t h i s , h a d o u r present m eth o d s th en been a va ilab le. *

A s y o u p r o b a b l y a l l k n o w , t h e b l o o d o f o n e i n d i v i d u a l is not n e c e ssa rily id entical w ith th a t of a n oth er, b u t th e type of blood o f e a c h fa lls in to o n e of fo u r g r o u p s . O f these g r o u p s , o n e , c o n s t i t u t i n g a b o u t 4 5 p e r c e n t , o f t h e w h o l e , is k n o w n as the O or U n iv e rs a l G r o u p , a n d blood fro m these d o n o rs c a n be tra n s fu s e d s a fe ly in to a n y r e c ip ien t n o m a tte r to w h a t g r o u p t h e l a t t e r b e l o n g s . I t is i m p o s s i b l e , h o w e v e r , w i t h o u t g r a v e d a n g e r to th e r e c ip ie n t to t r a n s f u s e in to h is b lo o d s t r e a m th e b lo o d fro m a d o n o r b e lo n g in g to a n y of th e th ree r e m a in in g g r o u p s u n le s s both re cip ien t a n d d o n o r p o s se ss b lood of the s a m e type. Y o u w i l l a p p r e c i a t e t h e r e f o r e t h a t t h e f i r s t s t e p in t h e o r g a n i s a t i o n of th e B lo o d T r a n s f u s i o n S e r v i c e w a s to o b ta in a very la r g e n u m b er of v olu n teers th ro u g h o u t the cou ntry, e a c h w i l l i n g to g i v e o n e p in t of b lo o d ; a n d to a r r a n g e to t e s t e a c h p e r s o n ’ s b l o o d in o r d e r t o d e t e r m i n e t h e g r o u p to w h ic h h e or sh e b elo n ged. O f t h e s e p o t e n t i a l d o n o r s a n u m b e r , p r o p o r t i o n a t e to t h a t of th e lo c a l p o p u l a t io n , w h o p r o v e to b e of the U n i v e r s a l G r o u p , is h e l d i n r e s e r v e f o r i m m e d i a t e u s e in c a se of need. T h e s e d o n o r s a r e c a l l e d u p o n if c a s u a l t i e s o c c u r i n t h e i r n e ig h b o u r h o o d , sin ce th eir blood ca n be g iv e n a t o n ce w it h o u t d a n g e r to a n y recipien t. O n a p re-a rra n g ed d a y a n d tim e the re m a in in g v o lu n teers a r e co llected at s o m e c o n v e n ie n t p oin t to w h ic h h as c o m e on e of the tra v e llin g c o lle c tin g v a n s of th e B loo d T r a n s fu s io n S ervice. T h e s e a r e ,J in f a c t , m o b i l e l a b o r a t o r i e s staffed w ith n u rse s a n d d o c to rs a n d a c c o m p a n ie d b y a v a n c a r r y in g b u ilt-in re fr ig e ra to r s . T h e w it h d r a w a l of o n e pin t of b lood fro m e a c h d o n o r o c c a sio n s no h a rm w h a te v e r, a n d w ith in h alf a n h o u r h e can r e tu rn to fu ll a c tiv e w o r k . T h e b l o o d is d r a w n i n t o c a r e f u l l y l a b e l l e d s t e r i l e b o t t l e s , w h i c h a r e p l a c e d a t o n c e in t h e r e f r i g e r a t o r s . Each b o ttle co n ta in s a so lu tio n w h ic h prev e n ts c lo ttin g t a k i n g p la ce , a n d b y the e v e n in g of th e s a m e d a y th e blood h a s re a c h e d on e of the c o lle c tin g sta tio n s estab lish e d th r o u g h o u t the cou n try. E v e r y s p e c i m e n o f b l o o d is n o w t e s t e d t o e n s u r e t h a t n o l a t e n t d i s e a s e is p r e s e n t , a n d , h a v i n g b e e n p a s s e d a s h e a l t h y , is d e a l t w i t h in o n e o f t h r e e w a y s . B l o o d f r o m U n i v e r s a l d o n o r s is p r e s e r v e d in s t e r i l e b o t t l e s i n r e f r i g e r a t o r s , a n d in t h i s f o r m c a n b e k e p t f o r tw o w e e k s on ly. It is is s u e d to t o w n s o r a r e a s w h e r e th e lo c a l s u p p ly is s h o rt, th e r e b y f o r m i n g w h a t a r e k q o w n a s B l o o d B a n k s , w h i c h c a n b e d r a w n u p o n a t a m o m e n t ’s n o tic e to m e e t th e n eed s of lo ca l ca s u a ltie s . B lo o d from d o n o r s f r o m t h e r e m a i n i n g t h r e e g r o u p s is m i x e d t o g e t h e r in m ilk s e p a r a to r s a n d th e n p a s s e d t h r o u g h e n o r m o u s filters. T h e f i l t e r i n g m a t e r i a l e m p l o y e d i s s o m e t w o f e e t in

F I R S T t h i c k n e s s , a n d s e p a r a t e s c o m p l e t e l y th e s o lid fr o m t h e liq u id p a r t o f th e blood . T h e c l e a r f l u i d w h i c h r e s u l t s a f t e r t h e f i l t r a t i o n is k n o w n a s p la s m a , a n d , w h e n t r a n s f u s e d in t o t h e v e in s of a c a s u a l t y , is o f a l m o s t e q u a l v a l u e t o w h o l e b l o o d . It h a s th e a d d itio n a l a d v a n t a g e th a t no h a r m fu l effects resu lt n o m a tte r to w h a t g r o u p the recip ien t m a y b e lo n g . T h e r e is, m o r e o v e r , a s t i l l f u r t h e r a d v a n t a g e . It h a s b een fo u n d th at p la s m a c a n b e sterilised w ith o u t i m p a i r i n g it i n a n y w a y , a n d , w h e n s o t r e a t e d , t h a t it c a n b e k e p t in s e a l e d b o t t l e s r e a d y f o r i m m e d i a t e u s e f o r a n ' in d efin ite tim e . L a r g e q u a n t i t i e s o f p l a s m a p r e p a r e d in t h is w a y is s e n t b y a e r o p l a n e b o th to t h e M id d le a n d F a r E ast. I t h a s a l s o b e e n f o u n d t h a t if t h e f l u i d p l a s m a b e d r i e d b y evaporation , the p o w d e r re su ltin g can be preserved a nd t r a n s p o r t e d t o p l a c e s in w h i c h f l u i d w o u l d b e l e s s s u i t a b l e . R e - d i s s o l v e d in s a l i n e s o l u t i o n , t h e l i q u i d p r o d u c e d s t i l l h a s a lm o s t th e s a m e life s a v i n g v a lu e a s th a t o f th e o r ig in a l blood. L a r g e q u a n t it ie s of p l a s m a h a v e b e e n s e n t to th is c o u n try from A m e ric a , a n d h a v e proved of in e s tim a b le v alu e d u r in g th e b attle of B rita in .

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Order of St. John. O n F r i d a y , M a y 2 8 t h , t h e E a r l o f P l y m o u t h , f o r t h e fir s t tim e, p resid ed o v er th e C h a p t e r - G e n e r a l of the V e n e r a b le O r d e r o f t h e H o s p i t a l o f S t . J o h n o f J e r u s a l e m in t h e B r i t i s h R e a l m a s th e s e v e n th S u b - P r io r s in c e t h a t office w a s c o n s t it u t e d u n d e r t h e R o y a l C h a r t e r of 1888. H is predecessor, t h e E a r l o f S c a r b r o u g h , w h o r e t i r e d in F e b r u a r y a f t e r 20 y e a r s i n o f f i c e , h a s b e e n a p p o i n t e d B a i l i f f o f E g l e in s u c c e s sion to th e la te S ir J o h n H e w e t t . In b e c o m in g the c h ief a d m in is tra to r of th e V e n e ra b le O r d e r u n d e r its R o y a l G r a n d P r io r, th e D u k e of G lo u c e s te r , L o r d P l y m o u t h , a f t e r a n i n t e r v a l o f 20 y e a r s , s u c c e e d s h i s f a t h e r , w h o w a s fif th S u b - P r i o r f r o m 1 9 1 5 t o 1 9 2 3 .

Southern Railway. A g r a n d c o n c e r t w a s h e ld a t S t. M a r y ’s H a l l , T w i c k e n h am , on T u e s d a y , M a y 11th , b y the T h a m e s V a lle y A m b u lan ce C lass. , M r . U z z e l l , W e l f a r e D e p t . , w a s in t h e c h a i r . M r. A b b ott, E le ctrica l D e p t., presented the a w a r d s . M r. T o m J e ff e r y ’s c o n c e r t p a r t y w a s a t o p lin e r, a n d w a s th e c a u s e of a go o d deal of lau gh ter. T h e a w a r d s p r e s e n t e d a t h a l f - t i m e w e r e :— 2 fir s t y e a r a n d 1 3 s e c o n d y e a r c e rtific a te s, 8 m e d a llio n s , 46 la b e l c a r d s , a n d tw o 7 y e a r m ed a ls, a n d on e 21 y e a r m ed al. M r. U zzell sp o k e on the a m b u la n c e m o v e m e n t a n d p erso n a lly th a n k e d M essrs. A. B ra zier, H . H a m m o n d , W . B a k e r a n d S . W . S m i t h ( s e c r e t a r y ) f o r t h e i r g o o d w o r k in th e T h a m e s V a l l e y class. H e also s p o k e of th e p a rce ls an d l e t t e r s s e n t t o t h e 2 3 0 r a i l w a y m e n p r i s o n e r s in G e r m a n y . M r. A b b o tt th a n k e d th e class on th eir a c h ie v e m e n ts. In s p e c to r C o k e r th a n k e d th e cla ss for th eir k in d in v ita tion to h i m s e l f a n d h is w ife. S u p t. S h a r p e a n d L t. U r w in , of t h e S .J .A . B. ; M r. S. U p to n , F e lt h a m c la ss se re ta ry , a n d M r. A. O s b o rn e , W i m b ledo n c la s s se c r e ta r y , w e r e a m o n g th e visitors. M r . H . H a m m o n d s p o k e fo r t h e c o m m it t e e , a n d M r. S. S m i th re sp o n d e d fo r the class. T h e co n ce rt con tin ued , a n d good program m e.

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N o . 2 8 ( H a r r o w a n d W e a l d s t o n e ) . — O n M a y 13th , S ta n m o r e Section , S . J .A . B . , S t a n m o r e F irst A id A ss o c ia tio n a n d f r i e n d s i n t e r e s t e d , a b o u t 120 i n a l l , w e r e a f f o r d e d a n o p p o r t u n i t y o f w i t n e s s i n g d e m o n s t r a t i o n s o f first a id a n d te a m w o r k b y m e m b e r s of “ S ” D iv is io n M e tr o p o lita n P olice. T h is w a s m a d e possib le t h r o u g h th e c o u rte sy of th e sen ior officers of th e D iv is io n . C h i e f I n s p e c t o r H e f f o r d in c o - o p e r a tio n w i t h th e D i v i s i o n ’s m e m b e r - i n - c h a r g e , S g t . M a r s h a l l , o rg an ise d the events. In sp ector H o w a r d a d ju d icated and P olice C o n s ta b le Y e o a cted as le a d er a nd co m m e n ta to r. T h e g a t h e r i n g w a s h o n o u re d b y th e p resen c e of C o m m a n d a n t M rs. A ttle e , B . R . C . a n d s o m e o f h e r officers, a ls o S u p t. C a lv e r. E a c h in cid en t w a s s ta g e d , the parties h a v in g no p rev io u s k n o w le d g e of the proposed occu rren ces. T h e con fid en ce, efficien cy a n d speed w ith w h ic h th e d ia g n o s is w a s m a d e a n d i n t e r p r e t e d , c a s u a l t i e s a t t e n d e d to, a n d e v a c u a t i o n c o n d u c ted, w a s a re v e la tio n o f w h a t c a n be a c c o m p lis h e d b y g o o d l e a d e r s h i p , k e e n f ir s t a i d e r s a n d c o n s t a n t i n t e l l i g e n t p r a c t i c e . Q u e s tio n s a n d c r itic is m s w e r e in vited a n d P .C . Y e o d isp o se d o f t h e s e in a m a s t e r l y a n d e f f e c t i v e m a n n e r . M r s . A t t l e e , in a f e w w e l l c h o s e n w o r d s , t h a n k e d t h e P o lic e on b e h a lf o f th e v isito rs for a n i n t e r e s t in g a n d in s t r u c tive e v e n in g . S g t. M arsh a ll m o ved a vote of th a n k s w h ich w a s a c c l a i m e d b y t h e a u d i e n c e in t h e u s u a l m a n n e r .

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a tta c h e d to N o . 16 ( H a m p s t e a d ) N u r s in g of £ 5 w a s ra ised b y a silver co llectio n in a i d o f t h e H a m p s t e a d N u r s i n g C a d e t s a n d D u k e o f G l o u c e s t e r ’s P r i s o n e r s o f W a r F u n d , w h e n a w e l l a t t e n d e d a nd in tensely in te re stin g lan tern lectu re on M a lta w a s g iv e n b y M r. L . V . M a rtin o , M . B . E . , on M a y 18th, a t H a v e r s t o c k H ill S ch ool, C h a lk F a r m . T h is w a s su ccessfu lly a rra n g e d by O fficer-in -C h a rg e M i s s I. F i n c h , a n d C a d e t S u p t . M i s s I. S . B u r l e y . W a r S e rv ice B a d g e s w e re presented b y fo rm e r D istrict S u p t. M iss A . M . W a l k e r , M . B . E . , to tw o ca d ets, a fter w h ic h a h e a rty vote of th a n k s w a s g iv e n b y D is tr ic t O fficer M rs. R a y n e r a n d seco n d ed b y C a d e t S u pt. M iss B u rle y . D iv is io n . — T h e su m

F o u r of th e H a m p s te a d N u r s in g C a d e ts of N o. 1 C o m p a n y , w e r e p r iv ile g e d to a tte n d a R e d C r o s s a n d S t. Jo h n C a d e t R a lly a t B u c k i n g h a m P a la c e on S u n d a y , M a y 16th, w h e n H e r M a je s ty th e Q u e e n in spected a n d a d d re sse d the boy a nd g ir l cadets.

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A t th e in vita tio n of C o lo n el C la u d e E . P u tn a m , C o m m a n d i n g O fficer, A m e r ic a n A ir F o rc e , o v e r th re e h u n d re d S t. J o h n A m b u l a n c e C a d e t s w e r e o n S u n d a y , M a y 30th , e n t e r t a i n e d a t a n A m e r i c a n a e r o d r o m e in t h e H o m e C o u n t i e s . T r u c k s p ick ed up the B edfo rd T o w n , L o n d o n R o a d , K e m p s ton, S t e w a r t b y , H o u g h t o n C o n q u e s t, a n d G r e a t B a rfo rd A m b u la n c e a n d N u r s in g D iv is io n s a t St. P e te r ’s G ree n , Bedford. O n arriv al, the C a d ets w e re in spected by C o lo n el C o le m a n , w h o w a s e sc o rte d ro u n d th e r a n k s a n d in tro d u c e d to th e o fficers b y th e L a d y C o u n t y C a d e t O ffic e r , J u n i o r C o m m a n d e r M rs. H u g h M cC o rq u o d ale. A fterw ard s, every cadet w a s a llo w e d to e n te r a n d v ie w a F l y i n g F o rtre ss , a n d th e y w e r e la te r g i v e n le m o n a d e a n d d o u g h n u t s in th e R e d C r o s s c a n t e e n , w h e r e t h e y t a l k e d w it h a n d g a v e a v o t e o f t h a n k s to th eir A m e r ic a n hosts.

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L a d y L o u i s M o u n t b a t t e n , L a d y S u p t . - in C h ie f, S . J . A . B . , v isite d N o t t i n g h a m o n M a y 26th, w h e n sb e in s p e c te d a g u a r d of h o n o u r c o m p o s e d of a m b u l a n c e siste rs of the N o tts. S . J . A . B . S h e w a s a cco m p a n ie d by the C o m m is s io n e r fo r N o t t i n g h a m , D r. S. J. W . D o n a ld , a n d th e L a d y C o u n ty S u p t., M iss W . G ib so n . S h e a ls o visited th e c o u n ty c a d e t h e a d q u a r te r s , S o u th p a r a d e , t h e R e d C r o s s a n d S t . j o h n s h o p , 9, C l u m b e r - s t r e e t , a n d th e h e a d q u a rte rs of th e N o t tin g h a m C o rp s, tra n sp ort N

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section . L a d y L o u i s w a s e n te r ta in e d to te a b y th e O ffic e rs of the N o ttin g h a m Corps. D r . C y r il B a n k s , m e d ic a l officer fo r the city, a n d P r e s id e n t of th e N o t t in g h a m S . J . A . B . , presided.

W a k e f i e l d . — D u r i n g W a k e f i e l d ’s “ W i n g s fo r V i c t o r y ” W e e k , th e W a k e fie ld N u r s in g C a d e ts , w ith a t a r g e t of ,£ 10 , e v e n tu a lly realised .£ 5 3. N u rsin g C ad ets Betty Jackson and R ita Ja m es o rg an ised a g a rd e n party w h ich w as opened by M r s . C R. H o n e , w if e o f t h e B is h o p of W a k e f i e l d , a n d t h e y m ade £ 2 3 . T h e o th er c a d e ts so ld d affodils g e n e r o u s ly g iv e n b y S i r l ' h o m a s P i l k i n g t o n of. C h e v e t P a r k , a n d t h e y m a d e

the o th er £ 3 0 . L a d v C a d e t Su pt. M iss E . C lin k e r a n d L a d y C a d et O ffic e r M is s F a r r o w a r e to be c o n g r a t u l a t e d on t h e ir a c h i e v e m e n t a n d o n t h e s m a r t a p p e a r a n c e o f t h e g i r l s in t h e i r u n ifo rm s. T w e lv e m o re c a d e ts h a v e re c e n tly o b tain ed th eir F irst A id C e r tific a te s , a n d all a r e e n j o y i n g th eir ro lle r b a n d a g i n g , p r e p a r a t o r y to o b t a i n i n g th eir H o m e N u r s i n g C e rtific a te s.

R I D C a d ets ) w h o h ad g e n e r o u s ly g iv e n th e p rem ises for C o u n ty H e a d q u a r t e r s , h a n d e d th e k e y to H . R . H . t h e D u c h e s s of G lo u c e s te r w h o d ec lared th e H e a d q u a rte rs open for the use of t h e B r i g a d e . T h e B i s h o p of H u ll, t h e R t. R e v . H . T . V o d d e n , th en d ed icated the p rem ises a n d H e r R o y a l H i g h n e ss u n v e ile d a c o m m e m o r a t iv e tablet. D u r i n g a vote of t h a n k s to th e D u c h e s s , prop osed b y M r. R . G . T a r r a n , the title d e e d s of th e p r o p e rty w e r e h a n d e d o v e r to her. T h e p rem ises w e re th en open for in sp ectio n left fo r the C . H . S . S . D e p o t a n d the R e d C r o s s P r is o n e r of W a r P a c k i n g C e n tre , a n d to th e lu n c h a t th e in vita tio n of th e L o r d M a y o r , officers of th e B r i g a d e w e r e p resen t.

H u m b e r s id e . — A m o n g th e n a m e s of th ose w h o have recen tly p a ssed the e x a m in a tio n for q u alificatio n as a la y in stru c to r a p p e a rs th at of H . R a n k in e , w h o h as been a p r o m i n e n t fir s t a i d w o r k e r in t h e B r o u g h d i s t r i c t a n d w a s t h e m e a n s of th e re g is te r in g of the B r o u g h D is tric t D iv isio n . H a v i n g sin ce fo rm e d 2 A m b u l a n c e D iv is io n s a n d N u r s i n g D i v i s i o n s in t h e a r e a , h e h a s n o w b e e n a p p o i n t e d C o r p s S u p e r in t e n d e n t of th e H u m b e r s i d e C o r p s , w h i c h s t a r t s o ff w ith a n initial s t r e n g t h of 5 D iv is io n s . D r. G eo ffrey T h o m p s o n of S o u th C a v e b e co m e s C o rp s S u r g e o n , a n d D i v i s i o n a l a r r a n g e m e n t s t o fill t h e s e v a c a n c i e s

w i l l b e n o t i f i e d in d u e c o u r s e .

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O n T h u r s d a y , M a y 6 t h , t h e B r i g a d e in t h e E a s t R i d i n g of Y o r k - h i r e w a s fa v o u r e d by a visit of th e n e w C h ie f C o m m is s io n e r, G e n e ra l S ir C liv e L id d e ll, K . C . B . , C . M . G . , D . S . O , a n d t h e L a d y S u p e r i n t e n d e n t in C h i e f , L a d y L o u i s M o u n tb a tte n , w h e n m em b e rs of A m b u la n c e , N u r s in g , A m b u la n c e C a d e t a n d N u r s i n g C a d e t D iv is io n s fr o m H u l l a n d the E a s t R i d i n g , t o t a l l i n g o v e r 1 , 5 0 0 , p a r a d e d in t h e g r o u n d s o f H y m e r s C o lle g e , H u ll (k in d ly len t for th e o c c a s io n b y the H

u l l

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governers). _ T h i s w a s t h e f i r s t d u a l I n s p e c t i o n e v e r h e l d in t h e E a s t R i d i n g a n d a l s o G e n e r a l S i r C l i v e L i d d e l l ’s f i r s t I n s p e c t i o n s in c e his a p p o in t m e n t a s C h ie f C o m m is s io n e r . F o llo w in g th e In sp ectio n th e p a ra d e m a rc h e d past a n d w e re a fte rw a rd s a d d re s s e d b y th e I n s p e c tin g O fficers w h o e xp re sse d th eir pleasu re at b ein g present and c o n g ra tu la te d the m em b e rs on th e ir t u r n o u t a n d th e w o r k th e B r i g a d e h a d d o n e in th e . , S o m e D iv is io n s w e re u n a b le to b e p resen t o w i n g to th eir m e m b e r s b e in g on w o r k of n a tio n a l im p o rta n c e or on a c c o u n t

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a n d the p a rty a n d St. J o h n G u ild h a ll for w h e r e senior

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a n d 39 P r iv a t e s . T h e e n t i r e m e m b e r s h i p is k e e n a n d a c t i v e ; 1 7 m e m b e r s a r e o n a c t i v e s e r v i c e , 3 in t h e N a v y , 8 in t h e A r m y , 4 in t h e R . A . F . a n d 2 in t h e R . A . M . C . D u r i n g th e y e a r , 4 m e m b e r s w e r e a w a r d e d c h e v r o n s for 3 y e a r s ’ e fficien t se rv ice . T h e D i v . S u p t . is t o b e c o n g r a t u l a ted on b e i n g a w a r d e d th e c e r tific a te of th e N o r t h e r n I n s titu te of M a s s a g e . P u b l i c d u t ie s p e r f o r m e d d u r i n g t h e y e a r n u m b e r e d 344. A t o t a l o f 2 7 0 c a s e s o f i l l n e s s o r a c c i d e n t w e r e a t t e n d e d , 66 of th ese re q u ire d tra n s p o rt to h o m e or h o sp ita l, a total d is t a n c e o f 809 m i l e s ; 9 r o a d a c c i d e n t s w e r e a t t e n d e d a n d t h e p a t i e n t s t r a n s p o r t e d a d i s t a n c e o f 99 m i l e s . T h e a n n u a l r e - e x a m i n a t i o n w a s h e l d e a r l y in t h e y e a r , 2 6 m e m b e r s p a s s e d , n o n e f a i l e d ; 12 o b t a i n e d t h e c e r t i f i c a t e of th e S .J .A .A . T h e a cco u n ts are v ery satisfactory.

past.

of t r a n s p o r t d ifficulties. A m o n g th e la r g e n u m b e r p resen t to w itn e s s th e p a ra d e w e r e th e L o r d M a y o r a n d L a d y M a y o r e s s of H u ll (A id. a n d M r s . J. L . S c h u l t z ) a n d n u m e r o u s o t h e r n o t a b i l i t i e s . O n t h e f o l l o w i n g m o r n i n g , H . R . H . t h e D u c h e s s of G lo u c e s te r p erfo rm ed th e o p e n in g c e re m o n y at the n e w C o u n t y H e a d q u a r t e r s , P r io r y H o u s e , 29, C o t t in g h a m - r o a d , H u ll

, . . . , W e a r i n g B r ig a d e u n ifo rm she w a s a c c o m p a n ie d by her L a d y in W a i t i n g , t h e H o n . G . M e r s e y T h o m p s o n , t h e L o r d M a y o r a n d L a d y M a y o re ss , and w a s m et a t the g a t e b y the C h ie f C o m m is s io n e r, G e n e ra l S ir C liv e L id d e ll, a n d the L a d y S u p e r in t e n d e n t in C h ie f L a d y L o u i s M o u n t b a t t e n w it h th e C o u n ty C o m m issio n er, N. J en n in g s, M .B ., C h .B ., J.P . A G u a r d of H o n o u r of A m b u l a n c e a n d N u r s i n g C a d e t s w a s d r a w n u p in f r o n t o f H e a d q u a r t e r s w h i c h w a s i n s p e c t e d b y H e r R oyal H igh n ess. A fte r w a r d s a n u m b e r of p ro m in e n t p e r s o n a g e s w e r e p resen ted to her. M r. R. G . T a r r a n (C o u n ty v ic e -P re s id e n t for A m b u l a n c e

N o.

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h o sp ital. D u r in g the dance,

Supt. T . C. Cooper, M .B .E ., spo ke

on th e n eed s of the St. J o h n A m b u la n c e . E x c e lle n t re fresh m e n ts w e r e su pplied

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V o lu n t a r y S ervice. C r e d i t fo r th e s u c c e s s of th is e x c e l le n t d a n c e w a s d u e to C a d e t S u pt. W . G. L e w is and C a d e t O fficer E . J. P ryo r, w h o p u t a g r e a t d e a l of w o r k in to th e a r r a n g e m e n t s .

B a r n s t a p l e .— M em b ers of the S .J .A .B . m u st present th e m s e lv e s for e x a m in a tio n a n d o b tain a la y in s tru c to r’s ce rtific a te to e n title t h e m to g i v e a s h o r t first a id c o u r s e to civil d e fe n c e w o r k e r s a n d to th e g e n e r a l p u b lic.

F I R S T A n e x a m in a tio n h a s b e en h eld a t B a rn s ta p le , a n d th e resu lt s h o w s th a t C o u n ty O ffice r L a tim e r , D iv isio n a l S u p t. F. G . K n o tt, L a d y C ad et Supt. R. L. D e Y u ld e r, and A m b u l a n c e O f f i c e r W . T . H u n t w e r e s u c c e s s f u l in p a s s i n g . T h e e x a m in a tio n c o n sists of oral, p ractica l w o r k , lecture, a n d a w ritten paper. T h e th r e e first tests w e r e j u d g e d b y C o u n t y S u r g e o n J. C . D i x e y a n d t h e w r i t t e n p a p e r s b y t h e s t a f f of t h e B r i g a d e ’s C h i e f S u r g e o n . F u r t h e r e x a m in a t io n s w ill be h eld to in c lu d e c a n d id a te s from th e w h o le of the N o rth D e v o n a rea, sev eral b e in g e x p e c te d from I lfra c o m b e an d C o m b e M artin .

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C .A .P ., K .S .K ., and B .B .C ., S t i n g y o u r eyes, y o u c a n n o t see, » A n d t h o u g h y o u t h i n k t h i s is n o t j a n n i c k , T h e H u n s m a y u s e it to c a u s e p a n ic . N

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D A ., D C ., D M ., D L ., In v isib le s m o k e s w ith o u t a sm ell ; Y o u r c h e s t is s o r e , y o u r h e a d is b a d , It s e e m s to f a ir ly d r iv e y o u m a d . R

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S iste r M u s a nd S ister L e w H o w I ’d h a t e t h e s i g h t o f y o u . Y o u sp o il th e g r o u n d , y o u spoil m y c lo th e s ; I ’ ll h o l d m y b r e a t h t ill I c o v e r m y n o s e . M y s u i t I ’ ll c h a n g e , m y e y e s I ’ ll w a s h . A n a r r o w s h a v e I ’ ll s a y , b y g o s h . B

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T h e r e ’s a t y p e o f G a s c a l l e d A r s i n e , R i s i n g from d e c o m p o s in g p o w d e r u n seen , I t s e f f e c t s a r e b a d , a n d t h e r e ’s a r e a s o n , It h a s put y o u r blood q u ite o u t of seaso n .

M u s t a r d y o u o ily in sid io u s t h in g ; L e w g i v e s t h e w i r e w it h a bit of a s t i n g . B o th of y o u b lister m y poor bald c ra n iu m , B u t L e w is ite g iv e s off a sm ell of g e r a n iu m . Y o u both do y o u r w o r k , but resu lts y o u d elay. W i t h B l e a c h I ’ ll s t o p y o u , t h e n c a l l it a d a y . I ’ ll w a s h m y e y e s a n d c h a n g e m y s u i t ,

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A v ery e n jo yab le so cial e v e n in g w a s sp en t a t th e D iv is io n a l H e a d q u a r t e r s on S a tu r d a y , M a y 22nd. T h e o cca sio n b e in g th e p resen ta tio n of th e b a d g e a n d certifica te of P resid e n t of th e D iv isio n to M r. R . D . M orris, M .E ., F .G .S . ; the certificate of H o n o r a r y M e m b e r to R ev . J o h n J e n k in s ; th e certifica te of L a d y D iv i s i o n a l S u p t . to M is s L e t t y W i l l i a m s ; w h i l e th e C a d e t N u r s e s a n d S e n i o r m e m b e r s w e r e p r e s e n t e d wfith a w a r d s g a i n e d in r e c e n t e x a m i n a t i o n s . O

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In th e u n a v o id a b le a b s e n c e of th e C o u n t y C o m m is s io n e r (D . M. E v a n s -B e v a n , E sq . J .P ., K .S t .J .) , the ch air w a s o ccu p ied d u r in g th e ea rlier p a rt of th e e v e n in g b y the C o rp s S e c r e t a r y o f t h e D u l a i s V a l l e y ( M r . D . J. D o w n ) u n t i l t h e ' late a rriv a l of th e A s s is ta n t C o m m is s io n e r (C. A r m s t r o n g , E sq ., J . P . , C .S t.J . T h e y w e re supported b y D iv isio n a l S u r g e o n D r . J. A . T h o m p s o n , C o u n c i l l o r G e o r g e J o n e s , J .P ., P o lice S e rg t. C u rtiss, a n d S ta ff S e r g t. W . H . S in n ett, w h o h a p p e n e d to be h o m e o n le a ve . A lig h t su p p e r w a s pro vid ed, a fte r w h ic h D r. A r m s tro n g m a d e th e p resen tations. H e co n g ra tu la te d D iv . Su p t. T . G . B a rtle tt a nd A m b u la n c e O ffice r J a m e s L e w is on th eir e x c e lle n t w o r k a n d th e p r o g r e s s m a d e re ce n tly . He a ls o c o m p lim e n t e d th e D iv is io n o n b e i n g a m o n g th e first ( if n o t t h e f i r s t ) in t h e c o u n t r y t o q u a l i f y in F i r s t A i d in C o a l M ines. In a c c e p t i n g office, M r. M o r r is s a id h o w p r o u d h e fe lt a t th e h o n o u r b e s to w e d u p o n h im . M r. J e n k in s a n d M iss W illia m s also responded. A w a r d s o f P r e l i m i n a r y C e r t i f i c a t e s t o 20 C a d e t s w a s m a d e b y the V ic e -P re sid en t, M r. Josiah Jen kin s. M r. M. G . T h o m a s , M . E . , g a v e a sh o rt h is to ry of th e D iv is io n sin ce h o stilities b e g a n , a n d re c o u n te d m a n y m e r ito rio u s activitie s by sen iors a n d ca d ets, of w h ic h the v illa g e sh ou ld be proud. H e la te r presen ted th e sen io r m e m b e r s a n d th e n u rse s w ith aw ards.

e w

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C a r d if f . — M ajo r A. W . A n derson , M .B ., C h .B ., pre sid ed a t a m e e t in g of th e a m b u la n c e c o m m itte e of th e P r i o r y f o r W a l e s , h e l d in C a r d i f f o n T u e s d a y , M a y 1 8 t h , w h e n n e w d ivisio n s of th e B r ig a d e a t C h e p s to w , L l a n r h u g (C aern arvon sh ire), C y m m e r, P o rth a n d C a rd iff w ere s a n c tioned.

D r. Joh n W ils o n R eid , B e a u m a ris , w a s a p p o in ted a n h o n o r a r y life m e m b e r , a n d D r . R . E . J o n e s , s u r g e o n to th e M y n y th o D iv isio n (C a e rn arv o n sh ire ), w a s a p p o in ted an h o n o r a r y life m e m b e r of th e P r i o r y a n d m e m b e r of t h e e x a m i n in g s t a ff for g r a t u it o u s s e rv ic e s a s lectu rer. T h e co m m ittee w e lco m ed the n e w s th at M a jo r G. S. Ph illips, M . D . , co rp s s u r g e o n , P o n t a r d a w e , h a d re tu rn e d f r o m A r m y s e r v i c e o n h e a l t h g r o u n d s , a n d it w a s a g r e e d t h a t h e be a s k e d to a c c e p t office a s A s s i s t a n t C o m m i s s i o n e r of th e P o n t a r d a w e C o u n t y A re a , h eld t e m p o ra r ily by C o u n tv O fficer T h o m a s W illia m s .

L o s t (in j^ e yto n sto n e ).— B ro n z e M ed a llio n , N o. a5 4 5 1S , Ivy N ew m an .

F o u n d . — Bronze M ed a llio n , No. 4S7751, W illia m M illard . O w n e r can o b tain s a m e from W . R ic h a rd s o n , 6 S y b o o m - s t r e e t , L e a B r i d g e - r o a d , L e y t o n , E . 10.

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a lo t h a s b e e n s a i d o f l a t e o f t h e c o m p l e t e l a c k o f sta n d a rd is a tio n of H . G . tra in in g . W h i ls t ru les a n d r e g u la tio n s a r e g o v e r n e d b y th e W a r O ffice, t r a i n i n g m e th o d s s e e m t o rfest, t o a l a r g e e x t e n t , w i t h t h e l o c a l C o m m a n d e r s , w i t h t h e r e s u l t t h a t t h e y o f t e n d i f f e r w i d e l y in t h i s r e s p e c t . T h i s is p a r t i c u l a r l y n o t i c e a b l e in t h e M e d i c a l S e r v i c e — s t ill t h e “ C i n d e r e l l a ” of th e H o m e G u a r d . I t is n o t y e t f u l l y r e a l i s e d t h a t m e d i c a l u n i t s a r e not n o n - c o m b a t a n t s , a n d e v e r y m e m b e r is e x p e c t e d t o b e c a p a b l e of u s in g a r m s w h e n n e ce ssary . C o n seq u en tly, th e P la toon C o m m a n d e r w a n t s a first-rate rifle m a n ; th e M .O . e x p e c ts a fir s t-r a te first a i d e r ; a n d t h e p o o r O r d e r l y g e t s a first-rate headache. M a n y C . O . ’s r e a lis e t h e p o s iti o n a n d a p p r e c i a t e t h e ir w o r k , b u t t o o o f t e n t h e m e d i c a l u n i t is l e f t t o s t r u g g l e a l o n g it s o w n c o n t e m p t u o u s l i t t l e w a y , u n t i l s u d d e n l y — a n a c c i d en t ; a n illn ess on p a r a d e ; a p r e m a tu r e fr o m th e N o rth over, a n d — H e llsa p o p p in ! M o s t c o r r e s p o n d e n t s a g r e e t h a t a u n ified c o m m a n d , s o m e w h a t s i m i l a r t o t h e R . A . M . C . , is t h e o n l y a n s w e r . M e a n w h i l e , d o y o u r b e s t fo r t h e C o m p a n y , b o y s ; i t ’s a g r a n d j o b y o u a r e d o i n g , a f t e r a ll. Q

u it e

S tr a p p in g a P a tie n t to S tr e tc h e r . — T h e f o l l o w i n g h a s b e en se n t m e b y C p l. R u s h to n , of th e 2nd N o tts ., a n d I pass i t o n :— U n d e r s t r e e t f i g h t i n g c o n d i t i o n s , w i t h t h e m a n y o b s t a c l e s i n v o l v e d , s o m e t h i n g l i k e t h i s is e s s e n t i a l . Three stretch er slin g s a re used. F ir s t , b r i n g p a t i e n t ’s fe e t le v el w ith e d g e s of c a n v a s . P la c e th e c e n tre of a slin g- over o u tsid e of b o th a n k le s , p a s s in g th e en d s u n d e r a n d u p b e tw een th e a n k le s, a n d o v er the o rig in a l cen tre of slin g , b a c k to s t r e t c h e r h a n d le s , w h e r e th e lo o p s a re slip ped over. P a t i e n t is t h e n p u l l e d u p w a r d s u n t i l s l i n g is t a u t . N e x t , b r i n g p a t i e n t ’s a r m s a b o v e h e a d ; p a s s a s l i n g o v e r th e ch est, clo se u p to b o th axillii, u s in g s u b s ta n tia l p a d s to p r e v e n t p r es su r e , a n d slip lo o p s o v e r h a n d le s . S lin g is t h e n a d j u s t e d a n d p a t i e n t ’s a r m s l o w e r e d t o h i s s i d e . F in ally, a t h i r d s l i n g is p a s s e d o v e r t h e p a t i e n t ’s b o d y , ju s t b e lo w the e lb o w s, rou n d the stretch er, a nd secu rely f a s t e n e d off. S tre tc h e r ca n th en be ca rried at a n y a n g le . C.

p r e a d b u r y (S e rg t.), S c h o o l H o u se , N o e l-ro ad , W .3 .

S e r g t . S p r e a d b u r y is p e r f e c t l y c o r r e c t in s u g g e s t i n g , in y o u r is s u e fo r M a y , t h a t m a n y first a id e r s a r e “ to o T e x t b o o k m i n d e d ” a n d “ l a c k i n g in i n i t i a t i v e . ” S t u d y of th e m e th o d s w h ic h h ad to be a d o p te d b y R . A . M . C . b e a r e r s in F r a n c e a n d o t h e r fields o f a c ti o n w o u ld b e o f in e s t i m a b l e v a lu e , n ot o n ly to t h e s e p e o p le, b u t to all p e rso n n el of the H o m e G u a rd . In th es e fig h t s th e r e w a s no t im e fo r “ t e x t b o o k ” first aid. T h e in ju re d h a d to be r e a c h e d , t h e y h a d to b e a tt e n d e d to, a n d t h e y h a d , w h e r e a t all p o s sib le , to b e g o t a w a y . T h a t is t h e l e s s o n w h i c h H . G . b e a r e r s h a v e t o l e a r n . If, a s m a y q u i t e p o s s i b l y h a p p e n , t h e r e is a n a t t a c k o n t h i s c o u n tr y , full su p p lie s of t r i a n g u l a r b a n d a g e s , r e a d y m a d e splin ts, etc., w ill not a lw a y s b e a v a ila b le . T h e H .G . M ed i c a l S e c t i o n s m u s t b e a b l e a n d r e a d y to im p r o v is e w it h a n y t h i n g w h ic h lies to h a n d . B e a r i n g t h i s in m i n d , t h e S . B . ’ s o f t h i s B a t t n . , u n d e r S e r g t s . M c A n e s p ie a n d T o r r a n c e a n d C p l. H a s t in g s , “ put on a s h o w , ” s o m e m o n th s a g o , fo r th e benefit of th e o p p o site n u m b e rs of n e ig h b o u r in g B a ttn s. It w a s g r a t i f y i n g to fi n d t h a t s e v e r a l o f o u r v i e w s w e r e n e w t o , a n d w o r t h y o f

A I D note by, the R . A . M . C . W e w ou ld m en tion h ere th at m u ch t h a n k s a r e d u e b y o u r M e d i c a l S e c t io n to th e R . A . M . C . fo r g r e a t h e lp a n d e n c o u ra g e m e n t, both of w h ic h w e r e m o st fr ee ly g i v e n a t all tim e s. I n t h e o p e n i n g i t e m it w a s d e m o n s t r a t e d t h a t a s e v e r e h a n d i n j u r y c a n b e v e r y c o m f o r t a b l y p u t u p w i t h a f ir s t - f ie l d d r e s s in g a n d splin ted w ith a b a y o n e t-fro g . T h e la tte r ca n b e s l i p p e d ov er - o n e o r t w o f i n g e r s a s r e q u i r e d . F o r f r a c t u r e o f t h e f o r e a r m it w a s s h o w n t h a t a b a y o n e t , w ith th e hilt in th e p a lm a n d th e d a n g e r o u s p o in t g u a r d e d w ith tu r f o r w o o d , m a k e s a n e x c e lle n t in n er splin t. The s c a b b a r d , a s o u t e r sp lin t, c o m p le t e s a v e r y s a t is f a c t o r y job. S u f f i c i e n t 1‘ p a d d i n g ” c a n b e o f h a y , s t r a w , g r a s s , e t c . F .S . c a p s a re also e x c elle n t for th is purp ose. It s h o u ld be n o t e d t h a t h a y, t w i s t e d i n t o r o p e s o f v a r i o u s l e n g t h s a n d t h ic k n e s s e s , m a y b e u s e d to a ffix th e s p lin ts a n d a ls o a s s lin g s , etc. O r s u c h a r t i c l e s a s b e l t s , p u l l - t h r o ’ s, b o o t l a c e s c a n b e e m p lo y e d to fix a n d s u p p o r t f r a c t u r e s o f th is typ e. F r a c tu r e of the sh aft of th e h u m e ru s ca n b e perfectly co n tro lled b y the u se of a p a ir of le a th e r g a ite r s . T ig h tly fo lded , o n e fo r m s th e in n er, a n d th e o th e r th e ou ter, splin t. T h e y c a n be tied on in s im ila r m a n n e r to th e fo r e a r m splints. T h e r if le , a f t e r r e m o v a l o f t h e b e l t m e c h a n i s m ( w h i c h , b y t h e w a y , s h o u l d b e s t o r e d in t h e p o c k e t o f t h e c a s u a l t y ) , m a k e s not o n ly a u se fu l splin t fo r a fr a c tu re d fe m u r, b u t, u s in g th e sp e cia l k n o t on th e b u tt, o n e w h ic h a llo w s of m o d ifie d e x t e n s io n b e i n g a p p lie d to th e lim b . T h i s item c a m e in for sp e c ia l in te re s t a n d a tte n tio n fr o m th e a u d ie n c e . T h e a p p lic a tio n of r o u g h b r a n c h e s a n d s tic k s a s sp lin ts w a s d em o n stra ted on a c a se of fra c tu re of both le g s. P le n t ifu lly p a d d e d , th e re su lt w a s b o th e fficien t a n d c o m fo rtab le. I t m i g h t b e e m p h a s i s e d h e r e t h a t , in a c t u a l p r a c t i c e , t h e t h o r o u g h p a d d i n g o f f r a c t u r e c a s e s is o n e p o i n t in w h i c h fir s t a i d e r s a r e a p t t o s l i p u p . S u f f i c i e n t p a d d i n g a n d fir m a p p l i c a t i o n o f b a n d a g e s a r e a b s o l u t e l y e s s e n t i a l in t h e “ d o in g -u p ” of fractu res. T h e u ses of stretch er s lin g s a re m a n y . P a tie n ts w ere la s h e d o n s t r e t c h e r s so a s to a l l o w o f t r a n s it s i d e w a y s t h r o u g h n a r r o w t r e n c h e s o r f o r l o w e r i n g o v e r c li f f s . The sp e cia l te c h n iq u e of re m o v a l of in ju red fro m th e n a r ro w con fin es of t a n k in teriors o r n a r r o w d ee p tre n c h e s w a s a lso shown. I n r e g a r d to th e r e m o v a l of c a s u a lt ie s fr o m “ e x p o s e d p o sitio n s.” A l l b e a r e r s a r e i n s t r u c t e d in t h e p r o p e r m e t h o d of th e “ c r a w l a p p r o a c h ,” so t h a t chin, ch e st, a b d o m e n a n d h e els a r e all tu c k e d in to th e g r o u n d . H e e l p l a t e s g l i n t i n g in th e l ig h t sp ell d a n g e r fo r th e re scu er. R e s c u e trom “ exp osed p o s itio n s ” w a s d one by 4 b e are rs w ith stretch er, s o m e w h a t a fte r th e m eth o d d escrib ed b y S e r g t . S p r e a d b u r y in y o u r A p r il issu e. T h e 2 bearer m e t h o d w a s , h o w e v e r , to w r a p th e p a tie n t in a g a s - c a p e a n d slid e h im to c o v e r b y t w o s t r e t c h e r s li n g s t h r o u g h e a c h a xilla. T h i s c a u s e s less d is t u r b a n c e a n d c o n s e q u e n t ly less “ s h o c k , ” a n d is e a s i e r o n a n d s a f e r f o r t h e b e a r e r s t h a n is th e stretch er m ethod. T h e a b o v e is, a s I h a v e s a i d , a n a c c o u n t o f a n a t t e m p t t o d e m o n s t r a t e “ i m p r o v i s a t i o n ” b y H . G . S . B . ’ s. T o save sp a c e , o n ly m i n i m u m d e s c r ip tio n is g i v e n of e a c h . S h ould fu r th e r d eta ils b e d esired , I w ill be v e r y h a p p y to su p p ly them . . T h e o b j e c t o f p u b l i c a t i o n is t h a t , b y d o i n g s o , m a n y oth er an d m o re v alu able m eth od s of u s in g co m m o n th in g s w h i c h “ lie to o u r h a n d s ” m a y b e f o r t h c o m i n g . T extb ooks h a v e lo n g m en tio n e d th at th in g s m u s t b e im p ro vised , but p recio u s fe w e x a m p le s h a v e ever been g iv e n . I w o u ld s u g g e s t th at F ir s t A id lead the w a y by th r o w i n g o p e n its p a g e s to s u g g e s t i o n s fo r “ F i r s t A i d I m p r o v i s a tio n .” S u c h k n o w l e d g e a s w o u l d s u r e ly a c c r u e w o u l d be, I a m v e r y c e r ta in , m o s t a c c e p t a b l e to a ll first a id e rs . B

o w m a n

d g a r

(M ajor).

( M . O . , 4th B a ttn . D u m fr ie s - s h ir e H . G . )

F I R S T

139

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HOME GUARD MEDICAL MANUAL

18, FITZROY STREET, FITZROY SQUARE, LONDON, W .l Telephone : MUSEUM 2703.

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P rice l7 /6 d .

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O F

Section on Air (April 1943)

B A N D A G IN G

FIRST AID

OAKES,

S.R .N ., D .N .

E x t r a C r o w n 8vo.

S e c o n d E d it io n . F IR S T A I D

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Pocket size. 32 pp. Illustrated. 4d. net. Postage Id. (April 1943)

P R O F E S S O R C . F . V . SM O U T , B IR M IN G H A M U N IV E R S IT Y .

FIRST

R EA D Y

In li m p rexine

264 page s.

6s. n e t P o s ta g e 6d.

( 1942 )

Triangular and Roller Bandaging simply explained and clearly Illustrated.

Postage I / - e x tra . Tw o

charts,

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E .

1 6 -1 7 ,

cloth, w ith ro lle rs,

S ,

T E V IO T

PLA CE,

FU R N I T U R E

P A T E N T

“ PORTLAND AMBULANCE

CEAR

The Gear illustrated (A.B.C.D.) carr'es tw o stretch ers on one side of Ambulance, leaving o th er side clear for sitting patients. The UP AND DOW N action is quick and easy for loading o r unloading. A.

Shows the two stretchers in position.

Shows the top stretcher lowered ready for loading.

Illustrates the same Gear with the top stretcher frame h in g e d dow n for use when only one stretcher case is carried.

Shows the same position as in “ C ” only with cushions and back rest fitted for convalescent cases.

W here Ambulances are required to carry four beds two Gears are fitted, one on EITHER SIDE, and th e same advantages apply as described above. . . Full catalogue o f Ambulance Equipment No. 7A will be sent on request.

G R E A TP O R T L A N DS T ., L O N D O N ,W .1 Telegraphic Address

Phone :

Longhorn 1049.

E D IN B U R G H

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KARVALID, WESDO, LONDON

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S ig n s.

Dislocations.* A d is l o c a t io n is t h e d is p la c e m e n t u s u a ll y the re su lt of violen ce.

of a bon e at a join t,

V arities.

(1) P a in , increased b y m o vem en t, m a y be v ery severe and ca u se fa in tin g or vom itin g. ( 2) S w e l l i n g . ( 3) D i s c o l o u r a t i o n o f t h e s k i n , d u e t o s u b c u t a n e o u s haem orrhage. T reatm en t.

1 .— Sim ple. 2. — C o m p o u n d .

A . — F ir s t A id.

3 .— C o m p licated . T h e s e t e r m s a r e u s e d in t h e s a m e s e n s e of fractu res.

a s in t h e c a s e

S ig n s. (a) (b) (c) (d) (e) (f)

A I D ' 1

P a in . L o s s of P o w e r. S w ellin g . D efo rm ity. D e c r e a s e d m o bility. N o crep itu s.

lotion. D o n o t a p p l y l e a d l o t i o n t ill t h e j o i n t h a s b e e n X - r a y e d , a s it m a k e s t h e p h o t o i n d i s t i n c t . B . — S u rg ica l. A n X - r a y is u s u a l l y t a k e n in s e v e r e c a s e s , a s a f r a c t u r e m a y be present. R e st, m a s s a g e a n d p a s s iv e m o v e m e n ts ard c o n t in u e d u n til all p a in is g o n e .

T h e p a i n i n d i s l o c a t i o n is v e r y s e v e r e , a n d m a y c a u s e th e p a tie n t to fa in t o r v o m it. T h e d efo rm ities com p rise th e presen ce of u n n a tu ra l d ep ression s a nd bo n y p ro m in e n c e s, a n d th e s h o r t e n i n g or l e n g t h e n i n g o f th e lim b . T reatm en t. A . — F irst A id . (1) N e v e r a tt e m p t to r e d u c e a d islo ca tio n . (2) P l a c e t h e p a r t in a c o m f o r t a b l e p o s i t i o n , a n d k e e p it a t r e s t b y m e a n s o f b a n d a g e s a n d s p l i n t s i f n e c e s s a r y . ( 3) A p p l y c o l d t o t h e j o i n t . B .— S u rg ica l. T h e d i s l o c a t i o n is r e d u c e d

K e e p th e jo in t at rest b y th e a p p lica tio n of splin ts a n d bandages. A p p ly cold w a t e r to th e jo in t, o r e v a p o r a t in g

by exten sio n a nd m a n ip u la

tion , a fte r b e i n g X - r a y e d . A n a n a e s t h e t i c is f r e q u e n t l y n e o e s s a r y t o r e l a x t h e m uscles. N o s p e c ia l a p p a r a t u s is r e q u ire d . A fter reduc tion , th e jo in t is k e p t fixed b y b a n d a g e s fo r a f e w d a y s . T h e n m a ssa g e and m ovem en ts are b egu n. D i s l o c a t i o n of t h e I n t e r n a l S e m i l u n a r C a r t i l a g e . T h i s is a d i s p l a c e m e n t o f t h e c a r t i l a g e l y i n g o n t h e u p p e r e n d of th e tib ia, in th e in te r io r of th e k n e e jo in t, a n d is c a u s e d b y v i o l e n c e w h e n t h e k n e e is f l e x e d . It c o m m o n ly o c c u r s o n t h e f o o t b a l l f ie ld . S ig n s. T h e r e i s a s u d d e n i n t e n s e p a i n i n t h e k n e e , w h i c h is lo c k e d so t h a t th e p a tie n t c a n n o t s t r a ig h t e n th e lim b . S w e l l i n g of th e jo in t c o m e s on rap id ly.

St. John Ambulance Association. Y a r m o u t h C e n t r e . — D is a p p o in tm e n t a t th e sm all n u m b e r of en tries w a s e xp re sse d a t th e a n n u a l com p e titio n s of th e Y a r m o u t h A m b u l a n c e C e n t r e o n S a t u r d a y , M a y 29th. In o n ly one ca se w a s th ere a co n tested en try. W i n n e r s of th e m e n ’s s e n io r se c tio n fo r th e B o r o u g h A m b u l a n c e B o w l w e r e th e Y a r m o u t h P o lice, w h o w e r e opposed by the L . N . E . R . team . T h e P olice w e re rep re se n te d b y S e r g t s . G . H a t c h (cap tain ) a n d H . S to n e a n d P . C . ’ s A . M o x e y a n d R . N e a l e , w i t h P . C . J. B u r n i s t o n a s reserve. T h e r a i l w a y t e a m w e r e u n d e r M r . W . J. P a g e . T h e Y a r m o u t h A m b u l a n c e C h a l l e n g e C u p f o r t h e m e n ’s ju n io r s e c tio n w a s w o n b y a n u n o p p o s e d p o lice te a m , c o n s i s t i n g o f P . C . ’s G . B r o w n ( c a p ta in ) , T . B o w l e s , G . B e c k a n d W . P a in te r , w it h P . C . N ic h o lls in reserv e. T h e r e w e re no en tries for th e P a lm e r a n d G r o u t C h a l l e n g e t r o p h i e s fo r t h e w o m e n ’s s e n i o r a n d j u n i o r s e c tio n s . A n e w featu re w a s the ju n io r team com petitio n . T h e r e w a s o n ly o n e e n t r y for th e b o y s ’ se c tio n a n d o n e for th e g irls. T h e fo rm e r w a s the 7th A m b u la n c e C a d e ts and th e la tte r the G o rlesto n G ir l C a d ets. T h e m e n ’s com petition s w e re ju d g e d b y C apt. W . G ood ley, th e C h ie f C o n s ta b le (M r. C . G. B o x ) a n d M r. B. Lake. T h e M a y o r (M r. F . H . D e b b a g e ) d istrib u ted th e prizes.

T reatm en t. A . — F ir s t A id. D o n o t p u l l o n t h e l e g n o r m a k e a n y a t t e m p t to s t r a i g h t e n it , a b a n d a g e w r u n g o u t in c o l d w a t e r m a y g i v e r e l i e f t o t h e p a i n w h i l e t h e c a s e is b e i n g r e m o v e d . S e n d for m ed ic a l a s s is ta n c e a n d re m o v e th e p a tien t on

Letters to the Editor. W e a r e in n o w a y r e s p o n s ib le for th e o p in io n s e x p r e s s e d , or th e.sta te m e n ts m ad e , b y C o rre sp o n d e n ts.— E d it o r . A

stretcher. B .— S u rg ica l. T h e c a r t i l a g e is r e p l a c e d b y m a n i p u l a t i o n , w i t h or w i t h o u t a n a n a esth etic, a n d th e jo in t re s te d a n d m a s s a g e d u n til the s w e llin g h a s d isap p eared . T h i s d is p la c e m e n t is v e r y l i a b l e t o r e c u r , i n w h i c h c a s e a n o p e r a t i o n is p e r f o r m e d , a n d th e lo ose c a r t ila g e re m o v e d . SP R A IN S . A S p r a in is a s u d d e n o v e r s t r e t c h i n g o r t e a r i n g of th e l i g a m e n t s a n d a d j a c e n t s o f t p a r t s o f a j o i n t , c a u s e d lj y vio len ce. * F .x tract fr o m th e M a n u a l of I n s tr u c tio n fo r the R o y a l N a v a l S i c k B e rth S taff, rep rin ted b y p erm issio n of the C o n tr o lle r of H . M . S t a t io n e r y O ffice,

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G a s W a r fa r e , F irst A id W h a t t o D o in E m e r g e n c i e s In flu e n z a , C o ld s , etc. M ea sles, M u m p s, C a ta r rh Corns and W a rts P h ysica l C u ltu re T r e a t m e n t fo r a ll S k i n D is e a s e s T h e L u n g s , P le u ris y H y g ie n e , A n ato m y, P h arm a cy

T h e P rin cip le s pf N u r s in g T h e E y e , the E a r T h e T h r o a t, the N ose T h e C h est, the H e a r t T h e S to m a c h , the L iv e r T h e T e e th , th e M uscles Infant W e lfa re H om oep ath y, N eurasth enia 3 75 P r e s c r ip t io n s , e tc ., etc.

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“ It more than comes up to my expectations, and I shall certainly recommend the volumes.’’ “ The work is in every way satisfactory, and is every thing you claim it to be. This is just the thing I have been waiting to obtain for several years.”

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R I D h osp ita l. H a v i n g u n lo a d e d this p a tie n t, y o u s h o u ld h av e d riven b a c k lik e the D e v il, lo a d ed the fra c tu re of s p in e c a se , a n d th e n told y o u r d r iv e r to r e m o v e th is patient s lo w ly a n d c a re fu lly .” Your c o m m e n ts on th is test w ill b e g r e a t ly ap p recia ted . Y o u w e r e r i g h t in y o u r d e c i s i o n t h a t b o t h c a s e s s h o u l d b e t r a n s p o r t e d a t t h e s a m e t i m e f o r t h e f o l l o w i n g r e a s o n s :— ( 1 ) W i t h a l l a i r r a i d c a s u a l t i e s t h e r e is a p r o f o u n d d e g r e e o f s h o c k a n d e a r l y a r r i v a l a t h o s p i t a l is e s s e n t i a l ; (2) O n t h e s t a t e m e n t g i v e n t o y o u t h e r e w a s a s h o r t a g e of a m b u la n c e s ; a n d c o n se q u e n tly y o u r veh icle w o u ld beyon d d o u b t b e re q u isitio n ed fer se r v ic e e ls e w h e r e ; a n d (3) T h e s p e e d a t w h i c h y o u r a m b u l a n c e t r a v e l l e d w o u l d n o t be d e tr im e n ta l to th e sp in a l fr a c tu r e c a se , p r o vid e d th a t l o a d i n g h a d b e e n c a r r i e d o u t in s t r i c t a c c o r d a n c e w i t h t h e in stru ctio n s of th e T e x t b o o k . — N .C . F .

T r a n s p o rt o f F r a c t u r e d S p in e . C o m p o s itio n o f W a te r G a s . A . E . ( R h o n d d a ) . — P l e a s e t e l l m e w h a t is w a t e r g a s ? I t is i n c l u d e d a m o n g t h e p o i s o n g a s e s in S e c t i o n I I o n p. 1 5 6 of the T e x t b o o k . W a t e r g a s is o b ta in e d b y p a s s i n g s t e a m o v e r re d hot c o k e w h ic h h a s th e effect of d e c o m p o s i n g th e w a t e r v a p o u r a n d of p r o d u c i n g a m i x t u r e of h y d r o g e n a n d c a r b o n m o n o x id e gases. W h e n m i x e d w i t h h y d r o c a r b o n v a p o u r it is c a l l e d c a r b u r e t t e c ( w a t e r g a s , a n d in t h i s f o r m is e m p l o y e d fo r m ix in g w ith coal g a s .— N. C or bet F letch er.

E x a m in a tio n H o w le r. F . E . ( S h r e w s b u r y ) . — In a re c e n t e x a m in a t io n I a s k e d on e c a n d i d a t e to tell m e w h a t h e k n e w a b o u t t h e c i r c u la t io n of th e blood. I w a s not im p re sse d t h o u g h I w a s a m u se d w h e n h e r e p l i e d " T h e blood g o e s dow n one le g a n d retu rn s

S . P . ( M o u n t a i n A s h ) . — W e h a v e b e e n d o i n g a c o u r s e o f fi r st a i d i n c o a l m i n e s , t h e t e x t b o o k f o r w h i c h — F ir s t A i d in C o a l M in e s — o n p. 89, d e a l i n g w i t h t r a n s p o r t o f c a s e s o f f r a c t u r e s o f s p i n e in c e r v i c a l r e g i o n , s a y s :— “ T h e p r e p a r e d s t r e t c h e r is p l a c e d u n d e r t h e p a t i e n t . ” S o m e a r g u m e n t h a s a rise n a s to w h e th e r a “ p re pared stretch er ” sim p ly m e a n s one w ith b la n k e ts and p a d s o r o n e b o a r d e d a s is l a i d d o w n in F i r s t A i d to the I n ju r e d o n p. 7 4 . W e s h a l l b e p le a s e d to h a v e y o u r r u lin g on th e m atter. I n t h e P r e f a c e t o F i r s t A i d in C o a l M in e s I r e a d :— “ I t is i n t e n d e d f o r t h e u s e o f m e n w h o h a v e a l r e a d y q u a l i f i e d in f ir s t a i d a n d s h o u l d b e r e a d in c o n j u n c t i o n w i t h F ir s t A i d to the I n ju r e d ." C o n s e q u e n t l y , it is c l e a r t h a t in t h i s i n s t a n c e a “ p r e p a r e d s t r e t c h e r ” i s o n e w h i c h is e q u i p p e d w i t h b o a r d s , blan k et and p a d s .— N .C .F . J

u p the oth er leg ! ” Good !

N e x t , p l e a s e ! !— N . C . F .

T h o m a s Sp lin t. E. W . ( C r ic k le w o o d ) .— I a m s t u d y i n g th e T h o m a s S p lin t an d w a n t t o f i n d o u t a s m u c h a s is p o s s i b l e a b o u t it . I am N o . 2 of o u r p a r t y ; a n d I s h o u ld b e v e r y g r a t e f u l for h e l p in t h i s d i r e c t i o n . T h e T e x t b o o k is q u i t e g o o d b u t it d o e s n o t g o f a r e n o u g h a n d e x p l a i n a l l t h e d e t a i l s . T h e use of th e T h o m a s S p lin t ca n o n ly be a p p recia ted a n d l e a r n e d in t h e p r a c t i c e r o o m . Y o u r d u ties as N o. 2 are f ir s t t o o p e n , t o b l a n k e t s t r e t c h e r ( T e x t b o o k p p . 2 5 1 , 2 06 , a n d 2 0 7 ) , a n d t o a p p l y t h e c l o v e h i t c h (p. 2 5 1 ) a n d t h e n t o a ssist g e n e r a lly a s req uired b y y o u r le a d e r.— N .C .F .

P r io r it y in A m b u la n c e . J .G . ( W e m b le y ) .— In o u r B o r o u g h w e h a v e a k in d of C o m p e titio n L e a g u e b e t w e e n th e v a r i o u s D e p o t s o n first a id and rescue w o rk . In a c o m p e titio n la st w e e k I w a s g i v e n t h e f o l l o w i n g t e s t :— “ Y o u h a v e tw o c a su a ltie s (1) a ca se of com p lica ted f r a c t u r e o f t h e r i b s a n d (2 ) a c a s e o f f r a c t u r e d i s l o c a t i o n of sp in e a t 3rd a n d 4th c e rv ica l v er te b ra s. B oth cases h a v e b een treated a n d p la ced n e a r a n a m b u la n c e re a d y for lo a d in g . T h e h o s p i t a l is f o u r m i l e s a w a y a n d n o o t h e r a m b u l a n c e is a v a i l a b l e . W h i c h c a s e sh o u ld h a v e p r i o r i t y in t r a n s p o r t ? ” I sa id th at I w o u ld g iv e th e m b o th p riority, m y r e a s o n s b e i n g t h a t in t h e s p i n a l c a s e t h e r e w a s a d a n g e r o f a s p h y x i a a n d t h a t it w a s e q u a l l y i m p o r t a n t t o g e t b o t h c a s e s a w a y a s c a r e fu lly a n d as q u ic k ly a s p ossible. The j u d g e ( w h o w a s not a d octor) h o w e v e r, g a v e m e no m a r k s a n d , w h e n a s k e d th e re a so n m a d e th is c o m m e n t: “ Y o u s h o u ld h a v e lo a d ed on th e a m b u la n c e the c o m p lic a te d fr a c tu r e of ribs c a s e a n d in stru c te d the d r iv e r to p r o c e e d a s q u i c k l y a n d c a r e f u lly a s p o s s ib le to

P u p ils in P o is o n in g . A . E . ( R h o n d d a ) . — C o u l d y o u p l e a s e e x p l a i n w h a t is t h e s t a t e of th e p u p ils in c a s e s of p o is o n i n g b y c a r b o lic a cid , prussic acid , p h o sp h o ru s, stry ch n in e , a n d iod in e ? T h e T e x t b o o k t e l l s u s a b o u t t h i s in p o i s o n i n g b y o p i u m a n d t h e d e t i r i a n t s b u t is s i l e n t w i t h r e f e r e n c e t o t h e o t h e r c a u se s of p o is o n in g b y th e m outn . O p iu m a n d b e lla d o n n a (an d th eir allie s) a r e th e p o is o n s w h ic h h a v e a specific a c tio n on th e pupils, th e fo r m e r c a u s i n g co n tra c tio n a n d th e latter d ilatatio n . W i t h a ll the o th er poison s th ere w ill be a te n d e n cy to d ila ta tio n co n se q u e n t on th e a sso cia te d s h o c k and v a r y in g w ith the d e g re e p resen t.— N .C .F .

B ite b y R a b id A n im a l. A . E . ( R h o n d d a ) . — U n d e r t r e a t m e n t for b ite b y r a b id a n im a l th e T e x t b o o k tells u s to a d o p t th e u s u a l m e t h o d s a n d a ls o to c a u te ris e th e w o u n d . F u r t h e r it t e l l s u s t h a t if m o re th a n h a lf a n h o u r h a s e la p se d w e a re to proceed a s in R u l e s 1 a n d 2 ( p p . 1 3 3 , 1 3 4 ) b u t n o t t o c a u t e r i s e wound. D o e s th is m e a n t h a t w e a r e to a p p ly th e s a m e treatm en t tw ice ? A ls o p le a s e s a y w h y w e a r e told to r e m o v e c o n stric tio n a n d n o t to c a u te r is e w o u n d ? C a u t e r is a tio n c a n o n ly a c t lo c a lly ; a n d , to be effective in d e s t r o y i n g t h e p o i s o n , it m u s t b e d o n e i m m e d i a t e l y a f t e r th e b ite h a s b een in flicted b y r a b id a n im a l . It c a n n o t affect th e p o is o n w h ic h h a s b e en c a rrie d in to th e s y s te m . Con s e q u e n t l y if a f i r s t a i d e r a r r i v e s h a l f a n h o u r o r m o r e a f t e r p a t i e n t h a s b e e n b i t t e n , h e h a s t o p r o c e e d a s in R u l e s 1 a n d 2 , in t h e h o p e t h a t b y a p p l y i n g a c o n s t r i c t i o n h e m a y p r e v e n t m o r e poison p a s s in g into th e g e n e r a l c ircu la tio n . T h e lig a t u r e is l a t e r r e m o v e d ( a s w i t h a t o u r n i q u e t , a f t e r t w e n t y m i n u t e s ) b e c a u s e it m a y e x p o s e t h e l i m b t o t h e d a n g e r s o f co n gestio n , in flam atio n a n d g a n g r e n e . F i n a l l y , t h e r e is n o s u g g e s t i o n th a t th e b ite s h o u ld be tr e a te d t w i c e . — N . C . F .

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M . ( H a r r o w ) .— S o m e tim e a g o I atte n d ed a lectu re on artificial re sp iratio n w h ic h w a s g iv e n b y a doctor. He s tre ss ed th e p o in t t h a t w e b r e a th e o x y g e n in to the lu n g s a n d e x h a le the b u lk of the o x y g e n to g e th er w ith an in cre a se d q u a n tity of c a rb o n d io xid e . C o n s e q u e n t l y , in m o u t h - t o - m o u t h i n s u f f l a t i o n , h e s a i d , t h e f ir s t a i d e r w a s a d m in iste rin g a m ixtu re w h ich, co n sistin g of o x y g e n a n d c a r b o n d io x id e , w a s g i v e n b y s u r g e o n s to p a tie n ts on th e o p e r a tin g tab le w h e n th e y t a k e a tu rn for the w orse. 1 u n d e rs to o d the d o cto r to s a y th a t th e c a rb o n d io x i d e n ot o n ly irr ita te d th e l u n g s b u t t h a t it s t im u la t e d a c e r t a i n n e r v e c e n t r e in t h e b r a i n w h i c h in t u r n c o n trolled th e b r e a t h in g m u s c le s . F u rth er, h e m ain tain ed th a t th is m e th o d of artificial resp iratio n h a d been s u c c e s s f u l in m a n y c a s e s o f a s p h y x i a b y b l a s t . I s h a l l b e g r a t e f u l to r e c e iv e y o u r c o m m e n t s o n th e a b o v e a n d e s p e c ia lly to k n o w w h a t h a p p e n s to th e t o n g u e of t h e p a t ie n t w h o is, of c o u r s e , l y i n g o n h is back.

T e a c o n t a in s t a n n in ; a n d in fu s io n s o f te a a r e s a id to h a v e b e e n u s e d b y t h e C h i n e s e f o r t h o u s a n d s o f y e a r s in t h e tre a tm e n t of b u rn s a n d sca ld s. T e a t a n n i n , h o w e v e r , is a d i f f e r e n t s u b s t a n c e t o t a n n i c a c i d ; a n d it s a c t i o n i s v e r y m u c h m ild e r th a n th a t of ta n n ic a cid . Indeed, exp erim en ts h a v e s h o w n t h a t t h e l a t t e r is t w e n t y f i v e t i m e s s t r o n g e r a s a n acid th a n tea tan n in . I t is i m p o r t a n t , h o w e v e r , t o a p p r e c i a t e th a t th e tea solu tion m u s t be s tro n g , a h a n d fu l of tea b e in g u se d w it h a s m a ll q u a n t it y of b o ilin g w a t e r , e v e n t h o u g h th is is a s e r i o u s d i s a d v a n t a g e in t h e s e d a y s o f r a t i o n i n g ; a n d t h a t t h e l i n t w i t h w h i c h it is s o a k e d a n d a p p l i e d m u s t b e a l l o w e d to d r y on t h e b u r n o r s c a ld . I n c i d e n t a l l y , it is c l a i m e d t h a t tea w h ich co n tain s no tan n in w o u ld be ta s te le ss .— N .C .F .

S ta g e s o f E p ile p s y . N . Y . ( C h e ls e a ) .— In a re c e n t le c tu re th e d o cto r said th a t the d e s c r i p t i o n o f E p i l e p s y in t h e T e x t b o o k w a s n o t g o o d b e c a u s e it o m i t t e d t o s t r e s s t h e f a c t t h a t a f t e r a n e p i l e p t i c fit t h e p a t i e n t m a y f o r s o m e m i n u t e s a p p e a r t o b e a c t i n g n o rm a lly a n d th at d u r i n g th is perio d h e m a y not be c o n sc io u s of w h a t h e h a s sa id or done. D o you a gree w ith th is c o m m e n t ; a n d w ill y o u p le a se e x p la in fu lly ?

T h e fa cts a re as yo u sta te ; a n d th e co n sen su s of e xp ert o p in io n is th a t in m o u t h - to - m o u t h in su ffla tio n t h e c a r b o n d i o x id e s tim u la te s th e re sp ira to ry c en tre of th e brain. O n one p o in t, h o w e v e r , y o u did m is u n d e r s t a n d y o u r le c tu r e r w h o c e r t a in l y n e v e r told y o u t h a t c a r b o n d io x id e irr ita te s th e lu n g s. W i t h a n u n c o n s c io u s p a tie n t l y i n g on h is b a c k , the t o n g u e d o e s n ot n e c e s s a r ily or in v a r ia b ly fall b a c k w a r d s a n d b l o c k th e e n t r y to th e l u n g s . W h e n , h o w e v e r , th e r e is a t e n d e n c y fo r t h is to h a p p e n , a g o o d p la n is to h o ld th e p a t i e n t ’s c h in w e l l f o r w a r d , w h i c h a c ti o n w i l l n o t i n t e r f e r e w ith the p e r f o r m a n c e of m o u th -to -m o u th in su fflation . In a n y c a s e , a s t h e T e x t b o o k t e l l s y o u i n R u l e 2 o n p. 1 4 9 it is t h e d u t y of a first a i d e r to k e e p w a t c h a n d to e n s u r e t h e fr ee e n tra n c e of a ir into th e w in d p ip e .— N . C . F .

Y o u r le ctu re r v oiced th e criticism w h ic h re p e a ted ly d o w n th e y e a r s I h a v e m a d e in th is c o lu m n (a n d e ls e w h e r e ) w it h r e f e r e n c e t o t h e d e s c r i p t i o n o f E p i l e p s y a s c o n t a i n e d in t h e T extbook. S o it m a y h e l p if I r e p e a t m y p r e v i o u s d e s c r i p tion , a s t w o y e a r s h a v e p a s s e d s in c e th e la st tim e. F i r s t , t h e t e r m “ E p i l e p s y ” is d e r i v e d f r o m a w o r d w h i c h sig n ifie s “ seized u p o n ,” a n d s u g g e s t s a w ild a n im a l s n e a k i n g t h r o u g h l o n g g r a s s to le a p fr o m b e h in d u p o n its u n s u s p e c t in g victim . S e c o n d l y E p i l e p s y is ( a s t h e T e x t b o o k s t a t e s ) “ a s u d d e n a n d c o m p le t e lo s s of c o n s c io u s n e s s ” w h i c h r e s u lt s fr o m th e su d d e n fa ilu re a n d loss of co n tro l of th e h ig h e s t b ra in cen tres. I t is a d is e a s e of th e b r a in ; a n d fr o m l a c k of in tim a te k n o w l e d g e o f i t s e x a c t c a u s a t i o n it i s o f t e n c a l l e d “ a b r a i n s t o r m . ” A l s o i t u s u a l l y f i r s t s h o w s i t s e l f in e a r l y a d u l t li f e .

S c h a fe r , S ilv e s t e r o r H o w ard . C.

M . (H a rro w ). — In the s a m e lectu re the d octor also re c o m m e n d e d S c h a f e r ’s m e t h o d f o r a p p l i c a t i o n t o t h e a b d o m e n f o r p a t i e n t w h o h a d b e e n s e v e r e l y i n j u r e d in t h e f r o n t of th e b o d y as th a t m eth o d w a s often app lied b y s u r g e o n s w h e n pa tie n ts ly i n g o n th eir b a c k s req u ired artificial

T h ir d ly , E p ile p s y o c c u r s in t w o f o r m s — m ild ( M in o r or a s it i s s o m e t i m e s c a l l e d P e t i t M a l ) a n d s e v e r e ( M a j o r o r G r a n d M al).

resp iration . Y o u r co m m e n ts a re a w a ite d w ith in terest ; a n d I w i s h t o a d d t h a t y o u r r e p l i e s a r e m o s t h e l p f u l t o m e in m y d u t ie s a s F i r s t A i d I n s t r u c t o r to a H o m e G u a r d

In M in o r E p ilep sy su d den a nd co m p le te con sciou sn ess m a y be th e o n ly evid e n ce of th e a tt a c k ; an d the patien t m a y re m a in s t a n d in g an d reco ver im m e d ia te ly . C o n s e q u e n t l y for M i n o r E p ile p s y th e r e is no c a ll fo r first a id t r e a t m e n t.

B a tta lio n . I t is i n c o r r e c t t o s a y t h a t S c h a f e r c a n b e a p p l i e d t o a p a tie n t on h is b a c k b e c a u s e th is m e th o d co n s is ts of p r es su r e on th e lo in s w ith p a tie n t on h is fa ce. I su spect, therefore, t h a t y o u r le c t u r e r r e f e r r e d to H o w a r d ’s m e t h o d w h i c h w a s first in t r o d u c e d in 1 8 7 1 . In its p e r f o r m a n c e , th e p a tie n t b e in g on h is b a c k , th e o p e ra to r p la ce d h is h a n d s o v er the l o w e r b o r d e r s o f t h e r i b s w i t h t h e t h u m b s t o u c h i n g in t h e m i d d l e lin e of p a t i e n t ’s c h e s t , c a u s e d e x p i r a t i o n b y t h r o w i n g h is w e i g h t o n to h is h a n d s a n d fin a lly in sp ir a tio n b y r e m o v i n g h is w e ig h t . O f co u rse , y o u k n o w th a t for a p a tie n t w h o c a n n o t be t u r n e d o n h is b a c k o w i n g to a n o p e n a b d o m i n a l w o u n d or o th e r c a u s e , t h e T e x t b o o k tells y o u to c a r r y o u t S ilv e s t e r ’s m ethod. F u r t h e r th is m e th o d of artificial re s p ira tio n w a s a l w a y s u s e d in s im ila r c ir c u m s t a n c e s w h e n I w a s a m e d ic a l

M e a n w h ile w e tender

I n M a j o r E p i le p s y t h e r e a r e t h r e e m o r e o r le ss d efin ite stages. F i r s t (a) th e r e is s u d d e n a n d c o m p le t e lo s s of c o n s c io u sn e ss w h ic h c a u se s p a tie n t to fa ll to th e g r o u n d , p o ssib ly o n t o t h e fi r e o r o n t o m a c h i n e r y . T h i s is i m m e d i a t e l y f o l l o w e d (b) b y t h e o n s e t o f c o n v u l s i o n s w h i c h a f f e c t a l l t h e v o lu n t a r y m u s c le s , e x p o s e p a tie n t to r i s k of in ju r y fro m s t r i k i n g p ieces of fu rn itu re , o ften g i v e rise to th e c u r io u s e x p ira to ry cry, c a u se p a rtia l a s p h y x ia as sh o w n b y flu sh in g a n d s u b s e q u e n t l i v i d i t y o f f a c e , a n d m a y r e s u l t in b i t i n g o f tongue. F in ally, w h en con vu lsion s cease th e patient passes (c) i n t o a s t a g e o f a u t o m a t i s m o r s u b c o n s c i o u s n e s s d u r i n g w h ic h he/she m a y s p e a k a n d a ct both n o rm a lly (and a b n o r m a l l y ) a n d y e t b e t o t a l l y u n a w a r e o f w h a t h e is s a y i n g a n d d o i n g u n t i l a f t e r a v a r y i n g p e r i o d m e a s u r e d in m i n u t e s h e is s u d d e n ly re sto re d to full c o n s c io u s n e s s .— N . C . F .

s t u d e n t in t h e o p e r a t i n g t h e a t r e .— N . C . F .

T re a tm e n t o f B u rn s. P .M . ( P a d d in g t o n ).— W e w e r e d is c u s s in g recen tly th e action of w a r m s t r o n g t e a in t r e a t m e n t o f b u r n s ; b u t w e co u ld n o t a g r e e a m o n g o u r s e l v e s w h a t i n t h i s c o n n e c t i o n is th e v a lu e of tea. S o w e d ec id e d to a s k y o u b e c a u s e you

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