First Aid Journal 1945 - 1946 by Museum of the Order of St John

F IR S T

A ID

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W ALTER

SCOTT,

J A N U A R Y , 1945 .

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N O T IC E

D A LE, REYN OLDS & 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 Address— " Twenty-four, London Telephone— City 3710.

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TH IS

N U M BER.

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Women Ambulance W orkers Lectures Delivered to Advanced Casualty Service Personnel in the 6th Y ear of W ar

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S .J.A .B . Headquarters and D istrict Reports Letters to the Editor

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P e n icillin : Its Uses, M edicine and Surgery

Y o ur F irst Case

The F a k in g of In ju rie s...

Common Deform ities in Children

Cadet M usicians’ Competition

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n s w e r s

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o r r e n s p o d e n t s

Transport of Fractured T h ig h Exam ination H ow ler M embership of Brigade Contact with E lectric Current Service Medal of the O rder... Position for A rtificial Respiration Schafer or Silvester Fractures of Clavicle and H um erus ... H um o ur in F irst Aid B rigade Efficiency... Action at B rigade R oll-C all Fractured Neck of Fem ur Treatm ent of Infantile Convulsions ...

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EDITORIAL.

F.R.S.A.

R EAD ERS.

F IR S T AID is published on the a o th of each m onth. Annual Subscription is 4s. post free ; single copies 3d.

CO N TEN TS

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A n im p ortan t feature of first aid and a m b u la n ce w ork is th e c o n v e y a n c e of the w o u n d ed to the B ritish h o sp ita ls. W e g a th e r from an article w h ich appeared recen tly in the Times that there are 130 R e d C ross and S t. Joh n v e h ic le s in the so u th of E n g la n d e n g a g e d in the w ork, and at the h ead q u arters of the c o n v o y there is a cam p of m ore than 130 w om en a m b u la n ce d rivers. T h e w ork of c o n v o y is of a m o st str en u o u s and e x a c tin g natu re, p er form ed m a in ly at n ig h t. E ach n u rse, s a y s the article from w h ic h w e q u o te , “ se r v ic e s h er ow n a m b u la n ce ; trem en d o u s pride is taken in the a p p earan ce o f the v e h ic le s in ter n a lly as w ell as e x te r n a lly . T h is w ork, w h ich tak es up a g rea t deal of tim e and a sh are in th e o rd erly d u tie s, o c c u p ie s the rest of their d ay e x ce p t for the tw o h o u r s ’ leisu re in the a ftern o o n . T h e n , so o n after tea, c a lls co m e in in c r e a sin g ly q u ic k ly for a m b u la n c e s. In a d d i tion to the h ead q u arters cam p there are tw o a d van ced b ases at each o f w h ich is kept an a v e r a g e of a b o u t 25 a m b u la n ces and th eir d rivers. It is here th at th ese a m b u la n c es and d rivers w h o are on call to g o to F ra n ce aw ait orders to m o v e to the co a st. A b o u t six a m b u la n c e d rivers w ith v e h ic le s are a lw a y s on d u ty at th ree a ir fie ld s.” It w ill be u n d erstood that recovery of th e p a tien ts d e p en d s la r g e ly on sp eed of tran sp ort, and it is in the h ig h e s t d e g r e e sa tisfa c to r y to hear that w h ile “ m an y of the ca su a ltie s w ere w ou n d ed in F ran ce that m o r n in g , by m id n ig h t of th e sa m e day th ey find th e m se lv e s ste a m in g o u t of a railhead in E n g la n d for a h o sp ita l in th e p r o v in c e s .” M uch a g a in d e p en d s u pon the p e r so n a lity of th e d rivers and the n u rses, and e v e r y th in g p o ssib le h as been d o n e to render th is an im p o rta n t item in th e w ork. A m b u la n c e s are so co n stru cted th at a d river can w alk from her d r iv in g seat d ow n the cen tre of her a m b u la n ce , so th at at a h a lt sh e can se e that her c h a r g e s are all rig h t, and h a v e a m o m e n t’s ch at w ith th em . A s to th e p e r so n n e l of the d riv ers, th is in c lu d e s R ed C ross and S t. John g ir ls from m ost of the E n g lis h sh ir e s, g ir ls from S c o tla n d w h o are m em b ers of the S c o ttish branch o f the B r itish R ed W om en A m b u la n c e W o zk ers.

F I R S T

C ro ss S o c ie ty and o f th e S t. A n d rew s A m b u la n ce A s s o c ia tio n , a n u m b er of the F ir st A id N u r sin g Y e o m a n r y , C anadian R ed C ross g ir ls from V a n co u v e r , M o n trea l, T o r o n to , Q u eb ec, O ttaw a, and oth er parts of th e D o m in io n , and so m e g ir ls from th e S o u th A frica n R ed C ross. A ll are under the a u th o rity o f R e d C ross and S t. J o h n . It w ou ld be im p o ssib le to la v ish too m u ch praise upon th e work that is b e in g d o n e or u p on the efficien cy w ith w hich th e g ir ls carry o u t th eir str e n u o u s d u ties.

Lectures Delivered to Advanced Casualty Service Personnel in the 6th Year of War.

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and the w all of the vessel, the fluid part of the blood appears to be almost clear of corpuscles. As we continue, however, to watch the opening stages of the battle, we shall notice that the stream is gradually becoming slower in the immediate neighbourhood of the invading bacteria, and that the white blood corpuscles are separating themselves from the red and lin in g the interior w alls of the capillaries. G radually they begin to push their way through the w alls and so into the tissues themselves in the infected area. Some of the fluid part of the blood also escapes and at once coagulates, liberating in the process the fluid known as serum. At this stage the finger is hot, swollen and throb bing, and, if an open wound exists, it is probably oozing thin straw coloured serum. Now the battle is joined in earnest between the defensive m achinery of the body and the bacteria. The increased flood of blood has helped to dilute, neutralise, and wash away the toxins, while the subsequent slow ing of the stream has enabled

By S IR H E N R Y L. M A R T Y N , K .C .V .O ., F .R .C .S . ( C ontinued from page 6 j )

I n one of our former talks I touched briefly upon the subject of resistance to infections and disease. I told you that the capacity of the body' to fight disease depended upon highly com plex m achinery, and, since some knowledge of this is now almost a commonplace of everyday life, let us con sider of what it consists in the hum an body. W hen bacteria gain access to the body, the harm which they do us is due to the production of poisons known as T o xins. These may be given off from the bodies of the bacteria, or be contained w ithin those bodies and liberated only when they are disintegrated in the tissues. The toxins thus set free can produce either local inflam m ations, as in the formation of an abscess, or a boil, or a whitlow, or general reactions shown by illness and fever. The body, therefore, if the disease is to be overcome, must be capable of three th in g s: (1) Destroying the bacteria themselves ; ( 2) N eutralising the toxins ; ( 3) R ep a irin g the damage after the battle is over. Blood, as you probably know, consists of two parts, a fluid know n as plasm a and solid elements or corpuscles. The corpuscles are of two kinds, red and white. The former average five m illion to the cubic millimetre. They contain the colouring matter, or haemoglobin, which gives the red colouration to the blood, and are the means by which oxygen is carried to the tissues from the lungs and carbon dioxide removed. The white corpuscles, or leucocytes, average about ten thousand per cubic m illimetre, and are of several different forms. It is upon these that the defensive machinery of the body largely depends, and the number present in the circu lation increases enormously when an abscess is form ing in any part of the body. Let us now take a simple example of what happens when bacteria gain access to the tissues producing local in flammation such, for instance, as would occur if one of us pricked his finger with a dirty needle. The first result is that the tiny capillaries in the im m e diate neighbourhood of the wound become dilated, there is an increased flow of blood to the area and the part becomes hot and red. If the tiny vessels are watched under a m icro scope, as is possible in the sem i-transparent web of a fro g’s foot, it w ill be found that, at this early stage, the corpuscles are ro llin g rapidly along, red and white together, in the centre of the stream. Between this column of solid elements

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the white corpuscles to penetrate the w alls and gain access to the invaders. The bodies of these leucocytes are of almost jelly-like consistency and are capable of spontaneous movement. As they are watched it w ill be seen that each one of them engulfs any bacillus in its immediate neighbourhood, the semi-fluid body flowing around the organism until it is w holly ingested and destroyed. M any of the leucocytes may themselves be killed in the process, and their dead bodies become liquefied into what we know as pus, thus g ivin g rise to an abscess. The evacuation of this either by spontaneous rupture or as the result of opening by the surgeon’s knife, removes both pus and bacteria and recovery ensues. It is by no means inevitable that abscess formation should occur, in many cases the bacilli m ay be overcome by the defences and the whole trouble quiet down. W e have all of us, at some time or another, sustained some m inor in ju ry which at first became inflamed, but with suitable treatment recovered completely. An understanding of what is actually happening w ill

F I R S T

help you to realise and appreciate the reasons for the treat m enl recommended in your training. You have been told to apply hot fomentations to the part, since by so doing you w ill dilate the vessels in the region of the infection and thereby assist nature in brin g ing to the battle area as much blood as possible, and with it more white blood corpuscles and more antitoxins. You have been told that it is important to apply a splint if the infected wound is in the neighbour hood of any joint, especially when a finger or hand is concorned. The obvious reason for this is that you wish to prevent the infection being spread freely into the surround ing tissues and remain localised into a single focus. You have also been advised to raise the part and to supoprt it in a sling, since by so doing the return of blood from the tissues through the veins is facilitated, and congestion and stagnation of the flow prevented. An exactly sim ilar process of abscess formation can take place in almost any part of the body. It is quite common for staphylococci to gain access to the bones of children, which, during the stage of growth, are especially vulnerable to such infections. W hen this occurs, death of the bone ensues, abscesses form in and around it, and, if not rapidly dealt with, a fatal termination may easily result. Abscesses may also form in the lungs after pneumonia, in the liver after some tropical diseases, and in the kidneys as the result of infection ascending from the bladder. It must be clearly understood, however, that not all bacteria are what is known as pyogenic, or abscess forming. Those, for instance, which cause Sm all Pox, Scarlet Fever, Measles, Influenza, Diphtheria, Tetanus, etc., produce their chief symptoms by the liberation of their toxins into the body as a whole, thereby g ivin g rise to the constitutional disturbances of the disease, such as various skin rashes, fever, delirium , paralysis, and even death. Abscesses, it is true, occur in various parts of the body in the course of any of these illnesses, but it is the constitutional disturbances which are predominant. Tetanus, or lockjaw , provides one of the best examples of profound general poisoning resulting from a sm all local infection. As I have told you, the bacillus of tetanus can exist in the soil for very long periods in the form of spores, which are high ly resistant to drying, to heat, and even to strong antiseptics. W hen introduced into a wound, such as that of a battle casualty, the spores develope into bacteria and multiply, but they do not themselves spread beyond the wound itself, where they rem ain producing their high ly virulent and in tensely powerful toxin. T h is toxin exerts its poisonous effects directly upon the brain itself, so increasing its excita bility that the muscles of the body are thrown into violent convulsions and death results from exhaustion. O w ing to the extremely rapid production of this toxin, the body defences have little or no time to develop their own antidote, or to destroy the bacteria before death occurs. It is in such cases particularly that modern science, by the discovery of methods to assist the natural defences of the body, has done so much both to prevent disease and even to save life after it has actually commenced.

(To be continued.) S .A .A .A .— A centre is being established in Cart Street, Clydebank, by the local section of St. Andrew ’s Ambulance Corps with a garage and ambulance. T h e corps has been guaranteed by Mr. Joseph Leonard, who took an active part on the committee which arranged the recent boxing show in aid of the b uilding fund. There is sufficient capital free of interest to enable them to place the order for the ambulance now, repayment to be made when public subscriptions are forthcoming.

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J o h n A m b u la n c e

HEADQUARTERS

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B r ig a d e

D IST R IC T

R EPO RTS.

N o . I (P rince o f W ales’s) D istrict No 67c ( M i l d m a y ) D i v i s i o n . — A very pleasant after noon was held at the headquarters of the above Cadet D ivision on Saturday, December 16th. Those present included D istrict Officer S. H . Collins, Area Cadet Officer Andrews, D r. M. N. Oster, D /Supt. E. Davidson of the parent D iv i sion and Cadet Officer B. L. Sclare. An inspection of the cadets was taken by Dist. Officer S. H . Collins and D /Supt. E. Davidson. At the tea party speeches were made by Dr. Oster, Dist. Officer Collins and D /Supt. Davidson. Presentations were made to Cadet Officer B. L. Sclare in charge of the Cadet D ivision, Hon. Secretary H . J. Glover, Cadet Sergt. R. D. Long and student member A. H yam s for the w ork they had done d u rin g the year. D/Supt. Davidson thanked his Cadet Officers, N .C .O .’s and all concerned, for the splendid way they had put their backs to the wheel in m aking this occasion a great success. T h an k s were also made to Corporal E. Cotton for the way he assisted.

County o f Berkshire. R e a d in g T o w n “ A .” — The above Am bulance D ivision held the annual competition for the Dr. Hartnett challenge cup on December 4th. Competitors entered in pairs and some good w ork was seen. The w inning pair was Cadet Officer A. F. C larke and Pte. R . Collins.

R e a d in g E a s t . — T h is N ursin g D ivision held a competi tion on December 4th, for the cup presented by the County Supt. who was herself present. It was an In d ivid u al Test and the cup was won by Cpl. F. M. Lutkin.

W in d s o r N u r s in g D i v i s i o n . — On December 11th, the members competed for a silver cup presented by Mr. Ashley Wood for general efficiency. M iss A. C. Stickland was the w inner by two m arks. T h is cup is to be competed for annually by the nurses.

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C o r p s . — On December Sth, at the Am bulance H a ll, a lecture was given to about seventy Am bulance and N ursin g Cadets by Div. Surgeon C. A. Boucher. The speaker described a road accident in cluding the correct method of approach, exam ination and treatment of the patient to be followed by cadets. R e a d in g

R e a d in g T o w n “ A .” — On December 18th, at the Am bulance H a ll, a first aid competition was held between five teams of this Am bulance Cadet D ivision. The competition was for a cup presented by Sister V. M. Crofts. No. 3 team, captained by Cadet Cpl. D. Fow ler, won the cup which w ill be held for twelve months.

R e a d in g W e s t . — On December 9th, at the Ambulance H a ll, the N ursin g Cadets held a sale of toys and fancy goods made by themselves ; this was in aid of cam ping equipment for the Division. T h e sum of £ 4 9 ls . 9d. was taken.

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O n

D ecem ber

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the

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Parish Room, Theale an enrolment ceremony was held, followed by a competition. E ig h t boys and 14 g irls were enrolled. The w inning team in the competition, which was for a shield, was cap tained by Cadet Sergt. M ary Parsons. C o u n ty o f H e rtfo rd . L e t c h w o r t h . — The Am bulance and N ursin g Cadets D ivisions of Letchworth S .J.A .B ., held a Christm as Party at the Co-operative H a ll on December 9th. The party com menced with a ta lk in g film show, followed by M iss Mona T in g e y ’s concert party until 4.30 p.m ., when tea was served to 100 young people by the Co-operative staff. O rganised games were then played until 6 p.m. when the party concluded. Arrangem ents were made by a joint committee com prising Cadet Supts. J. C. Seaton and M rs. M. Curley, Cadet Officers M iss M. Sum sion, VV. Savage and D. Greenshields. Guests included Officers from the County Staff and local Divisions.

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lance D ivision was held at the City Arm s Hotel. In the unavoidable absence of D ivisional Supt. W . Filer, Ambulance Officer S. G. Stead presided. Am ong those present were Mr. T . A. D. Bough, Corps Officers H ay, Smith, Poulter, Jackson and Dearlove, and Mr. G. W . Sherrington, who represented the directors of Y o rk City Football Club. An interesting ceremony took place when the chairm an presented a w arrant of appointment and badge of office to Mr. Bough, who had recently been appointed President of the D ivision. Speeches were made by Mr. B ough,. Mr. Sherrington and Corps Officers H a y and Smith.

L e tte rs to th e E d it o r . We are in no way responsible for the opinions expressed, or the statements made, by Correspondents.— E d i t o r . TREATM EN T OF FRACTURED

C o u n ty o f L a n c a s h ir e . T y i . d e s l e y . — T h e sudden death of Am bulance Officer Lees, has severed a connection with the Tyldesley Ambulance D ivision which commenced on Jan uary 5th, 1911 From the date of his jo in in g he was a loyal and concientious worker, never failing to give of his best in carrying out his duties and g ivin g of his best in time and labour to further the principles as laid down for members of the S .J.A .B . D u rin g the W ar 1914-1918 he served with the R .A . M .C. in France and Belgium ; after demobilisation he returned to the D ivision to carry on the w ork he had left. In April, 1927, he took over the duties of D ivisional Treasurer, which he still held at the time of his death. H e was promoted Am bu lance Officer in December 1931. From 1922 to 1936 he was a member of the R .N .A S .B .R . D u rin g the present w ar he carried out the duties of A cting/Supt., in the absence of the D iv. Supt., on w ar ser vice, a duty he carried out faithfully. H is genial disposition held him in high esteem among his many friends, and his death w ill be a great loss to the Ambulance Movement, especially in and around the Tyldesley and Mosley Common D istricts. D u rin g his career he was awarded the Decoration of H onorary Serving Brother of the Order of St. John of Jerusalem , on J u ly 26th, 1933. H e also held the Brigade Long Service Medal and 3 Bars. W e s t R id in g o f Y o r k s h ir e . H u d d e r s f i e l d . — Mr. C yril Tong, of Grange-avenue, B irkby, has been notified that the K in g has approved his adm ission as a Serving Brother of the Order of St. John of Jerusalem , from November, 1944. C y ril is well known in the Huddersfield District. He was an ardent w orker for the local A .R .P ., and has given instruction in first aid to W ardens, W .V .S ., and other organisations. From 1929-30 he acted as instructor to the Buxton Road Boy’s Brigade, and from 1932-33 was first aid and physical culture instructor at Outlane in connection with the Sunday School. Mr. T o n g was transferred in 1915 to the Huddersfield W a r Hospital, later to the R .A .M .C ., serving in France, Belgium and Italy. H e was in the 69th Field Ambulance, 2 3 rd Division. He has been a member of the B rigade for the past 30 years, and is Corporal in the senior Brigade and assistant secretary. C y ril is also an Officer in the Cadets. York

ity

. — T h e a n n u a l d in n e r of th e Y o r k C ity

Ambu

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LEG.

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It was with great interest that I read in your “ Queries ” column of the November issue of F i r s t A i d ‘ Treatm ent of Fractured L e g ” by B .H . (R .A .F . Camp). lt w ill be of interest to all first aiders to know that a splint capable of fixing a fracture on a bow-legged or knockkneed person without having to use an abnormal amount of padding, w ill be produced in the near future. T h is is the splint about w hich you kindly published an article for me in F i r s t A i d of May, 1942, and the adaptation mentioned above has been found out since that date. I have now a full patent on this appliance and as pro duction and control are likely to become easier in the near future, I have every hope of it soon being put into general use. It has been a great disappointment to me that w ar re strictions prevented me from putting this splint on the market before.— "V^ours faithfully, A .

a in e s

Sgt., Farnborough (H ant9.) D ivision, S .J.A .B , AN A P P R E C IA T IO N . D

e a r

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I would once again like to place on record my own and my D ivisional members appreciation of the valuable help we receive from the answers to the queries sent to D r. Corbet Fletcher, we enjoy them very much. I take my F i r s t A i d to my D ivision and read out the queries submitted, ask my members what they would do, and then I tell them what Dr. Corbet Fletcher says, and that method stamps itself on our minds, and should we be faced with some of the problems sent to N .C .F ., I feel sure that we should remember and follow his advice. I feel you render a great service to the members of the B rigade in publishing these queries and answers. So please carry on with the good w ork. By the way, I am about to commence my 43rd year of B rigade service. Y o urs Faithfully, J . C. C h e s t e r m a n (D iv. Supt.).

Congratulations to County Officer and Treasurer W . T . K n ig h t, O .S t.J., of Bedford, upon the aw ard of the seventh Bar. Mr. K n ig h t is now entering his 52nd year of service in the Brigade, and has been a subscriber to this Journal for 50 years.

F I R S T

Penicillin: Its llses, Medicine and Surgery.* D

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After pointing out that all the chemical antiseptics used in the last war had been more destructive to body cells than to bacteria, and that many of them had also a destructive effect on certain natural defences of the body, S ir Alexander Flem ing said that he had never encountered a chemical which was more anti-bacterial than it was anti-leucocytic until 1928 when he had encountered penicillin. Penicillin is a substance elaborated by a mould in its growth which has a very powerful inhibitory effect on the growth of many of the common bacteria which infect man. P enicillin acts only on certain microbes and has no effect on others. Some ten years later, Florey, Chain, and their colleagues at Oxford succeeded in concentrating penicillin and drying it, so that it remained stable. They showed that it had rem ark ably curative effect in suppurative conditions in man. Then m anufacturers here and in America began to prepare peni cillin. At first the mould was grow n on the surface of the culture medium in bottles, from m ilk bottles to W inchester quarts, but more recently deep cultures have been made in enormous tanks. Even now, the supply is limited, but it w ill not be long before it w ill be available lor all. L

a b o r a t o r y

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In the early days before penicillin was concentrated, a definite unit was not necessary, and a simple dilution factor served to indicate potency, but after it was concentrated this became cumbersome, and a unit was devised. It has come into general use, and has recently been adopted as an inter national unit. As yet, no chemical assay has been devised, so the potency of penicillin has to be estimated by its bacterio static power on a test organism , usually a staphylococcus. P

e n ic il l in

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The aim of treatment is to bring penicillin into contact with the infecting microbe, so that it can act on it and inhibit growth, k ill, or dissolve such microbes. T h is can be done in two ways :— ( 1) Systematic treatment by injecting a solution so that the penicillin enters the blood stream and reaches the infected area via the circulation. T h is is relatively easy, but is expensive in penicillin. (2) Local treatment, penicillin being injected into or applied to the infected area to affect the bacteria locally. T h is is economical in penicillin, but may be very difficult to carry out. Frequently systemic and local treatment are combined. In septic war wounds penicillin has been extensively used. It has a profound effect, but to obtain the best results efficient surgery is necessary. Systemic penicillin has been employed on a large scale as a prophylactic, with results which appa rently am ply justify its use. P enicillin acts only on certain microbes, and to obtain a good result it must be brought into contact with such microbes. There w ill be disappointment if it is used in infections by insensitive microbes or if it is inefficiently applied. O b i t u a r y . — Corporal W alke r H a ig h of the Dearne V alley D ivision (Huddersfield Corps) died on December 29th, after a short illness at the age of 73. H e joined the D ivision in 1915, held the Service Medal and was an enthusiastic member, always bright and cheerful. A great favourite who never grew old, just “ one of the la d s,” he w ill be greatly missed by a ll members.

* Sum m ary of the H arben Lectures, delivered in the Lecture H a ll of the Royal Institute of Public H ealth and Hygiene, 28, Portland Place, London, W .l, on December 11th, 12th, and 13th.

A I D

Your First Case. V e r y soon after passing the 1st first aid exam ination the candidate soon gets the thirst for the first “ case.” H e seems to acquire a kin d of fiendish delight in w atching the carver at w ork on the meat, in fact he is hoping the knife w ill slip and cause that incised wound he has heard so much about; that little children even w ill fall and sustain those beautiful lacerations and contusions he met with in the ex am inations— even his own mother w ill puncture that k n it ting needle in her hand. H e is for ever on the watch in the streets for good-hearted people to stroll under a ’bus for his benefit (and, maybe, for theirs) ! But has he ever thought of what his reactions w ill be when he meets the situation of his “ first case.” A lot w ill depend, of course, on the circum stances attending the case. Maybe that carving knife has slipped and made that nice clean clear cut incision, but it has also completely severed an artery, and he is faced with a beautiful bright flow of blood all over the meat and spurting on to the floor. H is excited brain starts to w ork im m ediately (or should do), and he thinks of a ll the pressure points he knows and, more often than not, fails to think of the one he wants, but he autom atically slaps his hand over the wound, as he would a cut in a hose pipe, w hich really is what is required; that is if if his training has been kept up to date and he is au fa it with current events in first aid. These home accidents are mostly of a nature that can be dealt with by the use of home “ first aid ” kit ; but such incidents as street accidents or enemy action incidents call for action of an entirely dif ferent nature. Street accidents are nearly alw ays accompanied by a crowd and sometimes one or two policemen. The crowd is gathered very close all round the patient, and watch with morbid interest the despairing efforts of the policeman to obtain (1) witnesses and (2) patient’s name and address. The first aider (after sub-consciously crossing his fingers) forces his way through the crowd, which causes such crowd to look upon him as an iutruder, and they straight away dislike him. T h is is ju st the opposite attitude he desires, because in a minute he w ill be a sk in g one of them for his or her overcoat to cover his patient with. (T h is sometimes has been know n to disperse a crow d.) H e w ill also need to send one for an am bulance and another for some water. T h is means that three of them at least w ill miss seeing something happen. But when he discloses the fact that he is a first aider, then he w ill be impressed with the generosity of the crow d by their offers of anything ra n g in g from at least a pint of brandy, or sal volatile, to super strong sm elling salts made up ot neat ammonia. The patient is in a rotten state, too. H e is ly in g in the road, the subject of much interest to the crowd, and of mixed feelings to the driver of the ’bus. Of importance, he is in a shocked condition, w'hich minute by minute ls increasing. Apart from attention to bleeding and in ju riss, he needs prompt anti-shock treatment. M ake good use of that over coat you can borrow, and then console your patient bv speech. Speak to him as you would like to be spoken to if you were in such a predicament. Do not adapt that super confident manner of a silent m echanical being, who says not a word but w orks w ith a strict method that resembles the robot. E q u ally as bad is the boisterous slap-dab comedian type who w orks with much noise and fuss, and really frightens his patient. There is nothing more irritatin g to the patient than to be stepped over. Y ou may even fail to step over him but w ill step on him, or catch your toe in his dress. As to those sm elling salts— beware— do please test them first. If they are too strong, then you w ill find your patient unconscious, and the interval w hile you aw ait his return to life w ill be the longest in yours ! Refuse that brandy (at least as far as your patient is concerned).

F I R S T

R eturn in g to the consoling question. Above all, don’t tell your patient that his injuries amount to nothing ; if you do, then your patient has no further doubt that you are a fool. H e knows all about his wounds and also they may leave a nasty scar, and your best way out of it is to agree with him and sym pathise; but you can mention that they w ill make a nice clean healing, etc. Consolation can be dealt with by your action, too. Often the handbag of your patient is not in her possession. If your patient is conscious, give it to her to hold. Cover up any portion of the body or underwear that m ay be exposed by torn outer clothing. It is extremely em barrassing for the patient to feel that he or she is m aking an unintended display of such items. In such circum stances, do as much w ork as you can under a coat or blanket. If there is any cutting to be done, make use of seams if possible. Y o u r patient w ill surely dislike an extra seam in his trousers. On arriva l of the am bulance, give the attendant a brief but accurate idea of what the position is, and then apart from any assistance you can give him, you cease to function. Make your exit as soon as possible, and resume your search for other cases. There is a tendency on the part of many first aiders to overdo their work. Y o u are not a d o cto r; you are not even anything approaching a doctor, even though you may have taken a second certificate, so don’t try to resemble one in any way at all, except to practice a bedside (or roadside) m anner. Y o u r duty ends when all first aid is exhausted.— J.

W .

S c o tt.

The Faking of Injuries. W it h reference to the query sent in by J.T . (M arket H a r borough) regarding the fakin g of injuries, we have received the follow ing notes from Mr. W . O. Chapman, L .A .R .P ., M .R .S .T ., C ivil Defence Instructor of Sheffield, which may also be of use to other instructors desirous of using this method of teaching :— M

a t e r ia l s

e q u ir e d

A. M o d e llin g M a teria l. — (a) Putty (coloured with car m ine 2 to give flesh tint) ; fb) Flesh plasticine. B. O ther M aterials. — G rease sticks : Carm ine 2 mixed w ith vaseline (1 pt. carmine, 2 pts. vaseline) ; carm ine 3 ; flesh No. 5 ; black No. 12 ; light blue No. 31 ; dark blue No. 33 ; white powder ; flesh tint powder ( “ Rachael ” ). N

o t e s

o n

e t h o d

(a) L ig h tly grease skin with vaseline, apply m odelling m aterial and build up the injury. Use a m odelling tool (sharpened point at one end and chisel edge at the other) and carve. F ill in torn flesh with carm ine 3 and vaseline, colour sw elling with carm ine 2 and vaseline, slightly blacken edges of wound and apply carm ine 3 to represent blood. (b) T o sim ulate shock, sm ear face with flesh No. S grease stick and apply eye shadows with ligh t blue or dark blue stick. Perspiration, fake with glycerine or castor oil as drops on forehead. (c) Pieces of bone used to fake compound fractures ; use meat bones fixed to the skin with adhesive plaster before applying the m odelling material. (d) Blisters. Use sausage skin, gutta-percha tissue or celophane previously soaked in castor oil, cut to size and fixed to skin with adhesive plaster— the blister filled with yellow or white vaseline according to type required. The follow ing firms supply the necessary materials :— M ax Factor & Co., 39/47, North End, Croydon, Surrey. H en ry C. M iner Ltd., 7, Stanhope-terrace, London, W .2.

A I D

The Regent Chem ists Ltd., 70, V au xh a ll Bridge-road, London, S .W . 1. L. Leichner (London) Ltd., 30/ 32, Acre-lane, S .W .2. R. Hovenden & Sons Ltd., 29/33, Berners-street, W .l. N .B .— Regent Chem ists supply grease paint remover, but not grease paint. (These notes have been taken from “ C ivil Defence T ra in in g Bulletin No. 12.” )

Common Deformities in Children. By A. T. F R IP P ,

m .b .,

f.r .c .s .

(From a Lecture delivered at the Royal Institute of Public Health and Hygiene, 28, Portland Place, London, W . l, on Wednesday, October 18th, 1944. M r. W. E. Tanner, M . S . , f . r . c . s . , in the C h air.) M r. F r i p p opened his lecture by pointing out the importance of recognising deformities early and of the general rules of health. H e said that adequate rest was essential, but many factors of life to-day tended to prevent this. W hen discussing postural deformities he observed that knock-knees was a very common condition which tended to disappear and that treatment was by alterations to the shoes and by exercises. H e said that scoliosis and kyphosis were caused chiefly by anxiety and fatigue, and these should be dealt with first— treatment being by remedial exercise. “ Rickets used to be common, but to-day it is rare in England. There are two factors— lack of sunlight and lack of vitam in D, the result being deficiency of calcium in the bones with softening and deform ity.” Tuberculosis of the bones and joints was a disease which ran in fam ilies, and bad surroundings and bad food pre disposed to it. No age and no part of the body were immune from attack. The spine, knee, hip and foot were most com monly affected, and most cases were caused by sw allow ing the tubercle bacillus. M ilk was most often to blame. The onset of disease was marked by pain and deformity, and early diagnosis and treatment were essential in order to prevent severe destruction of bone and reduce the final deformity. The aim of treatment was to improve the general health, to provide rest to the diseased part, and to immobilise the joint so that deformity was reduced to a minim um . The treatment of paralysis (spactic or flaccid) was firstly preventive so that deformities did not occur. Later, splints m ight be necessary to support weakened joints, or operations m ight be performed to correct deformities or to strengthen the joints.

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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 t s Queries w ill be dealt w ith under the follow ing rules :— 1.— Letters containing Queries must be m arked on the top left-hand corner of the envelope “ Q uery,” and addressed to F i r s t Aid, 46, Cannon-street, London, E .C .4. 2.— A ll Queries must be written on one side of paper only. 3.— A ll Q ueries 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. — T h e Textbook to which reference m ay be made in this column is the 39th ( 1937) Edition of the S .J.A .A . M anual of F irst Aid to the Injured. T ra n sp o rt of F ra ctu re d Th ig h. P.S. (H o u n slo w ).— It appears to me that the right way to remove from the place of accident, a patient suffering from a fractured thigh, is as laid down in the Textbook (pp. 73 to 76) for transport of patient suffering from fractured spine. Some members of our class disagree ; and so I ask for your kind ruling. The method of removal recommended in the Textbook for cases of fractured spine takes an unusual amount of time, requires extra bearers and equipment, and has been evolved because of the grave risk of further in jury to the spinal cord durin g liftin g and transport. Consequently, it is not indica ted for a patient suffering from fractured thigh, who should be removed recumbent on stretcher in the ordinary w ay.— N. C o r b e t F l e t c h e r . E xa m in a tio n H o w ler. M .B . (Cam bridge). — In a recent exam ination the doctor asked one candidate what she would do if she came across a patient suffering from a fracture of both bones of leg and had neither splints nor bandages. He smiled and gently corrected her when she replied “ I w ould im poverish them ! ” G ood! Next, please! !— N .C .F . M e m b e rsh ip of B rig ad e. E .H . (Leicester).— I am a member of the St. John Am bu lance B rigade and I do the norm al duties and parades. Yet I am told that I cannot wear B rigade uniform because I am a little lame. I shall be grateful if you w ill please put me rig ht on this point. As you are a member of the Brigade, we know no reason why you should not be allowed to wear B rigade uniform , certainly not on the grounds that you are a little lam e.— E d ito r .

Contact w ith E le c tric C u rre n t. D .H . (Southbourne). — In your reply to a query which was published under the above heading in the June issue of F i r s t A i d , you referred your correspondent to p. 159 of the Textbook. H a v in g scanned this page I can find nothing that tells us how to deal with hands firm ly adhering to electric wire, presum ing that this does in fact occur. I shall, therefore, be grateful for your further comments on this point. W h ilst the electric current, even at a moderately high voltage, has the effect of contracting the muscles, this con traction is not such that it cannot be overcome by the rescuer and that contact cannot be broken. If, therefore, the

A I D

patient is pulled by means of non-conducting m aterial (such as rubber, dry wood, and dry rope) it w ill be found that he can be released. In other words, the grasp of the hands can be overcome, and as I wrote in my previous reply the instruc tions on p. 159 of the Textbook hold good.— N .C .F . S e rv ice M e d a l of the O rder. J .B . (Stockport).— I joined the Peak D ale D ivision of the St. John Am bulance Brigade in February 1929 ; and I have been efficient each year, up to and including 1944. W ill you please inform me if I am entitled to the Brigade Service Medal ? There is no such aw ard as a Brigade Service Medal. In fact, you are referring to the Service (sometime called Con spicuous Service) Medal which is awarded by the Ven. Order of St. John for “ conspicuous” service in the advancement of its objects of foundation or of those of its several D epart ments. In the case of the Brigade this is regarded as synonymous with efficient service. If, therefore, you have been “ efficient” as defined in B rig a d e Regulations over a period of fifteen years, then you have qualified for this award. Efficiency, however, signifies more than mere length of service (and the Medal is some times and erroneously called Long Service Medal) and covers five points which you w ill find set out in R ule 212 on page 38 of B rigade R eg ulation s. — E d i t o r . P o sitio n fox A rtific ia l R e sp ira tio n . C. W . (C ardiff).— Though I have never had to perform artificial respiration in an actual emergency, I find that in practice it is better to place the patient’s arm s above his head than to place them alongside his body and then to raise them above his head. So will you please tell me if, by using my modification of the Textbook instruc tions, I would lose m arks in exam ination and in competition. To me the method described in the Textbooks is safer (and therefore more commendable) because the patient’s upper lim bs, being alongside his body, are less liable to in ju ry w hilst the operator “ pulls the body sm artly o v e r” (Textbook pp. 144 and 145). Incidentally, you w ill note that, whereas the Textbook and you speak about “ arm s ” 1 prefer the term “ upper limbs ” as more correct. Secondly, you would certainly lose m arks in exam ination (and more still in competition) if you failed to carry out the method laid down in the Textbook.— N .C .F . Schafer or S ilvester. R .T . (M oulton).— In the December issue of F i r s t A i d you reply, under the above heading, to a query about artificial respiration on a young child. In the last para graph of your reply it is stated that the operator should “ apply with gentleness and care.” T h is is rather a difficult measure to appreciate ! I ask if the difficulty could be overcome by applying the pressure on the w alls of the abdomen w hilst in the prone position, by putting a tria n g u lar bandage, belt or scarf under the patient’s abdomen and standing over, by lifting and relaxing the pressure cause the viscera to act on the diaphragm in the same way as Schafer’s method, which it might be considered as in reverse. Y o u r letter provides evidence of careful thought on the problem ; and to this extent you are to be congratulated. In principle, however, the instructions given in the Textbook and in my previous reply should meet all requirements w ith out the added complication of using a tria n g u lar bandage as you suggest. Further, I cannot concede that the m ajority of readers w ill fail to understand the m eaning of Professor Schafer’s words— “ with gentleness and care.” — N .C .F .

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th e

H y g ie n e L is t 91

Students

have gained H o n o u rs, an d in a d d i t i o n numerous S t u d e n t s h a ve gained

Passes.

M e n tio n ‘ F ir s t A i d . ’

C L O U G H ’S

corr. COLLEGE Tem ple Cham bers, London, E.C.4.

T e l. : C E N

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A G EN TS.

F I R S T

F ra c tu re s of C la v ic le and H um e rus. E. M. (L o u g h g all, Co. Arm agh). — Please tell me the correct treatment of a patient suffering from simple fractures of clavicle and hum erus (close to shoulder), the injuries being on same side of the body. Y o u h a v e p r o b a b ly r e a d e r e t h is , t h e r e p l y w h i c h I g a v e u n d e r t h e a b o v e h e a d i n g in t h e D e c e m b e r is s u e o f F i r s t A in , w i t h r e f e r e n c e t o t h e t r e a t m e n t o f s im p le f r a c t u r e s o f c l a v i c l e a n d o f h u m e r u s in m i d d le o f s h a f t . T h e sa m e reason s o p e r a t e if t h e f r a c t u r e o f h u m e r u s w e r e c lo s e t o t h e s h o u ld e r .

In other words, I would flex the lim b at rig ht angles and then control the fractured hum erus with a broad bandage applied as laid down on p. 82 of the Textbook. T h is done, I would then apply a second broad bandage round the lower end of the hum erus in such manner that it gave support to the forearm, since the fractured clavicle contra indicates the use of a sm all arm sling. In no circum stances would I place a pad in a x illa lest by so doing 1 displaced the fractured humerus. — N .C .F . H u m o u r in F irs t A id. E. F. (W alw orth). — He was an ambitious youngster ; and so he joined the first aid, and the music class. The exam inations tell on the same evening. H e rushed from the m usic room just in time to take his place in the first aid exam ination. H e replied satis factorily to one or two questions ; and then the exam iner asked him for a brief description of the heart. T h is is what he said :— “ T he heart is a com ical organ, p la ced upon a stair o f fiv e lines, situated in the chest, between the lun gs and im m ediately above the p icture frame. I t beats time ju s t below the left nipple ! ”

Good !

A I D

ru lin g with much interest ; and we ask you to tell us in what position the foot would be found. The Textbook does not expect first aiders to diagnose exactly the site of a fractured femur. Consequently you should treat all cases of this in ju ry precisely as laid down on p. 88 of the Textbook. W ith a fractured neck of femur and the patient being on his back, the lim b would in all probability be found with the foot lyin g on its outer side.— N .C .F . T reatm ent of In fa n tile C o n v u lsio n s. M .N. (F in ch le y ).— The Textbook on p. 162 tells us that a child suffering from infantile convulsions is to be placed and supported in a hot bath “ up to the neck.” Please tell me why the child must be supported and also the best means of carrying out these instructions. The child is to be supported in the bath because he/she, being in a state of convulsion, m ight easily become totally submerged and so more or less asphyxiated. It is, therefore, easier and safer to support the child with one’s hands in the arm pits than round the body, especially when the body and hands are rendered slippery by contact with water. W hile this is being done it is the job of an assistant to “ keep a sponge frequently dipped in eold water on the top of the head."— N .C .F .

“ F IR S T A ID ” and R E P L I E S C O U P O N .

QUERY

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 i e s .

J a n ., 1945.

Next, please ! !— N .C .F .

B rig a d e E ffic ie n c y . G .W . (Gorleston). — Recently the question was raised as to what happens if a D ivisional Superintendent fails to take the annual re-exam ination for four or five years. Does he lose his rig ht to the Lo n g Service Medal and his position as Superintendent of the D ivision ? Y o ur reply w ill be appreciated. F a ilu re to take (and pass) the annual re-examination on the part of an officer or member of a D ivision involves loss of efficiency for the year. Consequently, in the unlikely circum stances named by you, any officer or member would delay his elig ib ility for the Service Medal of the Order (which you incorrectly call “ Long Service ” )b y the number of years in which he fails to pass the re-exam ination ; and further he exposes him self to the risk of losing his B rigade membership, if for any reason he is marked non-efficient for three consecu tive years. — E d it o r . 99

44'

E la s to p la s t

A ctio n at B rig a d e R o ll-C a ll. W .R . (F lix to n ).— W ill you k in dly inform me what is the correct form of address/reply when answ ering to a St. John Am bulance B rigade ro ll-call taken by a N .C .O . with an Officer present ? In the circum stances named by you the response is addressed to the individual who calls the R o ll and is not affected by the presence of an Officer.— E d it o r .

a n d

d r e s s in g s

e c o n o m y

M odem Surgical practice favours an undisturbed dressing and for this purpose “ Elastoplast ” is used extensively in hospitals. It stays in place, protecting the wound while permitting uninterrupted healing. “ Elastoplast ” Bandages and Plasters com bine efficiency w ith economy in material and time. U se them w ith confidence for all m inor injuries. Made in England by T. J. Smith & Nephew Ltd., Hull.

F ra c tu re d N e ck of F e m u r. P. S. (C ard iff).— W e shall be obliged if you w ill settle a friendly disagreement by telling us how we should treat a patient suffering from a fracture of the neck of the femur. Some of my friends say that it should be treated as for a fracture of the pelvis. W e await your kind I

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LEG TRO U BLES T ry G erm olene y o u rse lf— and you w ill be convinced IN F L A M M A T IO N o f its pow er to soothe and RASH ES, SPO TS relieve skin com plaints. U nder the healing hand B U R N S, G U TS o f G erm olene m any skin afflictions vanish in a few days — or even hours. But G erm olene’s m ost w onderful victories are recorded in letters like the fo llo w in g : ‘ R E SU LT S H AVE B E E N W O N D ER FU L’ “ I have been troubled with bad legs for years . . . I applied Germolene three and sometimes four times a day. The results have been wonderful. I am sure it was only Germolene that got me on my feet again. No praise is too high for your wonderful ointment; it is worth more than I can say about it. You may publish this letter as you wish.” (Signed) C. A . B. (Mrs.), Shifnal, Salop.

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physiological excipient non injurious to the mucosa.

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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 8 th of each month, and must be accompanied ( not necessarily for publication) by the name and address of the Correspondent. Subscriptions, Advertisements and other business Communications connected with F IR S T A ID should be forwarded to the Publishers. D A LE, REYN OLDS & 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 Address— “ Twenty-four, London." Telophone— City 3710.

CO N TEN TS

TH IS

N U M B ER.

d it o r ia l —

The Motor Ambulance

Lectures Delivered to Advanced Casualty Service Personnel in the 6th Y ear of W ar

Reviews

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

Y o u r F irst Fracture

Priory for W ales Letters to the Editor

...

Great W estern R ailw ay Q

u e r ie s

and

n sw ers

90 to

o r ren spo d en ts

Eversion of Eyelids Exam ination H ow ler Treatm ent of Fractured Patella T im e Factor in Poisoning ... Compound Fracture of Low er Lim b H um o ur in F irst Aid Contact with Electric Current Concealed H a m o rrh a g e Action of Tea with B urns ... Pupils in Hypnotic Poisoning B rigade Efficiency... F racture of Shoulder Bone ... A F irst Aider’s Dilem m a

:—

94 94 94 94 94 94 94

96 96 96 96 96 96

I n th ese d a y s, w h en th o u sa n d s u p on th o u sa n d s of u n fo rtu n a tes are k illed or m aim ed a n n u a lly upon the roads, th e m otor a m b u la n ce p la y s a h ig h ly im p o rta n t part. N o t the le a st o f th e b en efits th at its in tro d u ctio n h as b r o u g h t a b o u t is the sp eed w ith w h ich p a tien ts can be rem oved to h o sp ita l, a lth o u g h it m u st be a g r eed as a se t-o ff a g a in s t th is th at w ere it n ot for th is v ery factor th ere w o u ld rem ain but c o m p a r a tiv e ly sm a ll need for it. T h e m ile a g e cov ered in th is co u n try by th ese v e h ic le s m u st run into m illio n s. T h e fig u r e s, h o w e v er , su p p lie d b y the B ritish R e d C ross for th e g r o u p o f 1,200 a m b u la n ce s under th eir co n tro l, g iv e so m e in d ic a tio n . S in c e 1940 , the O r g a n is a tio n ’s a m b u la n c e s h a v e carried ab o u t m illio n p a tien ts and h a v e travelled nearly 13 m illio n m ile s. S ix h u n d red o f th e a m b u la n ces are attach ed to th e A r m y , the b alan ce o p e r a tin g w ith th e O r g a n is a tio n ’s C o u n ty C om m ittees, h o sp ita ls and c o n v a le sc e n t h o m e s. A v ery in te r e stin g featu re o f th e se r v ic e is the m e e t in g of airb orn e c a su a ltie s at sev era l a irfield s, and the im p o rta n ce in th ese d a y s a tta c h a b le to th is p h a se of th e w ork can sc a r c e ly be o v er -estim a ted , and it m u st be added th at m an y o f th e O r g a n isa tio n ’s v e h ic le s are o p e r a tin g in N .W . E u ro p e, S .E . E u ro p e and In d ia, w h ile further v e h ic le s are b e in g prepared for th o se areas. F ig u r e s o f a sim ila r nature are b e in g su p p lie d by th e B ritish W a r R e lie f S o c ie ty , w h ic h o p era tes 300 a m b u la n c e s. U p to th e end o f la st y ea r, and s in c e the in cep tio n o f th e sc h e m e in 1940 , th ese v e h ic le s h ave covered 13 £ m illio n m iles and h a v e tra n s ported 679,876 p a tien ts. T h e re is no in v e n tio n of m odern d a y s th at h as received so m uch o b lo q u y as h a s been h eap ed u p on th e h ead o f th e in tern al co m b u stio n e n g in e . It w a s o n e th a t m ig h t h a v e conferred o n ly ben efit u p on h u m a n ity . S c ie n c e did not in v e n t it as an im p le m e n t of a g g r e s s io n , and for m a n y y ea rs it p a ssed a c o m p a ra tiv e ly h a rm less e x iste n c e , b en eficia l in m a n y o f its a sp e c ts. B u t m an h a s a h a b it o f p la c in g su ch th in g s to th e b a sest o f u se s, and the road h o lo c a u st is o n e of th em . O f its u se in w arfare it is u n

T h e M o to r A m b u la n c e .

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n e c e ssa r y to sp e a k . W h e n th e u n iv e r sa l m ad n e ss w h ic h n ow p erv a d es th e w orld has been rep laced b y re a so n , th e in tern al co m b u stio n e n g in e m a y c o m e in to le g itim a te u se , and ev en the road h o g m ay reform . V a tic in a tio n is im p o ssib le , h o w e v e r , and w e m u st rest c o n te n t th at its a p p li ca tio n to a m b u la n c e w ork fills the m o st u sefu l and b en e fic e n t o f p u r p o se s.

Lectures Delivered to Advanced Casualty Service Personnel in the 6th Year of W ar. By S IR H E N R Y L. M A R T Y N , K .C .V .O ., F .R .C .S . ( C ontinued from page 7 5 )

I n our last talk we discussed the m achinery which existed in nature lo r overcom ing and destroying bacteria which have invaded the body and the toxins which they produce. Let us now consider how modern science has developed methods by which these defences can be assisted and strengthened. W ere it not for advances in this particular field of work w hich have been made by medicine and surgery, civilisa tion could hardly exist in its present form, our over-crowded cities w ould be decimated by disease and the mortality am ong the sick and wounded in w ar would be infinitely greater than it is at present. I wonder how m any of you have considered why it is that we so seldom hear of an individual suffering from two attacks of certain diseases; Scarlet Fever, Diphtheria, Sm all Pox, Typhoid, etc., seldom occur twice in the life time of one patient. There are exceptions it is true, but, as a general rule, a single attack protects against subsequent infections. T h is is due to the development in the body of what is know n as Active Im m unity. By this we mean that, d u r in g the first attack, the bacteria of the particular disease have so stim ulated the body to produce large quantities of anti-toxins that sufficient rem ain in the blood to provide permanent protection against subsequent infection by that particular organism for the rest of that in d ivid u al’s natural life. Very m any years ago science first discovered that this state of active im m unity could be produced artificially. In the days when sm all pox was a constant scourge in this country, it had long been held that an attack of Cow Pox protected an in dividual from subsequently contracting Sm all Pox. In 1774 a Dorsetshire farmer, named Jesty, made the first essay towards the production of active im m unity by successfully vaccinating his wife and two sons with the lymph from the pustules of Cow Pox, from an attack of which he him self had just suffered. B y 1780 the idea of protective inoculation had become firm ly impressed upon the mind of the great Jenner. In 1796 an opportunity occurred to test his theories, and he took matter from the hand of a dairy maid, Sarah Nelmes, who had cow pox, and inoculated it into a boy, named Jam es Phipps. Now came the final proof, on J u ly 1st he inserted active, virulent matter from a case of sm all pox into the boy, but no attack of sm all pox followed, and from that moment

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the eventual defeat of the scourge of ages became certain. Further experiments were made in Am erica, using larger numbers of cases w ith m any controls, all of them only served to confirm the accuracy of Jenner’s w ork and the pro tective power of active im m unity conferred by vaccination was finally solved. Nowadays, the calf lymph used is prepared under Government control in ideal conditions, and vaccination is, of course, compulsory. Unfortuately, the obligation can easily be evaded by pleading conscientious objections or m edical reasons. The danger of this course is well illu s trated by an epidemic w hich occurred in Montreal in 1885. A considerable unprotected population had grown up in the city ow ing to the ignorance and prejudice of many of the people. On February 28th, 1885, a Pullm an car con ductor came from Chicago and was admitted to the Montreal H ospital suffering from sm all pox. The disease spread like w ild fire, and in all 3,165 people died as a result of their own foolishness. A sim ilar method of developing artificial active im m u nity was discovered by Pasteur in 1885 for the cure of that terrible disease, Hydrophobia, which resulted from the bite of a mad dog. Rabies am ong dogs was, at that time, very common in England, and still is in the East. A man bitten by an anim al suffering from the disease developed, some 6 to 8 weeks later, a most agonising and terrible condition, from which death was a m erciful release. Pasteur discovered that if the spinal cords of anim als which had died from rabies were hung in sterile ja rs and allowed to dry for varying periods, the virulence of infectivity of such cords was reduced in proportion to the length of time for which they were dried. Treatm ent consisted in the daily injection into the patient of a portion of the dried cord mashed up in broth, starting with the cord which had been dried for the longest time, and therefore contained the least virulent toxin, and reaching eventually that w hich had been dried for only one day. By this means the virulence of the dose was progres sively increased until a sufficient degree of active im m unity had been developed for the patient to overcome the infection itself. The inoculation of the serving soldier hoth against typhoid and many other diseases, such as typhus and plague, has now become a common place fact. Few people, how ever, have probably realised that this is only another way by which science has learned how to assist the protective mechanism of the body by g ivin g the individual active im m unity against the diseases in question. In civil life we use sim ilar methods by the adm inistration of vaccines to protect against the common cold, influenza, boils and many other infections. W hat is a vaccine and how is it prepared ? The production of a vaccine is, I alw ays think, one of the most am azing pieces of technique ever evolved in the scientific laboratory. The bacteria, such as those of typhod, are first grown on a suitable medium in a culture tube. They are then killed by heat and mixed w ith normal saline solution until a uniform emulsion of dead bacteria results. They are then counted— literally counted !— on specially made microscope slides, w hich are m arked into squares cut into the glass, but so minute that they are visible only under the highest power of a microscope. The bacteria lyin g on a num ber of squares are counted and the average, found perhaps to be 7 or 8, is worked out. The total num ber of organism s per cubic centimetre of the emulsion can then be estimated and the dose, the actual num ber of dead bacteria to be injected into the individual, finally determined. Several different kinds of bacteria may be combined in the same dose in varying proportions. A typical vaccine against typhoid alone m ay contain 1,000 m illion bacteria per cubic centi metre, three injections, at intervals of a week or ten days, of £ and 1 c.c., being given successively. A mixed vac

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cine against influenza may contain 400 m illion influenza bacilli, 200 m illion pneumococci and 80 m illion streptococci, sim ilarly progressively increasing doses being employed. T h in k of the technical m iracle which is achieved in accu rately counting and m ixin g such prescriptions ! The result of the injection of these dead bacteria is the creation of a sm all local reaction, perhaps some redness and sw elling at the site of inoculation, together with mild general symptoms such as slight headache and fever. W hen these have passed off, the patient has acquired active im m unity against the particular bacteria injected and can resist infection with the livin g organism s. T h u s far I have spoken only of active im m unity, but there is another method by which the natural defences of the body may be helped, namely, by the development of what is known as passive im m unity. T h is consists in, first of all, rendering an anim al, such as a horse, actively immune against a disease, for exam ple— tetanus, by injecting it with progressively increasing doses of the toxin in the same way as I have already described. The anim al is then bled and the serum, which now contains large quantities of anti-toxin, is injected into the man, thereby providing him with passive im m unity against tetanus. A sim ilar method is used in the production of anti-diphtheritic serum, a product which has saved the lives of many thousands of children. Anti-tetanic serum is used, as you know, in every case of wounding in war, whether it be in battle or in an air raid. The protection is produced immediately the serum is injected, unlike that provided in active im m unity, which takes some days to develop. H ad it not been for this dis covery, the m ortality from the dreaded lockjaw d u rin g this w ar would have been enormous. Anti-vivisectionists who would oppose the use of anim als in any form for such w ork are faced with a difficult position when called upon to decide whether to allow the use of serum to save the lives of their children or prefer themselves to ris k death from tetanus rather than agree to receive an injection of anti-tetanic serum. Experience suggests that they are seldom so enthusi astic when the lives of themselves or their loved ones are actually at stake. ( T o b e c o n c lu d e d .')

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S t . J o h n A m b u la n c e HEADQUARTERS

AND

B r ig a d e

D IST R IC T R E P O R T S .

N o . I (P rince o f W ales’s) D istrict C 49 W a n d s w o r t h a n d S o u t h f i e l d s . — On Saturday, F eb ruary 3rd, the above Cadets, joined by the N u rsin g Cadets, held their annual party at Benham & Sons W o rks Canteen, G arratt Lane, S .W .18. Given by the Cadet D iv i sional Hon. Vice President, Jack Benham, E sq., M .B .E ., B .Sc. ; M iss Benham and Mr. W . L. C larke, M . B E , and Mrs. C larke were also present, Mr. C larke ably fu lfillin g the roll of M .C. The party commenced w ith a very fine tea, being followed by all sorts of gam es and competitions for which prizes were given. M r. J. Benham then presented the “ Ja ck Benham M erit Cup ” to Corporal R . Buss for the best all round cadet of the year, also the annual individual F irst Aid Competition Cup to Cadet C. Barnett. After this the company were wafted to the realm s of mystery and m agic by Mr. Norm an Conquest. Then came more refreshments, everyone was happy and full of good things almost to bursting point. The cadets gave a very hearty vote of thanks, called for by D ivisional Supt. F. T . Browrt in appreciation for all the w ork and expense borne by Mr. J. Benham , and M iss Ben ham and M r. and M rs. W . L. C larke in organ isin g and carrying out such a very successful party.

County o f Berkshire. R e a d i n g C o r p s . — On Jan uary 10th at the Am bulance H a ll, Chatham Street, a social and dance was given to the R eading Corps by Mr. Prew and his Committee. Members were entertained by Mrs. H a rb o u r’s Concert Party which was followed by refreshments, gam es and dancing.

R e a d in g T o w n “ A ” .— On Jan u ary 15th at the Am bu lance H a ll, the Am bulance D ivision held its annual presenta tion of aw ards and social. The County Com m issioner Mr. C. A. Poole presented the aw ards w hich included vouchers, medallions and labels. H e also presented the D r. Hartnett Challenge Cup to Cadet Officer A. F. C lark e and Pte. Collins, the w inners of the recent competition.

R e v ie w s . By J. W ilson Reid, M .D ., B.Sc. Liverpool and London : Charles B irch a ll and Sons, Ltd. P rice 2s. net. T h is excellent little booklet has been designed to meet the needs of cadets training for service at sea, and also to meet the needs of junior officers in the M erchant Navy. By reason of the exigencies of their service, the requirem ents of cadets and ju n io r officers are somewhat different from the requirements of those who have to deal with sim ilar emerg encies ashore, where it is generally possible to obtain medi cal aid reasonably quickly. The section on Schafer’s method of artificial respiration has been taken, with permission, from the handbook of the Royal Life S aving Society, w hile the section on E ve ’s method has been approved by D r. Eve. The book is written clearly and concisely, and it w ill prove invaluable to those for whose benefit it has. been compiled. Em ergency Treatm ent of In ju re d and S ick at Sea.

Publishers N o te .— W ill readers please note that all back

num bers of “ F irst A id ” are now out of p rin t and cannot be supplied. W ill South A frican and o ther C o lo n ial readers please add to th e ir rem ittances, “ o r English equivalent,”

R e a d in g T o w n “ B .” — On Jan uary 8th, at the A m bu lance H a ll, the members of R ead ing Tow n “ B ” Am bulance D ivision held their annual presentation of aw ards and social. The C h air was taken by the County Com m issioner. Hom e N u rsin g Certificates, M edallions and Labels were presented.

R e a d i n g E a s t . — On Jan u ary 18th, at G reyfriars Schools, members of the N u rsin g D ivision and G reyfriars Gas Cleans in g Station held a “ L u c k y D ip ” party in honour of the Victory Players who produced the play ‘ ‘ L u c k y D ip ” in November last in aid of D ivisio n al funds. The County Com m issioner thanked the V icto ry Players for helping the D ivision to raise the m agnificent sum of ,£ 4 8 14s. The Com m issioner presented a medallion to Amb. Sister M. O akley who is shortly leaving this country for the U .S . A.

C ounty o f Bristol. T o t t e r d o w n . — At a social evening held on Jan u ary 12th in honour of Div. Supt. G. H . Tribble, who was recently promoted to S erving Brother of the O rder of St. John of Jerusalem , after 34 years service in this D ivision, the Assistant County Com m issioner G. J. Creech, presented him on behalf

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of the members of his D ivision, with a pair of book ends and an ash tray (suitably inscribed) of stone from the blitzed H ouses of Parliam ent. The C h air was taken by D iv. Surgeon J. V . Lucas. Later in the evening County Officer M iss M. Sarah made him a presentation on behalf of K no w lean d D istrict N ursing D ivision. An enjoyable entertainment was given during the course of the evening. B r i s t o l E a s t . — On T h ursday, Jan uary 25th, an a ll sound exhibition of some very interesting films was given at the B ristol East Centre by the D iv. Surgeon, D r. A, J. Struthers, for the benefit of the Ambulance, N ursin g and Cadet sections of the Bristol East Division. Those present included D iv. Surgeon D r. A. J. Struthers, Supt. E. J. Notton, Lady Amb. Officer Mrs. Brow n, Cadet Supt. G. M ountain and Cadet Lady Amb. Officer M iss A. E. G. Sanders, as well as a good audience from the various sections of the D ivision, m akin g a total of at least a 100 ; also present for a short while was Mr. H a rris from the B ristol Education Committee. The film s shown were chosen because of their especial interest to the am bulance and n ursing movements, and were as follows :— K n ig h ts of St. John ; M an W ounded ; F irst Aid on the Spot ; Blood Transfusion ; Nurse ; Of One Blood ; Red Cross in Action. The show ing of these lasted for over hours and were thoroughly appreciated by all present.

F i s h p o n d s . — The “ Jefferies C u p ” presented by Corps Officer H . T . Jefferies, was competed for on Jan uary 26th, for the second time and proved to be a most interesting feature. Supt. W . Hobbs, B .E . M ., of Butlers D ivision was the adjudicator and he spoke high ly of the standard of efficiency shown by the competing members. The winner, A. T . W otton, was closely followed by J. Moss, last year’s winner, and F. Blake, who ju st failed by a narrow m argin, to beat him. D iv. Surgeon Dr. Brassington, presenting the cup to the w inner expressed how much was owed to the great w ork and service of Corps Officer Jefferies, in stim ulating and encouraging the extension of good first aid, and it was with that idea that he had given them the opportunity of competing annually for this handsome cup which the D ivision have proudly named the “ Jefferies C u p .” Another excellent addition is the “ H istory of T h e Order ” also presented to the winner, and again given by the generosity of Corps Officer Jefferies. Fishponds D ivision is proud of its past achievements, and the years of devoted service given by those stalw arts Corps Officer Jefferies and Supt. E. Edbrooke, w ill be a last ing rem inder to those who follow on.

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A Cadet F la g was then presented to the Ambulance Cadets, followed by demonstrations by the Am bulance, N urs in g and Cadet D ivisions. T h e County Surgeon then pre sented the Service Medal (15 years) to Sgt. G. Gaines ; the 1st B ar (20 years) to D iv. Supt. L . Clifford and Cadet Supt. W . T . Robinson ; and 4th B a r (35 years) to Corps Supt. J. VV. Clifford. D r. C. A. Lupton was presented with his w arrant and badge as Hon. President of the Am bulance D ivision The final presentation was a handbag to Mrs. Sheldon on behalf of the N u rsin g D ivision, for her w ork with them as N u rsin g Officer. A very pleasant social followed. H e d g e E n d . — A presentation meeting and social was held in the B ritish Legion H a ll at Hedge End, when the officers present were Dr. O. T . J. C. de H . Clayre (County Com m issioner), D r. T . P. Lalonde (Assistant County Com.), Dr. B igby (County Surgeon), Mr. H . S. A. Thom as (County Officer), and M iss Tutt (Corps Supt.). The President of the H edge End Ambulance D ivision, Mr. A. A. Ratcliffe, J .P ., was presented with his w arrant and the County Com m issioner expressed the hope that Mr. Ratcliffe’s association with the D ivision would be a long and happy one. In a suitable reply the President mentioned that he received his first certificate in 1886. The County Com m issioner presented the awards and w arrants to the successful candidates in the recent re exam inations in first aid, home nursing, and in the N .C .O .’s class. A very jolly social evening followed the presentations.

County o f Hertford. W a r e . — The annual meeting of W are D ivision was held on Jan uary 16th, D r. W . G. Stewart, D ivision al Surgeon, presiding, supported by County Officer T. C. Forbes and Supt. T . H. Burgess ; 26 members were present. The financial statement presented by Supt. Burgess was considered satisfactory. Ambulance Officer F. Woodhouse reported that the D ivision had increased its membership by seven, and that 16 members were now serving in H . M. Forces. Cadet Supt. H . Beaumont Smith reported good progress by the Cadet D ivision, and stated that eight cadets had been presented with G rand P rio r Badges for passing exam inations in 12 different subjects. The D ivision notes with pride the aw ard of the M ilitary Medal to one of its old members, Sgt. P. Griffin, now serving in Italy as m edical sergeant with D urham L ig h t Infantry. County Officer T . C. Forbes presented to Cpl. F. Blazley and Pte. P. Lawrence, the meritorious award for 20 years and 15 years service, respectively. W arran ts were also pre sented to Am bulance Officer F. W . Woodhouse, Sgt. A. Blake, Cpl. E. N. Long and Cpl. E. H . Andrews.

County o f Leicester. C ounty o f H am p sh ire. — On Saturday evening, Jan uary 27th, there was a good attendance of relations and friends at the Tow n H a ll, Farnborough, to witness the enrolment ceremony and presentation of aw ards of the Am bulance, N ursin g and Cadet Divisions. The Chief Officer for the Northern Area of Ham pshire, Countv Surgeon D r. A. Cockayne, was am ong those present. Fo ur boys and one g irl were enrolled in the Am bulance and N u rsin g Cadets. Aw ards were then presented to the Am bulance Cadets, two of them, Sgt. Upton and Cpl. Culpin, having gained the distinguished aw ard of G rand P rio r’s Cadet Badge. These two were also presented with two sm all cups, given to encourage the cadets to gain the coveted award, F a rn b o ro u g h .

M a r k e t H a r b o r o u g h . — A very pleasant evening was spent in the Am bulance H a ll on Monday, Jan uary 8th, when the members and their friends met to commemorate Mr. C. H . M aycock’s 40 years’ service w ith the D ivision, for 10 years of which he had been their Superintendent. The Chairm an was County Officer T . G. Lowe, and the com panyalso included Am bulance Officers B arlow and Sykes, and the President of the D ivision, Mr. A. W . B rigg s. In the unavoidable absence, through illness, of the D ivisional Surgeon D r. C. T . Scott, Am bulance Officer B arlow presented to Mr. M aycock a gold watch, suitably inscribed, together with a framed roll of the names of a ll the subscribing members, in cluding 28 at present serving with H .M . Forces.

It w as in teresting to learn from Mr. M a y c o c k of the

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progress that had been made during his 40 years in the D ivision.

County o f Surrey. C h e r t s e y . — The annual meeting of this D ivision was held at the F irst Aid Post, Stepgates, on Monday, Jan uary 22nd. Although the financial position was stated to be healthy, some anxiety was expressed as to the strength. In his report D iv. Supt. R. J. G ristock said they would probably have to do something during the year with regard to new headquarters. The ambulance had travelled 5,391 miles, carrying 131 patients. The Services had sent 36 parcels to members in the Forces and had given monetary gifts to members on leave. The Secretary, Sergt. F. Hooks, said the strength of the D ivision was 40, of whom 19 were in the Forces. In the exam ination 12 entered and all passed. Cadet Officer D uke reported that the strength of the Cadets had gone down from 23 to 15, and asked the members to do what they could to get recruits. D u rin g the year 46 d rills were held. In the re-examination 11 passed and one failed.

County o f Sussex. L a n c i n g . — Mr. N. C. Page, of 16, The Drive, W ellan Park, Lancin g, has been a member of the S .J.A .B . for 23 years. On Tuesday, January 23rd, he was rewarded for his efficient services when, at St. M ichael’s Parish Room, he was presented with the Service Medal of the Venerable Order of St. John of Jerusalem . Mr. Page began his long association with ambulance w ork in 1907, when he joined the Post Office Am bulance Association. In 1911 he enrolled in the National Reserve, and from 1914 to 1919 he served with the R .A .M .C . Field Ambulance. It was in 1922 that he transferred to the S .J.A .B . H e has had an unbroken run of service with the movement ever since and has been passed as “ efficient” for each of the 23 years. The presentation was made by Mr. P. Ebbs.

E ast R id in g o f Y orkshire. H u m b e r s i d e C o r p s . — A competition was held at Brough on Saturday, Jan uary 27th. The Judge was D r. J. M. H e r mon, Hessle. In spite of the weather there was a fair attendance of members and friends. S ix teams competed, After a keen and interesting competition, the result was announced by Corps Surgeon Thompson as follows :— 1, W illerby and K irk e lla N ursin g Division, 56 points ; 2, B lackburn A ircraft Am bulance No. 1, 55 ; 3, Swanland Ambulance, 52 ; 4, Brough and D istrict Ambulance, 43 ; 5, South Cave (proposed) N ursin g, 42 ; 6, Brough and D istrict N ursing, 40. The B lackburn Ambulance Cup, competed for annually, was presented to the w in n in g team by Mrs. C. H arrison. In the evening a dance in aid of the Corps funds was held in the V illa g e H a ll. The Corps has a wide range of activities in this district, including extensive training in all the villages round about, an ambulance service which ran over 7,000 miles d urin g 1944, a medical comforts depot, and various other services.

W est R id in g o f Y orkshire. S h a r r o w . — The annual general meeting of the above D ivision was held on Sunday, January 14th, D iv. Supt. C. H. F a ris presiding. The Secretary’s Report showed that out of 44 members, 19 were serving in H .M . Forces. D u rin g the past year, D iv. Surgeon H . Finklestone-Sayliss passed away, his loss was keenly felt by the members. D rills and duties had been

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8' 9

well maintained throughout the year. F o r over four years the D ivision had m aintained an all night stretcher-bearer duty at the Childrens H ospital, involving the need for 21 men (3 men per night). D u rin g the past year the D ivision had been successful in four first aid competitions. The members of the D ivision acted as hosts to 40 wounded soldiers at B rigade Headquarters, when tea followed by a concert, was enjoyed by them. The D iv. Supt. expressed his thanks to all who had helped towards such a successful year’s work. S t a i r f o o t . — On Th ursday evening, Jan u ary 18th, at the Ardsley W .M .C ., Headquarters of this D ivision, the M ayor and Mayoress of Barnsley, Alderm an and Mrs. Jepson, attended a very large assembly to make various presenta tions. After a few well chosen words, the M ayor presented badges of office to the President M r. Geo. Tom linson, and Vice-Presidents M r. J. R ichards, J .P ., and M r. H u g o Wood, M .A .. T h e M ayor then presented the follow ing aw ards to mem bers of the N ursin g D ivision :— 1 M edallion, 3 Hom e N u rs ing Pendants, 6 F irst Aid and Hom e N u rsin g Labels. The President handed to M iss J. B lacker, Secretary of the N ursin g D ivision, a hand bag w hich was given by the ladies in recognition of her services. D r. S lack was form ally presented with a w arrant by the President. D u rin g the evening, pleasing m usical items were rendered, and refreshments served.

Your First Fracture. L a s t month I wrote about your F irst Case and what you should do about it. T h is month I am going to deal with “ Y o u r F irs t F ractu re .” Same place, patient, ’bus and crowd as last month, but your somewhat harrased diagnosis has ascertained that the patient has sustained a fracture of the leg, say, about three inches below the knee. I f you have arrived on the scene before a great deal of sw elling has taken place, then you should be able to notice that tell-tale shiny knob or bump, which is the bone pressing up against the skin. E ither tibia or fibula, or both, may be broken, but it does not m ake a great deal of difference if one or both are broken, except that, if both are broken, usually there is more deformity. If the leg is folded back over on to the patient’s thigh on its front, then it is safe to assum e that both have busted ! M uscle pull and im paction both cause shortening of the lim b, and in days gone by you were expected to grasp the patient’s foot and heave with all your m ight until the leg had been stretched to its norm al length, despite the agonising scream s of the patient, Nowadays, as the “ black book ” says, you only “ draw the lim b ” into position and fix. M anual extension had to be m aintained until that lim b was fixed, and if by chance or accident, or experiment, the pull was released, then the lim b sprang back, maybe into a firmer impaction, broken ends of bones were chipped off, and the patient completely faded out ! T h e fracture had become comminuted, and when the patient recovered— if ever he did — he had a permanent shortening. Extension is applied m echanically by means of that entertainiag instrum ent, the Thom as splint. W hen the intricate mechanism of this splint is revealed to first aiders, they can easily (?) place a lim b in it, and a very satisfactory “ h o ld in g ” is maintained, but extension is applied only under the direction of a Doctor or T . N. I f you find that your patient has a type of break “ where the bone pokes through the s k in ” (to quote many a cand i date at his exam .), then it is of the compound variety.

F I R S T

M any candidates seem to get the idea that that definition is the only one applicable to the compound fracture. Any fracture that is accompanied by a wound and allow s germ laden a ir to reach the seat of the fracture, is know n as be in g “ com pound.” Prompt covering of the wound is essen tial, and may save a lot of time in the healing. Be on your guard against would-be helpers in the crowd who, with every good intention, want to haul your patient on to the pavement. N early always, your “ sim p le ” case w ill become any thing of compound, complicated, impacted, etc., and you have certainly got some trouble then 1 Y o u can make far better use of these people by sending them for things— am bulance, water, blankets, or som ething that will do for a splint, As you know, pain greatly increases shock, and you must relieve such pain as soon as possible by getting the lim b at rest nnd splinted. No matter how keen you may be, you will not be carryin g splints and bondages around w ith you, and you therefore must look around for something to use as a substitute. Again, your friendly crowd comes in useful. Borrow an um brella, handkerchiefs, ties or braces, and you should be able to make quite a nice job of it. W hen tying these bandages, do not je rk the knot, alw ays apply a steady pull. Be sure that the splint or sub stitute is long enough and sufficient bandages are applied, because not only has the lim b to be fixed for transport, but, on arrival at hospital, the resident doctor may be engaged on an important job, and at all times the lim b must be in a fixed but comfortable position until such times as he can be attended to. Reef knots, please ; they are much easier for the nurses to untie. T o find a fracture point, where there is no wound or bump to guide you, merely run the fingers ligh tly along the b in e line until the break can be found, then fix firmly and get patient to hospital as soon as you can .— J. W . S c o t t .

A I D

L e tte rs to th e E d it o r . W e are in no way responsible for the opinions expressed, or the statements made, by Correspondents.— E d i t o r . W ORKS D

e a r

F I R S T A ID

LEAG U E.

,—

Since I last wrote to you, we in Rotherham have formed a W o rks F irst Aid League which is arousing great interest am ong first aiders in the district. The idea is this— each works or colliery enters one team, each team competes against every other team once, neutral judges are appointed and two weeks allowed for each match. The allocation of points is as follows : 3 points for a win, if the losers score 90 per cent, or more of the w inner’s total 1 point is allowed, this is called a near win, 2 points each in case of a tie. The matches have been very close, and this season 4 ties have taken place and several matches have been decided by 1 or 2 points. The League was first tried at our works (Steel, Peech & Tozer, Rotherham ) in 1942, when 8 departments entered, and you would be surprised at the improvement in the efficiency of the class ; 1943 and 1944 first aid re-exam ina tions were 100 per cent, pass— not bad for a class of over 85 persons. In every w orks for miles around, this W o rks League is discussed and people who had let first aid drop years ago, are com ing back and offering their services as judges. I have not heard of any other town doing this, but I shall be only too pleased to encourage anyone interested in first aid, anywhere.— Y ours faithfully, C y r i l T . G r e g o r y , Hon. Sec., Rotherham and D istrict W o rks F irst Aid League.

Priory for Wales. S e ve n S i s t e r s . — The annual meeting of the above D iv i sion, was held on January 16th, at the Ambulance H a ll. The chair was occupied by the Vice-President, Mr. Josiah Jenkins, who was supported by Div. Supt T. G. Bartlett, Amb. Officer J. L. Lew is, Sergeants Allan H a rris and E, C. Thom as and Corps Officer M. G. Thom as, M .E . The T re asu rer’s report was given by the Auditors Messrs. P. T . E vans and J. G Thom as, w hich again revealed a very satisfactory state of affairs. The Secretary then proceeded to give a brief review of the year’s w ork : Seven new senior members were trained and qualified in F irst Aid ; four senior members were trained and qualified in Home N ursin g ; twenty-one senior members q ualified at the annual re-exam ination ; seventeen male cadets tvere trained and qualified in Prelim inary F irst Aid ; five seni or nurses qualified in both Home N ursin g and First Aid, and nine n ursing cadets qualified in Prelim inary Home N u rsin g and F irst Aid. Competition successes were as follows :— Seniors : 1st prize at Y stradgynlais open competition ; 1st and 2nd prize at Brynam m an open competition ; 1st and 2 nd prize at Neath G roup Corps competition ; 3rd prize at M ountain Ash open competition ; 2nd and 3rd prize at Messrs. Evans & Bevan G roup Colliery competition. Th e cadets (male) obtained a 100 per cent, record, namely, 1st prizes at O nllw yn, Seven Sisters, Y stradgynlais, and 1st and 2nd prize at Neath. Nurses : 1st prize at Neath G roup Corps competition. N u rsin g C ad ets: 1st and 3 rd prize at Neath G roup Corps competition. The meeting ended with the Chairm an congratulating the D ivision on its record achievements throughout the year.

Great Western Railway. D u rin g the session 1943-44, members of the staff who passed first aid exam inations under the S .J.A .A ., totalled 5, 517, a decrease of 579. Of this num ber 116 were recruits to the movement. The South W ales D ocks D ivision has again been successful in w inning the Athlone Bow l.. The aw ards granted for exceptionally efficient first aid rendered d urin g the year 1943 were as follows :— Gold medal, 1 ; silver medal, 1 ; bronze medals, 2 ; certificates, 5. A total of 457 gold efficiency aw ards were gained d uring the year, and certificates in lieu thereof were issued. The services of Mr. H . Adams Clarke, Chief Staff and Establishm ent Officer, who is Chairm an of the Central Am bulance Committee and D ivisional Am bulance Secretaries’ Conference, have received further recognition from the S .J.A .A ., and he has been promoted to the Grade of Officer (Brother). M r. H . J. Peacock, Assistant Supt. of the Line, has also been admitted to the O rder in the same Grade, on representations made by the Priory for W ales. The follow ing members of the staff have also received recognition from the O rder for outstanding services to the movement over a long period of years :— Officer (B rother).— Mr. L. G. Bretsch, Swindon. Serving Brothers.— Mr. W . R. Barnes, Newbury ; Mr. F. W ise, K idlington ; Mr. A. C. Shaw, Swindon ; M r. R . T. M orris, Hereford (Joint) ; Mr. B. Board, Cardiff. M iss S. T w ig g , Superintendent Health V isitor for the Borough of Neath has been admitted to the O rder in the Grade of Serving Sister on the recommendation of the G .W .R . Centre.

F I R S T

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r h e u m a t is m . e p id e m ic

w h i c h io d i n e is u s e d a s a n o x i d i z i n g a g e n t .

(w h e n 4 ,7 7 4 p e rs o n s o u t o f e v e r y m illio n

I f y o u w o u ld l i k e t o k n o w m o r e a b o u t

o f th e p o p u la t io n o f E n g la n d a n d W a le s

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Where Ambulances are required to carry four beds two Geors are fitted, one on EITHER SIDE, and the same advantages apply as described above. Full catalogue o f Ambulance Equipment No. 7A w ill be sent on request.

G R E A T P O R T L A N D S t ., LONDON, W.1

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F I R S T

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F I R S T

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 t s Queries w ill 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 uery,” and addressed to F i r s t A i d , 46, Cannon-street, London, E .C .4. 2.— A ll Queries must be written on one side of paper only. 3.— A ll 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 may be made in this column is the 39th (1937) Edition of the S .J.A .A . M anual of F irs t Aid to the Injured.

E v e rs io n o f E y e lid s. P.O . (H o xto n ).— Recently a friend got a b il of grit under his eyelid and asked me to remove it. Unfortunately I could not do so and had to take him to the hospital where the house surgeon did with ease what I had failed to do. I wonder if you can suggest the probable reason for my non-success ; and I thank you in advance. Eversion of the eyelids is rendered easy if, having seated patient on a chair, we can persuade him to keep his eyes directed upwards w hile we are exploring the lower lid and to keep them fixed on the ground w hile we are everting the upper lid,. In other words, the patient must turn his eyes away from the lid which is heing everted. The reasons for your non-success, therefore, were probably that you did not assist your patient to relax by seating him on a chair and that you did not persuade him to keep his eyes turned away from the eyelid w-hich you were trying to exam ine.— N. C o rb e t

F le t c h e r .

E xa m in a tio n H o w ler. M .R . (Cannon S t.).— In a recent exam ination the doctor asked one candidate how he would recognise a case of fracture of the spine in the dorsal region involving the spinal cord. H e was intensely amused when the candidate replied— “ T h e -patient w ould w alk rvith a s lig h t lim p / ” G ood!

Next, please ! !— N .C .F .

T reatm ent of F ra c tu re d P atella. C. W . (South Y a rd le y ).— A debate has arisen in our D ivision re the correct interpretation of the Textbook instructions as to whether, at the commencement of treatment of fractured patella, the injured lim b is to be raised to its permanently treated position, or whether it is only to be raised sufficiently to place the splint into position and when splint and bandages have been applied to raise further and support the foot on a pillow, etc. Y our ru lin g on this point w ill be greatly appreciated. Briefly, it is better to have the leg at the same height from the ground both d urin g treatment and transport. In actual practice the first aider usually supports the injured leg on his own bent knee w hilst he applies splints and bandages ; and he then asks for any article which w ill serve as permanent support for the leg. T h e height of this article may be some what lower than that of the operator’s leg, but this is not m aterial to the issue because the fractured patella has now been controlled by splint and bandages,— N .C .F ,

R I D

T im e F a c to r in P o ison in g. C .R . (G reat Y arm o uth).— I have come somewhat unstuck by your reply which was published under the above heading in the October issue of F i r s t A i d . I have alw ays looked upon ptomaine as a delayed action and not immediately active poison, and not definitely diagnosable at once after partaking, therefore com ing under the heading of poisons taken accidentally and not under sudden illness. Tw o cases of food poisoning, of which I know, did not develop any signs and symptoms till some long interval had elapsed. H ad I been there I should have treated them. If we are not to treat these cases when the signs and symptoms develop, why the Textbook instructions ? I shall be pleased to have your (probably drastic) comments, having enjoyed them and gained much valuable knowledge from your Q. and A. for many years. You have overlooked the fact that food is not retained in the stomach for a lengthy period but is passed (whether poisonous or not) into the sm all intestine. It should be clear, therefore, that once food has left the stomach an emetic can serve no useful purpose ; and, as stated in my previous reply “ it would be a meddlesome act for any first aider actively to treat such a patient.” In short, it were w iser for him to leave the diagnosis of the illness and the treatment of the patient to the doctor and so protect him self from the grave error of adm inistering emetic and purgative to an unfortunate patient suffering from some more serious acute abdominal condition. — N.C. F. C o m po und F ra c tu re of L o w e r L im b . A. S. (M idland s).— I am w riting to ask you to settle a question which rather worries me. O ur instructor tells us regularly that, in the case of compound fracture of the lower lim b with tbe bone protruding, tying the feet together by the figure-of-eight bandage definitely applies extension. As he is the full time am bulance man at a large factory w ith a large amount of practical experience, I hardly like disputing his word, though I definitely think that the figure-of-eight bandage can be applied without causing any extension ; and it certainly holds the lim bs firm er than a bandage ju st tied round ankles as our instructor advocates. T h a n k you for your most interesting replies to queries published in F i r s t A i d , to which I look forward each month ; and I also thank you in anticipation of your kind reply to this query of mine. The pull necessary to reduce the shortening w ith a frac ture of the lower lim b is far greater than is possible by the application of the figure-of-eight bandage. In other words, I can im agine few cases of compound fracture of the lower lim b in which the application of the figure-of-eight is not justifiable and in accordance with the instructions of the Textbook. At the same time, the wound being fully exposed, the first aider can watch the protruding fragm ent and stop immediately if he sees that the fragm ent is, in fact, being pulled back into the wound. In short, your contention is upheld.— N .C .F . H um oux in F ir s t A id. B .T . (B irm in g h a m ).— I have pleasure in brin g ing to your notice the follow ing schoolboy howler— “ B loo d consists of two sorts of corkscrews , red and w hite ! ” G o o d ! Next, please ! !— N .C .F . Contact w ith E le c tric C u rre n t. N .C . (B roseley).— I wonder if the difficulties of your corre spondent (to whom you replied under the above heading

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in the Jan u ary issue o f F i r s t A i d ) is due to the fact that he is in possession of the T h irtieth (or subsequent) Im pression of the Textbook. If this is so, reference to electric shock w ill be found on page 138 and not on page 159. O w ing to shortage of paper the printers are using narrower m argins in theTextbook which has necessitated a change in pageing ! The present Textbook, therefore, has only 251 pages instead of 294 as formerly. \ our kind letter is much appreciated.— N .C .F .

A I D

212, confirm your reply to the first half of the question, but on page 39, clause 221, they state :— “ F ailu re to be returned as efficient for two consecutive years w ill autom atically entail discharge from the B rig ad e.” As a regular reader of your jo urnal, from which members of my D ivision and I have gained much help ful advice, I trust this letter will be accepted, as it is in tended, not as criticism , but to point out the mis-quotation. W e thank you for your letter and for your correction of a printer’s error. — E d i t o r .

C o n ce ale d H aem o rrh ag e. 13. N. (W estm inster).— The other day a colleague spoke about concealed haemorrhage. As the Textbook only speaks of wounds accompanied by haemorrhage and haemorrhage from an internal organ, I was rather puzzled and shall welcome your kind explanation. T h e Textbook classification fails because, as the result of disease or injury, haemorrhage may take place w ithin the body not only from an internal organ but also from a blood vessel. F o r this reason haemorrhage is usually divided into external (and seen) or internal (and concealed or not seen). \ our difficulties w ill disappear if you forget the qualify ing adjectives— “ external ” and “ internal ” and remember that haemorrhage sim ply means the escape of blood from the bloodvessels which norm ally contain it. The effects there fore, and the signs and symptoms, are identically the same, both when blood escapes from the body and is seen and when it passes internally into a closed cavity (e.g., skull, chest, and abdomen) and is concealed. — N .C .F .

A ctio n of T ea w ith B urn s. M .C. (C aistor-on -S ea).— The Textbook suggests warm strong tea as an alternative dressing in the treatment of burns and scalds. I have asked several of my colleagues without success to explain its action ; and so I now ask your kind help. Tea contains tannin ; and an infusion of tea has been used for many (rum our says two thousand) years by the Chinese in the treatment of burns and scalds. Tea tannin is a different substance from tannic acid ; and its action is much m ilder than that of tannic acid. Indeed, experiments have shown that the latter is twenty-five times stronger than tea tannin. Incidentally, it is claimed that tea w hich con tained no tannin would be almost tasteless.— N .C .F .

P u p ils in H ypn o tic P o isoning. O .S. (H ig h g a te ).— In the Chapter on Poisons the Textbook names the common hypnotic poisons and tells us that opium and its preparations may produce pin-point pupils. Does this mean that “ the tablets and preparations which are used to relieve pain . . . . ” may also cause pin-point pupils ? W e aw ait your kind reply with interest. No ! Pin-point pupils are peculiar to opium and its preparations ; and first aid aim s at preventing this com plica tion which is only present when the poisoning is well developed. The tablets and preparations, to which the T e xt book refers, are known as barbiturates and are much used to-day “ to relieve pain and produce sleep.” — N .C .F .

B rig a d e E ffic ie n c y . (Bedford). — In the Jan uary issue of F i r s t A i d under the above heading, you state that B rigade membership is lost if for any reason an officer or member is marked non-efficient for three consecutive years. B rigade General Regulations, on page 38, clause

W .P .

F ra c tu re of Shoulder Bone. J.P . (B irm in g h am ).— A friend of mine recently sat for his first S .J.A .A . certificate, and failed. The exam ining doctor requested him to treat a fractured shoulder bone. A little puzzled, my friend asked the doctor to repeat the question, and was asked again to treat a fractured shoulder bone. As the class was large there was no time for further questions. My friend, hoping for the best, treated a fractured shoulder blade, which proved to be w rong as the doctor required treatment of a fractured humerus. T h is was the only practical question. I have served five years in the Brigade, and spent many hours training my friend ; and I feel sure, that had the question been clear, the exam ination result would have been favourable. W e should be grateful for your observations on this problem. If the facts as stated in your letter are true, your friend was justified in treating as for a fractured scapula. Nevertheless, I feel there must have been a grave m isunder standing between the exam iner and him, as I cannot im agine a qualified man using a term which no anatomical basis.— N .C .F .

A F ir s t A id e r’s D ile m m a . G .T . (Thornton H eath).— Recently I was called to a neigh bour, who had fallen down in her garden. Upon ex am ination, I suspected that both bones of her leg were broken. So I at once called the am bulance ; and w ithin seven minutes the leg was treated and the patient had been removed to hospital, where my diagnosis was con firmed. Later, a neighbour told me that before I was called someone else had seen the patient and said that she could go to hospital by ’bus. Now, w ill you please tell me if I was rig ht in callin g the am bulance or if I should have called the police as well so as to verify what I was d o in g ? I am a member of the B rigade and shall welcome your advice on this problem. As a first aider you are expected to render efficient treatment in all cases of sudden illness and accident with w hich you come in contact, and for which the services of a doctor are not available. Clearly, on your statement of facts, you acted strictly in accordance with the principles of first aid ; and, further, you are not responsible for any thing that happened prior to your a rrival at the scene of the em ergency.— N .C. F.

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LEG TRO U BLES T r y G e rm o le n e y o u r s e lf — a n d y o u w ill be c o n v in c e d IN F L A M M A T IO N o f its p o w e r to soothe and RASH ES, SPO TS re lie v e s k in c o m p la in ts. U n d e r the h e a lin g h a n d B U R N S , C U TS o f G e rm o le n e m a n y s k in afflictio n s v a n is h in a fe w d ays — o r e ve n h o u rs . B u t G e rm o le n e ’s m o st w o n d e rfu l v ic t o rie s are re co rd e d in le tte rs lik e the f o llo w in g :

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Germolene three and sometimes four times a day. The results have been wonderful. I am sure it was only Germolene that got me on my feet again. No praise is too high for your wonderful ointment; it is worth more than I can say about it. You may publish this letter as you wish.” (Signed) C. A . B. (Mrs.), Shifnal, Salop.

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BIOLOGICAL MBI£ PREPARATIONS ANTIPEOL SEERS OINTMENT One or other or all of the three races of germs, Streptococci, Staphylococci and B. pyocyaneus are found in every skin infection common to this country, and AN TIPEO L O IN T M E N T contains the antibodies (antivirus) of these germs. Healing 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 BURNS and SCALDS, for it is microbicide and non-adhesive, and dressings do not require to be changed every day. W OUNDS, BURNS, etc., W IL L N O T TU RN SEPTIC if treated with A N T IP E O L O IN T M E N T .

RHINO-ANTIPEOL affords rapid relief of COMMON COLDS, IN FLU E N Z A , A N D CA TA RR H . Containing the antibodies of the germs common to infections of the nose and pharynx (Staphlylococci, Streptococci, B. pyocyaneus, pneumococci, pneumobacilli, enterococci, M. catarrhalis, B. Pfeiffer), Rhino-Antipeol is not just a palliative, but is a remover of the couse of the infection. During epidemics it is the ideal preventive of microbe development. C lin ic a l S a m p le ! o n r e q u e it fro m

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The

Its aim and object being tbe 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 8 th of each month, and must, be accompanied ( not necessarily for publication) by the name and address of the Correspondent. Subscriptions, Advertisements and other business Communications connected with F IR S T A ID should be forwarded to the Publishers. D A LE, REYN OLDS & 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 Address— “ Twenty-four, London." Telephone— City 3710.

CO N TEN TS

d it o r ia l

TH IS

N U M B ER.

—

Salaries of Mental Nurses

...

Lectures Delivered to Advanced Casualty Service Personnel in the 6th Y ear of W a r ... ...

Reviews

...

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

...

100

Y o ur Next Exam ination

...

101

Letters to the Editor

...

102

...

102

...

103

...

St. John Ambulance Association Escorting Mental Patients Q

u e r ie s

a n d

n s w e r s

t o

... C

o r r e n s p o d e n t s

:—

Fractured Stum p of Low er Lim b

...

106

Exam ination H o w ler

...

106

...

106

...

Fracture of T h ig h , Bone Protruding B rigade R a n k on Transfer ...

...

F racture of Sacrum

...

Corrosive Sublim ate

...

Treatment of T a r Scalds

...

106 ...

Treatment of Fractured Pelvis

...

Stings of Insects and Plants

...

106 106 106

...

106 108

Treatm ent of Bruises

...

108

R upture of M uscle

...

108

H um o ur in F irst Aid

...

108

M en tal d e r a n g e m e n t m a y be S a la r ie s o f regard ed as a e u p h e m istic term M e n t a l N u r s e s , for th a t u n fo rtu n a te co n d itio n w h ich m a n ife sts itse lf in in sa n ity , lu n a c y , m ad n ess or m an ia. T h e r e is p o s s ib ly no d istin c tiv e m e a n in g a tta ch a b le to a n y on e of th e se — th e y m erg e so the o n e in to th e o th er. C rabbe, in h is “ E n g lis h S y n o n y m e s ,” a ttem p ts a c la ssifica tio n o f sy m p to m s. In sa n ity , he sa y s, is p erm a n en t d ise a se , lu n a cy a v io le n t sort o f in sa n ity , m a d n ess and m an ia sta te s of m ental e x c ite m en t w h ic h m ay be m o st “ fu rio u s and c o n fir m e d .” W h a te v e r m ay be the co n d itio n of th e u n fortu n ate sufferers, th e y h a v e received the s y m p a th y o f their fe llo w s, and recen t yea rs h a v e w itn e sse d m uch a m elio ra tio n of their sad lo t. T h e d a y s o f straw and fetters are o v er, and th e y are no lo n g e r “ on sh o w ” lik e w ild b ea sts. T h e S u b -C o m m itte e of the N u r se s S a la r ies C o m m ittee o f th e M in istry of H e a lth h as for so m e tim e had the q u e stio n of sa la ries, e m o lu m e n ts and c o n d itio n s o f se r v ic e of th o se e n g a g e d in m en tal n u r sin g u n d er c o n sid e r a tio n , and w e n ow h a v e before u s N o . 2 o f the N o te s w h ic h h a v e been issu ed . T h e y em b o d y so m e su p p le m e n ta r y and a m e n d in g r e g u la tio n s and p o in ts of in terp retation w h ic h h a v e been s u b m itted to the S u b -C o m m itte e , and the M in ister c o m m e n d s the r e co m m en d a tio n s c o n ta in e d in the N o te s to e m p lo y in g a u th o ritie s. W e g a th e r the fo llo w in g from a C ircular issu ed b y th e M in istry (L o n d o n : H .M . S ta tio n e r y O ffice. P rice I d .) . In so m e c a se s u n q u alified staffs h a v e been and still are h o ld in g p o sitio n s w h ic h , u n d er th e C o m m itte e ’s reco m m en d a tio n s, are ap p rop riate o n ly to q u alified m en tal n u rses. In su ch c a se s th e S u b C o m m ittee co n sid e r th at their rates o f p ay and c o n d itio n s o f se r v ic e from O cto b er 1st, 1944 , fall to be determ in ed by th eir e m p lo y in g a u th o r ity . P a ra g ra p h 77 of th e S u b -C o m m itte e ’s report pro v id e s that, w h ere th e r e co m m en d a tio n s as to a n n u a l lea v e in v o le an in crease o f e n title m e n t, the a d d itio n a l le a v e sh a ll op erate from A p ril 1st, 1945 . T h e S u b -C o m m itte e h a v e been ask ed (or a d v ice as to th e p o sitio n r e g a r d in g a n n u a l le a v e b etw een O ctob er 7st, 1944 , and M arch 31 st, 1945 . T h e y

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reco m m en d in su c h c a se s p ro p o rtio n ate lea v e on th e old b a sis sh a ll be g r a n te d for th e period from th e en d of th e old lea v e y ea r up to M arch 31 st, 1945 . A s a resu lt of w a r-tim e c o n d itio n s, it is not a lw a y s p o s s ib le for a h o sp ita l a u th o rity to gra n t th eir n u rses th e fu ll period of a n n u al le a v e recom m en d ed in p a ra g ra p h 71 of their R e p o r t, and th ey are v ery s tr o n g ly of o p in io n th at, w h erever p o s sib le , th e fu ll period of a n n u a l lea v e sh o u ld be g ra n ted d u r in g th e lea v e y ea r. W h e r e , h o w ev er, th is is q u ite im p o s sib le under p resen t circu m sta n c e s , th e y reco m m en d th at the n u rses con cern ed sh a ll receiv e p a y m en t of sa la ry in lieu of that part of th e a n n u a l lea v e w h ic h th e y h a v e n ot been ab le to ta k e, th e sa la ry for th is p u rp o se b e in g in the c a se o f th e resid en t nurse th e resid en t sa la ry (but n ot a n y a d d itio n a l h o lid a y a llo w a n c e ), and in the ca se of th e n o n -r e sid e n t nu rse the n o n -re sid e n t sa la ry (b ut n ot a n y a d d itio n a l h o lid a y a llo w a n ce ). T h e R e p o r t h a s been circu lated a m o n g v is itin g c o m m itte e s , m en tal h o sp ita l board s, local a u th o ri tie s o w n in g certified in stitu tio n s, and c o u n ty and c o u n ty b o r o u g h c o u n c ils. -

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In all these processes of recovery, which are grouped under the name of convalescence, modern medicine h&s pro gressively played a greater and greater part, and, even in the quarter of a century w hich has elapsed since the last war, progress has been am azing, and the average period of incapacity from wounds has been more than halved. Speaking in general terms, nature’s method of repair consists in the healing of an injury, whether it be an abscess cavity resulting from bacterial infection or a wound, by means of the formation of fibrous tissue which we speak of as a scar. In the case of a wound, the edges of w hich have been closely approximated and which is free from infection union takes place by what is known as “ F irst intention,” the scar is at the m inim um and the eventual result is as near perfection as possible. W hen, however, m uch tissue has been destroyed and the wound impossible of oblitera tion, or heavily infected, then healing must take place by a slower method, which we speak of as healing by g ran u la tion or “ Second intention.” H a vin g overcome the infec tion and got' rid of the devitalised material, nature covers the surface of the wound with the soft and red tissue known as granulations, over w hich the surrounding skin slowly spreads inw ards until the whole skin is covered.

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Lectures Delivered to Advanced Casualty Service Personnel in the 6th Year of W ar. By S I R H E N R Y L. M A R T Y N , K .C .V .O ., F .R .C .S . ( Concluded from page 8p)

last part o f the defensive m achinery of the body which rem ains for us to discuss is the mechanism of repair. W hat ever may have been the nature o f the damage which has been suffered, whether from bacterial infection or from in jury, nature w ill endeavour to the utmost of her power to restore the affected part to norm al. The extent to which she w ill succeed, alone and unassisted, in reproducing per fection w ill depend upon the condition itself, and, in the m ajority of cases, it is only by a combination of science and nature that the best possible result can be obtained. A simple exam ple w ill occur to all of you. If a cut be allowed to gape widely, the resulting scar w ill be large and unsightly, although nature alone w ill have effected a sound enough repair. On the other hand, if the edges of the wound have been s k ilfu lly sutured together, the final scar m ay be almost invisible. Few of us realise how extensive and complicated are the reparative process which the body may be called upon to perform. A battle wound must not only be defended again st the bacteria which have contaminated it but the tissues which have been devitalised by the projectile must be got rid of before repair can even be commenced. Once clean, the wound must be healed, and throughout the whole process surroun din g muscles must be restored and the general w asting of the body overcome. F in a lly , last but not least, the m entality of the injured man m ust be re stored after possibly long periods of pain, sleeplessness and anxiety. T he

D iagram sh o w in g u n ion o f a fracture in a lo n g bone. I . — Good position. F irst stage. A, E xternal callus. B, P lu g in m arrow cavity. C, Com m encing per manent callus. I I . — F in a l stage. A and B absorbed. Strong per manent callus C only rem aining. I I I . — U nion in bad position. A and B persisting. No form ation of C. Muscles, tendons, bones and even nerves may be actu ally reformed by outgrowths from the injured parts, w hich spread into and through the granulations su r rounding them. The brain and spinal cord, however, can never be regenerated. It w ill be clear, therefore, to what an extent the effici ent handling, even of a simple wound, by the first aider influences the eventual result, and this is still more the case if we consider in a little more detail how a broken bone is united by nature. The shaft of a long bone, such as the hum erus or femur, consists of three elements. It is covered by a strong sheath of fibrous membrane, know n as periosteum, from which numerous vessels pass into and nourish the under lyin g layer of dense hard bone. The centre of the shaft is filled w ith soft vascular m edulla or m arrow. T o the outer surface of the bone are attached the muscles and ligam ents

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of the limb, the former being alw ays in a state of slight tension. W hen a fracture occurs, the periosteum is torn more or less completely, and the two rough spiculated ends of bone on either side of the break are displaced to a greater or less extent, both as the result of the force occasioning the frac ture and of the elastic pull of the muscles attached to the bone. T h is displacement may take the form of simple overriding of the fragm ents or may be so extensive that one piece may lie at rig ht angles to the other. The surround in g muscles, ligam ents, nerves and vessels are torn and much blood surrounds the site of the fracture. The straightening of the broken lim b and efficient im mobilisation in the field w ill at least prevent further damage from the sharp ends of bone, but it is unlikely to effect per fect alignm ent, and nature w ill require the assistance of the surgeon before the irre g u la r fragments are brought into exact position. In order to overcome the constant pull of the muscles and, finally, to im mobilise the fracture, the many ingenious appliances of orthopaedic surgery may be called into play. Powerful traction may be applied by weights fastened to the lower element, either indirectly through strapping fixed to the skin or by metal pins driven through the bone below the fracture. Even by these methods it may be found impos sible to set the broken ends exactly together, and it may prove necessary to cut down upon them, disentangle frag ments of interposed tissues and replace them by direct manipulation, fastening them subsequently together by silver plates or wires, or even by grafts of bone obtained from other parts of the body. Once perfect setting has been effected, absolute im m obility must be ensured, either by splints or plaster of P aris casings, and nature then left alone to effect her repair. W ithin a very few hours of im m obilisation this process has begun and the large mass of clotted blood is being absorbed. T h is is completed in about a week or ten days, and the broken bones are surrounded by a mass of loose scar tissue. • Into this mass bone form ing cells rapidly spread, and by the second or third week they have created a scaffolding of soft bone surrounding the site of the fracture. T h is is know n as the external or ensheathing callus, but it is, of course, at this stage quite incapable of bearing any strain. In the meantime, a sim ilar change has been going on in the m arrow cavity itself, with the result that both ends of this tube become closed by plugs of soft bone. The last element to take part in the healing process is the dense outer layer of bone, but gradually the broken irre g u la r edges are smoothed off and become united by a rin g of callus, known as the internal or permanent callus, which is itself continuous, both with the overlying ensheathing callus and the plugs in the m arrow cavities. Now comes the last change, if alignm ent has been exact, namely, the gradual absorption of the soft ensheathing callus and m edullary plugs which have acted as scaffolding, while the internal callus hardens to form a rin g of dense strong bone, often barely distinguishable, to show where the break has been. If, on the other hand, at some point the technique of those who, from first to last, have handled the case has failed, if coaptation has not been exact, if the slightest m obility has been allowed, or if weight bearing has been attempted too soon, nature may fall far short of perfection and union either occur in bad position or even fail entirely. In any case the process is a long one, and in the weight bearing bones of the leg months m ust elapse before it is complete. D u rin g all this time both the physical and psycho logical sides of the patient’s recovery must be considered. No longer do we allow him to lie in bed bored with reading

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or talkin g. Nowadays, his interest must be aroused and m aintained by directed occupational therapy, at first pos sibly by handicrafts, later perhaps by education in trades more suited to meet any subsequently anticipated dis ability. As his convalescence progresses, m uscles and joints must be freed from adhesions and restored to strength by active and passive movements, exercises and games, gradu ally increasing in their scope as recovery progresses. Throughout the whole long process of repair, the basic principle holds good, Nature is capable of effecting it, but the perfection of her w ork w ill depend not only upon the nature of the in jury but upon the know ledge and under standing possessed by every man and woman who has any part in the handling of the patient from the moment of his injury.

R e v ie w s . Illustrations of B a nd a gin g and F ir s t A id . T h ird Edition. By

Lois Oakes, S .R .N ., D .N . E d in bu rgh : E. & S . L iv in g stone. P rice 6s. ; postage 6d. W hen this book of 500 photographs was first published in 1940, we called it the most complete and best illustrated guide to bandaging w hich we had read. Evidently others formed the same opinion because it is still enlarg ing its circle of adm irers and is now in its third edition. T h is has been revised and retains all the characteristics w hich established its popularity. Also it includes several new features which still further enhances its usefulness. T h u s a section of coloured illustrations, entitled “ T yp ical W a r W o und s,” has been incorporated and should prove instructive to first aiders. Another new section deals with instructions on the blanket in g of the stretcher, m oving patient on the stretcher and rescue from gas-filled room, this being illustrated in detail by photographs of the w ork being done by a squad provided by the Pye Am bulance D ivision, S .J.A .B . In these circum stances we congratulate the authoress on an excellent book and we w ish it continued success. Tw elfth Edition. By D avid M. Macdonald, M .D ., D .P .H ., F. R .C .P .E . E din b urgh : E. & S. Livingstone. P r ic e 4s. ; postage jd . A guide to prescribing, w hich has been found of service to, and has gained the confidence of, several generations of medical students, must have peculiar m erits of a practical character. Such then is the outstanding feature of this book w hich was first published in 1882, and in its twelfth edition still lives up to its well-merited reputation. The present edition has been completely revised ; and the sections on “ Modern Rem edies,” “ Proprietary Preparations,” and “ Addenda to the B ritish Pharmacopoea ” have been brought up to date, in view of the m any and important advances recently made in therapeutics. The Students' Pocket Prescriber.

D u rin g a display at the Em pire Cinem a, Huddersfield, of the film “ The Story of D r. W a sse ll,” an appeal was made for blood-donors, and over 50 volunteers from members of S .J.A .B . who took duty each day at the cinema, were obtained. T h is is probably a record. The ability to use words gram m atically and the power to express yourself in good E n g lish are two of the most va lu able assets you can acquire. E nro l N O W for the Four W eeks’ Postal Course conducted by the author of “ E ve ry one’s Guide to Correct E n g lis h ,” and other highly-praised works. The fee, w hich includes the cost of the text-book, is only ls . Od. , Send your remittance to-day. AUTHOR (Dept. F.), 44, Toronto Road, Horfleld, BRISTOL, 7

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S t . J o h n A m b u la n c e HEADQUARTERS

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and the annual inspection on October 1st. The financial position was satisfactory. Additional equipment had been purchased, including a Sparklets Resuscitation outfit.

D IST R IC T R E P O R T S.

N o . I (P rin ce o f W ales’s) D istrict E a s t G r e e n w i c h . — It is w ith extreme regret that we have to report the death of Cpl. A. E. Middleton of the 19/2 East Greenwich D ivision, South Metropolitan Gas C o .’s Corps. H e joined the Brigade in 1920, on his discharge from the Grenadier G uards as an Acting Company Sergeant M ajor. Alw ays w illin g to help and alw ays proud of the uniform he wore as if attending a G uard's parade, his annual duty total was many times over the hundred mark. The funeral took place on Saturday, February 10th, at Shooters H ill Cemetery', when six members were given the honour of saluting his passing to his final resting place. T ru ly can it be said, he leaves a shining example for all to remember him by.

No. 168 (C .A .V . L i m i t e d , A c t o n ) . — On Saturday, February 10th, a grand social was held at the Y .W .C .A . E ast Acton Lane, for the wives, children and friends of mem bers. After a very nice tea, the guests were entertained with hum ourous sketches and m usical items by members of the D ivision, a first class conjuror, and Jackie Woods, the 16 year old silver soprano. The items were interspersed with some very enjoyable games, and after a break for light refreshments the evening closed with community singing, and on leaving, each child received a toy, an orange, an apple and a bag of sweets, and the ladies each received a sm all gift ; 180 guests attended, and all voted it a grand evening. It is generally admitted that competition w ork is the best and most interesting form of training for first aiders. W ith this end in view the W est London D istrict F irst Aid League has been formed. S .J.A .B . Divisions, industrial, com m ercial, and civil defence teams are eligible for member ship, and all interested, are invited to apply to the Hon. Sec., M r. H. G. Coles, 3, Moat-place, Acton, W .3, for full particulars. A ll teams meet each other in home and away matches, and 2 points are awarded for a win, and 1 point for a tie. Each match consists of : team test (15 mins. practical) and individual test (6 mins. practical), with a silver cup for the league winners, and a very nice silver medal for the individual w inner. No. 55 ( S o u t h a l l - N o r w o o d ) M i d d x . — The reports of the S o u'h all Ambulance D ivision and N ursin g D ivision given at the annual general meetings show that the good w ork per formed for many years in this borough, is being well m ain tained. Since the new am bulance was placed in commission on August 14th last, it has travelled 3,189 miles in removing 31 cases and attending eleven duties. A total of £ ^ 2 2 has been accumulated by various efforts d u rin g the past few years towards new and permanent headqnarters. Progress is being made with the raisin g of a fund to equip a full brass band for the cadets. Practice has already started under the qualified tuition of an ex-bandsman of the Iris h Guards, who is a member of the Brigade.

C ounty o f Berkshire. H u n g e r f o r d . — The annual meeting of the D ivision was held recently, and the report stated that there were 34 mem bers, 13 being in H . M. Forces. F ifty d rills were held d uring the year. The annual re-exam ination was held on Ju ly 4th,

R e a d i n g C e n t r a l . — On February 13th, at the Am bu lance H all, Chatham Street, the N ursing D ivision held their annual presentation of aw ards and social. The aw ards in cluded a silver cup given to the D ivision by the County Supt. and won by Ambulance Sister M iss Collins in a recent competition.

R e a d i n g S o u t h . — On February 12th, at the Ambulance H a ll, the N ursing D ivision held a party in celebration of its first birthday. About a hundred guests were present. A letter was read from the Com m issioner acknow ledging the sum of £ 2 presented by the D ivision to the Prisoners of W ar Parcels Fund. Entertainm ent and refreshments followed.

R e a d i n g T o w n “ B ” .— On February 19th, at the Am bu lance H all, the Ambulance Cadet D ivision held, an enrolment ceremony and parents’ night, which was attended by a large number of visitors. Tw elve cadets were enrolled. Entertain ment followed, and a collection made for the cadet funds, amounted to £ t 17s. 4|d .

T h e a l e . — On February 13th, the N ursin g D ivision and Am bulance and N ursin g Cadet Divisions, held a party at the P arish Room. The guests included about thirty wounded soldiers from Ufton Court and Englefield Convalescent Homes. A presentation, subscribed by the members of all three Divisions, was made by the Commissioner to D iv. Supt. M iss K . Corderoy in recognition of her fifteen years service in the Brigade. Games and refreshments were enjoyed.

C ounty o f Bristol. D u rin g the year 1944, the Transport Department of the County of Bristol attended 5,441 accidents, removed 7,780 invalids, and attended 514 fires, m aking a total mileage of 105,364 miles. T h is was a record year, being an increase of 1,303 cases over 1943. On Thursday, December 28th, when the weather was so bad that public transport was at a standstill, 83 calls were answered ; not one call was refused d uring the day. A full twenty-four hour service, seven days a week is m aintained with a fleet of nine am bulances and a staff of twelve drivers. S t a p l e H i l l . — On February 17th, at the Headquarters, Hebron Schoolroom, H ig h Street, Staple H ill, an inter D ivisional, inter Corps competition was held between P ar nells & P . A.C. and Staple H ill D ivisions No. 2 Corps, B. A.C. “ B ” D ivision, teams 1 and 2, and “ D ” D ivision, No. 3 Corps. Corps Surgeon D r. N. S. B. Vinter, adjudicated. About 130 people were present, including several D iv i sional Supts. A ll sat down to a good tea, d u rin g which Supt. E. J. Rowe (Staple H ill) presented D r. V inter w iih a pipe, pouch and lighter. D r. V inter in his reply thanked the D ivisions for the gift. Supt. Lear (P arnells & P .A .C .) paid tribute to Corps Officer Jeffries and referred to the long year£ of service given by him to the w ork in this area. Corps Officer H . Jeffries suitably replied. The result was : Parnells & P. A .C ., 129 m arks ; Staple H ill, 1 2 1 ; B. A .C. “ D ” Division, 112 ; “ B ” D ivision No. 1 team, 103 ; “ B ” D ivision No. 2 team, 77. Total possible 160 m arks.

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C ounty o f P lym outh, S. W . D ev o n and E . C ornw all.

County o f W arw ick.

— T h is year the M illbay R ailw ay D ivision celebrates its 50th birthday. E a rly in 1895, a sm all number of public spirited men started this great w ork in Plymouth, handicapped by lack of funds and in the face of many difficul ties. Since those days the w ork has grow n steadily and this D ivision is well known in the city and surrounding country side as being not only the oldest, but also one of the most h igh ly trained and active in the district. M any Service and civilian sick and wounded have cause for deep gratitude to the members of this D ivision for their s k ill and gentleness. It is hoped that birthday celebrations worthy of the event w ill be held in Plymouth d uring the summer.

W y k e n . — On Wednesday, February 7th, the W yken and D istrict Am bulance and N u rsin g D ivisions held their annual dinner and concert at the W hite Lion Hotel, Coventry. Am ong the guests present were the President of the Am bulance D ivision (M r. C. R ushby), Corps Officers Booth and Russell and the M ayor and Mayoress of Coventry (A lder man and M rs. H odgkinson). D u rin g the evening, the M ayor presented members of the N ursin g D ivision with their aw ards gained at the last re exam ination, and spoke of the good w ork the D ivision was doing in the interests of the community, and expressed the hope that it would continue to do so after the ceasation of hostilities.

M illb a y .

C ounty o f Stafford. M e ir a n d L o n g t o n . — The above Ambulance D ivision held their annual individual competition for the “ John Joule Shield ” on February 6th. It was a keen competition, only two m arks separating the first and second, and only one m ark between the second and third. The result was as follows : 1, Pte. A. Shaw (shield and prize) ; 2, Pte. E. Bentley (prize) ; 3, Pte. H . W arrilow (prize). T h is is the first time since 1938, that this competition has been held, ow ing to the war.

County o f Suffolk. B e c c l e s . — The purchase of Blyburgate H a ll for ^ 1,500 as the post-war headquarters of Beccles D ivision was announced at the annual meeting on Saturday, February 24th. T h is has been accomplished since August by the efforts of the members, coupled with the support of traders and residents. The sum of . £ 130, however, has to be raised d u rin g the com ing month. County Officer W. C. W atts stated that the Order was gran ting the Lady N ursin g Supt., M iss E. Tedder, an entry as a Serving Sister. Awards in exam ination successes were distributed by the Mayor (R ear-A dm iral C. S. Johnson).

County o f Surrey. G u i l d f o r d . — At the recent annual meeting of No. 1 N ursin g Division, Borough of G uildford Corps, D iv. Supt. Mrs. F a rle r presented a very encouraging report on the year’s w ork. Several new members had been enrolled, and the present strength was 53. Fifty-one practices had been held, all being well attended. D r. R. B. Duncan had conducted a first aid course, this being most successful, and 120 entrants had taken advantage of such a good opportunity. A home nursing course had followed, conducted by the N ursing Officer, Sister P. Rowley. F o r the first time since the war, it had been possible to hold the Inter-D ivisio nal Competition, Corps Supt. M rs. E. J. Henry, S .S .S t.J., and Corps Officer M iss D. Phillips ju d g in g the first aid and home nursing tests, respectively. Five teams competed, and the w inning team led by A/S M iss D. H asell, was presented with the “ Lady Knowles C u p .” Over 400 public duties and 1,200 transport cases had been attended by members in this D ivision d uring 1944, in addition to hospital and clinic duties ; and helped by friends, members had been able to assist the J. W .O . by kn ittin g 68 childrens’ vests for war relief work. Ambulance Sister M iss A. E. W heeler was presented with a bar to her Service Medal by Corps Supt. M rs. Henry, and Am bulance Officer M iss Collier was presented w ith "a F. A. N ursin g H aversack as an appreciation by members on completing 11 year’s service as D ivisional Secretary.

Your Next Examination. H a v in g reached the stage of a re-exam ination, a few reminders of procedure and happenings at such times may be welcome. The ends of bandages should be tucked in out of sight. The exam iner has been dealing with candidates who may have irritated him until his nerves are nigh on bursting point, and his sense of hum our w ill not appreciate you brin ging for his inspection, a head bandage with the ends of the bandage looking like the ears of a sick rabbit. The dose of Sal Volatile is 1 teaspoonful to a half tum bler of water. I ’ve heard candidates say 1 tablespoonful in a pint, 1 teaspoonful in a pint and a half. No doubt the day w ill come when I shall hear that it is administered in a pail ! In cases of syncope don’t tell the exam iner that you would pat the patient’s hands. You would, or should, not; it doesn’t make the slightest difference to the speed of patient’s recovery. Be ready for the exam iner that has that nasty habit of saying gently the one word “ W h y ? ” Tim es out of num ber I have seen candidates completely floored by that one little word. Be sure to have a ready answer prepared. A favourite, though sim ple example, is in the matter of arrest ing bleeding from a wound in the hand. The candidate explains that he would apply pressure on radial and ulnar points. The doctor immediately asks “ W hy both ? ” H e is not trying to catch you. H e only wants to see if you really know som ething about the job, that bit extra that makes all the difference. D on’t tell the exam iner that you would “ bash ” that hysteria patient. They only require stern but careful treatment, and someone to watch them, so that they do not disturb other real patients. If you do accidently tie a G ranny in your practical work, leave it so, but point out to the exam iner that you have done so. Do not hurriedly untie it and try to tie a reef, because the exam iner would be displeased to see you untie a knot. If your patient was a real one, you would not think of untying a bandage just because you had made a G ranny for fear of disturbing the wound or fracture, so you do likew ise at the exam. The fact that you have pointed it out to the exam iner, tells him that you do know the difference between the two knots.

D on’t fall to the temptation of having a good swot up of the “ book ” on the night before the exam. F a r better to leave it well alone after a final run over on the m orning before. If the exam, is on home n u rsing , quite a lot of pit-falls are ready for you. I know I had an aw ful dread of break in g the exam iner’s thermometer when he told me to shake it down. If you have not yet mastered that “ flick of the w rist action,” try this method. G rasp the thermometer firm lv

102

F I R S T

round its middle with the thumb and index finger, so that the bulb is in the palm of the hand. Then strike your knee sharply w ith that hand. T h is w ill have the same effect. I actually did drop it later, and the shock was so great that I hadn’t recovered when I was asked “ H o w much linseed for a poultice ? ” and I rashly replied 1 teaspoonful, and then hastily explained— with great hopes— that the poultice was for the tip of the little finger ! D on’t take too long over that Capeline Bandage, neat ness does count I know, but if that head is well covered, and the bandage fairly even, it w ill suffice ; and don’t apply it too tight. It is very uncomfortable for your m ock patient, and at times makes him giddy. In general, listen carefully to all questions, so that time is not wasted by the exam iner having to repeat him self ; thin k carefully before answ ering ; if you don’t know the answer, say so, don’t~guess at it. In the practical, make free use of all m aterial available, make sure that splints are long enough, reef knots if possible, tidy ends, and treat your mock patient as though he w asn’t. F in a lly — “ Good L u c k .” — J. W . S cott .

L e tte rs to th e E d it o r . W e are in no way responsible for the opinions expressed, or the statements made, by Correspondents.— E d i t o r . D

ear

,—

W e (a group of eight C ivil Defence members) are keenly interested in first aid and have held practices weekly for the past three years. f At a recent meeting we decided to keep going after hostilities have ceased, and we think there must be many other groups who, like us, w ill continue. W e should like to meet some of these teams in friendly competition (based on the black Textbook) to stim ulate and to increase our knowledge of first aid, and also to create friendly contacts. On behalf of our group, would you please publish this letter in F i r s t A i d , so that Secretaries or Team Leaders who are interested could communicate with me with a view to such competitions. T h a n k in g you for the many helps I have received dur in g the 16 years I have been a regular reader of F i r s t A i d , I am, yours faithfully, E . E. L e e . 17, K in lo ch D rive, K in g sb ury, N .W .9.

A R T IF IC IA L D

ear

R E S P IR A T IO N DEATH.

APPARENT

In one case the rescuer, when I arrived, was carrying out the movements of respiration too quickly, not allow ing enough a ir to get into the lungs, and w ashing out a great deal of valuable C 0 2 . I pulled the corner of the sheet over the face and sprayed under it pure Co2 (w hich I always carry in my bag). I only made three or four forceful respi ratory movements before hearing the welcome stridor of a natural inspiration. It must be remembered that C 0 2 in the blood is essen tial to automatic norm al breathing. It stim ulates the respiratory centre of the brain j nerve im pulses are sent thereby to the muscles concerned, and thus the chest move ments ensure a sufficiency of air for the work required to be done. I f the body w orks hard, more oxygen is consumed, and the resulting increase of carbon-dioxide in the blood in creases the rate and volume of breathing. Conversely, if the body is at rest, or if there is defici ency of oxygen entering the lungs, there is a deficiency of C 0 2 in the blood stream, and the respiratory centre, short of its stim ulant, ceases to send its automatic impulses to the muscles concerned with respiration. Moreover, the regu lar rhythm ic rate of norm al breath ing, or the accredited means of artificial respiration as taught, imitate the norm al action by allow ing time for the interchange of gases w ithin the a ir cells of the lungs. There is norm ally a definite amount of oxygen and C 0 2 left in the air cells between inspiration and expiration, and thus the blood is provided with a steady supply of both gases. If, however, the acts of respiration are carried out too quickly, these valuable contents of the a ir cells are washed out, and the blood becomes deficient of C 0 2 . T h is is especially important with an unconscious patient, who is not using up much oxygen, and therefore not m aking m uch C 0 2 . T h is deficiency of C 0 2 is apparent in all cases of pro longed artificial respiration, both m anual and m echanical (ro ckin g stretcher, etc.). In my opinion, resuscitation should be more prom in ently taught to first aiders (I have met many who consider it synonymous with artificial respiration) ; and in all cases for which artificial respiration is necessary, C 0 2 should be procured as soon as possible. One more point in conclusion— most cases of carbonmonoxide poisoning are found before breathing has ceased. Even if the patient is removed to the fresh air, there is a danger d u rin g the unconsciousness of a sudden collapse of respiration. In these casesa w hiff of pure C 0 2 occasionally w ill soon demonstrate its great service by an exaggeration of chest expansion and prolonged breathing almost at once. T h is, in fresh air, is a ll that is necessary ; in my opinion, the adm inistration of oxygen delays re suscitation. Y o urs faithfully, “ G .B .”

,—

D u rin g the last hard frost, I have had an unusual ex perience for a General Practitioner— the resuscitation of five people w ithin ten days, all from coal-gas poisoning. Three of the cases had ceased to breathe, and the other two were show ing signs of air-hunger. Fo ur of them were victim s who slept in a ground floor room, under which a frozen gas-pipe had fractured ; the fifth w as the victim of a careless practice of leaving the geyser aligh t w hilst tak in g a bath. T h e object of my w ritin g you is, firstly, to say that Schafer’s method of artificial respiration kept them alive, but chiefly to im press on your readers that in all five cases the return of natural breathing was delayed through deficiency of C O , in the blood.

St. John Ambulance Association. N

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result of the w ork of the Centre for the past year shows a slight improvement on the previous year. The number of aw ards total 1,600 against 1, 515. Classes num ber 77, enrolments 1, 912, F irst Aid aw ards 1, 315, Hom e N ursin g aw ards 233, and 52 Hom e H ygiene certificates were awarded. In recognition of 40 years’ service to the Centre, M r. F. W . K irk b y is raised from Serving Brother of the Order to the Grade of Officer. The

F I R S T

IODINE

V A P O U R

ID you know th at colds have been successfully treated by inhaling the vapour given off b y iodine crystals ? Dr. A. von H alasz o f B udapest reported consider able success w ith this m ethod in 1933. Thousands o f successful experim ents with iodine have been conducted b y the AllU nion C om m ittee for the F ight against Influenza in the U .S .S .R . Iodine has m any diverse uses. It can be

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By F. W . A U S T IN , M .B .E . (F o r much of the inform ation in this article I am indebted to D r. Kenneth Rodger, M -D . (Psychia trist), a D ivisional Surgeon of the S .J.A .B .)

workers are sometimes called upqn to escort mental patients travelling by train or other means ; and to “ stand g u a rd ” over border-line cases pending specialist opinion, or d urin g a purely passing phase of mental upset. It is sometimes an unpleasant task, often an arduous one, but not uninteresting ; and, of course, it is a very responsible duty. The duty is seldom undertaken single-handed, and ex perience indicates that much depends upon the discretion and resourcefulness of the escorting personnel in dealing with unforeseen circum stances, or a difficult patient ; but there are one or two general principles which might usefully be borne in mind. F irst of all, it should be mentioned that the noisy patient is not necessarily the worst, though he may well be the most troublesome. Often the quiet mental patient is the more serious case. Do not, therefore, be misled by a quiet patient, but adhere very closely to any instructions given by the doctor. If you are warned that a patient has suicidal tendencies, do not for one moment relax your watch. Should such a patient resent being accompanied to the lavatory or

C O L D S ?

used in m osquito control, in the steriliza tion o f drinking water, in the treatm ent o f rheum atism . I f you w ould like to know more about the uses o f iodine, w rite to the Iodine E ducational Bureau w hich has recorded every know n fact about iodine. The Bureau w ill be pleased to give infor m ation about iodine and its uses to any m edical auxiliary orU rst-aid worker. There is 110 charge.

E d u c a tio n a l

Escorting Mental Patients.

A m b u la n c e

103

R I D

B u r e a u

L O N DO N ,

G . 2

bathroom, then tell him that y o ii do not wish to be left alone, that y o u are afraid. T h is is an attitude of mind that a suicidal patient can appreciate, for he is him self the unhappy victim of a fear complex. In the ordinary course of events, never tell a mental patient a lie, for you w ill surely be found out !— and you w ill lose the patient’s confidence. Furtherm ore, he is u n likely to forget it. If the patient s a y s: “ Y o u ’re takin g me to the asylum ,” be candid and adm it it, adding, by way of en couragement, that it w ill be only a short time before the patient is out and about again. W hen you arrive at the mental hospital, do not forget to say “ Good-bye ” before you leave. M ental patients re sent being deposited like a body on the doorstep— and they seldom forget or forgive such treatment. Remember that before long you w ill probably again meet your patient in ordinary everyday life. In regard to patients suffering from hallucinations, it should be borne in mind that whatever illusio ns arise in the mind of such a patient— whatever he “ s ee s ” or “ h e a rs ” or “ sm ells ” — is just as concrete to the patient as your own perceptions. If the patient says that a baboon has just looked into the room, or that people were lined up to salute him as he passed by, don’t deny it. If you do contradict, then the patient w ill merely regard you as an idiot and a fool, for he has definitely seen what he says he saw. The better plan is to be hum bly apologetic that you missed see ing what the patient claim s to have seen. W hen accom panying a patient who is inclined to struggle, it is a wise precaution to carry handcuffs, especially when travelling by train, but such means of restraint should only be used as a last resort.

104

F I R S T

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F I R S T

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 t s Queries w ill be dealt with under the following rules :— 1.— Letters containing Queries must be m arked on the top left-hand corner of the envelope “ Q uery,” and addressed to F i r s t A i d , 46, Cannon-street, London, E .C .4. 2.— A ll Queries must be written on one side of paper only. 3.— A ll Q ueries 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. — The Textbook to which reference may be made in this column is the 39th (1937) Edition of the S .J.A .A . M anual of F irst Aid to the Injured. F ra c tu re d Stump of Lo w e r L im b . H .C . (B irm in g h am ).— W hile on Transport Duty at H .Q . at B irm ingham , I was sent with an ambulance, a nurse and orderly to a house to take a patient to hospital. On a rrivin g we found that the patient was a lady who com plained that she had fallen and that she had terrific pain and sw elling in her thigh. Tne nurse examined the lim b and suspected a fracture of the femur, but she also found fhat the injured lim b had previously been am puta ted above the knee. So we decided to put 2 well padded splints, 1 each side of the injured lim b and use 2 narrow bandages round both legs to im m obilise the injured one. W e should be grateful if you would pass your opinion on this method or perhaps say what your treatment would have been. On your statement of facts your treatment was quite satisfactory and accomplished all that was necessary in the circum stances, provided that, as I expect, the patient was warned not to attempt any movement. It certainly indicated resourcefulness in dealing with an unusual emergency ; and it would also be interesting to know if the diagnosis was confirmed by the hospital authorities.— 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. M .B . (C am bridge).— In a recent home nursing exam ination I asked one candidate how he would know if the water in his bath was of the rig ht temperature. I laughed when he replied :— “ I would, g e t into the hath. T hen if my body turned red , I w ould know that the water was too hot , whereas i f it turned blue I should know that the water was too cold I ”

Good !

Next, please ! !— N .C .F .

F ra c tu re of Th ig h , Bone P ro trud in g. A. B. (H a rro w ).— Please tell me if, in the treatment of a patient suffering from compound fracture of thigh with , bone protruding, it would be perm issible w ith all due precautions, to straighten the lim b supposing that it was bent at the knee. Y e s— provided that the m anipulation of the lim b did not exert traction on the fracture and more particularly did not drag the protruding bone back into the wound. Further, it would be easy to detect such a movement because the wound would be fully exposed before you started m anipula tion of the lim b .— N .C .F . B rig a d e R a n k on T ransfe r. T .H . (B irm in g h am ).— I have been a member of the Brigade

A I D

since 1924 and w as promoted by exam ination to the ran k of Corporal, in 1930. I am now liv in g in B irm in g ham and have Joined a D ivision here. Now the question has arisen as to whether I may still carry my stripes as a Corporal or be reduced to the ra n k of Private. I shall be grateful if you w ill put me rig ht on this point, and I thank you for the many helps received from your Query column. Y o u r query is answered in Clause 130, p. 25 of B rigade G eneral R egulations where it is stated that an N .C .O . on transfer to another unit, w ill retain his rank in the Brigade but w ill be supernum erary without holding any command until accepted for a vacancy in his new un it.— E d i t o r . F ra ctu re of Sacrum . P. S. (Y o rk ).— If we were called on to treat a fracture of spine in region of the sacrum , should we treat as for fracture of spine or of pelvis ? W e have had several heated argum ents am ong our selves on this point and now submit it for your kind ruling. The spinal cord ends at the second lum bar vertebra (Textbook p. 153)r consequently the loss of power and of sensation below' the lesion associated with fractures of the spine would not be present w ith a fracture of spine in sacral region. Further, the sacrum is part of the pelvis and if fractured should be treated as for a fracture of pelvis.— N .C .F . C o rro s iv e Sublim ate. N .W . (Y arm o uth).— W e are puzzled to know why in Chapter X I V the Textbook classifies corrosive sublim ate among the irritant and not the corrosive poisons ; and we ask you k in d ly to elucidate w'hat is to us a mystery. E ver since the tenth century, m ercuric chloride has been known under the name “ corrosive sublim ate ” on account of its corrosive and destructive action on the lustre of many metals. Its action is nothing like as active as is that of the corrosive acids and alkalies ; and the Textbook is correct in classifying it am ong the irritant poisons.— N .C .F . Treatm ent of T a r Scalds. W . P. (Chelsea). — Please tell us the correct treatment of scalds which result from hot tar. Should we attempt to remove the tar or not ? W e aw ait your kind answer with interest. W hen scalds are caused by hot tar or other adhesive substances, it is good first aid to do nothing except cover the injured part with a sterile dressing. More harm than good w ill be done by attempts to remove the tar which makes an effective air seal. Later when the tar has hardened it can be removed with benzine or ether.— N .C .F . Treatm ent of F ra ctu re d P e lv is . M .F. (W ellington, N .Z .).— Recently I was told to treat a supposed patient for fracture of pelvis. I thought that I had applied my bandages correctly. The doctor, how ever, asked me why I placed a broad bandage round the patient’s abdomen and if I wanted to keep this part of his anatomy warm . A§ I am perplexed I wonder if you can tell me how to avoid this m istake on a future occasion ; and I thank you in advance. Experience teaches that students often fail to appreciate the lim its of the pelvis and often misapply the broad bandage round the pelvis. If a tailoring suggestion w ill assist, then

F I R S T

FIRST AID

107

A I D

IG L O D IN E

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" A s a w o r k o f r e fe re n c e , th e b o o k w ill be e x tr e m e ly useful and

D A LE,

A S S O C IA T IO N

I t s H i s t o r y a n d I t s P a r t In t h e A m b u l a n c e By N .

E L IM IN A T IO N

The adm inistration o f a safe sed ative is often desirable in conjunction w ith the treatm en t o f conditions w hich cause pain and distress. A n a d in ,’ a w ell-balanced com bination in tbe aspirinphenacetin-caffeine group, can be relied upon for rapidity o f action in th e elim in ation o f pain. I t has no unpleasant after-effects and is u n likely to cause gastric disturban ce. M oreover, ‘ A n adin ’ is not con ducive to h ab it-lorm ation and is, therefore, com pletely safe in the hands o f th e p atien t.

S t., Lo n d o n ,

E .C .4 .

ANADIN LIMITED ■ 12 CHENIES STREET • LONDON • W.C I — M U — — i _ „ ‘ ‘ ^

io 8

F I R S T

the top of a m an’s side trouser pocket usually coincides with the crest of the haunch bone and the bottom of it with the prominence on the head of the femur. If, therefore, we apply the broad bandage firm ly between these two points, then we shall be happy because we have controlled the frac tured pelvis and the patient w ill be happy because we cannot put our hands into his trouser pockets ! !— N .C .F .

Stings of In s e c ts and P lants. T .P . (Plym outh).— If the poison injected with a bee sting or from a stin gin g plant be formic acid then a weak alk a li should be useful as an antidote. If, however, the poison injected with a wasp sting is alkaline, then it seems to me that the application of a weak solution (as suggested on p. 181 of the Textbook) w ill not be of any avail. T h is being my difficulty, I shall appreciate your kind help. The venom injected by the ant is known to be formic acid. In a ll other cases of stings by insects and plants, it is not known, but on the analogy of the ant it has been pre sumed that plants and insects inject acid venom. Con sequently treatment by application of alkaline solutions has alw ays been advocated. In these latter days, though the fact has not yet got into the Textbook, the venom injected by the wasp has been proven (by experiment with litm us paper) to be usually alkaline in reaction. T h is explains the old-time tale of the farm er who is reputed alw ays to apply slices of onion (the juice of which is acid) to wasp stings ; and it, therefore, suggests the advisability of applying a weak acid solution to counteract wasp venom. * ' Nevertheless, experience proves that the application of an alkaline solution may often give relief even with a wasp sting as it may w'ith any form of skin irritatio n .— N .C .F .

T reatm ent o f B ru ise s. C .C . (C ardiff).—-The Textbook, on p. 139, tells us to use equal parts of spirit and water in the treatment of bruises but does not specify the kind of spirit. Being in difficulty, I ask your kind help. Any spirit w ill do— brandy, w hisky, rectified spirit, surgical spirit, &c. Probably, however, consideration of costs w ill make you select methylated spirit which is the cheapest of the series and which, diluted with equal parts of water, makes an efficient application in the treatment of bruises.— N.jC. F. R u p tu re of M u sc le . D .N . (H am pstead).— W e shall be grateful if you w ill let us know if a wound is alw ays present when a muscle is ruptured. R upture of a muscle may occur without an external wound, as the result of violent and spasmodic m uscular effort. A common example of this in jury is rupture of the plantaris muscle, which is a sm all muscle present in the calf of the leg and which may be torn rig ht across d u rin g the exertion of run ning or jum ping, especially when the individual is not physically fit and indulges in violent exercise.— N .C .F .

H u m o u r in F irs t A id. S .T . (Cricklew ood).— -With reference to the joke published under the above heading in the February issue of F ir s t Aid, I wonder if you remember that you gave it as the “ Exam ination H o w le r” in the M arch 1941 issue. 1 know because I keep a file of such jokes ; and I wonder

R I D

how long you have made this a feature of your column in F ir s t A id . T h a n k you for the exact reference. The letter from my correspondent struck a note in my memory, though I did not refer to my file of jokes ; and hence I did not place it among the “ H o w le rs ” which I commenced to tabulate in M arch 1923, and have told month after month, since M ay 1923. W e must not forget that good jokes tend to recur and that some of the old ones prove am using to the younger genera tion of first aiders. In conclusion, when shall I receive your contribution to the series?— N .C .F .

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T H IS

NUMBER.

E d it o r ia l —

Burns and Scalds ...

...

109

Th e Place of Rehabilitation in Hospital Service

...

110

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Ill

“ City of Edinburgh ” Ambulances

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I ll

A Street Accident

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S .J .A .B . Headquarters and D istrict Reports St. John Ambtllance Association

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R a ilw ay Am bulance N ews

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Letters to the Editor

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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 :—

Electric R ailw ay Accident

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118

Exam ination Howler

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A W a lkin g Fracture Case

...

118

...

118

...

118

...

118

External Carotid Artery S h ellS h o ck

...

Treatm ent of Fractured L eg Adm inistration of Morphia ...

...

120

Four-H anded S ea t...

...

120

D ilem m a of a Division

...

120

...

120

Reactionary H aem orrhage...

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EDITORIAL.

1945.

F .R .S .A .

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CONTENTS

F .R .S a n .l.,

T h e early treatm ent of burns and sc a ld s b u lk s la r g e ly in first aid w ork, and it is really su r p r isin g h o w m a n y c a se s call for atten tio n , m o s t of them due to ig n o r a n c e or care le s s n e s s . In m o st c a se s, a c c o r d in g to a G la s g o w report, sq ualid li v i n g c o n d itio n s and the low standards of in te llig e n c e and c o n d u c t asso c ia te d w ith th e m prov ide the b a c k g r o u n d for acc id e n ts. O v e r c r o w d in g le a v e s no room for children to play e x c e p t in front o f the fite, and not o n ly is the law re q u ir in g a fireguard to be provided c o m p le t e ly ig n o r e d but p r o se c u tio n s for failure to c o m p ly w ith it appear to be a lm o s t u n k n o w n . C a r e le ss n e s s on the part of ad u lt v ic tim s and of the parents and g u a r d ia n s of children is c o m m o n , “ o n e of the m o st s tr ik in g in sta n c e s b e in g that of a m an w h o lost the w h o le of the skin of o n e l e g th r o u g h b urn in g h im s e lf at h o m e and then pro ceeded to set fire to his b e d -c lo th e s w h ile under tr e atm en t at h o s p it a l.” O ur q u o ta tio n is from the report referred to. S p e c ia l interest atta c h e s to N o . 2 49 o f the S p e c ia l R e p o r t S e r ie s of the M edical R e sea rch C o u n c il, entitled “ S t u d ie s of B u r n s and S c a l d s ” ( H . M . S t a t io n e r y Office. P r ic e 4 / - net). T h e R e p o r t d eals m a in ly w ith the m ed ical treat m en t of burned p e r s o n s ; it d o e s not tou ch the repairing of the results of burns, but d e a ls w ith the local treatm ent of the d a m a g e d su r fac e s, and here it appears that the c h ie f aim s h o u ld be to pre v e n t in fectio n . “ A burnt su rface is sterilised by the a g e n t w h ic h p r o d u c e s it, but it is im m e d ia te ly op en to receive i n f e c t io n ,” and (it is w ith s o m e m i s g i v i n g that w e take the a ss u r a n c e from the Medical Officer in its rev iew of the R e p o r t) “ the ch ie f d a n g e r s co m e not from the s u r r o u n d in g sk in , but from first-aid treatm ent, la r g e ly from d rop lets from the first a id e r .” In s e v e r e ca s e s , s a y s the Medical Officer, “ the treatm en t of s h o c k m u s t of c ou rse h a v e priority, a lt h o u g h b e y o n d o b t a i n in g a d m is sio n to h o sp ita l as rapidly as p o s s ib le , k e e p in g the patien t c o v er e d , and g i v i n g ho t s u g a r e d d rin k s and not m e d d li n g w ith the burnt su r fa ce s, the first aider can do n o t h in g for s h o c k . ” R e m o v a l to hosp ital is the g r e a t t h in g , s o in factories, raids

Burns and Scalds.

I 10

F I R S T

an d c o n fla g r a tio n s, w here m o st se v e re burns occur, a r r a n g e m e n ts to th is end s h o u ld be at hand. H a p p ily , the burns and s c a ld s w h ic h occur in d o m e s t ic circles are not u s u a lly of a very seriou s nature, and th o s e e n g a g e d in first aid m ay regard th em as a practice g r o u n d for the more seriou s c a se s w h ic h it m a y be their lot to e n c o u n te r later.

The Place of Rehabilitation in Hospital Service. By H A R O L D

BALM E,

o .b .e .,

m .d .,

f.r .c .s .,

d .f.h .

(From a Lecture delivered at the Royal Institute of Public H ealth and H ygiene, 28 , Portland Place, London, W .l, on W ednesday, February 28 th, with Mr. W . E. Tanner, M .S ., F .R .C .S ., in the Chair.) F r o m the point of view of hospital practice it may be claimed that the scientific application of rehabilitation possesses a threefold basis, or perhaps it would be better to say, has a threefold purpose in view. T here is firstly a physical basis, aim in g at the restoration of phj^ical capacity affected by the ravages of illness or the effects of a severe accident. There is secondly a psychological purpose, directed towards the re adjustm ent of mental or nervous disturbance, the dispelling of apprehension and depression, and the w inning of the patient’s confidence and full co-operation in the process of recovery. There is thirdly an economic purpose, with the object of restoring the patient to a useful and contented place in the community, or assisting in his resettlement in some new form of occupation suited to his reduced capacity for w ork and strain. Briefly stated, the physical goal is reached by the wise prescription of active movement, expressed in terms of physio therapy, remedial exercises, physical training, suitable handi crafts, and organised gam es, conducted under expert super vision and modified to suit each variety of physical disability and stage of recovery ; the psychological goal by the skilled assistance of the social worker, guided when necessary by the psychiatrist, in the removal of sources of apprehension and insecurity, and the diversion of the patient’s mind from undue preoccupation with his physical complaint ; and the economic purpose by means of the new m achinery set up as a result of the Tom linson Report and the Disabled Persons (Em ploy ment) Act, providing means for the vocational training and resettlement in industry of all who are disabled. D r. Balm e pointed out that prolonged immobilisation resulting from long illness or severe injury produced a condi tion of physical stagnation which could be effectively countered by active physical means ; and he discussed in som e detail the full program m e of rehabilitation (physical) a s carried out to-day in hospitals possessing the necessary facilities : 1 . T h e surgeon in charge of the case indicates on a specially prepared card the particular forms of physical re habilitation to be followed by the patient throughout the day.

2 . T h e actual supervision of rehabilitation activities is delegated to a specially designated Rehabilitation Medical Officer who also trains members of the ancillary rehabilitaon staff. 3 . Unless prohibited by the surgeon, ward exercises are carried out in bed once dr tw ice daily for all patients. 4 . Group exercises are given in the gym nasium for

A I D patients able to leave their beds. These are progressive, and the fact of their being conducted in groups introduces a healthy spirit of competition and co-operation.

5 . Occupational handicrafts form an important part of the patient’s daily program m e ; they divert his mind from his disability, provide a healthy and interesting occupation, and can thus be utilised for the gentle movement of particu lar parts of the body requiring more exercise than could be given in the gym nasium . 6. O rganised gam es give opportunity for valuable physical recreation while enabling the patient to forget for the moment those protective safeguards which he is alw ays apt to build around the dam aged part of the body.

7 . Educational talks and lectures, concerts and films, and all forms of stim ulating literature provide the necessary facilities for mental stimulus, combined with the equally important provision of complete physical relaxation. Dr. Balm e suggested that in peace-time the problem of providing physical rehabilitation facilities for civilians could be solved by establishing special accident hospitals fully equipped with all facilities for rehabilitation or by providing facilities for initial stages of rehabilitation at all acute hospitals and the transfer of all serious long-stay fractures to special orthopaedic hospitals or by the establishment by all large general hospitals or groups of hospitals of residential rehabilitation centres outside the town but near enough for regular visits by the physicians and surgeons. After m entioning that physical rehabilitation should not be confined to serious forms of disabling injury but should extend to cover minor injuries and infections (lacerated hands, burns, whitlows, Colles’s fractures) ; chest conditions ; abdominal and obstetric cases ; chronic rheum atic disorders ; and a number of conditions found in the chronic sick, Dr. Balm e discussed the facilities necessary in general hospitals for the rehabilitation of in-patients, out-patients, and longstay in-patients. Provision of these facilities would call for a considerable expansion of existing hospital services, but there was no doubt that it would be demanded in the future as part of our National H ealth Service and our Social Insurance Schemes. Psychological readjustment was as important as physical rehabilitation, for mental anxiety and psychological dis turbance could play a large part in retarding physical recovery. Anxiety about home affairs, anxiety regardin g money, fear of losing one’s job or of becom ing a permanent invalid or cripple— these factors all played a very large part in a m an’s or wom an’s recovery after a serious illness or accident, and everything which could be done to restore con fidence, to give reassurance and encouragem ent, and to call forth the patient’s hope and co-operation formed a most valuable part of rehabilitation. Dr. Balm e spoke of the fact that the hospital almoner, with her special training in social science and her long experience in dealing with individuals, was eminently fitted for this work. In the third aspect of rehabilitation— resettlement in industry— only the closest liasion between the hospital staffs, the disablement rehabilitation officers of the employment exchanges, and the representatives of industry could produce really satisfactory and lasting results. There were three types of patient : (i) the man who, though weakened, had no residual disability and would get well after a short change and holiday— all that w as necessary w as a note to that effect from the House Officer or alm oner to the employer ; (ii) the man who needed further specific rehabilitation before being able to stand up to the stress and strain of his particular job— three possibilities were at present being tried out experim entally, all entailing a period during which the patient continued his rehabilitation by carrying out special w ork in a factory or in the out-patient rehabilitation department of a hospital ; (iii) the man who w ill never be able to return to his old job but who w as or could be made

F I R S T capable of doing a useful day’s w ork if suitable employment could be found— w hat was needed here was for the extent of his disability to be carefully assessed and expressed in terms which employment exchange officers and m anagers in in dustry could readily grasp and for suitable w ork to be found for him or else for him to be given training for a vocation completely new to him, as was already being done at various Government centres. D uring training and in the early period of resettlement it was urgent that the hospital should keep in touch with their patients who should be able to report back at intervals to the physicians or surgeons who originally treated them.

West London and District First Aid League. A

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ra p id

o n ly re c e n tly in a u g u r a t e d , th is

progress,

e x citin g

and

m atches,

a lre a d y th ere

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re su ltin g

in a

d o u b t t h a t it h a s c r e a t e d

aid , a n d also efficien cy.

im p ro v em en t

m arked

great

have

l e a g u e is m a k i n g been

tie,

rev iv al in

and

several there

very is

o f in t e r e s t in first th e

sta n d ard

There have already been enquiries from several quarters from team s'w ishing to participate, and the Hon. Sec., Mr. H. G. Coles, 3 , Moat-place, Acton, W . 3 , w ill be pleased to send full particulars to anyone interested. Most of the teams also have in mind the Acton Hospital Cup Competition, the final of which takes place at the Acton Hospital Fete in Acton P ark about July. Full particulars of this will be announced later. Below is the league table to date : — Pl aye d W o n Drawn Lost Point C .A .V . ... ................ 6 4 l l 9 L .P .T .B . (Chisw ick, M en )... 4 4 0 0 8 L .P .T .B . (Chisw ick, Ladies) 4 4 0 0 8 Sperry’s “ A ” 5 3 0 2 6 G .W .R . “ A ” (Old O ak) ... 5 3 0 2 6 G .W .R . “ B ” (Old O ak) ... 7 3 O' 4 6 W . E aling “ B ” ... 4. 2 0 2 4 W . E alin g “ A ” ... 6 0 1 S 1 Sperry’s " B ” ... 4 0 0 4 0 44 /1. .Div. S .J .A .B . (Acton) 2 0 0 2 0 L .P .T .B . (Acton W orks) 0 3 0 3 0

“ City of Edinburgh” Ambulances. T w o am bulances which have been presented by the City of Edinburgh Branch of the B .R .C .S . to the Scottish Branch Headquarters were form ally handed over on March 27 th, at 16 , Moray Place, Edinburgh. Colonel H. L . W arden, C .B .E ., D .S .O ., D .L ., who made the presentation, said we had lost many things in the war, but one thing we had not lost was the power to give. T h e citizens of Edinburgh had provided the money for the purchase of these two ambulances. T h e number of vehicles which they had now given to the Scottish Branch was 26 . It was not only in money that gifts were made to the Red Cross, they were made in service and in other ways. T hey were all proud of w hat the Red Cross had done in this war. Lord Kinnaird, who accepted the am bulances on behalf of the Scottish Branch, mentioned that one of them was go in g into a convoy of 12 am bulances which were being handed over to the Free French,

111

A I D

A Street Accident. connection with the article that appeared in this Journal recently, under the heading “ Y ou r First C a s e ,” the follow ing m ay be of interest to readers or those in charge of classes for the purpose of instruction and debate. It is an account of a street accident that I had to deal with, with- the assistance of a B rigade Officer, during our Civil Am bulance days. It happened in the early nights of blackout, and the history was as follows :— Tim e.— about 11.30 p.m. Weather.— D ry, but a little cold. History. — Patient (aged S3 years) stepped off the kerb in front of a cyclist and w as knocked down. In tryin g to get up, he was again knocked down by a car. Before he was able to gather his senses, another car passed over him and knocked him on to the other side of the road. Here, two more cars ran over him. H e was discovered by a mem ber of the public, who sent for the am bulance. W hen we arrived a crowd of upwards of 300 people had collected, and, with much difficulty, we got the am bulance reasonably near to the patient and unloaded stretcher and kit. D iagnosis proved the follow ing injuries :— In

Extensive lacerations to back of head. Fracture (compound) to nose. Practically the whole of teeth knocked out. Severed little finger (right). Fracture (simple) of spine (lumbar region). ,, (compound) left thigh. ,, ,, righ t thigh (bone protruding). ,, ,, left leg (arterial bleeding). Patient, much to our surprise, w as conscious, and was not only able to give us a clear account of w hat happened but complained of the tight bandage round his feet. Spinal fracture later proved not to be so, but we were led to suspect this as the patient complained of pain in that region. But, as it w as, we were faced with a poser. W e were m ostly concerned with arterial bleeding from the leg, be cause we had no femurs to tourniquet on to, and could only apply thick, hard pads of lint to the wound, which, fortu nately, was not large. Th is action certainly stemmed the flow, but not entirely. Added pads were applied as the blood seeped through. Blood was also freely flow ing from the finger stump, but surprisingly ceased on the application of a pad and band age. W e did, however, loosely tie a handkerchief with two knots in it ligh tly round the w rist as a precaution. I gave attention to the head, placing a dry dressing on the laceration, and exam ined the mouth for lost or loosened teeth. T made two rolls of lint, pencil thickness, and placed each side of the nose, covered by a dry dressing, and the whole held in place by a trian gular bandage. It was difficult at first to determine if the eyes had in anyw ay been injured, because the blood was running into them trom the nose as patient lay on his back. After carefully dressing leg injuries (placing a rin g pad and dressing to the protruding bone), we placed two femur splints, one each side of body, and a shorter splint between legs and carefully tied up. Then slow ly, and with all assistance possible from the public, w e slow ly lifted him on to the stretcher and off to hospital. T h e Police had ’phoned the hospital to prepare for a case of m ultiple injuries, so when we arrived the casualty trolley was ready, anti-shock m easures were taken, and morphia was administered im m ediately on arrival. A S am w ay tourniquet w as applied to the leg, im m ediately above the wound, by a doctor. Patient died four days later from bronchial-pneumonia, brought on by shock through loss of blood. It m ay be mentioned that neither the cyclist nor the 4 cars stopped.— J, W . S c o t t ,

I 12

F I R S T

A I D Citadel, St. M ary’s Butts, where a special m eeting took place.

S t.

Jo h n

A m b u la n c e

H EADQUARTERS

AND

B r ig a d e

D I S T R IC T

REPORTS.

N o . I (Prince o f W ales’s) District No. 73 ( G r a y s ) . — For a number of years a very success ful Social Club has been functioning at Grays, composed of members and friends of both Am bulance and N ursing D ivi sions. Many happy hours have been spent at socials, dances and outings, w hilst the financial position has alw ays been satisfactory. Now fresh headquarters are wanted, and various events for the purpose of raising funds are being arranged, the last dance brin ging in ^ 14.

R e a d i n g T o w n “ A .” — On Saturday, March 24 th, at the Ambulance Hall, the Am bulance Division held a success ful dance in aid of funds. T h e M .C. w as Mr. C. Lem pke. A few competitions were run during the evening. All arrangem ents for the dance were carried out by the Divisional Social Committee.

R e a d i n g E a s t . — D uring the year March, 1944 , to F eb ruary, 1945 , members of the N ursing Division have collected the sum of ^,'566 5 s. 3 d. for the Penny-a-W eek Fund from the Licensed Victuallers in the Greyfriars area of Reading.

C adet N ew s.

R e a d i n g C o r p s . — As the result of a challenge, two teams ot cadets representing Reading Tow n “ A ” Am bu C. 16 ( H o r n s e y B .L .).— A very enjoyable camp w as heldlance Cadet Division and Reading W est N ursing Cadet D ivi jointly by H ighbury, Hornsey and M ilm ay S .J .A .B . Cadets sion, met on Monday, March 19 th, at the Am bulance Hall Divisions at Easter. Cadet Officers Reynolds, Sclare, Glover for a Quiz Competition. T his was a very keen contest, quite and Hunt and 29 cadets attended the camp which was held a high standard being shown. T he girls’ team were the at Roydon, Herts. winners by two marks. An inspection was made on the Saturday by Area Cadet Officer S. C. Andrews who congratulated the boys on their turnout. R e a d i n g C e n t r a l . — On March 20 th, at the Ambulance

No. 17 ( W l m b l e d o n a n d M e r t o n ) . — T he annual general m eeting of this Division was held at St. G eo rge’s H all, St. G eo rge’s Road, and w as presided over by the President, Sir Richard Sennett, K n igh t of the Order of St. John. Supt. T . H ow ell, in subm itting his report, stated that he was pleased to report that the activities of the Division had been well m aintained, as had the efficiency of the members. T h e valuable services which had been performed by the mem bers during the fly bomb raids had been appreciated by the local authorities. T he total strength of the Division was now 101 , of whom no less than 60 were on active service, 14 full time and 20 part time with the Civil Defence, and the rem aining 7 were on work of importance in other parts of the country. Public duties numbered some 400 , whilst 195 cases of injury had been dealt with. T han ks were due to the co-opera tion of the N ursing Division for their assistance in m anning the duties. • Dr. Powell Evans conducted the annual re-examination and all members attending passed. Mr. H ow ell stated the financial position was extrem ely good. T his Division established in 1899 , has now grow n to be one of the finest in No. 1 D istrict ; it meets each T uesday at 8 p.m. at St. G eorge’s H all, and Supt. Howell will be pleased to giv e any information. County o f Berkshire. regret to announce the death of Div. Surgeon J. C. H. Baird of R eading G reat W estern Am bu lance Division. D r. Baird was a popular lecturer and an excellent exam iner. H is death is a great loss to the B rigade in R eadin g and District, and the deepest sym pathy is extended to his widow and daughter. O b itu a ry .— W e

R e a d i n g C o r p s . — On Sunday afternoon, March 11th, a church parade was held of about 200 officers and members of the R ead in g Corps. T he parade, which was under the command of County Officer F. A. C. Jarvis, marched from the Am bulance H all, Chatham Street, to the Salvation Arm y

H all, the N ursing Cadet Division held an enrolment ceremony. Seven cadets were enrolled by County Com missioner Mr. C. A. Poole in the unavoidable absence of'the County Cadet Officer. There were tw enty cadets on parade. County of Hampshire. S h o l i n g . — Another Am bulance Cadet Division has been formed in Southampton, and on Friday, March 9 th, an enrol ment service was held in the Methodist Church, Sholing. Dedicatory prayer by the Rev. G. T . W aldegrave was followed by thanks to the officials and members of the Church for their outstanding and unqualified help. County Surgeon Dr. B igby presented a badge of office to Rev. W aldegrave and welcomed him as President of the newly formed Division. In his reply, he said he hoped there would be “ give and take ” and that the boys would remain as keen as they had already expressed themselves. Parents he hoped would be interested in the training of the boys. County Officer H. Thom as then gave the charge to 9 lads of Sholing and 9 from Woolston Divisions. “ K n ights of St. John ” was sung, led by Mr. W ilson at the organ and Cadet W hitcher on the violin. Area Cadet Officer Butt spoke to the lads and praised them for their evident keenness, and to the fact that they had gained the interest of the Church members which was excellent. “ Jerusalem ” su n g by members and congregation, was followed by the B lessing, and the National Anthem con cluded a very interesting meeting.

County of Sussex. E a s t S u s s e x . — Viscountess of Hailsham presented the trophies and prizes to the successful competitors in the cadet competition held at Eastbourne recently. E ight teams com peted in each section of the competition which was judged on team w ork in dealing with an incident, individual first aid, viva voce test on first aid. general efficiency, drill and correct ness of uniform and bearing. H astin gs Tow n Cadet Am bulanceTeam won the “ Jarvis” Cup and Hove Cadet N ursing Team won the “ Countess of Bessborough ” Cup. T he winners and runners up of each section will compete in the county final competition to be held at Brighton on April 21 st.

F I R S T W e s t S u s s e x . — Fourteen team s competed for the “ Countess of Bessborough ” Cup and the “ Trotter ” Cup for cadets, on Saturday, March 24 th, at W orthing. Keenness was the keynote of all competitors and each team 's w ork was applauded wholeheartedly. In presenting the trophies to the w inning team s the M ayor of W orthing stated that it had given both the Mayoress and himself, great pleasure to note the w ork that day of the 5 .J .A .B . Cadets. He thought that their selected hobby was a sensible one, and one in which as young citizens.they m ight in their lifetime find of great value to themselves and those around them. County Officer Pile announced the results, which were : Cadet Am bulance Section.— 1, Horsham ; 2 , Brighton ; 3, Chichester ; 4 , Southw ick ; S, Crawley ; 6, Littleham pton. Horsham winners o f “ T r o tte r ” Cup, together with Brighton, will represent W est Sussex Area in the county final. Cadet N ursing Section.— 1 , Brighton ; 2 , Roedean ; 3 , Chichester ; 4 , Patcham ; 5 , Horsham and Southw ick tie ; 6, Steyning ; 7 , Chichester. Hove, winners of the “ Countess of Bessborough ” Cup, will with Roedean, compete in the county final.

West R idin g o f Yorkshire. S h e f f i e l d C o r p s . — T h e annual m eeting of the Sheffield Corps N ursing Divisions held at the B rigade Headquarters, R ock Hills, on Sunday, March 18 th, was presided over by Assistant Commissioner and A cting Corps Supt. H. C. Else, Esq., K n igh t of Grace, supported by Corps Supt. Mrs. J. W indle. It was reported that the strength of the N ursing Corps at the end of 1944 was 444 , com prising 13 adult and 6 Cadet N ursing Divisions Four members were admitted as Serv ing Sisters of the Order of St. John. T h e duty report showed that the total number of volun tary duties during the year was 11, 072 , representing 49,542 hours of service. Mobile V .A .D .’s included ten serving in various parts of E ngland and one abroad. T w elve members are serving in H .M . Forces, one of whom is now overseas. The year 1944 has shown a substantial increase in the number of duties performed, and many letters of apprecia tion have been received, expressing thanks for services rendered by members.

St. John Ambulance Association. B o r o u g h o f W i s b e c h C e n t r e . — W isbech first aiders have sailed through their annual cup competitions with fly ing colours, for not only is the Mrs. de Rothschild C hallenge Cup (for ladies) in the possession of a W isbech N ursing Division, but the Elgood C hallenge Cup (for men) is now in the hands of a W isbech Brigade. This latter was announced at the end of the competitions for the Elgood Cup, organised, as for the other cup, by the W isbech Centre of the S .J .A .A ., and held in the W isbech W orkin g Men’s Club and Institute on W ednesday evening, March 28 th. In the six teams com peting, the runners-up were a W is bech S t. Mary Rescue Squad team, with an O ut well and Upwell men’s team third, the Gorefield team (which w as awarded the cup last year) com ing a close fourth. An interesting feature about the rem aining team s (both of Upwell) was that they were comprised of cadets, the members of one particular team being all under the a g e of 15 years. T he problem the competitors were faced with was a simple road accident. T hey are w a lk in g along together

R I D when they suddenly hear the screeching of brakes and a crash in a side road. T hey hurry to the scene and find that a cycle and a three-ton lorry have collided ; the cyclist is still conscious, lyin g twisted in his bike and half underneath the lorry, but the driver of the vehicle is unhurt. There is a house 50 yards aw ay where first aid kit is stored, the am bu lance is J of a mile aw ay and the hospital is two miles aw ay. Each team was allowed 20 minutes to complete his task. T o the audience, the cyclist was described as h avin g a lacerated wound on the forehead just above an old depressed fracture of the frontal bone, which itself needed no attention, a fractured righ t clavicle, a dislocated righ t elbow, a fracture * of the left tibia and fibula, and a wound on the leg which m ight or m ight not lead down to the fracture. Com m enting later on the team ’s prowess, D r. R. E. C rockatt, M .B ., C h .B ., the adjudicator, of Sutton Bridge, stated that only one team noticed the old depressed fracture of the frontal bone. T h e reason he had put this in w as because he had been told to m ake the test as hard as he liked, as the first aiders were go od — -“ and they a re ,” he said. S u g g estin g one or two improvements, he said with all due respect to the Superintendent that he did not really see the need for slings and for sm art drill movements on the job. Drill movements in the drill hall by all means, but he would rather see stretcher w ork smooth and quiet and preferably with no orders at all. Another point on which practically every team fell down, w as that they tried to move their patient before they really knew what was the m atter with him. T he doctor also stressed the need for en couragin g the patient. T h e W isbech B rigade which won the cup was awarded

130 points out of a possible 200 .

B o u r n e m o u t h C e n t r e . — It was reported to the annual m eeting of the Bournem outh Centre, that there had been a considerable reduction in the interest shown by adults in first aid and home nursing. L a rg e numbers of people received such instruction at the hands of St. John Am bulance B rigade during the w ar period and probably at no time in the history of the country have there been so many people equipped with the know ledge of how to render first aid to the injured. T h e present dim inu tion is perhaps a natural sequence to the general trend of events, the standing down, for instance, of Civil Defence in connection with which so much first aid w as taught. But if adult interest is fallin g off, the Association are able to report that the number of juniors com ing forward rem ains satisfactory.

T he final round of the men’s inter-D ivisional first aid competition organised by the B .R .C .S ., and held in the City Art Gallery, Leeds, on M arch 25 th, was won by Detachm ent 131 , Leeds Division V (Com m andant T . D ixon Page), who received the Divisional C hallenge Cup. D etachm ent 147 , Sheffield Division V I (Com m andant J. Brown), as runnersup, received the W est R iding Cup. T h e trophies were pre sented by General Sir W illiam Bartholom ew, R egional Com missioner for Civil Defence. T he first aid competition for the Ingham Brooke Shield, at Pontefract, on March 24 th, w as won by M ethley Junction Colliery team, with 226 m arks. Pontefract No. 1 were second with 224 . O ther placings were : Ackton H all No. 1 , 218 ; Allerton Byw ater, 217 ; Snydale, 212 ; G lass H oughton, 200 ; W heldale, 186 ; Pontefract No. 2 , 145 ; W hitwood, 141 ; Fryston, 135 ; Ackton H all No. 2 , 128. T h e shield and prizes were distributed by Mr. H. Hinchliffe, of Airedale Collieries,

i i 4

F I R S T

R I D SOUTH ERN

R a ilw a y

A m b u la n c e

New s.

L O N D O N , M I D L A N D & S C O T T IS H In his annual report of the w ork of the am bulance movement on the L . M .S. R. during the year ended June 30 th, 1944 , the Secretary states that since 1940 there has been a progressive decrease in the number of employees attending classes, which he was sure was due to w ar time conditions, involving longer w orkin g hours, and calls made upon stall in various directions such as the Hom e Guard and other Civil Defence activities. One gra tifyin g feature is the consistency with which the older members of the Centre have continued to retain their interest by passing annual exam inations. W ith the relaxation of the Civil Defence duties and the “ Stand D ow n ” of the Hom e Guard, it was hoped that all concerned would m ake a great effort during the next few months to recruit m any more employees into the classes so that from now on results would show a considerable improve ment. Appreciation was expressed to D istrict Secretaries, D is trict Committeemen, Class Secretaries, Instructors, and members of the Medical Profession for their continued assistance.

E d g e H i l l . — Mr. J. H . W ilem an retired from the Com pany’s service on March 17th, after com pleting 49 years service. For 39 years of this period he has been w hole heartedly associated with the am bulance movement in both the L .M .S . Centre and the S .J .A .B . H e served in H. M. Forces from 1914 to 1918 , first in the R .A .M .C . and later in the R ailw ay O perating Division. On return to civil life he im m ediately resumed his ambulance activities, ta k in g over the duties of Hon. Am bulance Class Secretary of the E dge Hill Loco. Class in 1922 . Eleven years later his service to the cause was recognised by his admission as a Servin g Brother of the Order of St. John. Since 1939 Mr. W ilem an has been a member of the Liverpool L .M .S . D istrict Am bulance Committee. He is the holder of the Com pany’s L on g Service Medal and four S-year bars as well as the L o n g Service Medal of the S .J .A .B ., in which organisation he is Am bulance Officer of the E dge Hill R a ilw ay Division.

L .N .E .R . L i n c o l n a n d D i s t r i c t . — T h e supposition that an aero plane had crashed into the waiting-room of a Lincolnshire railw ay station, k illin g the pilot and severely injuring two other persons, and that rescue parties could approach only by w ay of a passage roofed by a fallen girder, was the prob lem confronting competitors in the Lincoln and D istrict L .N .E .R . am bulance competitions, at Lincoln, on Thursday, M arch 22 nd, when two team s from Lincoln, two from Boston, and one each from Sleaford and Louth, were rivals in the contest for the district shield. Dr. G. Armour, of W oodhall Spa, ju d ged the team w ork and m arks for individual effort were awarded by Mr. Cun ningham , of Peterborough.

Results : Lincoln “ A ” team, 2 1 4 £ m ark s; Boston “ A ,” 208 ; Boston “ B ,” 170 £ ; Sleaford, 1 6 2 £ ; Louth, 1 5 1 ^ ; Lincoln “ B ,” 139 £. T h e M ayor of Lincoln (Coun. H . Bennett) presented the shield. T h e competitions were supervised by Mr. H . T . Bird, L .N .E .R . district engineer.

B a s i n g s t o k e . — T h e annual first aid class competition of B asingstoke was held on April 6th at the Great Western Hotel. T he Judges were Mr. W hite, and Dr. M acLean, assisted by Mr. F. A. Trott (W elfare D ept., W aterloo) and Mr. Francis (Class Secretary). T h e prizes were presented by Mr. E. Uzzell (W elfare Officer). Mr. A. Barrow, the D is trict Am bulance Secretary, presided. •

The competitors were told by the judges of the mistakes they had made in their work, and also remarked on the good results of the examination. Mr. Uzzell said how pleased he was to come to B asin g stoke. Although they were a big class, there was ample room for more men to take up first aid training. He announced that Mr. Francis had been awTarded the Meritorious First Aid Certificate for services rendered. T h e prize winners were 1, C. Parfitt, 2 , A. Garrett, 3 , S. W ilde, 4 , W . Owen, 5 , A. Govier, 6, C. Field. First year Division— I. Pharoah. A prize for the best advanced mem ber not in the prize list was given to F. Ball. Mr. Collyer (Motive Power Foreman) proposed a vote of thanks to Mr. UzzeU and to Mr. Barrow, and supported the appeal for new members. Mr. Francis seconded and pre sented Mr. Barrow with a wallet for the interest he had shown in the class. «

L etters

th e

E d ito r .

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

D ear S cott,—

W ill you kindly pass on the follow ing few lines to our Readers and Advertisers, through the medium of the Journal. As you well know, I have been overseas for three years, and although I have heard from our supporters regularly, this will be the first time they have heard from me. Since leaving England, I have served in five countries under conditions and clim ates which have varied immensely. T he Journals have followed me through them all. I would like to express my admiration and sincere thanks to all who have carried on so gallantly, often under very trying conditions, during the past few years. For your grand support I say “ T h an k Y o u .” I hope to be with you all at no very distant date, the Allies having gained a glorious V ictory, and laid the foundations for a L astin g Peace.— Yours very sincerely, A. J. D a l e R o b i n s o n (Major, R .A .C .). Tow n Major, Ham adan, P A IF O R C E . (M an aging Director, D ale, Reynolds & Co. Ltd.) March 9 th, 1945 .

S .J .A .A .— T he tem porary headquarters of the St. John Am bulance Association at W illey Park, Broseley, Shropshire, will be closed as and Jrom May 5 th, 1945 . From that date all communications including those in connection with lectures, exam inations, awards, stores, equipment and other correspondence, should be addressed to St. John’s Gate, London, E .C .I

F I R S T

c AN

I O D I N E V A P O U R C URE C O L D S ?

you know that colds have been successfully treated by inhaling the vapour given off by iodine crystals ? Dr. A. von Halasz of Budapest reported consider able success with this method in 1933. Thousands of successful experiments with iodine have been conducted b y the AllUnion Committee for the Fight against Influenza in the U .S.S.R . Iodine has m any diverse uses. It can be

I o d in e 2 0

A I D

S T O N E

H O U S E ,

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

Ii8

F I R S T

QueriesandAnswers toCorrespondents Queries w ill 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.

4.— T he Textbook to which reference m ay be made in this column is the 39 th ( 1937 ) Edition of the S .J.A .A . M anual of First Aid to the Injured. E le c tric R a ilw a y A c cid e n t.

J.W . (B ebington).— At Divisional Practice recently, we had to treat, in the ligh t of a handlam p, a man who was supposed to have fallen o(T a railw ay platform in the darkness, on to an electric live rail and to be suffering from bleeding from the temporal artery and from a simple fracture oTkneecap. T h e electric current had been cut off im m ediately after the accident. One member said that he would treat the patient in the position found and remove to hospital, but another said that he would first treat the bleeding, tie a figureof-eight bandage round the feet and then remove patient to the platform where he would complete treatment before despatching patient to hospital in ambulance. Please tell us which method is correct. T o me your test is faulty because, although it states that the patient fell on a live rail, it says nothing about the presence of burns which must surely have been present. In the treatment of the injuries named, the suggestions in the second method are the right ones, the reasons being (1) that the patient would be uncomfortable lying on the rails, (2) that no aggravation of the injuries would result, provided that due care is exercised, (3 ) that the patient will be transferred to hospital more quickly if the bearers do their w ork on the platform rather than on the rails, and (4 ) that the railw ay line would be re-opened more quickly and the inconvenience to hundreds of passengers m inim ised.— N. C orbet

F le tch e r.

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

S. J. (C ricklew ood).— Further to your request in the Query Column of the March issue o f F i r s t A i d , I send the follow ing howler for publication if approved :—■ D urin g an exam ination the doctor asked a candidate w hat he would do if he were called to a man who had just had a haemorrhage into the brain tissues. He looked surprised when the cadidate replied :— “ / would, walk the patient up and down the bedroom to keep him Jrom Jailin g asleep ! ” I Good.

Next, please! !— N .C .F .

A W alk in g F ra c tu re

R I D of patient in case the pedestrians bumped into him. W e thank you in advance for your kind ruling. T here is not much in your problem, though of the two positions I favour w alk in g on the injured side of the patient. Incidentally, pedestrians are not likely in broad daylight to collide with a patient who has his forearm supported in an arm -sling.— N. C. F.

E x te rn a l C a ro tid A rte ry .

II. B. (Crew e).— H avin g just returned home from Divisional Practice where an argum ent am ongst very keen competi tion first aiders— an argum ent which seemed likely to go on “ ad infinitum ” — it was agreed that I should write to you and that we should stand by your ruling. Incident ally, if I am correct our Cadet Fund will benefit financially at the expense of my errant colleagues. On pages 113 - 114 , the T extbook re a d s :— “ The external carotid artery gives off three important branches . . . . ; the artery is then continued upwards to supply the scalp in the front half of the head (tem poral).” In my opinion, these words clearly define the artery, from the point where it gives off three branches, as being the continued external carotid artery and that not until it reaches the temporal pressure point does it change its name. Nevertheless, I cannot convince my colleagues that the T extbook plainly says so ! ! W e aw ait your kind ruling and thank you for your column in F i r s t A i d . You are right when you say that the temporal is the direct continuation of the external carotid artery ; but you are w rong when you say that the former starts at Pressure Point No. 3 . In point of fact, it starts where the main artery leaves the region of the neck, approxim ately at the angle of the jaw . T his being so, all of you missed the m ark and all of you should pay into the Cadet Fund. Prosit !— N .C .F .

S h ell S hock.

D. C. (East Molesey).— Some friends and I have been dis cussing “ shell s h o c k ” — how to diagnose and how first aiders should treat the condition. W e should value your advice on these two points ; and we would also like to have an explanation of what takes place in a person suffering from shell shock if you will be good enough to tell us. Shell shock— a term now obsolete— was the name applied during the last war to the mental illnesses produced by the strain and noise of war. D u rin g the period between the two European W ars, psychiatrists have sorted out the various mental states involved and given them names accordingly. T he principal factor in this type of mental illness is the inability of the individual to adjust himself to the conditions in which he has to live and w ork, whether in w ar or peace. T h e diagnosis and treatment of such conditions are far beyond the scope of first aid.— N .C .F .

T rea tm e n C o f F ra c tu re d L eg.

C ase.

J. W . (B ebington).— A gain, if a man suffering from simple fracture of clavicle was able to w alk a short distance to hospital, should the first aider w alk on the injured or the uninjured side to shield the patient? In a discussion of this problem at Divisional Practice one member said that he would w alk on the injured side

J. S. (Oldbury).— A friendly argum ent has arisen in our Am bulance Class as to the correct interpretation of the Textbook instructions on p. 92 re the putting up of a fractured leg when no splints are available. Should there be three or four bandages used ? Your decision on this question 'would be very much appre ciated.

Three bandages are required— viz., a figure-of-eight

F I R S T

FIRST AID

119

R I D

IG L O D IN E —FIRST-AID

HANDBOOKS

“ I t d o e s n ’t h u r t in t h e l e a s t ” — I g l o d i n e can be applied t o an o p e n w o u n d w ith o u t pain. T h is safe, b u t p o w e r f u l antiseptic cleam es and heals cuts, w o u n d s , b ru is e s, scalds and b u rn s .

A N A T O M I C A L DIAGRAM S A N D C H A R T S FOR LEC TU R ES

The P A IN L E S S Antiseptic H.

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a nd o t h e r R e s p ira to r y Sufferers sh o u ld c o m m u n ic a te w ith B ritish M edica L a b o ra to r ie s , L td ., f o r p a rtic u la rs of “ S a n o le n ” t h e m o s t e f f ic a c io u s H o m e R e m e d y k n o w n t o M e d ic a l S cience : N o w being u sed w ith r e m a r k a b le success e v e r y w h e r e : E n d o rsed by t h e M edical P ro fessio n . B R IT IS H

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The adm inistration o f a safe sed ative is often desirable in conjunction w ith the treatm en t o f conditions w hich cause pain and distress. A n a d in ,’ a w ell-balanced com bination in the aspirinphenacetin-caffeine group, can be relied upon for rapid ity o f action in th e elim ination o f pain. I t has no unpleasant after-effects and is u n lik ely to cause gastric disturbance. M oreover, ‘ A n adin ’ is n ot con ducive to habit-form ation and is, therefore, com pletely safe in the hands o f the patient.

A S S O C IA T IO N

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F I R S T

round ankles and feet, one narrow round thighs and another narrow round legs. It is unfortunate that the T extbook in R ule 4 on p. 92 refers to “ round ankles and feet as figu re-of-eight” and in the sentence which commences “ when no splint is avail able ” to “ feet, ankles, & c ., ” in this order. Of course, ankles and feet is correct. Also for the com m a between “ feet, ankles ” you should substitute the word “ an d .” — N .C .F .

R I D event of the Officer-in-Charge becom ing, in the eyes of its members, incapable of perform ing his duties efficiently ? B rigade Regulations m ake no ru lin g on this matter. Before we can answ er your query, you must send us your names and addresses.— E d i t o r .

A d m in is tra tio n of M o rp h ia .

J. S. (B eccles).— I am a m ember of the St. John Ambulance Brigade, No. 1 Prince of W ales’s District, having joined it in 1931 and during the past five years I have served with the R .A .F . Medical Service as a nursing orderly, in which time I have gained much experience in medical and surgical w ork, not forgetting first aid. W hat I would like to write to you about is the use of morphine in first aid w ork. In the service we are issued with w hat are know n as T ubunic Ampoules each of which contains morphine hydrochlor— 1/3 gr. and atropine sulphate— 1/120 gr. I am fully aw are of the fact that usin g morphine in first'aid m ay have some disadvantages, but don’t you think it is more to the advantage by g iv in g the drug early in cases of severe injuries such as compound frac tures, burns and extensive wounds, as it puts the patient to rest and therefore lessens the effects of shock. I have already spoken about my idea to several M .O .’s with whom I have worked ; and they all told me that they thought it was a good thing. T h is only applies, of course, to registered members of the S .J .A .B . and the B .R .C .S . D etachm ents to adm inister this drug, and it must be fully instructed that on no account should this d ru g be given in cases of head injuries or abdominal pain. If y o u a g r e e w i t h m e o n t h i s s u b j e c t , w o u l d y o u be g o o d

e n o u g h

th o s e

A id

h a v e

a u th o r it y

M e a n w 'h ile

m y b y

v ie w s

b ro u g h t

p u b lis h in g

th a n k

yo u

t h is

th e

le tte r

F o u r - H a n d e d S eat.

found an error in the description of the four-handed seat on p. 196 where it states that “ this seat is used when the patient can assist by u sin g one or both arm s.” Of course the words “ one o r ” should be deleted. It is curious that I did not notice the error previously. Personally, I cannot concede that the instruction is an error. I do, however, agree that the bearers would have to move more slow ly and cautiously if their patient should have only one arm to place round the neck of one bearer, than they would if patient could use both arms in this w a y .— N .C .F . o f a D iv isio n .

P r i v a t e s . ” — Could you please inform us what action could be taken by a B rigad e Division in the

F e d -u p

Reactionary haem orrhage signifies serious bleeding which takes place subsequently— and yet is due— to the original injury. D uring recovery from shock a reaction alw ays takes place. In consequence of— and as part of— this improvement in the patient’s general condition, the heart beats more forcibly and gives rise to further bleeding which w e call “ reactio n ary” as distinct from “ p rim ary ” haem orrhage at the time of the accident.— N .C .F .

“ F IR S T Q U E R Y T o

and

c u t

o u t

A ID ”

R E P L IE S

a n d

e n c lo s e d

w ith

C O U PO N . a ll

Q u e rie s .

April, 1945 .

F ir s t

a d v a n c e .

A. S. (Ipsw ich).— R eadin g m y T extbook the other day, I

“

O. P. (Carlisle).— Please tell us what is meant by the term reactionary haem orrhage, which w e cannot find in the Textbook.

a tt e n t io n

Under wrar conditions there are authorised em ergency methods of treatm ent which would never be sanctioned for the mishaps of civilian life on the grounds that for the latter, doctors are usually readily available. Further, the adm inistra tion of morphia by lay persons is em phatically open to grave consequences. In point of fact, the chief danger from m orphia is that it depresses the respiratory system. For this reason, it should not be given to those suffering from serious head injury or severe shock attended by depression of that centre as shown by slow and shallow respiration. In these circum stances, I can only stress that its use is beyond the scope of first a id .— N .C. F.

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MANUALS OF FIRST AID By

CORBET

FLETCHER,

O .B .E .,

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(Stretcher, Individual and Question— Six Folders). Price 6 for 3s. posted. Each Folderr contains special article on Competitn Competitions N o . 1, Tra in in g of Cornpetition Teams ; N o . 2, Conduct C iucl of Team in Competition Room ; N o. 3, Common Errors in Competition ; N o. 4, Further Errors in Treatm ent; N o . 5, H istory of Competition ^Tests ; N o . 6, Preparation of Tests.

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W H E R E F O R E IN F IR S T -A ID . I s . 3 d . post 2 d . D ifficu ltie s in Study and T rea tm e n t solved by Q uestion and Answ er. Fifth Edition.

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I H E best guide for competitors. Based on actual experi1 ence. l i d . Post free (8/- dozen) Fountain Press, 46 , Chancery Lane, London, W .C . 2 . D O I S O N S C H A R T — H andy Q uick Reference— Treatm ent * and Remedies for 30 different poisons. H aw kins, l i d . Post free (8/- dozen). Fountain Press, 46 , Chancery Lane, London, W .C . 2 . YO U

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C I R S T A ID Competition and Practice Tests. Book conI taining six team tests, six individual, six oraj, price 2/-, postage Id. Compiled by D ivisional Superintendent. From : Robinson, BCM /First Aid, London, W .C .I.

-clears upMANY SERIOUS LEG T R O U B L E S T r y Germolene yourself— and you will be convinced IN FL A M M A TIO N o f its power to soothe and RASHES, SPO TS relieve skin complaints. Under the healing hand BURNS, CUTS o f Germolene many skin afflictions vanish in a few days — or even hours. But Germolene’s most wonderful victories are recorded in letters like the fo llo w in g: •R E SU LTS HAVE BEEN W ONDERFUL’ “ I have been troubled with bad legs for years . . . I applied Germolene three and sometimes four times a day. The results have been wonderful. I am sure it was only Germolene that got me on my feet again. No praise is too high for your wonderful ointment; it is worth more than I can say about it. You may publish this letter as you wish.” (Signed) C. A. B. (Mrs.), Shifnal, Salop.

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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 8th of each month, and must be accompanied ( not necessarily for publication) by the name and address of the Correspondent. Subscriptions, Advertisements and other business Communications connected with F IR S T A ID should be forwarded to the Publishers. D A LE, REYN OLDS & 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 Address— “ Twenty-four, London Telephone— City 3710.

CONTENTS

d it o r ia l

T H IS

NUMBER.

—

Superannuation and Pensions

...

121

...

122

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

...

123

W ar— and Peace

...

R ailw ay Ambulance News

...

124

Letters to the Editor

...

125

S .J .A .B . Overseas

...

126

Nasal H aem orrhage

...

126

W est London and D istrict First Aid L eagu e

...

126

Obituary Q

u e r ie s

... a n d

... n s w e r s

t o

... C

...

o r r e s p o n d e n t s

...

126

:—

Treatm ent of Concussion

...

130

Exam ination H ow ler

...

130

Artificial Respiration and First Aid Instruction

130

D igital Pressure on the Subclavian

...

130

...

Treatm ent of Burns

...

130

Seniority in Division

...

130

Treatm ent of Pneum othorax

...

130

Treatm ent of Fractured T h igh

...

Compound, Complicated Fracture of Forearm Schafer or Silvester Method

...

132 132

...

132

The

r e c o m m e n d a tio n

that

Superannuation central fund s h o u ld be e sta b and Pensions, lished to pro vid e p e n s io n s for 5 8 ,0 0 0 nurses and w id w iv e s not in the se r v ic e of local a u th orities has been m ade by the S u p e r a n n u a tio n S u b - C o m m it t e e ap p o in te d by Lord R u s h c lif f e ’s N u r s e s S a la r y C o m m itte e and the S c o t tis h N u r s e s S a la r y C o m m itte e , and it is p roposed that the fund p r o v id in g for n u rses and m id w iv e s in salaried e m p lo y m e n t of v o lu n ta r y h o sp ita ls and ap p rov ed o r g a n is a tio n s , w h e r e the R u sh c liffe and T a y lo r sc a le s h a v e been a dopted, s h o u ld be m a n a g e d by a sta tu tory b o d y repre se n ta tiv e of all interests. T h e report se e k s to s ecu re u n ifo r m ity of su p e r a n n u a tio n and inter c h a n g e a b ilit y of p e n sio n r ig h ts for n u rses and m id w iv e s in local au th o r ity serv ic e , but that a separate fund s h o u ld be set up c o n f o r m in g broadly to local auth ority fu n d s, in w h ic h s h o u ld be in c luded nurses and m id w iv e s in the e m p lo y m e n t of v o lu n ta r y h o sp ita ls and a p p r o v e d o r g a n is a t io n s w here the R u s h c liffe and T a y l o r s c h e m e s h av e been ad op ted . F o l l o w i n g on the lin e s w hich h av e been adopted in a n a lo g o u s c a se s, c o n tr ib u tio n s of s ix per cent, of the salary are to be paid by the nurse and a m a x im u m of 12 per c ent, by the e m p loyer. T h e r e is a m in im u m q u a lification of 10 y e a r s ’ c o n tr ib u tin g se r v ic e with c o m p u ls o r y retire m en t at 60, w ith the op tio n of retiring at 55 on c o m p le tio n of 30 y e a r s ’ ser vic e . P e n s i o n s are to be based on the a v e r a g e sa la ry of the last five ye a r s of ser v ic e . It w o u ld be at the rate of o n e six tie th for e v e ry year of c o n t r ib u t in g ser v ic e , su b je c t to a total m a x im u m of tw o-th ird s o f su ch a v e r a g e salary. P e n s i o n s on p e r m a n e n t in c a p a city are to be on a sim ila r b a sis to t h o s e for a g e , w ith a m in im u m of o ne-third, s u b je c t to c o m pletion of 10 y e a r s ’ c o n tr ib u tin g s e r v ic e . The f o llo w in g e x a m p le is g iv e n : A nurse en ters a v o lu n ta r y h o sp ita l at 18, rem ains a staff nurse all her life, her sa la ry u ltim a te ly r is in g to £ 2 3 0 a year. If sh e retired at 55 her an n u al p en sio n w o u ld be ^ 141 16s. 8 d. If s h e rem ained in se r v ic e till 6 0 s h e w o u ld receive ^ j l 5 3 6 s. 8 d. If s h e had ob tain ed an a p p o in t m e n t as ward sister at

122

F I R S T

30 her p e n sio n at 6 0 w o u ld be . £ 1 8 6 13s. 4 d . T o preserve e x i s t i n g r ig h ts and interests, it is proposed that n u rses w h o are con trib u tors to the Federated S u p e r a n u a tio n S c h e m e sh o u ld h av e the o p tion of r e m a in in g in it.

W A R -A N D A

P le a

fo r th e

and

M o d e r n is a t io n

S IR

HENRY

PEACE.

C o n t in u a t io n ,

In t e n s if ic a t io n —

o f F ir s t A id

T r a in in g .

M A R T Y N , K .C .V .O ., F .R .C .S .

B y the time these words are in print it appears probable that the w ar in the W est will have dralvn to a victorious con clusion and the problems of peace w ill be the subjects of anxious consideration. Even excluding the Japanese war the world will remain unstable for some years to come, like some vast conflagration which has only just been subdued, and which is liable to flare up in minor local disturbances at any moment. All eyes w ill be turned upon San Francisco and the hope of establishing an organisation capable of m aintaining per manent security and peace. T he nations have learned their lesson and appreciate that peace can only be maintained against the deliberate aggressor, not by moral suasion and treaties but by the strong man armed and prepared to protect the three freedoms if necessary by force. U ntil stability is established we cannot afford, as a nation, to sink once more into the rut of self satisfied com placency. Not only must the F igh tin g Services remain prepared but the Civil Defence Services with all that they entail, must be maintained, at least in em bryo— and— be it remembered, the Civil Defence Services consist of everyday citizens whose courage and determination has focussed the eyes of the world upon them since the days of the first Blitz. Even excluding w ar itself, the toll of the roads is likely to continue, unfortunately, however much the prospective new precautions of the Government to cut down this grievous loss of life m ay succeed. It is already clear that the authorities are definitely con tem plating the establishm ent of some form of permanent Civil Defence, presum ably with skeleton Rescue Services and First Aid Posts. From whatever angle we consider the sub ject, the need for every possible encouragem ent for the con tinuation, intensification and modernisation of First Aid training remains a policy to which the Government are already g iv in g the most energetic encouragem ent. It is curious to think that any good whatever can arise from the agon y and horror through which we have passed, and yet in one respect at least, very real good does result, nam ely in the improved medical and su rgical know ledge which invariably occurs in war. T h e lay mind has an alm ost universal tendency to accept post hoc as invariably propter hoc. T hat is to say to believe im plicitly that if recovery from some illness or injury has followed the use of any particular form of treatment, then necessarily that treatm ent has been the cause of the recovery. A badly cut finger has perchance remained clean and free from infection after it has been bathed with some form of antiseptic. T h at to the laym an becomes proof positive that the particular antiseptic employed, has been the cause of the successful result. U n fo rtu n a te ly the m edical m in d h a s le arn e d from m a n y

A I D years of experience that the effect is not by any means invariably the result of the apparent cause. Not until oppor tunity occurs to observe and record long series of identical or nearly identical cases occurring under identical or nearly identical conditions in patients of sim ilar calibre, treated in identically the same w ay can any really authoritative opinion be given as to the efficacy or otherwise, of any particular form of treatment. It is because of the unfortunate existence of vast quantities of clinical m aterial that medicine in five years of w ar can gain more know ledge for the benefit of mankind in general, than in many many years of peace. At the beginning of the last w ar we treated all our wounds with varying antiseptics applied in varying ways. In spite of all we could do, the results were bad and at the end we were beginning to discover other methods, to appreci ate that antiseptics were of little value once a wound was heavily infected, and to realise that excision of the dam aged area was the ideal treatment if it could be done soon enough. T he Spanish W ar produced Truetta, the famous Barcelona surgeon, to carry on from where we had left off in 1918 , and to prove conclusively that excision of the wound was the ideal treatment. T his w ar started where lie finished and, throughout, both the Allies and Germ ans alike, have treated their wounds on the lines which T ruetta laid down, reinforced by the marvels of the Sulphonamide group of drugs, Penicillin and blood transfusion. T he results have been beyond comparison with those of any previous wars, and the medical profession has scored a triumph in the vastly lowered m ortality and shortened con valescence of all wounded. There is one great lesson from all this however, which some of us, I think are apt to forget, nam ely that the advances in surgical know ledge must, if they are to be effective, entail advances in First Aid know ledge also. Even the simplest basic principles are not unchangeable and must perforce advance as all scientific teaching advances. It was probably a sound principle in the Middle A ges to teach the then embryonic First Aider that an emulsion of snails and rats tails, if applied to a dog bite would protect the victim from the rabies, but we should be a little surprised to find such a dictum maintained nowadays. And yet relatively the advances in First Aid teaching have, in the last five years, been almost as surprising, a fact born out by the necessity which the Ministries have found for issuing the several adm irable editions and reprints of A .R .P . Handbook No. 10 , each including new facts and new discoveries in First Aid w ork in Civil Defence. W e shall have to realise that the methods of treatment of war wounds are equally applicable to the serious wounds of civil life. T he bad sm ashes of railw ay and car accidents will no longer be treated by w ashing with water and apply ing an antiseptic under a dry dressing, even in the absence of a doctor, but by the simplest possible protection of the wound and the earliest possible removal to hospital for excision and immobilisation. T riglifts have come to stay and no longer will the patient be lifted by hand however well trained the First Aiders may be in the other methods. K now ledge of the Crush Syndrome and how to handle casualties pinned beneath heavy debris will have to be taught upon the lines we have learned by bitter experience. In short, First Aid training must be made to embody every lesson which this w ar has taught us, for the benefit of m ankind, no longer should it be limited to the weary reiteration of one textbook, however sound that book m ay be. T h e bogey that too advanced training m ay cause the First Aider to assume the functions of a doctor is, I remain convinced, a pure myth ; the average man suffers far more from tim idity than from the confidence which can only be born of know ledge.

F I R S T

S t.

Jo h n

A m b u la n c e

H EADQUARTERS

AND

B r ig a d e

D I S T R IC T

REPORTS.

County o f Berkshire. On Red Cross and St. John Sunday, April 22 nd, a com bined Church Parade was held by over 600 members of the British Red Cross Society and Order of St. John. The parade attended a special service at St. M ary’s Church, Reading, conducted by the Rev. M. J. Nott, B .D ., A. K .C . The collection in aid of the D uke ot G loucester’s Fund amounted to ;£18 6s.

— On Tuesday, April 17 th, a competition was held in first aid and home nursing for the Divisional Shield. Three team s entered. The winners were team No. 2 captained by Cpl. Miss Nichols, the runnersup being team No. 3 captained by Cadet Officer Mrs. Ewart, who were only six m arks behind. T h e a le

N u r s in g

D iv is io n .

B e a r w o o d . — The Royal Merchant N avy School N ursing Cadet Division has now been registered. T h e Officer-inC harge is Mrs. C. Eppstein. An enrolment ceremony was held and eleven cadets were enrolled by the County Cadet Officer Mrs. C. A. Poole.

County o f Devon. T o p s h a m . — The third annual meeting of the Topsham Division was held recently. T he Secretary reported no change of personnel but serious depletion from active list ow ing to members being called aw ay from home due to various forms of National Service. T h ou gh a difficult year, rem aining members have stoutly carried on. T h ey had succeeded in greatly enhancing the financial position of the Division and had acquired new headquarters which would be of great benefit towards a unity of training and service between the Am bulance, Home N ursing and Cadet units. Th e Division is now at the commencement of its fourth year and on a sound footing, and well placed to receive the homecoming of its absent members when the demobilisation of the Services began. There was every sign that the demands of peace would be met and faced by the Division w ith full confidence.

County o f Leicester. G i p s y L a n e . — This Am bulance Division held a birthday party on April 25 th, to m ark their 10 th anniversary. T he President of the Division, Mr. L. Miller, presided, when 52 members and friends sat down to supper ; a birthday cake with 10 candles was provided. T h e Div. Supt. T . Ham es proposed a Toast for the members aw ay in the Forces and to the success of the D ivi sion in the future. Mr. L. Miller spoke of the services of the Div. Surgeon Dr. P. H ughes, and asked him to accept a pair of pipes in appreciation of all he had done for the Division. Dr. H ughes replying, thanked all for the gift, which came as a great surprise. S in g in g and dancing brought the party to a close.

County of Norfolk. N o r w i c h . — A Conference of Officers of the S .J .A .B . in N orfolk was held at the Stuart H all, Norwich, on April 21 st.

R I D

123

T he conference was opened by the County Com m issioner Sir Thom as Cook, M .P ., who has ju st been released from the Forces, this being the first conference since w ar started, and he stated he was very pleased to be back and welcomed all the new members. Dr. May R utledge, County Supt., addressed the m eet in g on Recruiting. Mr. J. Todd of the M inistry of W orks, gave some useful information re Huts. Miss M. E. D yanne of the County Education Committee ga v e a talk on what was being done by the Education Authorities for cadets, etc. T his was followed by a very interesting talk by Dr. W . C. Bentall, Deputy Surgeon in Chief. T ea followed these talks, when everyone was able to discuss matters connected w ith their individual Divisions.

On Sunday, May 6th, the County Com missioner, Sir T. Cook and other County Officers, inspected the Gt. Y a r mouth and Gorleston N ursing, Am bulance and Cadet Divisions.

S h e r i n g h a m . — T h e annual inspection of the Am bulance and Cadet Divisions was carried out on April 9 th, by Sir T. Cook, M .P. T h e inspection took place outdoors where the D ivision was drawn up under Div. Supt. S. E. Day. T he County Commissioner afterw ards remained for the annual general m eeting and addressed the members. T he 18 th annual report recorded that 1944 had been a year of quiet but steady progress ; the strength of the D ivi sion was 37 with 17 of these members serving with H .M . Forces. Three more members had qualified for the L on g Service Medal. Members still continued to stand by when the lifeboat was launched. T he Cadets’ report showed the strength w as 20 ; 7 boys had obtained their preliminary certificate in first aid and there w as a 100 per cent, pass am ongst those tak in g their annual re-exam ination. Sir T. C ook in his speech, congratulated the parade upon their sm art turn out and said that he was glad to re-establish contact with St. John work in Sheringham .

County of Oxford. W i t n e y . — A memorable service was held in the Con gregational Church, W itney, on Sunday, April 22 nd, when in the presence of a large congregation, Supt. J. C. Chester man unveiled a Roll of Honour and a Memorial Tablet. On the Memorial T ablet are the names of four men who have died whilst members of the Division. T h ey are Theodore H. Roux, Ernest Cantw ell, Alfred Calcutt, Albert Powell. T h e Supt. paid a high tribute to them and said that perhaps they were unseen witnesses at the ceremony. On the Roll of Honour are the names of the men who are serving with the Forces, two of whom were prisoners of war. Just before the service began, the glad news was received that one of them, Private J. Cox, had been released and had arrived in England. A very m oving service was brought to a close by the sin gin g of the hymn H oly Father in T h y mercy H ear our anxious prayer Keep our loved ones now far distant Neath T h y care.

County o f Stafford. M e ir a n d L o n g t o n . — The annual presentation of aw ards and prizes for 1944 , of the above D ivision, took place on Saturday, April 21 st, at Edensor New Schools, Longton. In the absence of Mrs. F. R. Oliver, Mrs. F. E. S. Jones presented the aw ards, shield and prizes and a special g ift was presented to Dr. F. R. Oliver by Mr. W . Bath.

124

F I R S T

In his rem arks the Chairm an (Mr. B. Skellem ) spoke of the splendid work which the St. John Am bulance Brigade were doing in this w ar, and especially the men of the L o n g ton Division who had helped considerably in the convoys and transportation of wounded soldiers in this area. T h e Div. Surgeon, Dr. F. R. Oliver, in his reply stated that he w as very pleased to hear that his w ork for the D ivi sion had been very helpful, not only to members at home, but to those serving abroad also. Div. Supt. F. E. S. Jones thanked the members of the D ivision for their keen interest and support during the past year. Later in the evening refreshm ents were served.

County o f Sussex. T o m ark the com ing of a ge of the Preston N ursing Cadet Division, the Officers, members and a large gath erin g of parents, attended a social at Brighton, recently. An excellent program m e w as arranged, gam es, dancing, demonstrations, songs, and the spotlight of the evening being a speech from County Officer for Cadets Miss E. M. Trill, who spoke on the progress that had been made in the D ivi sion, and of the movement as a whole. She congratulated Miss Collinson who formed the Division 21 years ago. T h e D ivisional aw ards were presented and refreshments served ; the youngest member of the Division tried to extinguish the 21 candles on a cake which had been pro vided to m ark the occasion. P r e s to n .—

A I D

R a ilw a y

A m b u la n c e

New s.

L .N .E .R . N o r w i c h . — T he L .N .E .R . Norwich District Officers’ Am bulance Shield Competition, which has not been held since the w ar started, was revived on April 12 th. The m axim um number of points was 360 . T h e results were :— Norwich 257 , Yarm outh 228 , Attleborough and Brandon tied for third place with 214 points and Thetford secured 209 points.

T he team test was as follows :— A passenger is w aiting on the platform for his train when a porter, pushing a heavy barrow, piled high with lu g g a g e runs violently into him and knocks him to the ground ; he is evidently badly hurt. The teams must render first aid. In addition to the team test, each member of the team had to submit himself to an individual examination. Dr. May R utledge presented the shield and prizes. Mr. G. G. Goodings, D istrict Goods and Passenger M anager presided and the ju d ges were D istrict Staff Officer T . E. W alsby and D istrict Officer E. W . Haines. The arran ge ments were made by Mr. R. D. Brown.

SOUTHERN Members of the St. John Am bulance B rigade from many parts of Sussex gathered at Pelham -street School, Brighton, on Saturday, April 21 st, for the County Cadet Competition. T o use the words of one of the judges, the entrants revealed “ a standard of the highest quality ” and drew m any com pliments on the w ork of the B rigade in the county from visitin g officers from other parts of the country. T h e members were required to demonstrate first aid, both as team s and individually, and also to answ er questions. There were General Efficiency and D rill tests, while music w as supplied during the afternoon by H astin gs Corps Cadet Band, who attended by kind permission of the Corps Supt. H . W . W ren. For the Am bulance C adets’ tests the highest possible number of m arks w as 325 , the winners being Horsham with 235 J m arks— this entitled them to the “ H in ck ley ” cup; Brighton were second with 234 g, H astings third with 222 J, and Lew es fourth with 182 J. T h e “ H ig h est Captain in Drill and General E fficien cy” test, for which there were 40 m arks, was won by H astings, who became the winners of the “ H ey wood ” cup with 34 marks. T h e tests for N ursing Cadets was won by Hove with 231 ^ m arks out of the m axim um 325 . This made them the winners of the “ Sussex ” cup. Brighton were second with 230 |, Roedean third with 219f and Lew es fourth with 157§. The” “ H igh est Captain in D rill and General E fficien cy” test w as won by Roedean with 32 m arks out of a m axim um of 40 , m akin g them the winners of the “ T r o tt” cup. T h e cups were awarded by the Lady Supt. in Chief St. John Overseas, the Hon. Mrs. Copeland-Griffiths, who expressed her pleasure at the sm artness and the capability of the entrants.

For nearly l i hours, six members of the Medical Profes sion dealt with questions at the First Aid Post, Charing Cross Station, on W ednesday, April 18 th, which were sent in by members of the Southern R ailw ay Am bulance Centre. From hair grow in g to blood production, from the treatment of shock to the treatm ent of nose bleeding, all questions were well and truly answered in one of the best “ Brains Trusts ” yet held. Possibly this w as because the “ Trust ” included Englishm en, a Scot, an Irishm an and a W elshman, each having his own views. Mr. E Uzzell (W elfare Officer) in his own inimitable manner introduced the “ T ru st.” A crowded house enjoyed the session which was of an instructive and pleasant nature.

Mr. Uzzell presided at W aterloo recently when the pre sentation of meritorious long service certificates was made to Sub-Station Inspector G. W . Salthouse and Fitter H. Prince members of W elling and Slades Green Am bulance Classes, by Mr. J. R. W ard, Distribution Engineer Electrical Depart ment, who congratulated the recipients and spoke of the value of first aid know ledge, referring to the w ork as a most useful hobby. Mr. Salthouse in acknow ledging, said his fam ily had been associated with Am bulance activities for a number of years, and that his wife and two daughters recently qualified in first aid.

S a l i s b u r y . — On the occasion of a film show given recently to members and friends of the Salisbury Ambulance Class, Mr. R. M. Barton, R unning Shed Supt. presented Mr. T row bridge, Sub-Inspector, E ngineer’s Department, with a meritorious certificate for services rendered to the first aid cause. An interesting program m e of films was shown to con clude the evening’s events, which were well attended.

A L L R A N K S ^ A L L S ER VIC ES] Thank them NOW, by a gift o r legacy to ~

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F I R S T

L etters

th e

E d ito r .

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

A LETTER D

ear

FROM

SO U TH

A F R IC A .

,—

May I say how much we in South Africa appreciate your journal ? There is hardly a page, but has som ething of great interest to St. John workers in this country, and we look forward every month to reading about the activities of our own and similar organisations in Great Britain. O ur interest in the mother country has alw ays been intense, and now that distance is fast succum bing to modern transport that relationship is gain in g an added importance. Surely in the era of friendship and understanding that we all hope post war days will bring, the Am bulance movement will be able to use its not inconsiderable power in hum an itarian work to good effect, and to this end all concerns should co-operate. F i r s t A i d m akes possible for us in South Africa closer contact with the centre of Am bulance w ork in Britain and thus indirectly with many other countries. I feel, that as we appreciate this, so perhaps your readers m ight appreciate news from other countries too, and in view of this I venture to send you some notes on the w ork of the S .J .A .B . in Southern Africa. Perhaps there will be one or two points of interest to you, and should this be the case I will be only too pleased to send you reports on those aspects of our w ork at intervals. W ith renewed thanks and all best wishes for even greater successes for F i r s t A i d . — Yours faithfully, F. W . S m y t h (Secretary) W itw atersrand and Southern T ransvaal Centre. April 20 th, 1945 . A R T IF IC IA L D

ear

R E S P IR A T IO N DEATH.

APPARENT

,—

I have read with interest G. B .’s letter stressing the value of C 0 2 for restoring breathing in cases of apparent death, and congratulate him on his success in dealing with cases of carbon monoxide poisoning. The value of C O z has been recognised for several years by the addition of 7 per cent. C 0 2 to pure oxygen in the wellknow n apparatus supplied for restorative purposes. The use of oxygen in cases of carbon monoxide poisoning greatly hastens the expulsion of this gas from blood, by overcom ing its far greater com bining power for haem oglobin. It quickly supplies the needs of the heart and other vital organs and so prevents the dam age which so easily arrives from oxygen want. I would not advise then the giv in g up of oxygen, but its continued use with 7 per cent. C 0 2 .— Yours faithfully, S ir

L e o n a rd

H ill,

F .R .S ., M .B ., L .L .D .

Nicholls W ood, Chalfont St. Peter, Bucks. April 14 th, 1945 .

12 5

R I D

H is grandfather started first aid and am bulance work d uring the Crim ea W ar and in the Indian Mutiny, and on discharge kept it up on the Caledonian R ailw ay w orks at G lasgow . H is father took his first certificate in 1887 and w as afterw ards for 11 years, captain of the St. Rollox R a il w ay w orks team and is still carrying on in A .R .P . work. He also has 3 brothers and a son all qualified first aiders, and he claim s the fam ily have the proud record of approx im ately 91 years am ong them, quite an achievem ent I think. — Y o u rs sincerely, J.W . Neasden. April 11 th, 1945 .

PO ST W AR D

ear

F I R S T A ID .

,—

Let us be provocative— let us start some argum ents. Let us ask questions. H ow can the teaching and prac tice of post w ar first aid be made more efficient ? Are three “ official ” organisations, St. John’s, Red Cross, and, in Scotland, St. Andrew ’s, really necessary? Would not one association, “ T he British Council on First Aid ” be more powerful and save overlapping and m is understandings ? And why, in H eaven’s name, three “ official hand books ” ? with the exam iner accepting only the methods of his Society. W hy is the training done alw ays with trian gular band ages and ready-made splints ? W hy is there no practical instruction in improvisation ? W hy lecture to students that “ if you have no splints or bandages you m ust improvise ” — and yet give no advice as to how this should be done ? Y o u r m agazine did splendid w ork in spreading methods of wartim e im provisation— you ga v e a new impetus to jaded first aiders. W hy not do the same for peacetime work ? Let us have some “ Mufti Im provisation.” Is hard w ork and merit to come into its own in the “ great new world of the fu tu re ” ? Are efficient first aid workers to be able to command extra pay because of holding an efficiency certificate ? Are tw enty year old certificates still to com mand the same respect as those of recent date and repeated courses of instruction ? W hen are the Powers that be— and sleep— go in g to waken up and state that certificates over three years old are autom atically cancelled ? W hen w ill they issue a three years efficiency badge which guarantees that the holder is really efficient in first aid and can be trusted with any type of case ? W hen will Somebody do Som ething to lower the tragic “ death and injury ” list on our roads ? It can be m arkedly improved by the spread of good F .A . T a lk in g does no good. H ow , when, and whence do w e g e t some action ? H ave we been provocative enough for a beginning ? Perhaps we have not yet tramped hard enough on som eone’s toes to get results, but this is only the opening barrage. T here are tons of more shots in the lockers of keen first aiders. Y o u will, no doubt, be hearing from them .— Yours, & c ., B o w m a n E d g a r , M .B ., C h .B . Kirkconnel, Dumfries-shire. M ay 1st, 1945 .

A RECORD? D

ear

,—

D urin g the course of conversation at our B rigade class the other evening, one of our members, a Mr. Forest, gave us the record of his fam ily which we thought w as very interesting, viz. ;—

T he Chief Com m issioner has been pleased to sanction the award of the Grand Prior’s B adge to N ursing Cadet Corporal M ary Rowan G ough, of Chichester Cadet N ursing Division,

F I R S T

Nasal haem orrhages which persist for over half an hour or are frequently recurrent have a graver outlook and should be given adequate medical attention.-— F . A . Attendant, B .C.

S.J.A.B. Overseas. S

o u t h

f r ic a

— T

r a n s v a a l

is t r ic t

During' the month of April, 1945 , the annual inspections of the various Corps of the T ransvaal district were held. All the parades were m arked by a spirit of enthusiasm, increased by the unusually large number of interested spectators w atch in g the splendid turn out of sm art and efficient Am bulance and N ursing Divisions, am ong whom the increased number of Cadet D ivisions was particularly noticeable. These inspections were particularly memorable since the Priory Commissioner and Director of Am bulance, Mr. Alpheus W illiam s, B .S c., K .S t.J ., made the inspection for the 12th and last time. Mr. W illiam s has been directly connected with the B rigade for 27 years, and is resign ing his present position, which he has held for tw elve years, on St. John’s Day, June 24 th, 1945 . H e hopes, however, to continue in associa tion with Priory Headquarters at Cape Tow n. Great regret is felt throughout the Priory that once again, as so often in the past, the practice of retiring will cause the loss of a wise and experienced m an’s guidance. T he Priory H .E . the Rt. Hon. N. J. de W et, P .C ., K .S t.J ., Officer adm inistering the Government, hasappointed B rig. C. M. Hofife, M .In s t.T ., C .S t.J ., General M anager of the S.A. R. & H. to fill the vacancy, and to him, a hearty welcom e is extended.

Nasal Haemorrhage. Bv D r .

R I D

DAY

West London and District First Aid League. S i n c e the last report, there have been some rare tussles in the quest for league points, and the enthusiasm and keenness grow s week by week. News of the league is spreading rapidly and enquiries are being received from far afield, even from Ireland, from those w ishing to form sim ilar leagues. All enquiries are being answered promptly, as it is the Com m ittee’s desire to foster the league competition spirit for the benefit of first aid over the widest possible field.

Should there be sufficient teams, it may be possible next season, to divide the league into local divisions, and thereby avoid undue travelling. T his, and many other points will receive the Com m ittee’s earnest consideration in due course. Below is the league table to date :— Played

C .A .V .......................................... G .W .R . “ B ” (Old O ak) ... L .P .T .B . (Chisw ick, Ladies) L .P .T .B . (Chisw ick, M en )... G .W .R . “ A ” (Old O ak) ... Sperry’s “ A ” L .P .T .B . (Acton Works) W . E aling “ A ” ... W . E aling “ B ” ... 44 /1. Div. S .J .A .B . (Acton) Sperry’s “ B ”

W on

12 11

Drawn

0 0 0 0 0 1 0 0 0

10 12

7 7 7

10 10 8

7 4

Lost

3 5 3 5 7

2 2 0 0

7 4

Point

19 16 14 14 14 12 10

5 4 0 0

Specialist Eye, Ears, Nose and Throat.

B le e d in g from the nose may be due to numerous causes such as injury, infection, constitutional blood diseases and tumours. In by far the largest percentage of cases the bleeding takes place from ruptured blood vessels of the anterior portion of the nasal septum. It is the treatm ent of haem orrhages from this region which is briefly discussed in the follow ing paragraphs. T he rational object of treatm ent is to stop the flow of blood. Employm ent of simple and readily available means is desired. Do not place the afflicted flat on his back or he will be doubly inconvenienced ; as in such a position the blood flows into the throat and has to be expelled by cou gh ing or spitting or else swallowed. Sit the patient upright astraddle a chair facin g b ack wards with his arm s resting on the back of the chair and his head inclined forwards. In this position the blood runs out the anterior end of the nose leavin g the throat and mouth as a free airw ay. Pressure is applied over the alae (the car tilaginous flap on the outer side of either nostril) of the nostril which is bleeding or to both sides, if both are affected, with the thumb, preferably the patient’s, towards the mid line. Firm pressure is maintained until the bleeding ceases. The blood will well backw ards in the nostrils and flow over into the throat, from whence it is expectorated. C lotting takes place, which is nature’s w ay of arresting haem orrhage. Eventually the flow of blood lessens, due to pressure and clotting, and finally ceases, do not attem pt to free the nostrils of the clots, leave them alone, they will come a w ay when they have accomplished their purpose.

OBITUARY. Sunday, April 29 th, 1945 , Dr. J. Stanley Davies, M .A ., M .B ., C .M ., passed aw ay and was laid to rest on M ay 4 th, with B rigade honours. Dr. Davies was associated with No. 16 (New Cross) Division since 1904 . H e was an untiring w orker for the B rigade and did much valuable work on its behalf, in recog nition of which he was appointed Honorary Associate of the Order in 1914 . His genial personality and valuable fund of know ledge will be sorely missed by all with whom he cam e in contact. On

Oxford B .R .C .S . and St. John’s Association joined together on Sunday, April 22 nd, on the occasion of Red Cross and St. John’s Day. A very fine parade resulted and the Service held in Christ Church was well received. Personnel from surrounding districts also attended.

G By

—

S y n o p s is o f D e f e n c e A g a in s t ’ ’

JOHN FENTON, M.B., B.Ch., B.A.O., D.P.H.

P R IC E : Is. Id. post free. E S S E N T IA L

FACTS

W IT H O U T

P A D D IN G .

Published by D ale, Reynolds & C o ., Ltd., 46. Cannon Street, London, E.C.4.

F I R S T

c AN

I O D I N E V A P O U R C URE C O L D S ?

Iodine 20

127

R I D

S T O N E

H O U S E ,

used in mosquito control, in the steriliza tion o f drinking water, in the treatm ent of rheumatism. I f you would like to know more about the uses of iodine, write to the Iodine Educational Bureau which has recorded every known fact about iodine. The Bureau will be pleased to give infor mation about iodine and its uses to any medical auxiliary or first-aid worker. There is no charge.

E d u c a t io n a l

B I S H O P S G A T E ,

B u r e a u

L O N D O N ,

E . G .

“ SANOID” INTERLOCKING EXTENSION SPLINTS (Patent Number 53165 of 28/7/39.) IN C U R V E D E D G E OF S O C K E T

TH E

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B y th is In v e n tio n S p lin ts m ade in any co n v e n ie n t lengths m ake rigid co n n e c tio n s b y m eans o f in cu rv e d o p p o site edges o f th e m e ta l so cke ts o r sleeves firm ly engaging w it h tra n sve rse g ro o v e s in the surfaces o f th e S p lin ts w h e n pressed hom e in to t h « so cke t.

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A je w ot the Subjects treated: I lo w to Keep W ell, First Aid T h e Principles of N ursing W hat to Do in Em ergencies T he Eye, the Ear Influenza, Colds, etc. T h e Throat, the Nose Measles, Mumps, Catarrh The Chest, the Heart Corns and W arts T h e Stom ach, the Liver Physical Culture T he Teeth, the Muscles Treatm ent for all Skin Diseases Infant W elfare T he L ungs, Pleurisy Hom oepathy, Neurasthenia H ygiene, Anatom y, Pharm acy 375 Prescriptions, etc., etc. T H E Y O U N G W I F E will find just the information she requires. M O T H E R S who wish their daughters to develop naturally will find exactly the teaching they need. W O M E N O V E R 4 0 will find their difficulties regarding health frankly discussed. P R E S C R I P T I O N S — 375 proved remedies. Hundreds of subjects.

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13 °

F I R S T

QueriesandAnswers toCorrespondents Queries will be dealt with under the follow ing rules :— L

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 . 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 . M anual of First Aid to the Injured. T r e a tm e n t of C o n cu ssio n .

G .C . (South Shields).— In concussion of the brain, according to the Textbook, the face of the patient would be pale ; and therefore his head and shoulders should be placed low. Can you please explain why, with the head in this position, we are told to apply continuous cold to the head? M ay I add that as a regular reader, I thoroughly enjoy your answ ers to our queries month after month ? After a blow on the head sufficiently forcible to cause concussion, it is usually impossible to determine the extent of the injury or the com plications which m ay ensue. As the T extbook tells us, one possibility is the onset of compression as the result of haem orrhage into the brain tissues ; and this may be very insidious. Consequently the T extbook tells you to apply cold to the head in all cases of head injury ; and in short this treatment is a purely preventive m easure.— N. C

o r bet

letc h er

R I D D ig ita l P r e s s u r e

on th e S u b clav ian .

J.B . (Instone).— W ill you please say in what position the patient should be placed in order to apply digital pres sure on the subclavian artery. Presum ably in an actual case the patient, if con scious, would be so badly shocked that it would be necessary to lay him down. T he necessity for applying digital pressure on the sub clavian artery is not the factor which dictates the position of the patient ; and the T extbook is right in not specifying any particular position. In point of fact, the deciding factor is the condition of the patient ; and digital pressure can be applied equally well whether the patient is standing, sitting or lyin g on the groun d.— N .C .F . T re a tm e n t of B urns.

J.S. (Beccles).— I have read in various first aid textbooks that the treatment of burns and scalds is to cover them with cotton wool, when the services of a medical man can be obtained quickly. This treatment I have seen carried out ; and the result has been that, on exam ination by the doctor, the cotton wool has made adhesions to the skin. W ould it not be far better to state in first aid text books that on no account should cotton wool be placed next to the burned area, but only gauze, lint and any other clean m aterial ? Meanwhile I thank you for your kind advice on this matter. Personally, I agree with you that the use of cotton wool does cause some inconvenience on the arrival of such patient at hospital, since it is usually necessary to soak off adhering particles of cotton wool. In actual circumstances, however, this is a minor detail and no harm can result from the application of cotton w ool.— N .C .F .

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

S e n io rity in D iv isio n .

M .R . (Cannon S t.).— In a recent exam ination, the doctor asked one candidate w hat he would do if he were called to a man who had swallowed a teaspoon. H e was not impressed when the candidate replied— “ Punch him hard in the p it o f the stomach and so make him vom it! ”

R .C . (W olverton).— ( 1) W ould you be so kind as to settle a matter which has caused a good deal of controversy in the N ursing Division of which I am a member ? Since the new ranking of the Cadet Superintendent and Officer has come about, m y Divisional Supt. main tains that the Cadet Supt. now becomes the senior Officer in the N ursing D ivision— this in spite of the fact that the N ursing Division already had its full complement of officers. Is this correct, or are the Cadet Supt. and Officer supernum ary to establishment and as such, have no power of command in the N ursing Division ? ( 2 ) Would you also please state the position taken by these officers on parade— with the other officers in front or in the supernum ary rank ?

G ood!

Next, p lease! !— N .C .F .

A rtific ial R e s p ira tio n a n d F ir s t A id In s tru c tio n .

D .S . (Home Counties).— As a B rigade Surgeon, I venture to send a cuttin g taken en bloc from the March 10 th issue of the British M edical Journal, because this will probably prove interesting to readers of F i r s t A i d :— “ Dr. J. L. Barford (Stoke Park, Guildford) writes : As it m ay be a novelty I venture to mention a very small ‘ t ip ’ which I have employed recently when demon strating artificial respiration. It sim ply consists of putting (sm ugglin g, for dram atic effect) a whistle into the casualty’s mouth. On expiratory effort the clearness of the airw ay is made abundantly clear and impresses the students rem arkably. It can be employed in Schafer’s, the rocking, or any other method, except, of course, Laborde’s ! O ther instructors m ight like to copy. Iucidentally I note that Dr. F. C. Eve (Jan. 6, p. 21), when describing the successful revival of a drowned child by rocking, states that this was the first (successful) resuscitation by m anual rocking. Surely the rockin g and sw in gin g employed to induce the new born infant to breathe, although not strictly a resuscita tion, comes under this category ? Perhaps I am so old-fashioned that this procedure, which I remember em ploying successfully, is now superseded.” Best thanks for your letter and the news cu ttin g .— N .C .F .

( 1) B .O . 757 , issued in March 1945 , lays it down that a Cadet Superintendent shall have the rank of Am bulance Officer in the Adult Division supernumary to establishment. It should be noted, however, that, on relinquishing appoint ment as Cadet Supt., the seniority as Am bulance Officer dates from the appointment as Cadet Superintendent. In this case and on the assumption that the date of appointment as Cadet Supt. was earlier than the dates of appointment of the other Am bulance Officers of the adult Division, then the Cadet Supt. becomes the senior Officer after the Divisional Surgeon and the Divisional Supt. (2) These Officers when on parade, would take their places in the supernumary rank. — E d i t o r . T re a tm e n t of P n eu m o th o rax .

M .A. (H aifa, Palestine).— In your Textbook there is no men tion made with reference to pneumothorax, whereas up till now, when teaching from our Textbook, we have alw ays taught our classes the signs, symptoms and first

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F I R S T aid treatm ent of pneumothorax. As we now w ant to put before our Board of Instruction the proposal to adopt universally your Textbook, we shall greatly appreciate your explanation on the reasons for om itting pneumo thorax. T he diagnosis of pneum othorax (which term signifies a collection of air within the cavity of the lungs as the result of perforation of a lung) calls for long training in the methods of exam ination of the lungs. Consequently it is outside the scope of first aid, the three objects of which are (1) preserva tion of life (2) prevention of a ggravation of injury or condi tion and (3 ) provision of proper transport.— N .C .F .

T r e a tm e n t of F r a c tu re d T h ig h .

M .A. (H aifa, Palestine).— Recently, discussion arose am ong some of our instructors, as to whether or no, the treat ment of a fractured thigh without splints is of any value. Som e thought that the secure fixation of the injured to the sound limb with two broad bandages round the knees would be an effective temporary measure until som ething suitable as a splint could be found. Others, however, were of the opinion that this method was of no value whatever. In these circum stances I ask if you will be good enough to help us find the right solution of our problem. W hen splints arc not readily available, our Textbook (in Rule 5 of General Rules of Treatm ent) lays it down that “ the upper limb, if fractured, may be tied to the trunk and in all cases a fractured lower limb should be bandaged to its fellow .” In other words, it is sound first aid to tie the frac tured lower limb to its uninjured fellow which serves as a natural splint. T h e suggestion that two trian gular bandages round the knees would exercise effective control of a fractured femur does not commend itself to me. Indeed, if I had only two such bandages, I would apply one as figure-of-eight round ankles and feet, and the other (as broad bandage) round knees. Three bandages, however, are usually regarded as necessary, two being applied as just stated and the third round both th ig h s.— N .C .F .

C o m p o u n d , C o m p lic ated F rac tu re

S c h afer or S ilv este r M eth o d .

W .M . (K etterin g).— At a recent competition held in the dis trict the test set for 2 competitors read as follows :— “ A man has been d ragged out of a burning build ing unconscious. There is no apparent breathing ; and also his face is severely burnt.” W ell, now, the exam ining doctor in his rulings, insisted on Silvester’s method of artificial respiration, and if Schafer’s method was performed, he deducted 10 points. Subsequently, at a Divisional Practice we talked about this method of artificial respiration being used ; and no one agreed with the exam ining doctor. Now I want to ask for your ruling which method is correct in a case of this nature. W e shall look for your answ er in due course and with intense interest in the columns of F i r s t A i d . M eanwhile our thanks are due to you for all your help and inspiration month after month. On your statem ent of facts there is nothing in the test which would justify your competition in selecting the Silvester Method. T his, as you know from p. 149 of the Textbook, ‘ ' is only to be used when it is impossible to turn the patient on to his fa ce.” Th is being so, I wonder if your competitors missed any such cause which m ight have heen disclosed as the result of careful exam ination.— N .C .F .

44 F I R S T Q U E R Y

and

A ID ”

R E P L IE S

C O U PO N .

To be cut out and enclosed with all Queries. May,

1945.

of F o rea rm .

M .A. (H aifa, Palestine).— T he test in a recent competition w as a man who w as supposed to have been wounded by a bomb fragm ent in the forearm, the fragm ent breaking the radius and causing arterial haem orrhage. D igital pressure on the brachial artery was at once applied. As, however, the tourniquet had to be applied on this pressure point, the judge told a candidate that he should have applied digital pressure on the subclavian artery to facilitate the application of the tourniquet. I disagreed and pointed out that it was possible to press with the thumb, place the pad of the tourniquet over it, then quickly w ithdraw ihe thum b and fix the tourniquet. My friend agreed, but said that if the impossibility of pressure on the wound is know n before digital pres sure began, her method is better. W e agreed to put the m atter before you and to accept your kind ruling. Y o u do not say whether or no, the first aider who had to treat this patient was single handed or not. In any case it is not a simple m atter to apply digital pressure and later to substitute a tourniquet on the same pressure point without undue loss of blood. T h e m ajority of first aiders are not so h igh ly skilled ; and, therefore, the ru lin g that in these cir cum stances pressure should be applied on the subclavian artery at the outset of treatm ent was correct. A lthough this cuts off the whole of the blood supply of the upper limb, no deleterious effects would result, provided that no time is lost in applying tourniquet to brachial artery.— N .C .F .

E la sto p la st’ a n d d r e s s in g s e c o n o m y Modern Surgical practice favours an undisturbed dressing and for this purpose ‘ Elastoplast ’ is used extensively in hospitals. It stays in place, protecting the wound while permitting uninterrupted healing. ‘ Elastoplast ’ Bandages and Plasters com bine efficiency with economy in material and time. Use them with confidence for all minor injuries. Made in England by T . J. Sm ith & Nephew L td ., H u ll.

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T R A IN IN G

O F

C O M P E T IT IO N B

R .

“ G iv e s clear and constructive advice on selecting and training team s fo r first aid com petitions, and provides useful tips on individual and team b ehaviou r d u rin g c o m p e t it io n s ...................should find a ready p u b lic .” — Fire Protection. J O R D A N

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M r. B oyce-M ears advises m ost com peten tly on the b u ild in g o f the team , on training fo r com p etition w o r k , w hat to exp ect in the test, diagnosis and exam ination routine and com pletes t^le b o o k le t w ith a ve ry useful and in form ative specim en o f an average ju d g e ’s m ark sheet. C H A N C E R Y

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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 snbjects 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 8th of each month, and must be accompanied ( not necessarily for publication) by the name and address of the Correspondent. Subscriptions, Advertisements and other business Communications connected with F IR S T A ID should be forwarded to the Publishers. D A LE, REYN OLDS & 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 Address— “ Twenty-four, London." Telephone— City 371a.

CONTENTS

d it o r ia l

T H IS

NUMBER.

—

The Protection of Registered Nurses

...

133

...

134

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

...

135

Burns and Scalds

...

137

Letters to the Editor

...

138

Reviews

...

“ W hat I W ould L ike to See Done ”

...

Police Am bulance News Q

u e r ie s

a n d

n s w e r s

... t o

...

... ...

o r r e s p o n d e n t s

...

142 142

:—

Treatm ent of Concussion

...

142

Exam ination H ow ler

...

142

Contents of B rigade Pouch ...

...

142

Cause of Incised Wound

...

142

Treatm ent of Apoplexy

...

142

...

144

Functions of Brain

...

144

Treatm ent of Fractured Patella

Fracture of H um erus

...

144

Rem oval of Clothing

...

144

Efficiency of Cadet O fficers...

...

144

T h e tim e is a p p r o a c h in g w hen

The Protection every p r o fe ssio n , trade and callof Registered in g will form a c lo s e preserve, Nurses. into w h ich non e can enter u n le s s d u ly qualified and ap p ro v e d . D o c to r s, solicitors, architects, e n g in e e r s , s a n i tarians and m an y others h a v e alread y acquired, or are on the ev e of a c q u ir in g , specific o r g a n isa tio n s, and this c a n n o t but w ork for the p u b lic g o o d if a due m easure o f restraint is e x ercised by the various c o m m itte e s into w h o s e h a n d s the c o n t r o llin g po w er and that of se le ctio n are placed. T h e p rofession of n u r s in g ha s received that r e c o g n itio n to w h ic h its im p o rta n ce en titles it, and the am ateu r will ere l o n g find it difficult to obtain entry into its ranks. A n in sta n ce arose the other d a y in the H o u s e of C o m m o n s , w h e n the M inister of H e a lt h w as asked w h y certain in d iv id u a ls attached to the C hristian S c ie n c e m o v e m e n t had been perm itted to call th e m s e lv e s nurses, in vie w of the recent A c t w h ic h lim its the description “ n u r s e ” to th o s e su ita b ly qualified. T h e M inister said the q u e stio n e r w as la b o u r in g under a m is a p p r e h e n sio n . H e had not y e t b r o u g h t into operation the p r o v isio n s of S u b sectio n (I) of S e c tio n 6 of the N u r s e s A c t, 1943, w h ic h w ill restrict the u se of the title “ n u r s e ” or m ade r e g u la tio n s under p r o v iso (b) to that s u b -se c tio n . W h e n he did it w a s his intentio n to require C hristian S c ie n c e nurses to describe t h e m s e lv e s as “ C hristian S c ie n c e n u r s e s .” He w a s w ell aware, he said, that the w h o le pu rp ose of that A c t w a s t o p r o t e c tS t a t e re siste r e d n u r se s and pro tect the public from im p o sto rs, and that in this s p e c i a lly p r iv ile g e d g r o u p , the Christian S c ie n c e g r o u p , the w o m e n h a v i n g no n u r s in g qu alificatio n s w h a t s o e v e r , as he told the H o u s e on an e a r lie r o c c a s io n , an a ssu ra n ce on this matter w a s g iv e n by his pre d e ce sso r , and it w as very la r g e ly based on the fact that the H o u s e , w h e n the P u b lic H e a lt h A ct, 1936, b e c a m e law , g a v e sta tu to ry r e c o g n itio n to C hristian S c i e n c e n u r s in g h o m e s . T h e o b ject of the A c t w o u ld , h e t h o u g h t , be su fficien tly and p roperly met by a provision that C hristian S c ie n c e n u rses s h o u ld be required s o to d escrib e t h e m s e lv e s . T h e c o n c lu s io n is in e v e r y w a y s a t is

F I R S T

!34

facto ry, and w e h a v e but o n e c o m m e n t to m ake. T h e u se o f the wc*rd “ i m p o s t o r s ” w a s u ncalled for. A Christian S c ie n c e nurse m ay h a ve an in flated idea of herself and her pow ers, m ay c o n sid e r h erself in c lo se to u c h w ith the H i g h e r P o w e r s , but that is a matter of m ental d ise a se rather than of deliberate im p ostu re.

“ What I Would Like to See Done.” B ritish

First

B y

A id

BOW M AN

the

P o st-w a r

EDGAR

W o rld .

M .B ., C h.B .

above title, for the ram bling thoughts which follow, was chosen because it contains an invitation to first aiders to send in suggestions for im proving the Service. Before go in g further we should ask the question— “ Is First Aid a useful service to the com m unity at la r g e ? ” It is a service which can save life and ease pain, therefore it is of great use to the country at large. W e have only to consider the road-accident rate for the last ten years to see the need for such service being available to the public. This quite apart from the occurrence of daily accidents in all other w alks of life. W e are entitled, therefore, to claim that an efficient F irst A id Service is of inestim able value to the country. But it should be an efficient service— it will be agreed that in the past this has not alw ays been the case. H ow can First Aid be raised to, and maintained at, the high level, to which it should attain, to be in keeping with modern know ledge and requirem ents? T hat is the question which it is time we tackled in earnest. T o begin with Organisation. A satisfactory N ational undertaking cannot be properly run except under unified control. At present, in these islands, there are three organ isations carryin g on three separate First Aid Societies, that of St. John’s in E ngland, St. Andrew ’s in Scotland, and the B. R. C. S. over the whole country. T h is is surely absurd and lack in g in co-ordination. If it be essential for the three to continue as separate entities, which, to the onlooker, seems doubtful, let us at least have an overall ruling Council, “ T he British Council of First A id .” Th e duties of this Council would be manifold. Firstly, to organise the service on a N ational footing with one standard of teaching for the whole country. T o insist on one real standard of attainm ent am ong the workers. T o schedule the first aid resources in every county and parish, so that, in national em ergency, an effective service can be put into action without any delay. T o take steps to have the service recognised as an essential one. T o consult with Governm ent as to the F .A . responsibilities of all em ployers of labour, all road users, all education authorities — in short, to m ake the public able to help themselves and their neighbours whenever necessity m ay arise. In addition to the above, the Council should be em powered to issue a “ British M anual of First A id .” Such m anual to supersede all the three (why in H eaven’s name three) “ auth orised ” handbooks now in use throughout the country. Such m anual to be in keeping with modern outlook on the subject, simple, em inently practical, with only the essentials of theory, and written In simple lan gu age. Such m anual to contain space at the end for the

The

A I D quarterly bulletins which the Council would be expected to issue. These 'bulletins to give information on new ideas, methods, discoveries, and so on. For example, E ve’s method of resuscitation had been, I believe, in use in the Navy for some time before it was made known to the majority of first aiders, A short description in the form of a “ bu lletin ” would have created much interest, and m ight have resulted in valuable suggestions being forthcoming. Such issues would seive to give a new impetus to every day work. Another duty of the Council would be to consider the question of the commercial value of First Aid know ledge. Up to the present, the first aid treatment of accidents has been accepted by the public as a right, which, in very many cases, did not even call for a courteous “ T h a n k you.” W hen the doctor arrived, the F.A. man was allowed to slip aw ay unheralded and unknown. T his is a large question which has many sides to it. No first aider will ever, if his services are required, “ pass by on the other side.” But, it should not be forgotten by the public, that same man has given time and study in order that he may be able to give requisite treatment in em ergencies. His services, which may save life and will certainly save suffer ing, should not be forgotten and ignored when the em erg ency is over. F ar from being ignored, the memory of the great work done, in the Blitzes and on the battlefield, by First Aiders, is due full recognition from the Country. How better can gratitude be expressed than by recognis ing the Service as a National one, under the title of “ The Royal First Aid Service.” This is an achievement for which the suggested “ C ou n cil” would be expected to w ork with all its power and enthusiasm. T o attain this title, and to keep it worthily, the Service must be unified, co-ordinated and National, but, above all, it must be efficient and of as much value to the Country in Peace as it has been in W ar. And that means that the Honour of the Service, when formed, w ill lie on the shoulders of every First A ider in the land. W e now come to the important question of Training. Some years ago a Government order was issued that, in cer tain works, there must be a holder of a F .A . certificate to every so-many-men employed. And it didn’t, appar ently, matter a jot how old the certificate was nor how utterly lack in g in first aid know ledge was the holder. Certificates dated 25 years previously were shown, and accepted, as proof that the holdei posesessed a satisfactory understanding of how to deal with the injured. T h at was just gra n d — the Government order had been carried out— it didn’t m atter a tinker’s curse to the Govern ment Departm ent which issued the order, nor to the W orks M anagem ent, whether injured men would be efficiently treated or not. A n d there was no F .A . Council to protest on behalf of any injured. Everyone was happy, the prescribed number of certificates had been forthcom ing T he fact that the majority of the holders knew absolutely nothing about F .A . did not m atter a damn. So it would appear that a central body is badly needed to keep an eye on silly Government orders and to ensure that the training and issue of certificates is kept up to a high standard. My idea is, that no efficiency certificate, or preferably badge, should be issued on less than three years’ training. T h a t is if we are go in g to raise F .A . in the eyes of the public. Unless we institute three properly graded courses of study, with strict exam inations, the value of certificates will be, as at present— well, problematical. I would su ggest the follow ing :—

1st year course and exam, success ... 2 nd ,, ,, ,, ... 3 rd ,, ,, ,, ...

Novice Badge. Q ualifyin g Badge. Efficiency Badge.

F I R S T All efficiency badges to be autom atically cancelled un less renewed by three yearly efficiency tests. No appointments to F .A . posts in works, etc., to be granted to any but efficiency badge holders. And failure to pass the three yearly test would mean loss of the appoint ment. In this w ay we would ensure a very high standard of know ledge am ong the holders of official F .A . posts. These latter would, of course, be paid appointments. T hat there is a decided opening for good First Aid men is certain. T a k e my pre-war competition team of five men. One is now a colliery m anager, another is in charge of large pit-head bdths, another is F.A. man to one of the biggest airplane m anufacturers in the country. T he fourth before joining the N avy was F.A. man to w hat is, perhaps, the largest w orks in the North, and the fifth was training, and in charge of, half a dozen rescue teams in central Scotland. As one of them said to me, “ If a man has brains enough to do well at F .A ., he soon sees that he does not need to remain a labourer all his life.” The actual training should be, in the first year, as simple and practical as possible— and every student should be en abled to do everything for himself, nett only told how to do it. Especially should he be taught how to handle a patient. A recent cup competition made me very doubtful if this sub ject of handling a case is taugh t as it should be. A demon stration by the exam iner of what was wanted drew the re mark, “ But we were never shown that before.” Students who have not been accustomed to exam ining by handling are apt to be either afraid to cause pain or rush ramstam into trouble. By “ h an d lin g” I mean acquiring know ledge of how to examine a joint, a bone, the two collar bones at the same time so as to discover any differences between them, and so on. Students must learn how to use their fingers for the purpose of obtaining information without causing harm to the injured person. How to exam ine a patient without m oving him, etc., etc. In addition to what is present day pure F .A ., it should be part of the advanced student’s train ing to learn the use of the clinical thermometer, the application of heat externally, and so on. There is no reason why a man should have to take out a “ hom e-nursing” course before he can learn these very important practical procedures. There is much to do. Everyday there are lives to be saved. Know ledge, fresh know ledge, has to be acquired, for our present idea of excellence is but a thumbnail scrap ing from the vast store of the unknown which aw aits our breaking into it. If these ram bling thoughts should serve to fill the Editorial postbag with fresh ideas for the improve ment of F .A . in the days to come, then, I am sure, the Editor, for one, will be m ighty pleased.

A m b u l a n c e U n i f o r m s . — In the House of Commons on Tuesday, May 29 th, Sir Thom as Cook asked the President of the Board of Trade if he would reduce the number of coupons at present required for the purchase of uniforms for the S .J .A .B . Mr. O liver Lyttleton replied that he was shortly review ing the coupon arrangem ents for all civilian wearers in 1945 - 1946 , and he would bear in mind the su g g e s tion of the member for North Norfolk.

R I D

S t.

135

Jo 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

R EPORTS.

N o. I (Prince o f W ales’s) District No. 148 ( T e d d i n g t o n ) . — T he first annual general meet ing of the 148 (Teddington) N ursing Division was held on May 3 rd, at the British L egion, Teddington. Div. Supt. G. W illoughby kindly took the Chair in the absence of Dr. P. W . L. Cam ps (President). Mrs. S. Lee (Cadet Officer) reporting on the past year, said that despite evacuation the average attendance at drills was 85 . Area Cadet Officer Miss L. M. Phillips presented nine aw ards for Prelim inary Home N ursing, and twelve awards for Prelim inary First Aid. D etailing the duties carried out during the year, Am bu lance Sister G. Short (Secretary) said the Division would heartily welcom e anyone interested in this work either as a member or hon. member, and it was hoped that many Civil Defence personnel would join as soon as conditions permitted. A Social Committee had been formed, and with Mrs. M. E. Brown as Chairm an it was felt that this side of the Division’s activities would flourish. Mrs. W ilkins, Hon. Treasurer, reported a balance in hand of £ 5 6 2 s. 2 d. Current expenses had, however, exceeded income, and she appealed for an increase in hon orary membership. Mrs. Jackson, Div. Supt., said that one of the chief plans of the Division was to form a Medical Comforts Depot in Teddington— the need was urgen t— and she appealed for help in finding suitable accommodation. No. 150 ( E l g e e ) . — On Saturday, May 12 th, the N ursing Division of Landis and G yr (No. 150 E lgee Division) held their first birthday party in their w orks canteen. Also invited were members of the factory’s first aid party and friends. After tea, which was provided by the canteen staff, there was an impromptu concert given by the E lgee Concert Party. There was also a table on which articles made by mem bers of the N ursing Division were on sale. The follow ing were presented with w arrants of appointm ent: Miss A. Peter, vice-president ; Mr. E. W. W oolcott, hon. auditor ; Miss V . M. Leech, hon. secretary ; Miss W arw ick, hon. treasurer. T he follow ing aw ards were received : 1 label ; 6 m edal lions ; 5 vouchers ; 4 certificates. Everyone also had a piece of the large birthday cake baked by Miss W ilder, who had written on it the St. John’s motto “ Pro U tilitate H om inum ,” in chocolate icing. The party finished with a dance and social. N o 75 c W a n s t e a d a n d W o o d f o r d — At South W ood ford Secondary School, St. Barnabas Road, South Woodford, on Saturday afternoon, June 9 th, boy cadets from the Chadwell Heath, D agenham , Plaistow and W anstead and W ood ford Divisions competed in first aid competitions for the Inter-Divisional Shield. T he Judges, Corps Supt. A. E. A. Am bler and Div. Supt. Bandy, awarded the follow ing m arks :— W anstead and W oodford— Competition Test 159 , Team T est 92 £ ; P laistow — 115^ and 64 £ ; D agen h am — 110 and 58 ; Chadwell H eath— 92 and 69 . Team leader Cadet H. Booker, W anstead and Woodford, offered useful advice and comments to all competitors. T he gatherin g, which was very well attended, included Dr. Stanley Thom as (D ivisional Surgeon) and m any officers of the S.J A .B ., who joined Dr. T hom as in congratulating Cadet P. D urrant of the W anstead and W oodford Division,

13 6

F I R S T

w ho obtained the record of 100 per cent, m arks in the Individual Team Test, and also praised the w ork of the Cadet Movement. Dr. Thom as said that he regarded this work as an attem pt to save life as opposed to the experience of the whole world in this last six years. T he Shield was presented by L ad y D istrict Officer Mrs. Morrish, and the individual prizes by the donor Com m ander Barton-Sm ith, “ J ” Division, Metropolitan Police Special Constabulary. Afterwards the pleasant proceedings terminated with tea and a concert provided by the W anstead and Woodford Division. County o f Berkshire. R e a d in g C o r p s . — On May 2 nd, at Palm er Hall, W est Street, R eading, a Brains T ru st was held consisting of a team of Doctors from P ark Prewitt Hospital, the Question M aster being Mr. F. A. T rott, Am bulance and A .R .P . Inspector, Southern R ailw ay, W aterloo. T h e evening was arranged by the Southern R ailw ay Am bulance Centre at R eadin g and a large number of the R eading Corps, S .J .A .B . were present by special invitation. Questions were previously invited and a number were submitted by members of the Corps. T h e questions asked included such subjects as auto suggestion, stuttering, tourniquets, effects of narcotic poisons, blood transfusion and yaw ning.

On Sunday, May 27 th, over fifty officers and members of adult and cadet Divisions of the Reading Corps attended a special Red Cross Parade Service which was held at Wycliffe Baptist Church by the Rev. E. J. W illis. — On May 15 th, at the Am bulance H all, Chatham Street, the N ursing Division held a first aid competition for the T illin g Cup. T w o team s entered and the w inning team was captained by Amb. Sister Steele. R e a d in g

C e n t r a l.

W in d s o r N u r s in g D i v i s i o n . — On Sunday, May 13 th, twelve nursing and eight cadet members attended a church parade, after which they were inspected by the County VicePresident, Lady Loraine. T he cadets were in uniform for the first time.

M a id e n h e a d

C a d e t

— At .th e Am bulance aid competition was held Cadets. Th is was an Mrs. Buchanan Barbour T he winner was A/Cadet runner-up N/Cadet Ivy

D iv isio n s.

Hall, Holm anleaze, recently, a first between Am bulance and N ursing individual test for a cup given by (the wife of the County Surgeon). J. Eaton with 50 points and the R ichard with 45 points. County o f Cheshire.

P o r t S u n lig h t C o r p s . — The competitions for the “ Rothery ” trophies took place this year in Church Drive Schools, Port Sunlight, on M ay Sth and 12th respectively, for team s from the Senior and Cadet Divisions. T h e number of entries for both competitions fell rather short of expectations. Nevertheless, the goodly number of spectators present on both occasions enjoyed two interesting and keenly contested events. T he tests set by the Judges represented the type of accident which m ight occur at any time. In the first com petition the seniors were required to treat a lorry driver whose load of timber had partially collapsed on him and pinned him to the ground, whilst the cadet team s were called upon to treat a boy cyclist who w as lying in a ditch with his legs entangled in his cycle. T he results were as follows :— “ Rothery ” Cup for Senior T eam s.— W inners ; Brom-

R I D borough M argarine W orks Division “ B ” team ; runnersup : Brom borough M argarine W orks Division “ A ” team. “ R o th ery ” Bowl for Cadet T eam s.— W inners : Port S unlight Cadet N ursing Team ; Runners-up : Bebington Am bulance Division “ A ” team. Both competitions were in the capable hands of Corps Supt. E. E. Searl (Officer of the Order) and Divisional Supt. L. R. Lew is (S .B . of the Order) of Liverpool “ B ” Corps. County o f North, East and M id-D evon. T o r q u a y . — T he first aid post, manned by members of the S.J. A. B., on Torre Abbey Sands was re-opened on Satur day afternoon, May 19 th, by the Mayor of Torquay (Mr. A. Denys Phillips). T he Mayor said the whole town realised what wonder ful work the St. John Am bulance personnel had done on the sands in previous years. H e recalled, too, the great work that had been carried out by them during the hit and run raids. T he Mayor was thanked by the County Commissioner for Devon (Mr. H. J. Vick) who was accompanied by the N ursing Division Supt. (Miss W hitehead). On arrival, the Mayor was greeted by a guard of honour formed by personnel of the N ursing Division, the Brigade and Cadets. After the re-opening ceremony, the County Commissioner presented the fourch bar to the S .J .A .B . Medal for 35 years’ service to the Supt. of the Torquay Division (Mr. G. H. Davey) and the third bar to Corpl. W eeks for 30 years' service. D u rin g last summer the post dealt with hundreds of minor injuries— cut feet, wasp stings, sprains, etc.— and earned the grateful thanks of visitors and residents alike. County of Worcester. T h e Inter-Corps competition between representatives of the North W orcestershire and Dudley and D istrict Corps of the S .J .A .B . was held on Saturday, May 26 th, in St. Thom as School, Dudley. T h e trophy at stake was the Lench Cup, and the winners will represent the Northern Area of the County in the County Finals at the T ow n H all, D udley on June 16th. T he contestants were Stew arts & Lloyds Am bu lance Division, winners of the Somers Cup (North W orcester shire Corps) whilst the Dudley and District Corps was repre sented by Brierley Hill Am bulance Division. T he card for the team test read as follows :— “ D uring demolition w ork a wall collapses, bringing down with it one man who was w orking 15 feet from the ground, and partially burying another man who was clearing the debris from the ground at the foot of the wall. T h e first man is unconscious but the second is conscious. Y ou recognise the first man as a patient of the nearest D octor.” T he test proved to be a very interesting one and certainly tested the teams thoroughly. Assistant Com missioner D. M. Chapman announced the result as follows : Brierley H ill, 275 m arks ; Stewarts & Lloyds, 261 marks. T he first church parade and inspection of the newly formed Northern Area N ursing Corps of the S .J.A .B . took place on Sunday, May 27 th, at Halesowen. T h e parade led by the drum and bugle band of the Quinton Cadet Am bulance Division, marched to H alesowen Parish Church, and was composed of 90 nurses and 89 nurs ing cadets. T he service which was of a very inspiring nature was conducted by the Rector, T he Rev. J. T . Davies. O w in g to the inclement weather the inspection had to be held in the Drill Hall, and in view of the very confined space available, the march past was extrem ely well done. The County Commissioner was the Inspecting Officer. After the dism issal of the parade, tea which had been provided by all the Divisions, was served in the dining room at the G ram m ar School.

F I R S T North R idin g o f Yorkshire. D a r lin g to n .—

T h e D arlington N ursing D ivision cele brated its Silver Jubilee on Friday, May 25 th, at a Dinner held in the Imperial Hotel, D arlington. About 70 guests and members were present. T he Chair was taken by Div. Supt. Miss A. G. Gardner. It is very pleasing to note that there are seven of the founder members still in the Division. Although the Division is small it has a rem arkable record of public service. Members have done 5,800 hours’ voluntary duty at Greenbank, Memorial and Municipal Hospitals, and in addition have treated about 10,000 cases apart from help given in homes where needed. Since 1938 they have trained 1,326 members of the public in first aid, etc. They have had a Medical Comforts Depot since 1927 , and a Cadet N ursing Division was also formed during the same year. The present strength of the Division is 53. West R iding o f Yorkshire. H a r r o g a t e . — T he peacefulness of Starbeek was awakened on Sunday afternoon, June 3 rd, when the Cadet Drum and B ugle Band of the H arrogate Division turned out in H igh Street for the purpose of receiving a presentation tenor drum, the gift of patrons at the H arrogate Hotel. The proceedings were opened by Supt. A. Ridsdale who thanked all who had given support to this wonderful effort. He invited Mrs. Edgerley, wife of the licensee of the Harrowgate Hotel to present the drum and equipment. Cadet Smith was the lucky boy chosen to receive and play the drum. Mrs. E dgerley in presenting the drum said she hoped all the boys, both now and in the future, would enjoy much pleasure in having it in their possession. Band S gt. Lifford replying on behalf of the band, said there were few boys’ bands who possessed a tenor drum and added it would prove a valuable asset in the training of the boys. He briefly outlined some of the w ork the boys do ; in addition to their am bulance training they were taught to become good citizens and learn to be of use to others at all times.

«■ •

■

Burns and Scalds. By

D r.

urns

T . H. L E G G E T T , Surgeon-in-Chief, St. John Ambulance B rigade, Canada.

a n d sca ld s

are

ever

p r e s e n t d a n g e r s in c iv il life a n d

t h e i r h a z a r d is g r e a t l y i n c r e a s e d in w a r t i m e d u e to o u r w a r in d u s t r i e s ; a n d m o r e s o in a c t u a l w a r a r e a s d u e to t h e e ffe c t of in c e n d ia ry a n d e x p lo siv e bom bs.

The first aider should divide his study of this subject into two parts, viz :—

1. The correct first aid treatm ent of the burn itself. 2 . The procedure in added dangers from sm oke and s u f f o c a t i o n in c a s e o f fire. T

orrect

ir st

reatm ent.

The most important thing to remember is that shock is the first consideration even before local treatm ent of the burned area. T im e spent on treating the burn must not be at the expense of treatm ent for shock, the details of which we will not discuss here, but of which the first aider should have a full knowledge. About 70 per cent, of the deaths from burns occur within 48 hours and the cause is shock. If the incident is near a hospital and can be removed quickly to have the benefit of hospital facilities, it is better to trans port the patient without attem pting any local treatm ent ; but giv in g full attention to treating for shock. Pain greatly intensifies the shock. T h e burn leaves the little nerve term inals exposed, and these are exquisitely sensitive to contact with air. T he greatest factor then in the relief from pain is avoidance of exposure to the air. Keep

R I D

137

the part covered. D elicate handling of the burn and gentle movement of the part are extrem ely important. D on ’t try to remove clothing stuck to the burn. Cut around it rem oving the loose clothing and leavin g the parts that are stuck. T he classification of burns is not within the field of first aid. T h e depth of a burn is difficult to ascertain even by the skilled physician ; and the know ledge does not help in first aid treatment. Redness usually spoken of as a first degree burn, or even redness with some blistering where the skin is intact, is made more com fortable by dressing with boric acid ointment or vaseline. All other degrees of burns, i.e., those where the skin has broken, may be considered in the one class so far as local treatment is concerned. Here we avoid the use of all greasy and tanning preparations. These were widely used in times gone by, but experience has taught us that they are difficult to remove and em barrass the surgeon in his choice of final treatment. T hey have now been removed from the list in most first aid kits. Cover the burned area with absorbent cotton (cotton wool), gauze, or clean cloths. Absorbent cotton is preferred by most surgeons as it best excludes the air, is more com fortable and is easily removed. Moisten the dressings with a solution of bicarbonate of soda (baking soda) or carbonate of soda (w ashing soda) or normal saline (table salt)— one or two level teaspoons of any of the three to a pint of water. Scalds.— Burns caused by hot liquids or steam are called scalds. Treatm ent for burns and scalds is the same. Burns from hot fat, hot oil, or molten metal are very painful. T hey usually occur from spattering drops which burn deeply, m akin g little pockets in the flesh. Do not try to remove them but flush the parts with large quantities of w ater until they are cooled and cover with dressing until the doctor comes. Chemical B urns.— These are caused by strong acids or alkalis. Strip off all clothing which has any acid or alkali on it ; and flush the burned area with large quantities of w ater to dilute and wash off the chemical. (Carbolic acid burns should be washed with alcohol, if available.) Electrical B urns.— T w o things to remember : Break contact with the electric current, then persevere with artifi cial respiration until the victim breathes naturally or the physician pronounces him dead. H ow to break contact with the electric cu rren t: Caution ! — copper, iron, steel, water and the human body are electric conductors. Rubber, wood, cloth, paper, and leather are good nore-conductors. Hence if not possible to turn off the electric current, push wire aw ay from victim with dry pole or board ; or stand on dry clothes, papers, wood, etc., and with the hands covered w ith rubber, several thicknesses of dry cloth, or newspapers, etc., d rag the victim from the conductor. % After contact has been thus broken, there is no danger in touching the victim. Likew ise, there is no danger in touching a person who has been struck by lightning. A

dded of

D F

angers

from

moke

and

u ff o c a t io n

ase

ir e .

In rescue from a burning building don't lose your head. Canvass the whole situation coolly. Rem em ber the halls and the stairw ays are apt to m ake for drafts which fan the flames filling the air with heat and sm oke. If cau gh t in an upstairs room with no outside fire escape, be extrem ely cautious in opening the door into the hall. If the door feels hot to the hand, don’t open it as the hot door indicates that the air on the other side is many times hotter and one breath of this intensely heated air m ay cause unconsciousness, or even death. Go to the window and attract the attention of persons below who m ay put up a ladder. If this does not succeed quickly, tie together strips of sheets, clothing, etc., by which a descent m ay be made from the window.

F I R S T H eat and sm oke rise ; so the air near the floor is cooler and freer from smoke. It follows then in attem pting rescue of a person from a burning building, one should craw l along the floor keeping the head down. In this way, one is less apt to lose his w’ay as he can see more clearly and will be much less affected by the sm oke and heat. If a person’s clothes are on fire, keep him lyin g down. Flam es rise ; and thus the erect position is apt to cause serious burns about the head and neck. A victim with clothes on fire running about frantically, fans the flames and m akes the burns much more extensive. Sm other the flames with blankets, coats, etc., or roll victim on the ground as you would a burning stick to put out the flames. — Canadian First A id.

A I D experience in over 33 years ambulance work. I would like to underline the words of Sir Henry : “ The bogey that too advanced training may cause the First Aider to assume the functions of a doctor is, I remain convinced, a pure myth ; the average man suffers far more from timidity than from the confidence which can only be born oj knowledge. ” Now, rank and filers, let’s hear from you. W hat do you think chums ? Yours faithfully, B a sil

A R T IF IC IA L D

L etters

th e

E d ito r .

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

P O S T -W A R S

F IR S T

A ID .

,—

I have read the letter signed Bowm an E dgar, M .B ., C h .B ., Kirkonnel. Y o u r correspondent asks for criticism. Perhaps the follow ing observations will open the subject further. This subject is go in g to be interesting. W e of “ T h e O rd e r” are proud of the fact that our organisation goes back ages, but is still, we say, the standard teaching. W hy is training alw ays done with trian gular bandages and ready-made sp lin ts? It is not. In our Division we hold regular practices on improvisation, and I know others that do. Efficient “ first aiders ” do get extra pay from at least one combine that I know of. Th is is not a good practice to my w ay of thinking. Tw enty-year-old certificates do not get anybody any where with us. W e are compelled to qualify annually. Now, Sir, that is a start. I shall look forward for more comments on this. In the meantime, m ay I ask that you do not publish my name, although I will give it as a matter of good faith.

T a ffs

(Pte., S .J .A .B .).

Catford, London, S .E .6. June 6th, 1945 .

ear

R E S P IR A T IO N DEATH .

IN A P P A R E N T

ir ,—

In answer to Sir Leonard H ill’s letter recommending oxygen for carbon-monoxide poisoning, I would like to say that, in the first two cases that I mentioned, the Police called an am bulance equipped w ith “ the well-known oxygen apparatus supplied for restorative purposes ” about the same time as they sent for me. By the use of a supply of C 0 2 carried in my pocket, the two people had been resuscitated 40 minutes before the oxy gen apparatus arrived. W ithout using your columns to express my views against the use of the 7 per cent, oxygen-carbon dioxide cylinder in g a s poisoning, I can only say that it is my honest opinion that all the five cases mentioned would have been fatal if I had awaited the arrivat ot the cumbersome oxygen cylinder. I consider that a small cylinder of C 0 2 used in fresh air, with its normal 20 per cent, oxygen, is the ideal First Aid treatment for all cases of g a s poisoning. I would reserve the oxygen cylinder for hospital use with the “ Iron L u n g ” and other m echanical means of carrying out a long period of arttficial respiration. Y o u rs faithfully, “ G .B .” Hemel Hemstead. May 26 th, 1945 .

Yours faithfully, “ F

ir st

id e r

.”

A P P E A L T O F I R S T A I D E R S IN N E W D ear

W A R — AND D

ear

PEACE.

ir ,—

May I, through your excellent paper, heartily thank Sir H enry Martyn for the paragraph under the above head in g appearing in M ay issue of F i r s t A i d . In July 1944 issue, I wrote you (and you kindly pub lished) a reply to Lionel Cole’s letter, stating there is no limit to the acquirem ent of personal know ledge, but querying its reception by S .J .A .B ., and statin g my experience. The com ment of my Superintendent was “ It ought not to have been published ! ” W h y ? There seems to be a definite hostility as well as apathy towards efficiency. Th is is borne out by Dr. E d g a r’s letter re Post W ar First Aid. W e have in London, a London Am bulance Service with its L .A .A .S . (Auxiliary). W hy not a National Am bulance Association to train and supplyrecruits to the paid public am bulance services, and as a united body of voluntary workers to assist with public duty where requisite ? One body, one textbook, one aim of public good, not isolated organisations with little or no agreem ent between each other, as at present constituted. T his has been my own

ZEALAN D.

S ir ,—

For a long time now my wife and I have been interested in New Zealand, and feel that as soon as the opportunity arises we would like to em igrate. If we do travel, I hope that I may be able to continue m y association with the St. John Am bulance movement, and in the meantime would welcom e the opportunity of ex changing letters with a fellow member of the Association, preferably with someone in the W ellington district. I have been an active member of the Association since 1939 , when the “ V auxhall Motors” started a Division which later grew into a Corps. Now I do not know the address of any person through which I can m ake enquiries. If you can help me in this matter, your kindness will be much appreciated. May I add that for years I have alw ays looked forward to the monthly delivery of F i r s t A i d and to reading the in teresting articles they alw ays contain. T h a n k in g you in anticipation. Yours faithfully, J.

25 , W indermere-crescent, Luton. May 21 st, 1945 .

ates

. ).

FIRST

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AID

I O D I N E FOR S U N B U R N T"'v id you know that iodine can be used in the treatm ent o f p a in

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F I R S T

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R I D

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(jitic u r a O I N T M E N T

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FIRST

R e v ie w s . The

N urse's Dictionary. Revised by Florence T aylor, S .R .N ., S .C .M . L ondon : Faber & Faber, Ltd. Price y/6.

T h e N urse’s D ictionary has again been thoroughly revised for this, its twentieth edition, to ensure that its con tents are both comprehensive and up-to-date. N ew terms have been added with full explanations, together with new theories regardin g the course of certain diseases. Besides the definitions, exam ples are frequently added and reasons given for the various operations and treatm ents. T he D ictionary, of which the total number of copies printed is now well over half a million, has long had a great reputa tion, and the present edition, with its many improvements, should advance still further that reputation.

AID

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 39 th (1 9 3 7 ) Edition of the S.J.A.A.

Manual of First Aid to the Injured.

The Nurse's Pocket Encyclopedia and Guide, 1945. R e vised by H ilda M. Gration, S .R .N ., S .C .M . Price 5/-. T h is Encyclopsedia has for thirty-nine years splendidly served the needs of trained nurses as a pocket reference and guide to all matters connected with the practice of their profession. It includes a Calendar for 1945 , and also a comprehensive and com pact D irectory of N ursing In stitutions. T h e present edition has been carefully revised, and it covers everything from m aking a bed to m akin g a will. Beyond doubt, it will continue to prove useful to all who are en gaged in nursing duties, whether in hospital or at home.

T re a tm e n t of C o n cu ssio n .

P. S. (Cricklewood). — Please tell me if it is of any practical use to fan a person suffering from Concussion of Brain ; and, if so, w hy such treatm ent is of service. Frankly, I doubt the practical use of fanning such a patient, except when it serves to keep a meddlesome by stander or assistant out of mischief. At any rate, fanning patient is not included am ong the instructions detailed on p. 168 in Textbook for treatment of Concussion of B rain.— N. C o rb e t

F le t c h e r .

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

Police Ambulance News. For the third year in succession, the Richmond police team won the “ Codings ” cup in the first aid competition at the D rill H all, Parkshot, on Sunday, May 27 th. Judged by Dr. E. S. Abraham , M .R .C .S ., L .R .C .P ., Assistant Com missioner of the S .J .A .B ., the team gained 176 m arks out of a possible 200 . T he runners-up were Metropolitan Special Constables ( “ V ” Division), with 130 A marks. T h e task of the competitors was to give first aid to a man who had received bullet wounds and was suffering from haem orrhage. T h e scene w as in a street where enemy air craft overhead were m achine gu nning. T h e winners and runners-up were presented with N ational S avin gs Certificates. T h e Deputy M ayor (Councillor P. V . M auger), who pre sided and presented the aw ards, congratulated the w inning team on the high standard of its work. H e hoped contests of that kind would be held annually and that in the future there would be more entrants. Representatives of “ G ” Division, Isle of W igh t, dis tinguished them selves in the Inter-D ivisional First Aid Com petitions of the H am pshire Joint Police Force, at Winchester, by carrying off both cups competed for. In the team com petition for a cup given by Lord Mottistone, the Lord Lieutenant of the County, there were 10 competitors, and the Isle of W igh t won with E astleigh as runners-up. There were 50 competitors in the individual competition for a cup given by Lady Louis Mountbatten, and the winner was Sergt. A. Aym es (Div. H .Q ., Newport). On the Island representatives’ return, the first to con gratulate them on their success was Col. R. G. Spicer (the former Chief Constable of the I.W . Constabulary), who has recently returned from his arduous duties with the Civil Affairs Organisation in Italy. H e was the originator of Police first aid competitions in the Island.

M .B. (Cam bridge).— T h e am using howler published In the May issue of F i r s t A i d calls to my m emory an exam i nation in which I asked one candidate what he would do if he had to treat a sm all boy who had pushed a button into his ear. I remember that I could not refrain from lau ghing when he replied— “ I would give the hoy a dose oj castor oil and so get rid oj the foreign body 1 ” Good 1 Next, please 1 1— N .C .F . C o n te n ts of B rig a d e P o u c h .

W . W . (Bristol). — Could you please tell me what is the regulation equipment which members of the St. John Am bulance B rigade are supposed to carry in their pouches ? T he regulation contents of the pouch are as follows :— 1 triangular bandage, 1 1 in. wrapped roller bandage, 1 2 in. wrapped roller bandage, £ oz. packet plain lint, £ oz. packet cotton wool, 1 oz. bottle of Liq. Ammon Arom at., 1 pair scissors, 6 safety pins, 1 oz. bottle Surgical Spirit, 1 piece strong cane for improvised tourniquet, 1 m easure.— E d i t o r . C au se of In c ised W ound.

P .P . (Hounsditch). — Recently a boy crashed his head on a chest of drawers in his bedroom and sustained a vertical incised wound in middle line of his forehead. Please explain this result in view of the statement on p. 104 of the T extbook that wounds are caused by sharp instru ments such as a razor. Direct violence applied to face and head is apt to cause typical incised wounds by reason of the im pact on the sub jacent bone. — N .C .F . T rea tm e n t

of A p o p le x y .

N .O . (Cardiff).— I have been told that in the treatm ent of Apo plexy it is incorrect to turn the patient’s head to the side

F I R S T

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where the diseased blood vessel has burst. T h e T e x t book does not give any such w arn ing ; and I venture once again to seek your kind ruling on this problem. Imm ediately after a stroke it is rarely possible to locate the site or side of the haemorrhage into the brain tissues ; and certainly such a diagnosis is utterly beyond the skill of a first aider. Y o u r problem, therefore, is not a practical one ; and, further, I do not know w hat harm would result to such a patient, even though his head were turned to the side “ where the diseased blood vessel has burst 1” — N .C .F . F u n c tio n s

limb at the knee joint (which would still further separate the fragm ents) ; and for this purpose the application of a back splint reaching from buttock to beyond heel is urgently indicated. On the other hand, with a fractured limb first aid seeks to prevent all movements of the leg, and especially side-to-side movements. T o this end the tying together of both limbs contributes considerably, and should only be omitted when for some unusual reason it is positively con traindicated.— N .C. F.

o f B ra in .

P .R . (Chelsea).— Please tell me what part of the brain con trols the sub-conscious— the cerebrum or the cerebellum. Also, is the cerebrum that part of us mortals w hat is called “ the soul ” ? If so, then w hat is the function of the cerebellum ? If I am exceeding the lim its of first aid, I ask to be excused, but 1 hope that you will once again solve my problem in your usual lucid style. T he “ s o u l” is that part of a man which thinks, feels, etc., and is supposedly located in the cerebrum, which is “ the seat of the intellect, the emotions and the w ill” (Textbook, p. 152 ). The cerebellum, however, is the great centre for co-ordination of m uscular movement, and especi ally the harmonious adjustm ent of those muscles concerned with keeping the body erect and in a position of equi librium .— N .C . F. F rac tu re

A I D

of H um erus.

R .R . (N ewcastle). — Recently I heard a curious story which I can hardly believe ; and I submit to your ruling the facts, which are as follows :— D u rin g a football match a player slipped when racing for the ball ; and another player fell on top of him. H e was carried off the field, but five minutes later he was able to resume and played out the gam e. On the same evening he visited his doctor, who, on exam ination, told him that he was suffering from simple fracture of the collarbone. Now I aw ait with interest and thank you for your comments. T ruth is alw ays stranger than fiction. If, however, you look up your T extbook (p. 80 ) you w ill find that a frac ture of collarbone is peculiar in that— “ the arm on the in jured side is partially helpless.” In other words, it is quite possible to find more or less free movement of the upper limb when the clavicle is fractured. This is especi ally the case when the outer third of the clavicle is involved and is more easily understood when you remember that the clavicle is thekeybone of the shoulder girdle and serves to keep out the point of the shoulder. Further, in the excite ment of the gam e the pain associated with the fracture would be m inim ised.— N .C .F . T r e a tm e n t of F r a c tu r e d P a te lla .

S.J. (W eston-super-M are).— At a recent practice much dis cussion arose with reference to the treatm ent of a frac tured patella. One member contended that it would be advantageous to lay patient down, to raise the in jured limb, to tie bandages above and below the fractured patella (w ithout a back splint) , to raise the other limb, and to tie the injured to the uninjured limb. I disagreed wholeheartedly with these suggestions, and I said that I would seek your kind assistance. I agree with you. Indeed, it would avail little if in this case w e tied the injured to the uninjured limb, because, .with fractures of patella, we try to prevent flexion of the

R e m o v a l of C lo th in g .

V. W . (E dinburgh). — In Principle No. II the Textbook tells

us to “ uncover the patient as little as possible since exposure increases sh o ck .” W hile I agree that this would happen if we stripped the patient, I cannot see how shock would be increased by rem oval of clothing covering a simple fracture of a limb or part of a limb. I wonder, therefore, if there are other reasons which are involved ; and I thank you for your kind reply. Personally, I can think of three other reasons. First, much valuable time will be lost during the removal of clothing and their replacement, which must be carried out slow ly and deliberately, whereby the removal of the patient to medical aid m ay be unduly delayed. Secondly, the necessary manipulations will favour aggravation of the original injuries, especially the conversion of a simple into a compound and/or complicated fracture. T hirdly, the clothing affords suitable padding for splints.— N .C .F .

E ffic ie n cy of C a d e t O fficers.

W .L . (New South W ales, A ustralia).— I would be pleased to know if it is compulsory for a Cadet Superintendent or a Cadet Officer to attend the Drill nights of their Adult Division in order to gain their Brigade efficiency for the year. W hen it is considered that Cadet Officers attend their Cadet Division w eekly m eetings, attend to Divisional correspondence at home, attend the regular m onthly m eetings of the Cadet Officers, and the Cadet Competitions and D isplays when arranged, an extra night per month just to be with the Adult Division is considered an imposition. As this is a burning question am ongst some of our Cadet Officers, your reply is eagerly awaited. W e have submitted your query to B rigade Head quarters, to whom our thanks are due for an official reply, as follows :— “ It is not compulsory now for the Cadet Superintend ent or Cadet Officer to do the twelve Duties with the Adult Division. T hou gh this is not definitely stated in any Brigade Order, you will see in Brigade Circular of March, 1945 (paragraph a), that it is implied by reason of the fact that all Cadet Officers’ duties must now be entered on the Cadet B .F .l , while on the Senior B .F . 1 it is simply noted that the Cadet Officer concerned is attached to that Division super num erary to establishm ent.” — E d i t o r .

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CONTENTS

d it o r ia l

T H IS

NUMBER.

—

T h e Nurses Act, 1943

...

W ithin the Scope of First Aid

...

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

...

R ailw ay Am bulance News

...

Cadet Author’s Cup Competition

...

“ W hat I W ould L ike to See Done ”

...

Letters to the Editor

...

S .J .A .B . Overseas

...

Common Errors in First Aid Q

u e r ie s

a n d

n s w e r s

t o

o r r e s p o n d e n t s

:—

Treatm ent of Burst Varicose Vein

...

Exam ination H ow ler

...

Treatm ent of Hornet S tin g ... Seniority in Division

...

... ^ ...

...

Contents of Su rgical H avresac

...

Treatm ent of Fractured L eg

...

D em ulcent D rinks in Poisoning

...

Fed-up Privates

...

Silvester Method

...

Poisoning by Carbon Monoxide

T h e M inister of H e a lt h and the

The Nurses Act. S ec r e ta r y of S ta te for S c o tla n d 1943. h a v e n ow m ade orders under p o w e r s conferred upon them by t h e N u r s e s A c t , 1943, and the N u r s e s ( S c o t la n d ) A ct, 1943, b r in g in g into operation th o se p r o v isio n s of the A c t w h ic h restrict the u se of the title “ n u r s e ,” and g o v e r n the l ic e n s in g and control of a g e n c ie s for the s u p p ly of nurses. T h e s e p r o v isio n s w ill c o m e into effect g e n e r a lly on O c tob er 15th next, but there are e x c e p t io n s (for a d m in istr a tiv e reasons) in c lu d in g th o se r e la tin g to a p p lic a tio n s for lic e n ce s, w h ic h c a m e into operation on Ju n e 15th. F rom O c to b e r 1 5 th next, it w ill be an offence for a person to u se the title “ n u r s e ” u n le ss he or s h e is a state registered nurse or an e nrolled a s s is ta n t nurse, but an e x c e p tio n is m ade in the A c t s p e r m ittin g c h ild r e n ’s n u rses to use the title “ n u r s e ,” u n le s s there are c ir c u m sta n c e s w h ich s u g g e s t th e y are s o m e t h i n g other than child ren 's n urses. T h e M inisters h a v e also ex er c ised the p ow ers conferred upon them by the A c t s to m ake r e g u la tio n s p e r m ittin g certain c la s s e s of pe r son s to u se e x p r e s s io n s c o n t a in in g the w ord “ n u r s e . ” T it le s w h ic h m a y be used i n c l u d e : “ T rain ed nurse ’’— th is m a y be used b y p e r so n s on the ge n e r a l part of the list kept under se c tio n 18 of the N u r s e s A c t, 19 43, and the N u r s e s (S c o t la n d ) A ct, 1943 ; “ m aternity nurse ” (b y m id w iv e s ) ; “ s tu d e n t nurse ” (by p e r so n s in t r a in in g for S ta te R e g i s t r a t i o n ) ; “ pupil a ss is t a n t n u r s e ” (by per s o n s in tr a in in g for the A s s is t a n t N u r s e s ’ R o ll) ; and a person h o ld in g the T u b e r c u lo s is N u r s in g Certificate of th e T u b e r c u lo s is A s s o c i a t io n , or u n d e r g o i n g t r a in in g for th is certificate m a y use a n y e x p r e ssio n c o n t a in in g the w ord “ n u r s e ,” w h ic h sufficiently in d ica tes that he or s h e is either a nurse or tr a in in g to b e c o m e a nurse o f tu b e r c u lo sis patients o n ly . P art II of the A c t s prescribe that a g e n t s for the s u p p l y of n u r se s m u s t be lic e n se d by local a u th o r itie s, w h o m u st s u p p ly o n ly pe r son s w h o are S ta te registered n urses, e n rolled a ssista n t n urses, m id w iv e s , or m e m b e r s of other c la s s e s to be prescribed by the M in isters and sa tisfy va riou s other c o n d it io n s . T h e c la s s e s

F I R S T

oth e r than S t a t e reg istered nu rse s, e nrolled a ss is t a n t nu r se s, or m id w iv e s , w h o m ay be s u p p lied by s u c h a g e n c ie s are set ou t in the N u r s e s ’ A g e n c i e s R e g u la t io n s , 1945. T h e y c o n s is t of s o m e , but not all, of the c la s s e s perm itted to use the title “ n u r s e ” by the N u r s e s ’ R e g u la t i o n s . 1 he m ea su re is o n e that has l o n g been n e c e ssa r y , and the p ublic w ill n ow be a d e q u a te ly protected, o n ly p e r s o n s p o s s e s s in g n u r s in g qualifica tio n s b e in g perm itted to describe t h e m s e lv e s as nurses.

Within the Scope of First Aid. By S IR H E N R Y L. M A R T Y N , K .C .V .O ., F .R .C .S . wind whistled dism ally across the vast expanse o f the great football stadium in which the cup tie final in the year of grace 1946 was to be played. George, fully conscious of his smart First Aid uniform, stood at one of the entrance gates w atch in g the crowd as it surged past the barriers. By virtue of his numerous certifi cates he felt quite competent to carry out the objects of First Aid which, at intervals, he repeated to himself— ( 1) to pre serve life, (2) to prevent aggravation of injury or condition, ( 3 ) to provide transport. lt was true that at times he experienced some qualm s of anxiety lest perchance this vast concourse of people m ight provide him with some case which the hitherto som ewhat narrow restrictions of his train ing m ight not have regarded as com ing within the “ Scope of First A id .” Did such an unfortunate thin g occur he felt that it was go in g to be a little difficult to carry out either ( 1) or (2 ). H owever, he comforted himself, such a m isfortune w as unlikely, and, if it did occur, the fault would be rather with those who directed his train ing than with himself, and, in any case, he could alw ays m ake good on ( 3 ). H e was not allowed long to meditate, and a groan be hind him caused him to turn sw iftly to see an elderly man leaning heavily again st the ga te post. An expression of utter terror marked the agonised face as the victim, with his rig h t hand pressed over his heart, appeared hardly to.dare to breathe. G eorge looked at him and realised at once that the man was in extrem is, but how to carry out either ( 1 ) or (2 )— much less (3 )— was beyond the scope of his training, at least as far as his little black book had taught him. W ith the sudden realisation of his ignorance, the appearance of a sm all efficient looking woman pushing her w ay towards him gave him some reassurance. She wore no uniform save a small brooch bearing an enamelled red cross. W ith a sw ift glance at the patient, now supported by George, she slipped a hand into his pocket, w ithdraw ing it after a brief search holding a sm all gla ss ampoule. This she wrapped in her handkerchief and snapped beneath the patient’s nose. T h e quick gasp and sudden relaxation of the tense muscles gave sure indication of relief from the obvious agony from which the man had been suffering. T h e pale face flushed all over as the drug did its w ork, and the whispered thanks gave immediate confirmation of the accuracy of the little w om an’s diagnosis. "W h a t was it ?” said the crestfallen George. “ A n gin a,” said the little woman. ‘ ‘ Common enough, unfortunately, but it’s in our book and surely in yours also ?” “ N o,” he replied, and was left wondering how in 1946 two great societies could exist, both gra n tin g certificates of efficiency The

A I D in First Aid, but which could not yet agree as to what came within its scope. W ith their patient safely ensconced in the First Aid Post to rest, G eorge and the little woman turned once more to watch the crowded mass of hum anity. A sudden com motion not far aw ay caused them to edge their w ay swiftly through the closely packed people to the spot where a m as sive constable bent over a fallen youth u rgin g the crowd to stand back and give him air. T he boy on the ground looked, and obviously was, very ill. His pale sw eat covered face and dry lips were clear evidence that his was no condition to brook delay, whatever m ight be the cause. At first glance, G eorge and his companion thought the case to be one of simple fainting until they realised that the victim was, at any rate not as yet, unconscious. H is hands fumbled continuously towards his pockets, and one word, which seemed to their anxious ears to be " s o - g a r ” , cam e repeatedly from his trem bling lips. H astily repeating to one another the objects of First Aid, the two experts realised that as regards ( 1) and (2 ) they were stumped, and they turned together to get (3 ) go in g at once. As they did so, a sm all man pushed past the protesting constable. H e wore no uniform or indication of possessing any training, but, kneeling quickly beside the patient, he slipped his hand into his pocket. T h e constable appeared for a moment to think that he was w itnessing a barefaced robbery, but a swift glance at a card which the newcomer withdrew seemed to be all that he needed. A lump of sugar appeared as if by m agic in his hands, to be pushed a second later between the victim ’s trem bling lips. More sugar, now dissolved in water, followed it, and by the time the stretcher arrived the patient was on his feet, to the amazement of G eorge and the little woman, apologising for the trouble which lack of food after a dose of insulin had caused. “ N o,” said the sm all man, he had no First Aid certificates, but he happened to be a diabetic himself and knew that the vast m ajority of his fellow sufferers carried on their persons some easily found card indicating their liability to such attacks. He had seen them in others often enough in circum stances as diverse as the pomp and majesty of the Jubilee Service within St. P au l’s Cathedral to the peace and calm of a Devonshire cottage garden. “ S u rely,” said G eorge, sadly, to his companion expert in first aid, “ insulin has been in use for many years, the diagnosis of this urgent condition cannot be said to need long training or even a doctor’s know ledge before its treat ment can be undertaken, since the patient often carries it upon him — and yet the powers that be have not yet appre ciated that it should come ‘ W ithin the Scope of First A id .’ ” A rum bling, followed by an appalling crash, came suddenly from behind them ; a moment of dead silence, succeeded by a chorus of screams and groans which rent the air, left no doubt in any mind that some great catastrophe had occurred. G eorge and the little woman turned to see that the vast grand stand behind them had apparently disappeared and was now replaced by a billow ing cloud of dust. Grand stands have collapsed before and will doubtless do so again, and George and the little woman had no hesita tion as to where their duty lay T h ey went to it quickly enough and soon found themselves units am ong an arm y of helpers seeking to»aid the injured and dying who lay in hundreds am ong the ruins. H avin g dealt with several cases, they came across a lad who lay at the edge of an enormous pile of debris. A hu ge steel girder pinned one leg to the ground, but, since its w eight was taken by other girders, the leg itself did not appear to be gravely injured. T he boy w as obviously shocked, but it w as clear that, although the pressure was severe, he w as not in great pain. G eorge and the little woman, content at last that they were faced with a case about which there was nothing

F I R S T which their books had omitted to teach them, proceeded to deal with it according to their lights. T hey realised only too well, from the mass of debris above their patient, that his release could not possibly be effected for m any hours, so, warmed by a cup of tea, a pillow beneath his head and rugs over him, they reassured him as to his ultimate safety and patiently awaited his rescue. Doctors hurried past, and seeing an apparently well looked after patient hastened to more urgent cases. Slow ly the hours passed while armies of men laboured to clear the wreck, until at last the girder was lifted and G eorge and his companion sighed with relief to see their patient carried aw ay on a stretcher in good con dition and with an apparently intact leg. Ten days later they met at the gates of the hospital with the intention of visiting their erstwhile patient, in whom they felt a proprietary interest. Their horror was unconcealed when the House Surgeon who interviewed them informed them gravely that he had died that morning. “ B u t,” said George, “ he was barely injured, his leg was pinned for some hours, that was a ll.” “ Q uite en ou gh,” said the surgeon. “ Did you not learn in the last w ar all about these crush injuries and how to prevent, during the time they are trapped, the subsequent kidney dam age that so often kills ? W hy, I remember a special reprint of A R P handbook No. 10 being issued solely to teach people how to save these lives.” “ N o ,” said the little woman, sadly. “ W e still learn from the same old books w earily repeated to us year after year by bored lecturers.” “ But one thing I know which we, at least of the rank and file, have learned— until the “ Scope of First Aid ” can be expanded— until the lessons of war, which cost so many lives to learn, can be brought by men of wider vision into the teaching of peace— and until the whole of our training can be made fearlessly into a vivid living entity, the art of First Aid, which could have done so much, can have little future before it in the Brave N ew W orld to com e.”

S.J.A.B. Overseas. IN D IA — No.

3 D istrict, B o m ba y .

C o s m o p o l i t a n D i v i s i o n . — At an almost exclusive St. John gatherin g held on June 16 th at the Governor’s pavilion at the Cricket Club of India, Bombay, Capt. J. D. Ivothawala, Div. Supt., S .J .A .B . Cosmopolitan Division, and Mrs. K othaw ala entertained H is W orship the Mayor of Bom bay Dr. Jos Alban D eSouza and Mrs. D eSouza to an afternoon reception. Am ongst those present were M ajor General R. H ay, Commissioner No. 3 District, and Mrs. H ay and several senior D istrict and Divisional Am bulance and N ursing Officers. Th e Mayor, accompanied by Major General H ay and Capt. K othaw ala, inspected the Guard of Honour drawn from the men of his own Division. Capt. K othaw ala in a short address, w elcom ing the guests of honour and others, eulogized Dr. D eSouza’s ser vices for over 30 years with the S .J .A .B . as Div. Surgeon, Cosm opolitan Division, and said that not only the Cosm o politan Division, not even No. 3 Districc alone, but the whole of the S .J .A .B . Overseas within the Em pire of India had reason to be justly proud that one of its Officers had received the unique honour of being elected the first citizen of this Urbs Prim a in Indis. The Mayor suitably replied, than kin g Capt. and Mrs. K othaw ala for the honour done to him, and in doing so, referred to Capt. K oth aw ala’s services with the Am bulance B rigade and the Army.

A I D

S t.

Jo 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.

O r d e r o f S t . J o h n . — T h e Annual Festival and General Assem bly of the Order of St. John was held on Tuesday, June 26 th, the first time these functions have been held since 1939 . O w in g to the fact that the Priory Church in Clerkenwell was destroyed by enem yaction in 1941 , the Commemoration Service was held in St. Jam es’, Clerkenw ell Green. Members of Chapter-General in their robes w alked in procession from the Chancery of St. John’s G ate to the Ghurch where the sermon was preached by the Rev. E . C . Ratcliffe. At the General Assem bly of Members and Associates of the Order held in the Chapter H all at St. John’s Gate, the Earl of Clarendon, K .G ., G .C .M .G ., G .C .V .O ., P .C ., (the A ctin g Sub-prior) presided, and reports on the various depart ments of the Order were given by B rigad ier W . B. G. Barne, C .B .E ., D .S .O . (Secretary-General), the H ospitaller, the Librarian, the D irector of Am bulance, and the Chief Com missioners of the B rigade (At-H om e and Overseas).

County o f Berkshire. F i n c h a m p s t e a d — On Sunday afternoon, June 24 th, the N ursing and N ursing Cadet D ivisions held their annual inspection. T h e inspecting officer w as the County Com missioner, Mr. C. A. Poole, who expressed his satisfaction with the general sm artness and efficiency of the Divisions.

M a i d e n h e a d . — O n June 10 th, 92 officers and members of Maidenhead adult and cadet Am bulance and N ursing Divisions attended the annual church parade, the first to be held since 1940 . T h is was followed by the annual inspection which was carried out by the County Commissioner, who expressed his entire approval of the turn-out and w ork of all four Divisions.

R e a d i n g . — On June 15 th, at the Southern R ailw ay Station, tw enty officers and members of the R eadin g N ursing Corps under the command of Corps Supt. Miss E. C. Sudul, formed a Guard of Honour with members of the B .R .C .S . on the occasion of the visit to R eading of B ritain ’s R ailw ay Queen (Miss G reta Richards), and of the opening of the Red Cross and St. John Exhibition Coach. T h e exhibition was opened by the Mayor of R eading, Alderm an W . M. Newham.

R e a d i n g E a s t . — T he annual inspection of the N ursing Division was held on June 11 th. It w as carried o u t by t h e County Com m issioner who congratulated the Division on their appearance, drill and practical work.

T h e a l e . — D u rin g the week, June 2 0 th to 2 6 t h , members of T heale N ursing, Am bulance and Cadet Divisions, o r g a n ised a series of events to raise funds for their new D i v i s i o n a l Headquarters. T h e w eek started with a bazaar f o l lo w e d by a pageant, repeated on Thursday, a w hist drive, a n d e n d e d with a dance and the annual inspection.

C adet

N ew s.

R e a d in g .—

Fifteen N ursing Cadets, in the charge of Cadet Supt. Mrs. M. Bunce, took part in the parade on Em pire Y ou th Sunday. T h e parade marched to the Tow n H all where an Empire Youth Sunday Service was held.

F I R S T

R e a d i n g S o u t h . — On Saturday, June 2 3 rd, a garden sale and entertainment in aid of D ivisional funds, was held at 41 , Eastern Avenue by kind invitation of Mrs. W arren. T he net amount realised for the funds w as ;£18 7 s. lOd.

O b i t u a r y . — W e regret to announce the death of Mrs. T . F. J. V. W aters who was a member of Reading N ursing Division. She joined the B rigade in 1903 , and at the time of her retirem ent held the rank of Divisional Supt. Eler funeral was attended by officers and members of the Reading Corps.

N o . I (Prince o f W ales’s) District No. 122 ( E l t h a m ) . — T his Division held a very success ful social on Saturday, June 16th, at their headquarters. T he program m e commenced with musical items followed by dancing, in which old and young all joined. Then D ivisional Supt. H arbottle spoke to the g.athering and said that in B rigade w ork the wives of the members had to make sacrifices by stayin g at home, while the men were on duty. He also thanked Div. Supts. and men from other Divisions who had attended at the invitation of the Social Committee. T h e other Divisions represented were the 41 st and 49 th Am bulance Divisions, and the 105 th N ursing and N ursing Cadet Divisions. Div. Supt. H arbottle also thanked the band and stewards who had helped to m ake the evening a success. After the interval, during which refreshments were served, there were more songs by Mr. K edge, followed by d ancing and gam es. There were also some side shows and a raffle for a parcel of unrationed goods, which w as won by Pte. Kennedy. The duties of compere were very ably carried out by Cadet Officer S. Anderson. Arrangem ents were in the hands of the Social Com m ittee consisting of Cpls. Nunn and Gardiner, and Ptes. Kennedy, W aterm an and Hindson.

County o f Lancashire. L i v e r p o o l — T h e Liverpool Corps have for some time had the Y outh Movement at heart ; the success of patient train ing of the cadets was demonstrated on Saturday, June 17 th, at Upper D uke Street Corps Headquarters, when junior team s from various parts of the City competed in the final for the “ Liverpool Silver Cadet C hallenge C u p ” which had been given to the Corps by Mr. Stubbs and Mr. Spencer (jointly). Thirteen teams had been whittled down to six teams for the final. T he “ Cavell N ursing Cadets ” won the honour, with the Longview Am bulance Cadets in second place. T h e cup was handed to the winners by Miss W illiam s, Matron of the Liverpool Radium Institute. T he team test was drawn up and judged by Dr. W illiam D uncan, Div. Surgeon., and the individual questions com piled and judged by Supt. J. Anthony. T h e team test staged a boy cycling to a doctor with a m essage, who falls, and is found suffering from bruised fore head, bleeding nose, and broken collar-bone. T h e casualty is dazed and suffers badly from shock. T h e weather is reported to be very good. T h e winners were marked a good team.

County o f N ortham pton. D e s b o r o u g h . — D u rin g the St. John’s D ay celebrations at D esborough on June 24 th, County Cadet Officer Mrs. E. Shaw , M. B. E ., presented the long service medal of the Order to Div. Surgeon W . E. Lock, who has been with the N urs ing D ivision since its registration in 1929 . Mrs. Shaw conveyed the hearty congratulations of the County Commissioner, Dr. E. H. Shaw , and the County Supt., Mrs. I. Jennings, to Dr. Lock, on his being the first D ivisional Surgeon in the county of Northampton to merit this award.

A I D Desborough Cadet N ursing Division celebrated St. John’s D ay with other cadets from the K ettering N ursing Cadet Corps. T his took the form of a demonstration, tea, and church parade. County Cadet Officer Mrs. E. H. Shaw inspected the cadets, and presented aw ards to the Desboro’ cadets for home nursing, child welfare and firefighting. After the demonstration, tea w as held in the Conservative Club tea room, after which the officers and cadets paraded to the Parish Church, where a service was conducted by the Rev. W . L. Green, M .A., and the address was given by Canon G. F. Tow nley, M .A ., R .D . (Vicar of St. M ary’s S car borough). At the conclusion of the service the parade again formed up and marched back to the Council schools, where Corps Supt. Mrs. D. Gibbons thanked the Desborough Cadets for the wonderful day they had arranged.

County of Worcester. T h e Am bulance and N ursing Competition Finals of the S .J .A .B . in the county of W orcester were held in the Tow n H all, Dudley, recently. The contestants in the Ambulance Final were Redditch and Brierley Hill. T he card for the team test was as follows :— “ There has been a factory on fire and Fire Brigade members and a party of S .J .A .B . men are arriving. Part of the building has collapsed and three casualties are there. T he competing team s must deal with, and treat these cases.” The com peting teams in the N ursing Competition were H alesowen (holders) and Brom sgrove. T he card for the team test was as fo llo w s:— “ Y o u are sitting one sunny sum m er afternoon about 50 yards from the bank of a river listening to the laughter of the bathers in the river below, and w atching the boats in the distance. You are also interested in some of your senior cadets who are cam ping near by and are m akin g tea at a camp fire outside their tent. There are no houses in the neighbourhood. Y ou will deal with any em ergency which may arise.” County Commissioner Dr. F. L. Newton announced the results as follows :— Am bulance Shield, Brierley Hill, 285 m arks ; Redditch, 256 . Ollis N ursing Shield, Brom sgrove, 230 m arks ; H alesowen, 177. D u d l e y . — T he annual Divisional Inspection, by the Corps Officers, of the Dudley Cadet Am bulance Division took place on Thursday, June 21 st, at the headqaarters of the Division, Baylies School, Dudley. T he Inspecting Officers were Corps Supt. J. A. Harris and Corps Officers W . O llis and J. H. W atkins ; 18 cadets were on parade under the command of Cadet Supt. R. R. Hines. After the Inspection, the cadets gave demenstrations of company, stretcher and hand seat, followed by gam es. Corps Supt. H arris expressed his pleasure at all he had seen, there were only one or two sm all things in their drill which required alteration. Corps Officer J. H. W atkins said that he had examined the books and records of the Division and had found these to bs in order. He appealed to the cadets to stick to the Brigade, and when.they were old enough, to become mem bers of the adult Division.

H a l e s o w e n . — T h e annual Divisional Inspection, by the Corps Officers, of the H alesowen Nursing- Division took place on Tuesday, June 12 th, at the headquarters of the Division. T h e Inspecting Officers were Corps Supt. Miss N. Ash ton and Corps Officers Miss W akefield and Mrs. Northwood; 15 members were on parade under the command of Div. Supt. Miss M. E. Fearnside. After the inspection, the members gave demonstrations of home nursing, including bed m aking, charting pulse,

FIRST respirations, temperatures, etc. Corps Supt. Miss Ashton said that she was extrem ely pleased with their dress, which was neat and correct. At the close, refreshments were served to all present by the members. O ld b u r y .—

There is now a very strong possibility that a Cadet N ursing Division will shortly be formed in Oldbury. Great enthusiasm was shown by 35 girls who attended the first m eeting which was held at L an gley. Mrs. W . Lamb, Area Cadet Officer, presided. T he cadets are start ing in real earnest with their training in first aid and kindred subjects, and it is hoped to register the Division very shortly. Th e w eekly m eetings will be held at the headquarters of the N ursing Division, Arden Grove, Lan gley, every T u es day at 6.30 p.m ., and all girls between the ages of 11 and 17 years who are interested will be welcome. L y e . — The annual inspection, b y the Corps Officers, o f Lye,D ivision, was held recently at the headquarters o f the Division, Ambulance H all, Lye. The Inspecting Officers were Corps Supt. J. A. Harris and Corps Officers H. G. Mills and J. H. W atkins ; 24 m em bers were on parade. After the inspection, the members gave demonstrations of company, hand seat and stretcher drill. Corps Supt. J. A. H arris said he was pleased with the marked improvement in the drill which had taken place in the last 12 months.

West R idin g o f Yorkshire. B r a d f o r d . — The first anniversary of the Bradford City Nursing Division was celebrated by a cadet party, to which officers and members of the other four Bradford Cadet D ivi sions were invited. T he gu ests of honour were County Cadet Officer Mrs. E. Ford, Corps Supt. Mrs. Bruce and Corps Officer Mrs. Sheard. A program m e of gam es and competitions was thoroughly enjoyed by a company of about 120. Prelim inary home nursing certificates were presented by Mrs. Ford. T han ks were due to Mrs. Mitchell, Supt. of City N urs ing Division for the two tier iced birthday cake, surmounted by the Maltese Cross, the ingredients of which were con tributed by members. The cadets are proud of the progress made since their inauguration, having successfully negotiated the preliminary first aid and home nursing exam inations, the seniors also having taken adult exam inations in these subjects. Several of the cadets are actively en gaged in duties at the Bradford Royal Infirm ary, and undertake public duties as occasion arises. Cadet Supt. Miss Lilian Gransbury was ably assisted by Cadet Officer Miss Dorothy Leach.

D y s a r t C o - o p e r a t i v e A m b u l a n c e T e a m . — This year the Senior team has won the Scottish Co-operative C hallenge Cup open to Scotland, the East of Scotland Championship Shield, and the M athewson Cup. W hile the Junior team won the Scottish Co-operative Ambulance Shield open to Scotland. Thus m aking the finest record for any Am bulance section in Scotland this year.

G u ild fo rd S t . J o h n N u r s e s A b r o a d . — Amb. Sister Miss D. W oolgar, a member of No. 2 N ursing Division, was present at the Victory parade at New Delhi when the Viceroy took the salute. Miss W oolgar volunteered for service in India last year and is w orking at a hospital near Calcutta. Amb. Sister Miss Cosh who is also a member of No. 2 D ivi sion went out at the same time and is serving in a hospital near the Burm a border.

AID

R a ilw a y

A m b u la n c e

News.

L .N .E .R . It is very pleasing to note that despite the m any calls upon members of the staff who are interested in first aid, it has again been possible to hold competitions in all the six districts nam ely :— D arlington, Hull, Leeds, M iddlesbrough, N ewcastle and York. T h e competitions were arranged on pre-war lines. The sta g in g of the team tests was particularly outstanding and thanks were extended to the officials who so w illin gly met the requirements. T h e w inning team from each district competed in the North Eastern Area Final, in the Technical College, D a rlin g ton, on May 12th, the setting being the local “ Red L io n ” which w as ably reproduced by the D istrict Engineer. Mr. J. Taylor Thom pson, the Engineer, Y o rk , presented the Substitute Shield to the w inning team (D arlington D istrict Engineers) and the Hornsby C hallenge Cup to the runnersup (H ull Station). Dr. A. C. W hite K nox, M .C ., M .B ., C h .B ., London, adjudicated, and sincere thanks were extended to him. T h e Group Competition was held in the Board Room, Marylebone Station, London, on May 29 th, the ju d ge being Dr. M. M. Scott, London. T he result was :— Bishopsgate, Great Eastern Area, 294 £ m arks ; Peter borough (New England), Great Northern Area, 272 ; L an gwith, Great Central Area, 242 £ ; D arlington (Engineers), North Eastern Area, 233 £. SOU TH ERN T h a m e s V a l l e y . — T he fifth annual presentation of aw ards and grand free concert was held at St. M ary’s H all, Tw ickenham , on Thursday, June 21 st. T h e chair was taken by Mr. W . Baker. The aw ards were distributed by the D istrict Secretary, Mr. A. Barrow, to the 70 successful candidates. H e hinted that the R ailw ay first aid w ork was to be reorganised and rejuvenated in the near future, and thanked the Secretary, Mr. S. W . Sm ith, for the invitation and said only those who have been class secretaries know how much w ork has to be done with a big class. Supt. C. W . Sharpe, Kingston Division, him self a rail w ay first aid w orker for 17 years, appealed to those who had not taken up first aid w ork to do so. T h e concert program m e under the direction of Mr. Tom Jeffrey, was very good and much appreciated by all. Mr. C. G. Merritt, W elfare Dept., proposed thanks for the visitors.

Cadet Authors’ Cup Competition. Cadet Authors’ Cup Competition for the C hallenge T rophy presented by B arbara Cartland (the w ell-known authoress and playw right) for annual competition am ong cadets of the S .J .A .B . in England, W ales and Northern Ireland, for the best short story or play, has been won for 1945 by Cadet Sylvia Bull, aged 15 years, of the Addiscombe C ollege N ursing Cadet Division (Croydon, Surrey). T he runner-up w as Alan Durston of the Farnborough Cadet Am bulance Division. A special prize given by Mr. Philip Barker (of Pathe Pictures and A .B .C . British Films) for the composition show ing the highest journalistic promise was awarded to Cadet David O rw ig Jones of the Cynfli Cadet Am bulance Division, Caernaevon. T he

Both the trophies will be presented to the successful

F I R S T

competitors at the annual inspection of No. 1 (Prince of W ales’s) D istrict, to be held in H yde P ark on A u gu st 11 th. In addition to the Championship trophy, Sylvia Bull w ill also receive a personal cup from Lord Luke. All the entries were judged by B arbara Cartland (who is County Cadet Officer for Bedfordshire) and Mr. Peter Cheyney.

“ What I Would Like to See Done.” W e have received considerable correspondence upon the Article entitled as above by Dr. Bowm an E dgar, which appeared in our June issue. W e regret that pressure on space, ow ing to shortage of paper, prevents us reproducing this in extenso, but we give below extracts from several letters which reveal the trend of the correspondence :—

C o le

(Clapton, E.S) :—

T h e article by D r. Bow m an E dgar should raise the enthusiasm of all real first aiders. I would, myself, like to see his ideas adopted. One of my difficulties with the A. R. P. first aiders at the post where I am employed, was due to the fact that one or two were trained by the B .R .C ., whilst 1 used the St. John Manual from which I had my first aid training. Argum ents would crop up during their practice. I compromised by in form ing them that, so long as they applied efficient first aid, it mattered not w hat method they used. W hat would happen if two contrary spirits were to attend one casualty ? It seems much would depend upon the vitality of the victim. T h e idea of three grades, I think adm irable— and if each three yearly efficiency test w as made a little stifFer, it would keep us on our toes, both for practice and theory. W hy not a window sign, or som ething sim ilar, for those first aiders proving their right by exam ination ? T h e idea of a British Council seems to me to be really sound.

A I D time, it w ill be illegal for any person to use the title of “ N u rse ” without some recognised degree of qualification, and quite rightly. Th is has been instituted for two reasons : 1 . T o protect the public from unqualified persons. 2 . T o raise the status of the profession. It is agreed by responsible persons that first aid is a service which may be the means of saving life, so why should the above suggestion not be applied to first aiders ? I believe that by this means, and this means only, can a really efficient national first aid organisation be built up and maintained.

S. S.

D ean

(Alresford, H ants.) :—

I agree with Dr. E dgar Bowm an that we could at least have an over all ru lin g council, and that the w ork of the separate organisations could be standardised. In short, I press for :

1. T he preservation of the three organisations as separate bodies, but 2. Standardisation of their methods and teaching, and 3 . Measures for persuading public opinion that the very essential services rendered by the first aid organisations should receive a measure of State aid, and should not be entirely dependent on public charity.

L etters

th e

E d ito r .

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

ear

FROM

IT A L Y .

,—

Please permit me, a new but interested reader of F i r s t and a member of the S .J .A .B . in N .Z ., at present serv in g in a N .Z. General Hospital in Italy, to say a few words which may be of interest to readers. One outstanding factor that I have noticed over here in treating accident cases is the strikin gly different attitude of the bystanders from those of my own homeland, or, for that matter, any E nglish-speaking country. I am referring to the very apparent ignorance and non-co-operation of the Italian citizens, which is in contrast to the spontaneous attitude of helpfulness which one finds am ong British com munities There was a case of an old man suffering from a com pound fracture of the tibia and fibula who w as lyin g on the road for a quarter of an hour or more before I arrived, and apparently nothing had been done for him. L u ck ily there was no severe haemorrhage. It was impossible for me to obtain im provising m aterial for securing the limb ow ing to lan gu a g e and other difficulties. A small child, being led by his m other’s hand, accidentally tripped over the injured leg, causing slight movement. In New Zealand, the crowd would have been controlled by police and an am bulance sent for. Eventually, I was assisted by a few army personnel who had arrived at the scene. Another recent case was that of an apparently drowned small boy. W hen I arrived I found fellow bathers holding him in the air by his feet and m anipulating his arms. Per haps this is a method of artificial respiration' unknown to the British. After a few minutes of Schafer’s method, breathing w as restored. It is a great pity that there is no efficient organisation in Italy sim ilar to the S .J .A .B .— Yours truly, A id

“ F irst

A id e r”

(Blackpool) :—

I am in agreem ent with much of w hat is said re unified control, but I am in favour of it being under St. John ruling. T he St. John Association has a long and worthy record. First aiders who gain their livin g as such, are very un wise if they do not keep them selves up to date. Y o u r correspondent stresses three yearly exam s. W e of St. John, Divisional Officers included, are re-examined annually, and if we fail, lose a year’s service, yet I know members of the constabularies who have not been re examined since their certificate, years before.

S. W .

D ore

(Surrey) :—

W ith regard to the formation of a national organisation composed of all services now operating, I will not express my views as Dr. E d gar Bowm an has expressed these far better than I could. I will content myself by sayin g that I agree entirely on that point. W ith the part of the article dealing with efficiency I have strong views. Since 1939 , some hundreds of thousands of certificates have been awarded to the public which certify that they are “ qualified to render first aid to the injured,” this after a minimum of six lectures and the equivalent num ber of hours practical work. Is first aid w ork as easy as that ? T he nursing and other medical auxilliary services must have a recognised standard of qualification before they can practice in their particular fields. In fact, in a very short

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F I R S T

QueriesandAnswers toCorrespondents

Common Errors in First Aid. B y.A . D A V ID B E L I L I O S , M .B ., B .S ., D .P .H . Lecturer, B attersea Polytechnic and W im bledon Technical C ollege ; Physician, W im bledon Hospital.

a n y

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a r is e

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its

sco p e.

F irst aid provides for the immediate treatm ent of patients who are suffering from the effects of accidents or sudden illness. It is intended, above all, to cater for that im portant interval which elapses between the occurrence of an em ergency and the earliest opportunity of access to ade quate medical facilities. U se of the term “ medical facilities ” brings the prac titioner actively into the field, for he him self is on unfam iliar ground when w orkin g at the scene of an incident. There can be no greater error than to im agine that first aid is de signed exclusively for laymen. It is a branch of medical science with which the laym an, nurse and practitionei must be equally concerned. It has been stated that first aid caters for an interval. But this interval must be made as brief as possible ; it is a gross m istake to lengthen it any w ay by undertaking any treatment of an elaborate nature which belongs rather to the realm of a casualty departm ent than to first aid- T he am ount of treatm ent supplied in any particular case should be confined to the bare minimum that is com patible with efficiency. It is first aid that is required and nothing more. There can be no doubt about the scope of the subject. Never, in the history of the world, has the public been more first-aid minded than it is to-day. T otal w arfare has brought about the emancipation of first aid, and, most important, it has stim ulated the interest of a higher proportton of the medical profession than ever before. Moreover, it has proved conclusively the value of the practitioner at the scene of incident— a lesson which w ill not easily be for gotten. W ith the advent of peace, the pi;blic will rightly expect the continued interest of the medical practitioner — not only a medical first-aider himself, but also as a teacher to laymen. Hence, one of the chief objects of this article is to direct attention to some of the commoner errors in first aid which must be emphasised in teaching. C a s e -t a k i n g .

C ase-taking includes not only the im m ediate actions of a first-aider on arrival at a case but also diagnosis/and most particularly the general organisation of treatment. It will be appreciated that there are so many important details to be considered sim ultaneously that errors of omission are relatively common. C ase-takin g cannot be made a routine ; it must be subject to quick modification according to the circum stances and surroundings of the em ergency. Approach.— A common fault on approaching an acci dent which has occurred in a road, factory or elsewhere, is to forget the possibility of a source of danger liable to cause further harm to the patient or to the first-aider himself. Such sources are not uncommon. Thus, when an accident occurs at a corner or on the bend of a road, omission to de tail bystanders to take up suitable positions so that they can regulate oncom ing traffic m ay be mentioned, for exam ple, the risks of fire in m otor-cycle accidents and the dangers caused by poisonous fumes, escaping gas, and an exposed current of electricity.

(To be continue a?.)

Queries will be dealt with under the following rules :— left-hand corner of the envelope “ Query,’’ and addressed to F i r s t A i d , 4 6 , Cannon-street, London, E.C. 4 .

( Reprinted Jrom the February, 1945, issue oj “ The P ractitioner" by hind permission oj the Editor. )

u re

A I D

3 .— All Queries must be accompanied by a “ Query Coupon ”

Manual of First Aid to the Injured. T r e a tm e n t o f B u rs t V a ric o s e V ein .

F .P . (Y o rk ).— In a recent test I was asked what I would do for a patient who, havin g been treated for a burst varicose vein, insisted on w a lk in g home. I replied that I would endeavour to m ake the patient realise the advisability of being removed in recumbent position with the lower limb elevated ; and that if I failed to convince .him , then I would assist him — pointing out that I did so on his responsibility and in face of the possible danger of faintness follow ing the loss of blood. Please tell me if I could do more than this. No. There is no law which can compel a supposedly rational person to accept the advice of medical practitioner or first aider.— N. C o r b e t F l e t c h e r . E x a m in a tio n H o w le r.

M .B . (Cam bridge).— In a recent exam ination the doctor asked one candidate how he would discover whether or no a boy (who had fallen off his bicycle and was lyin g on his back in the road way) had sustained fracture (or frac tures) of lower limbs. He frowned with displeasure when the candidate replied :— “ The quickest way to fin d out i f a fracture had occurred would be to stand the bov on his feet! ” G oo d ! Next, please ! 1— N .C . F. T r e a t m e n t o f H o rn e t S tin g .

M .W . (Bedford).— I shall be greatly obliged if you will tell me w hat w e should do in the case of a hornet sting, as a lady whom I know , was quite ill after being stung. She tried witch hazel. A hornet is a species of wasp so called because of its antennae (or horns). Treatm ent of its stin g is for S tin gs of Insects, as laid down on p. 181 in Chapter X V of the T ex t book which, incidentally warns you that “ these give rise to serious inconvenience and in some cases grave symptoms arise.” — N .C .F .

S en io rity in D iv isio n .

T . L. (Port T alb ot).— I read with much interest your reply to a query which was published under the above title in the M ay issue of F i r s t A i d ; and I venture to point out that, while you explained fully the new ran kin g of the Cadet Superintendent, you made no reference to that of the Cadet Am bulance Officer. I shall, therefore, be grateful for your kind help on this point. B .O . 757 (March, 1945 ) which we quoted in our previous reply lays it down that Cadet Officers have the rank of Ambu lance Officers in the Adult Divisions, supernumary to

F I R S T

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R I D

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“ It d o e s n ’t h u r t in t h e l e a s t ” — I g l o d i n e can be applied t o an o p e n w o u n d w i t h o u t pain. T h is safe, b u t p o w e r f u l antiseptic cleanses and heals cuts, w o u n d s , b ru is e s , scalds a n d b u r n s .

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W E L F A

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T h e relian ce ,which fa c to ry w orkers place in their W elfare N urse is com parab le w ith th a t w hich she in tu rn places in her F irst A id eq u ipm en t. R a p id relief from pain and distress is no less essen tial in the N atio n a l interest than to th e sufferer, and calls for the prom pt ad m in istratio n o f a safe analgesic and sed ative. T h a t is w h y <•A n a d in ,’ a b alan ced com b in ation in the aspirinph en acetin -caffein e grou p , is rega rd ed as indispen sable in F a c to r y W elfa re w ork.

A N

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F I R S T establishm ent. On relinquishing the appointment the seniority as Am bulance Officer dates from the date of his reversion.— E d i t o r .

C o n te n ts

of S u rg ica l H a v re sa c .

VV. W . (bristol). — Thank you for your reply to my query about the contents of the pouches carried by Brigade members which was published in the June issue of F i r s t A id . I shall now be grateful if you will tell m e what is the regulation equipment of the surgical havresac. The regulation contents of the su rgical havresac are :— Splints j splint stra p s; trian gular bandages (each in envelope); first aid dressings ; roller bandages (each wrapped in paper) ; cottonwool ; boric lint ; plain lin t; spool adhesive p la ste r; scissors; bottle containing liquor ammon. aromat. ; dredger boric powder ; medicine measure ; St. John tourni quet ; safety and plain pins ; and bottle containing sm elling salts. T h e measurem ents of the havresac are :— Length IS inches ; width six inches ; and depth nine inches.—- E d i t o r .

T rea tm e n t of F ra c tu re d Leg.

J.S . (Oldbury). — Many thanks for your decision (which was published under the above heading in the April issue of F ir s t A i d ) on our friendly argum ent re the putting up of a fractured leg when no splints are available. W e think however, that either the printer or yourself have made a m istake, inasm uch as you state that the band ages should be round ankles and feet (one bandage), thighs and legs, whereas the B lack Book states ankles and feet, knees and thighs. No, it w as not an error to use the word “ le g s ,” because in such an em ergency I should place the bandages in the positions as stated in my previous reply. It should be remembered that splints and/or bandages are used to im mobilise broken bones as far as is possible ; and, if this is achieved, the exact position of the bandages is not of para mount importance. Nevertheless, first aiders are advised to comply strictly with the instructions of the T extb ook .— N .C .F .

D e m u lc e n t D rin k s in P o iso n in g .

M .O . (Stepney).— Please be good enough to explain the uses and actions of the several demulcent drinks named on p. 172 of the T extbook in the treatment of cases of poisoning. There are three kinds of dem ulcent drinks named on p. 172 , each of which has its special indication. T hus ( 1 ) m ilk thickened with cream, e g g s or flour is particularly use ful with Non-Corrosive Poisons because a clot is formed in which the poison m ay become enclosed ; (2) anim al or vegetable oils are most serviceable with Corrosive and Irritant Poisons because they serve to soothe and also protect the linings of the throat and stom ach ; and (3 ) barley w ater and thin gruel are recommended for cases of Phosphorus Poison in g for which the administration of oils is contraindicated.— N .C .F .

A I D Officer as are also all the County Officers. They all agree that I have been a good Private and that I have not had a square deal. Each time they send my name forward for promotion to the head one, he alw ays turns it down ! I have the Service Medal and two Bars and I hope that they will let me have my next Bar in time to come. On the facts submitted your case is sim ilar to that of many others, not only in the Brigade but also in the F igh t ing Services. Promotion is based on seniority and suitability ; and therefore those selected for promotion as N .C .O .’s should be capable ultim ately of ta k in g positions as Officers. In the B rigade the decision on this point rests with the County Commissioner. — E d i t o r .

S ilv ester M eth o d .

H .H . (K in gsto n ).— W ill you please tell me the reason for the sm all firm cushion or folded article of dress placed under the shoulder blades prelim inary to the performance of Silvester’s method of artificial respiration ? Also, could this method be performed satisfactorily without this support ? M eanwhile my best thanks. For its effective performance, Silvester’s method requires free movements of the victim ’s upper limbs “ outwards, up wards and towards the operator ” in order to produce full in spiration. This would be utterly impossible if the victim ’s shoulders were lying flat on the ground. Consequently the pad beneath the scapulae is an essential factor in the per form ance of Silvester’s m ethod.— N .C .F .

P o iso n in g b y

As the poison is inhaled, there is no object in administer ing an emetic even though the patient is conscious and able to sw allow . T he gas is present in “ after damp ” following explosions in coal mines and in coal gas. It is much more active than carbon dioxide and m ay be the cause of death from use of charcoal stoves and geysers in bathrooms w ith out efficient flues. Death has resulted from running the engines of motor cars in closed garages. T he leading signs and symptoms follow ing exposure are (1) giddiness and headache ; (2) pulse good at first, though rapid and small later ; ( 3 ) vom iting and w eakness of lower limbs ; and (4 ) loss of consciousness passing to coma. The last named m ay continue for hours and even days after removal of the victim from the influence of the gas. T h e lines of treatment are ( 1) to keep patient lyin g flat, (2 ) to provide fresh air freely, (3 ) to persevere with artificial respiration for hours if necessary, (4 ) to administer oxygen by inhalation and better still oxygen with 5 per cent, carbon monoxide, (S) to take prompt steps to keep patient warm with blankets above and below him, hot water bottles and friction to the limbs, and (6) to stim ulate patient by giving hot coffee by the mouth when he is able to sw allow .— N .C .F . .

“ F IR S T

F ed -u p P riv ates. “

— Perhaps the “ Fed-up Privates ” whose query was published in the April issue of F i r s t A i d would like to be treated as I have been. Then they would have a case to write about. I have done over 32 years in the B rigade. My Superintendent is a good

D is g r u n t l e d

P r iv a t e . ”

C a rb o n M o n o x id e.

D .N . (D ublin).— Please settle a dispute by telling us if it is correct to give an emetic to a patient suffering from Carbon Monoxide poisoning. My friend says that it is but I disagree. Also please tell us the leading symptoms of this condition and the correct treatment.

Q U E R Y

and

A ID ”

R E P L IE S

C O U PO N .

To be cut out and enclosed with all Queries. July, 1945.

MANUALS OF FIRST AID By

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t h is book w o n d e rfu lly s im p lifie s a com p le x s u b icct a n d s h o u ld be re a d by students. ” — L . & N .W . R y . G a z e tte .

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CUTANEOUS V A C C I N E

O IN TM E N T

O n e o r o t h e r o r all o f the three races o f g e r m s , S t r e p t o 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 are f o u n d in e v e r y sk in in fe ct io n c o m m o n t o 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 (antivirus) o f these g e r m s . H e a l i n g is e xp e dit e d b y the p r o v e d in gre d ie n ts o f the o in t m e n t , a nd 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 iv ir u s sterile v a c c in e filtrates. A N TIPE O L O I N T M E N T is u nsu rp ass ed f o r B U R N S a nd S C A L D S , f o r it is m ic r o b ic id e a n d n on -a d h e siv e , a n d d r e s s in g s d o n o t r e q u ir e to be c h a n e e d e v e r y d a y . 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 at ed w i t h A N T I P E O L O I N T M E N T .

O P H TH A L M O -A N T IP E O L i s a semi-fluid o in tm 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 lesions. 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 ed ia tely 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 , a nd the a n tiv ir u s p r e v e n ts g e r m s f r o m d e v e lo p i n g .

R H IN O -A N TIP E O L affords rapid 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 the a n tib od ie s o f the g e r m s c o m m o n to in fect ions o f the n o se and ph a r y n x (S taph ly lo co cc i, S tre p to co cci, B . p yo cy 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 . catarr halis B. PfeifferV 11Qfs /-.fo fflipthem finp /'ffect l/xion, n D n .in n .1 1ideal J 1 Pfeif fer), R Rhhin i noo--A Annttin i peeooll is is n o t iu just aa nalliative. pa llia tiv e, hbu t is aa frpe rmn oo vwe rr o f the ncause D u r i n g epid e m ic s it 2is- xthe p r e v e n ti v e o f m ic ro b e d e v e lo p m e n t.

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CONTENTS

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NUMBER.

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H o sp ita l O rd erlies

C o m m o n E r r o r s in F i r s t A i d St. Jo h n A m b u la n c e A s s o c ia tio n

S .J .A .B . H e ad q u a rte rs and D istrict R ep o rts

H o n o u r for F i r s t A id e r ...

R a ilw a y A m b ulan ce N ew s

S ta r tin g a M ed ica l C o m forts D ep o t

F i r s t A id to th e I n ju r e d

L e t t e r s to th e E d it o r

St. A n d r e w ’s A m b u la n c e A sso ciatio n

R ev iew s

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L II.

NOTIC E

SC O TT,

C o rre s p o n d e n ts

T r e a t m e n t of O p iu m P o is o n in g

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

T o rn F em o ral A rtery

H u m o u r in F i r s t A id

B u r n s D u e to C o rro siv e s

T h o m a s S p lin t

P o is o n in g b y C a rb o n M ono xid e

B u r n or S cald

W o m a n w ith F ra c tu r ed L e g

In fection from R a b id A n im a l

R a t e of A rtificial R e sp ira tio n

T r e a t m e n t of S n a k e B ite

...

T r e a t m e n t of H a e m o rrh a g e ...

WE gather from the correspondence column of a medical contemporary that still another training scheme for nurses has been put forward. Scheme succeeds scheme, and another and yet another follows, although we understand that the proposed scheme “ goes back to the fundamental issue in a way that no other does.” The plan of the scheme is laid out in three stages, we are told. The first is a pre-hospital course of simple scientific and technical subjects sufficient to give the nurse a basis upon which to build her nursing training, and the length of this course will vary according to each student’s need. When a satisfactory standard has been reached the student will pass on to stage 2 . This is a period of practical nurse training and it is estimated that — freed from extraneous duties and by learning as a bona-fide student, this will occupy two years. “ It must be emphasised that this time is to be devoted to learning essential practical nursing pro cedures and the mistake of overcrowding this with snippets from specialised subjects is to be avoided as distracting.” Stage 3 is the post-qualification period. The qualified nurse who wishes to remain at the bedside as a staff nurse should be encouraged to do so by salary and working conditions com parable to those in other forms of nursing work and in other professions. Those who wish to become ward-sisters, tutors, health visitors, mid wives, and so on, will first gain experience as staff nurses and then proceed to further training. Having removed the non-nursing duties from the hands of the nurses, who is to do them it is asked? A new type of skilled worker is required, it is said, “ Under the auspices of the Ministry of Labour a new National Auxiliary Service for Hospitals could be created to supply trained hospital orderlies, male and female. From the Services, many could be recruited with experience of this work ; others, and civilians who are willing but lack experience would need short courses of practical training which could be given in the various training centres already existing under the ‘ training for all ’ scheme. In hospital, the trained orderly would need good H o s p ita l O rd e rlie s .

F I R S T

working conditions. Hoursofduty, remuneration, duties to be performed, holidays, for example, would be settled by negotiation with the trades union it is anticipated they would wish to form. The work should be pensionable and— a matter of no little importance— a smart uniform should be supplied.” The proposed scheme has our approval, but we fail to see that it is in any great degree original. Stress may be laid on the need for a new type of skilled worker. The Ministry of Labour is, unfortunately, not likely to be of much use in the creation of a service to supply trained orderlies. Its mission so far has been to insert square pegs into round holes, or the reverse.

C o m m o n E r r o r s in F irst A id . By A. D A V I D B E L I L I O S , M . B . , B .S., D . P . H . Lecturer, Battersea Polytechnic and Wimbledon Technical College ; Physician, Wimbledon Hospital. ( R e p rin te d Jro m the F e b ru a ry , ig 4 S , issue n j “ The P r a c titio n e r " by k in d perm ission oj the E d it o r .) ( C o n tinu ed jrom page 1 0 )

A r r iv a l.— On arrival, the first-aider should instruct his patient to lie still, and should invite the co-operation of the bystanders to prevent him from being moved until instruc tions are given. It is surprising how often this rule is broken, lt seems to be almost a human tendency to move a patient immediately after an accident, and usually for no obvious reason. There are occasions, of course, when im mediate removal is essential— for example, when fire is present or when the accident has been caused by heavy machinery— but, whenever possible, a quick examination should be made to determine probable injuries so that the affected parts can be carefully supported during re moval. A point that is often forgotten is to ask, whenever pos sible, for permission to attend the patient. Similarly, if during the course of treatment it becomes necessary to cut clothing, permission should also be obtained. In it ia l ex am in a tio n .— On arrival, the first-aider should halt a few paces a w a y from his patient in order to obtain a general outline of all the circumstances connected with the case. H e should notice particularly the need for life-saving measures, e. g., the presence of asphyxia. A common error on arrival is for the first-aider to kneel down immediately at the patient’s head and waste valuable seconds testing consciousness and the like, while all this time blood may be escaping unnoticed from another part of the body. A short visual examination from a distance pre vents the risk of failing to notice a dangerous condition. At this stage it will not come amiss to mention that a good colour of the face does not mean that a patient is unharmed in coal-gas poisoning. It is a characteristic feature of asphyxia due to this agent, for the colour of the skin and mucous membranes to be pinker than normal. I m m e d ia t e

A c t io n .

E a r ly T reatm en t oj Shock. — First-aiders are rightly taught to begin treatment for shock as soon as possible ; but this instruction is often neglected and simple preliminaries,

R I D such as covering the patient, are often postponed until treat ment of the injuries has been completed. A good first-aider remembers to instruct bystanders to obtain suitable wraps, hot bottles and a warm drink almost as soon as he arrives at the incident. Covering of the patient must be complete, yet how often is it noticed— even in hospital— that a patient, although wrapped in blankets, has an extensive area of his skin visible at the side of his body ! It is, however, a serious mistake, according to modern teaching, to attempt to warm a patient too quickly. M u ltip le C a su a ltie s.— When several persons have been injured as a result of a single accident, it is necessary to make an immediate survey of all the patients and decide on the order in which they should be treated. It is easy to slip up on this point, and on discovery of a relatively serious case to forget temporarily the importance of having a quick look at the others. In this connection the value of intelli gent bystanders must not be forgotten, for they can be quickly shown how to support, for example, an injured limb, thus providing some treatment at any rate until the more serious cases have been dealt with. R e m o v a l oj P a tie n t.— Arrangements for disposal of the casualty must be made early in case-taking, and an ambu lance, if required, should be sent immediately, so that its arrival will anticipate the completion of treatment. Failure to remember this point may leave the first-aider in an invidi ous position, for there can be nothing more embarrassing than having to wait by the side of a patient whose treatment has been completed, pending the arrival of the ambulance which could easily have been obtained much earlier. Sometmes, removal of the patient should be purposely delayed, but the decision depends entirely upon the environment and the facilities available. It is an error of judgment, for example, to remove a case of cerebral haemorrhage immedi ately when there are facilities for providing temporary treatment on the spot. Similar errors occur through re moving too quickly certain cases of shock, hasmatemesis and haemoptysis. An old rule, so often omitted, is to warn a hospital in advance to expect the arrival of a casualty, supplying some details of the nature of the case. In these days of shortage of house surgeons, it is a courtesy which should certainly be remembered, particularly for the smaller hospitals D ia g n o s is .

Any diagnosis that is made in first aid is only intended to be provisional. It is sufficient to appreciate the most serious possible injuries which may have been sustained and to treat them as if present until there is an opportunity of investigating the case more thoroughly under more suitable conditions, and when the patient has recovered from shock. It is an error to spend longer than is absolutely necessary to establish such a diagnosis. This limitation on the scope of diagnosis, however, does not excuse the need for a complete examination, although it may, and in fact should, be cursory. Short cuts should be employed whenever possible. A common mistake is to be content with finding one injury and to curtail the examination at this point. O w in g to the intensity of pain and the severity of shock, a patient (e.g., one who has broken his leg) may not realise that he is suffering from other injuries which for the moment are causing him less pain. Unnecessary exposure of the patient when examining is strongly condemned. T he examination should be conducted in such a manner that the greater part of his body remains covered during the process. Thus blankets can be partially removed to expose individual parts of the body, which are then re-covered as soon as examination has been completed. It is scarcely ever necessary to undress a patient at an incident ; it is quite possible, in the majority of cases, to examine him through his clothing. Wounds provide the

F I R S T o n ly e x c e p ti o n to th is ru le , b u t th e ir p r e s e n c e c a n u s u a ll y be d etected b y m a r k s or d a m p n e s s on th e clo th in g . T h e im p o r t a n c e of e x a m i n i n g th e b a c k ribs, scapulae, a n d s p i n e is o f t e n f o r g o t t e n . T h i s sh o u ld be d o n e w ith a s little m o v e m e n t a s p ossible, g r e a t c a r e b e in g ta k e n w h e n t u r n i n g th e p a tie n t o n to h is s id e to roll th e b o d y a s a w h o le a n d to u s e th e s e r v ic e s of a b y s t a n d e r to m a in t a in th is p o s i t i o n w h i l e t h e e x a m i n a t i o n is b e i n g c o n d u c t e d . F ractures.

D ia g n o s is . — F i r s t - a i d e r s a r e t a u g h t

th e u s u a l list of s y m p t o m s a n d s i g n s of a f r a c t u r e , n a m e l y ( 1 ) p a in , (2 ) lo ss o f p o w e r , (3) s w e l l i n g , (4) d e f o r m i t y , (S) u n n a t u r a l m o b i l i t y , ( 6 ) t e n d e r n e s s , a n d ( 7) s h o r t e n i n g . In sufficien t e m p h a s is , h o w e v e r , is l a i d o n t h e p r e s e n c e o f s h o c k a n d i t s v a l u e a s a d ia g n o s tic sign . I f, a f t e r a n a c c i d e n t , a p a t i e n t c o m p l a i n s o f s e v e r e p a i n i n a l i m b a n d o b v i o u s s h o c k is p r e s e n t , it is s u f f i c i e n t f o r f ir s t a i d p u r p o s e s t o a s s u m e a f r a c t u r e , a n d a l l t h a t is r e q u i r e d b e f o r e b e g i n n i n g t r e a t m e n t is t o d e t e r m i n e the p ro bab le sea t of in ju ry. T h i s c a n often b e d etected b y in sp ectio n , w h ic h s h o u ld a l w a y s p r ec e d e p a lp a tio n — a point t h a t is f r e q u e n t l y f o r g o t t e n , a s is a l s o t h e v a l u e o f c o m p a r i s o n w it h t h e o p p o s ite sid e. T h e i m p o r t a n c e o f t e n d e r n e s s a s a p h y s i c a l s i g n is o f t e n u n d e r v a l u e d ; it is h a r d l y m e n t i o n e d in s o m e o f t h e s t a n d a r d first a id b o o k s . O f t e n it m a y b e t h e o n l y s i g n p r e s e n t i n i t i a l l y , e s p e c i a l l y i f t h e f r a c t u r e is o f t h e f i s s u r e d t y p e . It m u s t b e t a k e n a s a g o l d e n r u l e t h a t if, a f t e r a n y a c c i d e n t , a n a r e a o f t e n d e r n e s s , h o w e v e r s m a l l , is d i s c o v e r e d a l o n g t h e co u rse of a bone, the p resen ce of a fr a c tu re sh o u ld be a s s u m e d a n d fir s t a i d p r o v i d e d u n t i l t h e d i a g n o s i s is c o n f i r m e d o r e x c lu d e d by X - r a y . F a i l u r e t o o b s e r v e t h i s r u l e is r e s p o n s i b l e f o r m a n y m i s t a k e s in m e d i c a l w o r k , e s p e c i a l l y w i t h f r a c t u r e d f ib u la s n e a r t h e a n k l e , s m a l l b o n e s o f t h e h a n d s a n d f e e t , a n d s o m e tim e s e v e n of the spine. T rea tm en t . — T h e f i r s t p r i n c i p l e is t h a t d i r e c t l y a f r a c t u r e is s u s p e c t e d , e i t h e r b y h i s t o r y o r s y m p t o m s , t h e a f f e c t e d p a r t m u s t im m e d ia t e ly be ste a d ie d a n d su p p o rte d u n til e x a m i n a tion of th e p a tie n t h a s b een c o m p le te d , a n d u n til the in ju r y h as been su itab ly secured . T h i s is a r u l e w h i c h is t o o o f t e n b ro k e n , a n d n ot o n ly b y th e la y first-aid er ! It is n o t u n c o m m o n t o s e e — e v e n in t h e c a s u a l t y d e p a r t m e n t o f a h o s p i t a l — a n o b v io u s fr a c t u r e b e i n g left u n s u p p o r t e d w h ile e q u i p m e n t is o b t a i n e d o r f u r t h e r e x a m i n a t i o n o f t h e p a t i e n t u n d e r tak en . T h e m e t h o d s of t r e a t m e n t e m p lo y e d in first a id fo r fr a c tu re s of in d iv id u a l b o n e s h a v e been m u c h criticised b y m ed ica l p ractition ers d u r in g the w a r. U n fo rtun a tely, h o w ever, the criticis m h a s b een ch iefly d es tru c tiv e and, a lth o u g h p r a c t i t i o n e r s w h o a r e e x t e n s i v e l y e n g a g e d in t h e t e a c h i n g o f first a id a r e o n ly to o h a p p y to le a r n o f n e w m e t h o d s , f e w s u g g e s t i o n s of v a l u e h a v e c o m e f o r w a r d to j u s t i f y a n y d r a s ti c c h a n g e s in t h e s t a n d a r d m e t h o d s . I n t h i s c o n n e c t i o n it m u s t not be fo r g o t t e n th a t first-a id p r o c e d u r e s a r e d e s ig n e d fo r t h e ir s im p lic ity , r a p id it y of a p p lic a tio n , a n d to c o n f o r m to t h e g e n e r a l p r in c ip le s o f first a id , of w h i c h o n e of t h e m o s t i m p o r t a n t is t h a t t h e a f f e c t e d p a r t s h a l l n o t b e m o v e d d u r i n g treatm en t. I t is i m p o s s i b l e t o d i s c u s s in d e t a i l t h e n u m e r o u s e r r o r s w h i c h a r e m a d e b y e l e m e n t a r y s t u d e n t s in t h e t r e a t m e n t o f fr a c t u r e s of th e in d iv id u a l b o n e s. M i s t a k e s , s u c h a s o m is s io n to a p p l y s l i n g s fo r fr a c t u r e s of ribs, a n d in d ee d fo r all f r a c tu res of th e u p p e r lim b , a re soon re c o g n is e d b y th e m ed ica l in stru c to r. A b i g p o i n t is m a d e o f t h e i m p o r t a n c e o f m a k i n g su re th a t the circu la tio n h a s not been ob stru cted b y tig h t b a n d a g e s , a s in t h e t h r e e - h a n d k e r c h i e f m e t h o d f o r a b r o k e n collar bone. S e r i o u s e r r o r s o c c u r in t h e t r e a t m e n t o f l o w e r - I i m b f r a c tu res, p a rtic u la rly of th e fractu re d fe m u r. H e r e t h e first s t e p in t r e a t m e n t i s to s t r a i g h t e n t h e e v e r t e d f o o t a n d t h e n t o a p p l y m a n u a l e x te n s io n , d r a w i n g it d o w n w a r d s in to le v el w i t h i t s f e l l o w o f t h e o p p o s i t e s i d e ; t o t h i s i t is t h e n s e c u r e d b y m e a n s of a fig u r e - o f- e ig h t b a n d a g e r o u n d b o th feet a n d

K I D

a n k les. A f a u l t w h i c h m u s t b e a v o i d e d a t t h i s s t a g e is t o l e a v e g o o f t h e i n j u r e d f o o t , e v e n f o r a s e c o n d , u n t i l it h a s been secured. O n c e t h e f e e t h a v e b e e n t ie d t o g e t h e r , t h e r e i s n o n e e d to m o v e th e in ju red lim b , h e n c e the first-a id er h a s no tim e f o r t h e c o m m o n m e d i c a l m e t h o d in w h i c h t h e l i m b i s p a r t l y f l e x e d w h i l e it is b e i n g s e c u r e d t o a l o n g L i s t o n s p l i n t b y m e a n s of a ro ller b a n d a g e . E x a c t l y th e s a m e princip le a p p l i e s in f r a c t u r e s o f t h e l e g . I t s h o u l d b e n o t e d t h a t it i s a n e r r o r t o a p p l y e x t e n s i o n in a c o m p o u n d f r a c t u r e .

(T o be concluded..')

St. J o h n A m b u la n c e A s s o c ia tio n . B r is t o l C e n t r e . — T h e B ris to l C e n tr e of the S .J .A . A . h eld the ju n io r c o m p e titio n s on S a t u r d a y , J u ly 2 1st, a t the Z o o lo g ical G ardens.

S ix te a m s of g ir ls a n d fo u r t e a m s of b o y s c o m p e te d , all b e i n g h o ld e r s of th e p r e l i m i n a r y first a id c e r t ific a te of th e S . J . A . A . , u n d e r 16 y e a r s of a g e . T h e p ra ctica l test w a s j u d g e d b y D r. H . G . K y le ( c h a ir m a n of the B risto l C en tre), a ssiste d b y C o u n t y O ffice r C. G ribb le, B .E . M ., a n d c o n sisted of tre a tm e n t of a fractu re, a r r e s t of a r t e r ia l h a e m o r r h a g e , S c h a f e r ’s m e t h o d o f a rtific ia l resp iratio n an d th e d escrip tio n an d u se of th e t r ia n g u la r bandage. T h e v iv a -v o c e test, c o n d u c te d b y D r. C. C. L a v in g t o n ( v ic e - p r e s id e n t of th e B r is to l C e n t r e ) , a s s is t e d b y S u p t . W . E. P r i c e , r a n g e d t h r o u g h t h e s y l l a b u s o f t h e p r e l i m i n a r y fir s t aid co u rse . A k e e n c o n t e s t r e s u l t e d in t h e W e b e r ( F i r s t J u n i o r ) C u p b e i n g r e t a i n e d b y la s t y e a r ’s w i n n e r s , F i l t o n A m b u l a n c e C a d e ts , w ith a to tal of 1 7 5 | m a r k s ( 8 7 f p er c e n t.). T h e Jefferies C u p w a s w o n b y th e W e s t b u r y - o n - T r y m N u r s i n g C a d e t s w i t h 1 6 8 m a r k s (84 p e r c e n t . ) . T h ir d p la ce w a s g a in e d 1 6 S m a r k s (82A p e r c e n t . ) .

by No. 1 N u r s in g C a d e ts w ith

A t the e n d of the co n tests th e ju d g e s c o m m e n te d on the w o r k of the te a m s a n d th e resu lts w e r e a n n o u n c e d b y the hon. treasu rer, M r. W . G . H a w k in s . C o u n t y O fficer M iss M . E . S a r a h presen ted th e trop h ies to th e w in n ers . T h e d o n o rs of th e c u p s h ad p ro vid ed for e a c h m e m b e r of t h e t e a m w i n n i n g th e W e b e r C u p a c o p y of th e H i s t o r y of th e O r d e r of St. J o h n , a n d th e Jefferies C u p w in n e r s a silv e r m ed allion . T h e th ird te a m re ce iv ed a c o p y of th e C h ild W e lfa re M a n u a l, presented b y S u p t. H . P. W iltsh ire. D iv is io n a l S u p t. M . C . M a x w e l l p r o p o s e d a v o t e of t h a n k s to the d o c to rs w h o h a d j u d g e d th e co m p e titio n s, a n d to th e s t e w a r d s a n d h e lp e rs w h o h a d w o r k e d to m a k e the a ftern o on a su ccess.

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HEADQUARTERS AND DISTRICT REPORTS. County of Berkshire. D i d c o t . — O n S u n d a y aftern oon , J u ly 15 th , a t the S en io r B o y s ’ S ch ool, D id co t, the A m b u la n c e a nd N u r s in g ad u lt and c a d e t D iv is io n s h eld th e ir a n n u a l in sp ectio n . T h is w as c a r r i e d o u t b y t h e C o u n t y C o m m i s s i o n e r , M r. C . A . l’ oole. F o r t y - f o u r o fficers a n d m e m b e r s w e r e on p a r a d e u n d e r th e c o m m a n d of D iv . S u p t . W . J. F is h e r .

R e a d i n g T o w n “ B . ” — O n M o n d a y e v e n in g , J u ly 9th, a t th e A m b u la n c e H a ll, C h a th a m Street, R e a d in g , the A m b u l a n c e a n d A m b u l a n c e C a d e t D iv is io n s h eld th eir a n n u a l in sp ectio n . T h e in s p e c t in g officer w a s th e C o u n t y C o m m is s io e r, a n d fo rty-fiv e officers a n d m e m b e r s w e r e o n p a r a d e u n d e r th e c o m m a n d of A m b u la n c e O fficer R. T a n n e r .

W a l l i n g f o r d . — O n S u n d a y e v e n in g , J u ly 15 th , at the F r e e L i b r a r y , S t . L e o n a r d ’s S q u a r e , W a l l i n g f o r d , t h e a b o v e A m b u la n c e , N u r s in g a n d N u r s in g C a d et D iv isio n s w ere in sp ected b y M r. C . A . P o o le. F o r t y - n in e officers a n d m e m b e r s p a r a d e d u n d e r t h e c o m m a n d of S u p t . F . J. H o lle y . A fte r th e in sp e ctio n n in e N u r s i n g C a d e t s w e r e en rolled .

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S u n d a y afte rn o o n , J u ly 22nd, on the la w n of M a lv e r n H o u s e S ch o o l, th e a n n u a l in sp e ctio n of the N u r s i n g C a d e t D iv is io n s w a s h eld. A hundred and tw enty officers a n d c a d e ts p a r a d e d u n d e r th e c o m m a n d of th e A s s is ta n t C o u n ty C o m m is s io n e r, M r. F . A . C. Jarvis. The in sp ectio n w a s ca rrie d out b y M iss V ir g in i a C u n a rd , C h ie f O ffic e r for N u r s i n g C a d e ts .

A I D on S a tu rd a y , Ju ly 21st. T h e fo llo w in g te a m s to o k part K in g s w o o d , S ta p le H ill, F ish p o n d s, B u tlers, P a rn a ll & P .A .C . of N o. 2 C o rps, a n d B .A .C . “ A ” a n d B .A .C . “ B ” of N o . 3 C o rp s. C o rp s S u rg e o n D r. V in ter, N o . 2 C o r p s , w a s the e x a m i n e r fo r th e p r a c t ic a l test. C o rp s Supt. B a k e r, No. 3 C o r p s t o o k c h a r g e of th e o r a l sid e. T h e w in n e r of this c o m p etitio n w a s F ish p o n d s D iv isio n , w ith B u tle rs D iv isio n as ru n n ers up. D r. V in te r presented the a w a rd s. A ft e r te a , e n t e r t a in m e n t w a s p r o v id e d to r o u n d o ff a m o st en jo y ab le and in te re stin g afternoon. A p p r o x im a t e ly 130 m e m b e r s a n d fr ien d s w e r e present, a n d it is h o p e d in t h e n e a r f u t u r e t h a t o t h e r c o m p e t i t i o n s o f th is n atu re w ill be a rra n g e d .

County of Kent. B r o m l e y . — T h e f o u r U n i t s o f t h e B r i g a d e in B r o m l e y , A m b u la n c e , N u r s in g and the tw o C a d e t D iv isio n s, h a v in g n o w c e a s e d t h e i r A . R . P . d u t i e s , h e l d t h e i r fir s t S o c i a l o n S a tu rd a y , Ju ly 21st, at St. A n d r e w s H all. T h is w a s w ell atte n d ed b y m e m b e rs a n d frien d s, w h o en jo y e d th e e n te r ta in m e n t provided. R efreshm ents w ere h a n d e d r o u n d b y th e c a d e ts d u r i n g th e in terva l. F u n d s a r e n e ed e d for a p e r m a n e n t h a ll or h u t to h o u s e the four D iv ision s, the o rig in a l h e a d q u a rte rs h a v in g been b a d ly blitzed, a n d th eir a im s w e r e ou tlin ed b y C /S u p t. F . T h o rp e , an d L a d y S u p t. M rs. E. G o d fr e y to g e th e r w ith A m b / O ff ic e r E . W i t h e r s w h o s p o k e on th e n e ed for th e s u p p o r t o f a l l m e m b e r s a n d f r i e n d s in t h e m a n y e v e n t s t o c o m e in c o n n e c t i o n w i t h t h e d r i v e f o r r a i s i n g t h e n e c e s s a r y f u n d s . T h e s o c ia l, w h i c h w a s t h e first fo r m a n y y e a r s , w a s voted a g r e a t success.

R e a d in g .— On

R e a d i n g W e s t . — O n M o n d a y e v e n i n g , J u l y 9th, th e N u r s i n g C a d e t s held a n e n r o lm e n t c e r e m o n y . N in e cadets w e r e e n r o l l e d , a n d a f t e r w a r d s p r e l i m i n a r y fir s t a i d a n d p r o ficie n cy c ertifica tes w e r e p resen ted .

T h e a le .— On

M o n d a y a ftern oon , J u ly 23rd, at C a lco t P la c e , T h e a l e , fifty-five c a d e ts fr o m th e A m b u l a n c e a n d N u r s in g C a d e t D iv isio n s w e re e n tertain ed a t a G a rd e n P a rty g iv e n b y S ir F e lix and L a d y Pole. T e a w a s p rovid ed, a fter w h ic h th e N u r s in g C a d e ts p e rfo rm e d e x c erp ts from the p a g e a n t p la y “ K n ig h t s of the W h ite C r o s s .”

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T h e d e a t h h a s o c c u r r e d of, C o r p s S u p t . J a m e s W i n t e r b o u rn e of R e a d i n g C o rp s. M r. W i n t e r b o u r n e p a s s e d his f ir s t a i d c e r t i f i c a t e e x a m i n a t i o n in 1 8 9 8 a n d j o i n e d t h e B rig ad e. H e w a s a m e m b e r o f t h e S . J . A . B . C o l u m n in t h e S o u th A fr ic a n W a r ; serv ed d u r in g the G r e a t W a r , and d u r i n g t h e p r e s e n t W a r h e w a s in c h a r g e o f t h e u n l o a d i n g p a rties a t the R o y a l B e rk sh ire H osp ita l. H e w a s a S e rv in g B r o t h e r of th e O r d e r a n d held the L o n g S e r v ic e M ed a l w ith five B a r s . T h e F u n e r a l to o k p la ce on W e d n e s d a y , Ju ly 1 1 th , at R e a d in g C em etery, Lond on R oad.

County of Bristol P a r n a l l . — A n in te r-D iv is io n a l a n d C o rp s co m p etitio n t o o k p la ce at th e H e a d q u a r te r s of P a rn a ll P .A . C . D iv isio n s

County of Leicester. S h a r n f o r d . — A sp len d id p a r a d e w a s held at S h a r n fo r d , of A m b u la n c e , N urses, a nd C a d et D iv isio n s and S co u t Troops. T h e p a r a d e a s s e m b le d a t t h e Y . M . C . A . a t 2 .30 p .m . a n d w a s h e a d e d b y t h e S h a r n f o r d S i l v e r B a n d t o S t . H e l e n ’s Church. T h e p r in c ip le officers of th e c o u n t y w e r e p r e s e n t a t th e C h u r c h t o h e a r a v e r y i m p r e s s i v e s e r v i c e in t h e f o r m o f a c a d e t e n ro llm e n t a n d re -d e d icatio n c e r e m o n y d irected b y the R e v . L u m b , M .A ., P resid en t of the S h a rn fo rd St. John

D ivision s. C a d e t s e n r o l l e d n u m b e r e d 10. A fte r the service, th e C o u n ty O fficers t o o k th e s a lu te b y the W a r M em oria l.

M a r k e t H a r b o r o u g i i . — C o m m issio n er G . F. B ro w n e in sp ected a p a ra d e of M a r k e t H a r b o r o u g h St. John personn el on S u n d a y , J u ly 2 2nd , c o n s is t in g of A m b u l a n c e , N u r s i n g a n d C a d e t D iv isio n s fro m M a r k e t H a r b o ro u g h , L u b e n h a m , W i g ston M a g n a and W ig s t o n S ou th . T h e p a r a d e f o r m e d u p in A b b e y S t r e e t in f r o n t o f S t . John H e a d q u a rte rs and, h ead ed by the H a r b o r o u g h S ea C a d e t B a n d le d b y S u p t . C . A . M a y c o c k , M . M . , m a r c h e d t o th e g r o u n d s of M rs. S y m i n g to n , S ta tio n R o a d for th e fo rm a l in sp ectio n . A ft e r th e in sp ectio n , a d is p la y of a m b u la n c e a n d n u r s i n g w o r k w a s g iv e n by vario u s team s. A t t h e e n d o f t h e p r o c e e d i n g s o n t h e f ie ld , t h e C o m m is s io n e r t o o k th e s a lu t e a s th e D iv i s i o n s m a r c h e d b a c k to H ead quarters. F o llo w in g d ism isal, tea w a s served b y M rs. G r ee n , M rs. B a r lo w a n d th eir com m ittee. T w o r e m a r k a b l e t h i n g s a b o u t H a r b o r o u g h D i v i s i o n is t h a t t h e i r S u p t . , C . A . M a y c o c k is a l s o F i r e B r i g a d e C h i e f a n d s e c o n d ly t h a t o u t of a to ta l p e rs o n n e l of s ix ty , t h e y h a v e t w e n t y - n i n e in t h e F o r c e s .

F I R S T

County of Worcester. A n i n t e r e s t i n g e v e n t t o o k p la c e a t M e s s r s . T . W . L e n c h ’s can teen , B la c k h e a t h , recen tly. T h i s w a s t h e final r o u n d for the C h r is t o p h e r D a r b y S h ie ld w h ic h w a s g iv e n by th e la te D r . D a r b y of L y e , for th e in d iv id u a l t r e a t m e n t of h a e m o rr h a g e a m o n g th e A m b u l a n c e a n d N u r s i n g D iv is io n s of the S . J . A . B . in t h e c o u n t ) ' o f W o r c e s t e r . T h e r e w e r e t w o c o m p e t i t o r s :— P r i v a t e B . C a r d y ( R e d ditch) re p re s e n tin g the so u th of the co u n ty , an d P r iv a te F. H i n g l e y ( T . W . L e n c h ’s) r e p r e s e n t i n g t h e n o r t h e r n a r e a . T h e C a r d f o r t h e p r a c t i c a l t e s t w a s a s f o l l o w s :— “ Y o u a r e w a l k i n g d o w n a c o u n t r y l a n e in t h e l a t e e v e n i n g , r e t u r n i n g fr o m a p u b lic d u t y , w h e n y o u find a c y c li s t w h o h a s c r a s h e d in to a w a l l a t th e b o tto m ol a h ill, o w i n g to h is m a c h in e h a v i n g g o t ou t of con trol. Y o u are 5 m in u tes w a lk fr o m a h o u s e w h e r e y o u k n o w t h e r e is a t e le p h o n e a n d 1 m ile fro m a to w n w ith h o sp ital, a m b u la n c e a n d d octor. A ct.” O n e x a m i n a t i o n th e p a tie n t w a s fo u n d to be s u f f e r in g fr o m a fr a c t u r e of th e m id d le o f th e s h a f t of th e left fe m u r co m p lica ted by a sev ered fem o ral a rte r y w ith no e xte rn a l w ou n d or haem orrhage. H e also h ad a b r a sio n s on the face a n d h a n d s w ith a w o u n d on the fo reh ead . C o u n t y C o m m is s io n e r D r. F . L . N e w t o n a n n o u n c e d the resu lt as fo llo w s : P r iv a te C a rd y , 143 m a r k s ; P riv a te H i n g ley, 134. D r. N e w to n c o n g ra tu la te d both c o m p etitors upon th eir s h o w in g , a n d C o u n ty O fficer M iss E . C. J e a k e s pre s e n te d th e tr o p h y to th e w in n e r .

T h e N o r t h e r n A r e a N u r s i n g C o r p s h eld th eir e lim in a t in g ro u n d of th e N e w t o n C u p , a n n u a l l y c o m p e t e d for b y the 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 in t h e c o u n t y . T h e even to o k p la ce a t M essrs. O a k le y ’s P a vilion , O ve re n d , C ra d le y . T h re e C a d et N u rsin g team s took part— H aleso w en , S to u r b r id g e , a n d B r ie r le y H ill. T h e C a rd for th e te a m test w a s a s fo llo w s : “ Y o u a n d y o u r t e a m h a v e b e e n c a lle d to a n a c c id e n t . Y o u fi n d a g i r l l y in g o u tsid e a h o u s e s u rr o u n d e d b y debris. R e n d e r fi r st aid. Y o u h a v e y o u r e q u ip m e n t w ith yo u . A ct.” O n e x a m in a t io n the patien t w a s fo u n d to be s u ffe r in g from a fractu re d r ig h t a rm a n d a w o u n d on th e fo reh e a d w ith a suspected foreign body. D u r i n g th e test a n o th e r patient c a m e o n th e s c e n e w h o w a s s u ff e r in g fr o m a b ite b y a d o g w h o w a s s u sp e c te d of h a v i n g rabies. A r e a C a d e t O ffic e r M rs. L a m b a n n o u n c e d the resu lt as fo llo w s B r i e r l e y H i l l , 2 3 3 £ m a r k s ; H a l e s o w e n , 219-ir ; S to u rb rid g e , 175. C o rp s S u r g e o n L lo y d sa id th at he h a d th o r o u g h ly e n jo y e d t a k in g th a t c o m p etitio n . T h e sta n d a rd of a ll the t e a m s w a s m u c h h i g h e r t h a n h e h a d e x p e c t e d it t o be. He w i s h e d to c o n g r a t u l a t e t h e w i n n e r s .

A I D

H i l l a n d C a k e m o r e . — A n in sp e ctio n of th is N u r s i n g D iv is io n b y C o r p s O ffice r s, w a s held a t th e C l in ic R o o m , L o n g L a n e , B la c k h e a t h , on M o n d a y , J u ly 23rd. A fte r the in sp e ctio n , th e m e m b e r s g a v e d e m o n s tra tio n s o f f ir s t a i d a n d h o m e n u r s i n g . T h i s w a s fo llo w e d by re fre s h m ents. T h e in s p e c tin g officers e x p re s s e d th eir s a tis fa c tio n w ith the w o rk , u n ifo rm s a n d reco rd s of the D iv isio n .

C o u n ty S u pt. M rs. A . H . L e c h m e r e , G r o v e H ill, S u c k le y , h a s , f o r h e a l t h r e a s o n s , r e s i g n e d h e r p o s i t i o n in t h e S . J . A . B . in t h e C o u n t y o f W o r c e s t e r . M rs. L e c h m e r e h as been ap p oin ted C o u n ty V ice-P resid en t. C o u n t y O ffic e r D r. M rs. Porter, C h u r c h S treet, K id d e r m i n s t e r h a s b e e n a p p o i n t e d C o u n t y S u p t . in t h e p l a c e o f M rs. L e ch m ere.

West Riding of Yorkshire. M a n n i n g h a m . — O n J u ly 23rd, t h e N u r s i n g C a d e t s h eld t h e i r f ir s t b i r t h d a y p a r t y . C o u n t y C a d e t O fficer M rs. E. F o r d cu t th e l a r g e b ir t h d a y c a k e a n d p r es en te d th e v a r io u s prizes. A re a O fficer M r. A. C. C r a w fo r d assisted w ith the g a m e s . C o rp s O fficers M rs. F. B ru c e a n d M rs. H . S h e a rd w e re also present. A c t in g P r e s id e n t M rs. T a y l o r v e ry k in d ly p ro vid ed the c a k e a n d the refresh m en ts, a n d C a d e t S u p t. M rs. A . M. C la u g h t o n , an d C a d e t O fficer M iss E. M . T o w n a r r a n g e d a p l e a s a n t e v e n i n g in w h i c h a l l t h e B r a d f o r d C a d e t D i v i s i o n s w e re w ell rep resen ted . A t the en d of the p arty, C a d e ts D o re en R o b in so n , R ita T a y lo r and Joan B u llen presen ted b o u q u e ts to th e th re e L a d y O fficers. T h e g r e a t su c c e s s of th e p a rty w a s d u e to th o se m e m bers of the M a n n in g h a m a d u lt N u r s in g D iv isio n w h o v ery k i n d l y s e r v e d th e r e f r e s h m e n t s , a ls o to th e ir D i v is io n a l S u p t. M rs. B. M . H all, a n d A m b u la n c e O fficer M rs. M . M id g le y .

Honour for First Aider. H .M . T h e K i n g h a s b een g r a c io u s ly p lea sed to g iv e ord ers f o r t h e a w a r d o f t h e B r i t i s h E m p i r e M e d a l ( C i v i l D iv i s i o n ) t o M r. G o r d o n J o h n D a r w o o d , L e a d e r , M obile, F i r s t A i d S q u a d , W o r k s C i v i l D e f e n c e S e r v ic e , C r i c k l e w o o d , a n d for h is n a m e t o b e p u b l i s h e d in t h e L o n d o n G a z e t t e a s h a v i n g r e c e i v e d a n e x p r e s s i o n o f C o m m e n d a t i o n f o r h i s b r a v e c o n d u c t in C i v i l D efen ce. T h e f o l l o w i n g is e x t r a c t e d f r o m t h e L o n d o n G a z e t t e :— “ A fly in g b o m b d em o lish e d t r a p p e d in t h e r u i n s .

N orthern A re a N u r s in g Corps, h eld th eir e li m i n a t i n g r o u n d of th e L e c h m e r e C u p , on S a t u r d a y , J u l y 2 8 t h , in t h e T e c h n i c a l S c h o o l , O l d b u r y . T h is cup is o p e n f o r a n n u a l c o m p e t i t i o n b e t w e e n t e a m s o f f o u r f r o m 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 c o u n t y . T h e r e w e re tw o te a m s entered, i.e., H a le s o w e n an d O l d b u r y , a n d t h e c a r d f o r t h e t e a m t e s t w a s a s f o l l o w s :__ “ W h i l s t on y o u r w a y to th is c o m p e t it io n a m a n ru s h e s u p to y o u a n d s a y s t h a t a b illp o ste r h a s s lip p e d o ff h is la d d e r , s m a s h i n g a b r a c k e t g a s l a m p in h i s fa l l . Y o u k n o w th a t the n e a r e s t e q u i p m e n t i s in t h i s b u i l d i n g , a h u n d r e d y a r d s a w a y . A ct.” O n e x a m i n a t i o n th e p a tie n t w a s fo u n d to be s u ff e r in g from a fr a ctu re d r ig h t k n e e ca p a n d fr a c tu r e d r ig h t l e g and fro m th e effects of co a l g a s p o is o n in g . N o rth e rn

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A t the co n clu sio n of th e co m petitio n , C o rp s S u p t. M iss A s h t o n a n n o u n c e d t h e r e s u l t a s f o l l o w s :— H a l e s o w e n , 1 8 5 m a rk s , O ld b u ry , 171^ . H a le s o w e n w ill th erefo re c o m p e te a g a in s t the w in n e rs of the N o rth W o rc e s te rs h ire a n d D u d le y a n d D is trict C o r p s c o m p e titio n s on S e p t e m b e r 15 th .

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“ D a r w o o d a n d his s q u a d s ta r te d r e s c u e o p e r a tio n s a n d , h e a r in g cries fro m u n d e r the w r e c k a g e , D a r w o o d b u r r o w e d h is w a y t h r o u g h 25 fe e t of d e b r is a n d fo u n d a w o m a n w h o m h e s u c c e e d e d in r e l e a s i n g a f t e r w o r k i n g f o r a n h o u r . W h ilst so d o in g , h e u n c o v e re d th e h e a d of a n o th e r b a d ly in ju red wom an. B y t h e s l o w p r o c e s s of r e m o v i n g t h e d e b r is b r i c k b y b r ic k , h e w a s a b l e to r e n d e r first a i d to t h e c a s u a l t y . He h a d w o r k e d h im s e lf to th e f a r s id e of th e v ic tim fr o m w h i c h p o in t h e w a s b e tte r a b le to w o r k a n d to k e e p c o n s t a n t w a t c h o n h e r con d ition . W h e n sh e b ecam e v ery w e a k , a doctor w a s ca lle d a n d a blood tr a n s fu s io n w a s g iv e n . D a r w o o d did n o t p a u s e in h i s e f f o r t s u n t i l h e b e c a m e e x h a u s t e d , s u f f e r i n g fro m th e effects of g a s a n d l a r k of fr es h air. A ft e r a b rief rest he w e n t b a c k u n d e rn e a th th e w r e c k a g e a n d a g a i n to o k co n tro l of th e r e s c u e w o r k . F u rth er tra p p in g had occu rred in h i s a b s e n c e , b u t a f t e r a b o u t 3 h h o u r s o f b a c k b r e a k i n g t o i l , t h e c a s u a l t y wra s l o a d e d o n t o a s t r e t c h e r a n d t r a n s p o r t e d in to t h e op e n , still u n d e r g o i n g t h e t r a n s fu s io n . “ D a r w o o d sh o w ed c o u r a g e and d ete rm in a tio n w ith o u t t h o u g h t for h is o w n s a f e t y . ”

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T h e w o r k of th e L . M . S . R a i lw a y A m b u la n c e M o v e m e n t in S c o t la n d w a s , a s in f o r m e r y e a r s , c o n d u c t e d u n d e r th e a u sp ic e s of the S . A . A . A . d u r in g th e y e a r en ded M a r c h 31st, 1945. A l t h o u g h t h e i n t e r e s t o f t h e s t a f f i n f ir s t a i d w o r k h a s b e e n m a i n t a i n e d t h e r e h a s b e e n a s m a l l d e c r e a s e in n u m b e r s c o m p a r e d w i t h th e p r e v io u s y e a r , o w i n g to w a r c o n d itio n s . T h e c l a s s r e s u l t s f o r t h e 68 s e c t i o n s — 3 2 c l a s s e s w e r e h e ld — for th e y e a r w e r e a s fo llo w s : 1 s t y e a r, 56 ; 2nd y e a r, 33 ; 3rd a n d s u b s e q u e n t y e a r s , 1,3 2 8 . In ad d itio n 275 efficient m e m b e r s a r e s e r v in g w ith H . M . F o rc e s . T h e n u m b e r of l o n g se rv ice a w a r d s to m e m b e rs of the s t a f f in S c o t l a n d n o w t o t a l : L o n g S e r v i c e M e d a l ( 1 5 y e a r s ) , 1 , 2 7 7 ; B a r s , 20 y e a r s , 7 5 3 ; 2 5 y e a r s , 4 6 3 ; 30 y e a r s , 2 9 4 ; 3 5 y e a r s , 1 3 4 ; 40 y e a r s , 3 6 ; 45 y e a r s , 7 ; 5 0 y e a r s , 2. I n a d d itio n , d u r i n g th e p a s t y e a r 103 V o l u n t a r y M e d ic a l S e r v i c e M e d a l s w e r e g r a n t e d t o m e m b e r s b y t h e S . A . A . A . in r e s p e c t of fifteen y e a r s ’ efficien t s e rv ice .

R I D s u p p o rt, w h ic h h e s a id did so m u c h to s t im u l a t e th e m e m b e r s in t h e i r e f f o r t s . A m o s t e n j o y a b l e e v e n i n g ’s e n t e r t a i n m e n t fo l lo w e d .

A s h f o r d . — T h e first a n n i v e r s a r y of t h e A s h f o r d M o ti v e P o w e r a n d S tatio n A m b u la n c e C la s s w a s celeb rated b y a tea a n d c o n c e r t h e ld on t h e S o u t h e r n R a i l w a y B o w l s P a v ilio n on J u ly 26th. T h e g u e s ts of h o n o u r w e re M r. D . S h ep p y, E a s te r n D iv is io n a l M o tive P o w e r S u pt. a n d M r. E . U zzell, W e lf a r e O fficer. A m b u l a n c e a w a r d s w e r e d istrib u ted d u r in g th e in terva l b y M r. S h e p p y , w h o c o n g r a t u l a t e d th e c la s s on its e x c e l le n t b e g in n in g a n d w ish e d th em s u cce ss for th e fu tu re, an in crease in m e m b e r s h i p a n d a w i n n i n g t e a m in t h e R a i l w a y c o m p e t i tion . M r. R . G . N e a t w h o p r e s id e d , re fe rr e d to t h e v a lu e of th e w o r k a n d th e e n t h u s ia s m a t A s h fo r d , for c r e a t i n g a l a i g e

class. M r . U z z e l l in c o n v e y i n g t h e P r e s i d e n t ’s c o n g r a t u l a t i o n s to t h e c l a s s o n b e c o m i n g a s e p a r a t e e n t it y a n d to th e re c ip i e n t s of a w a r d s , t h a n k e d M r. S h e p p y a n d M r . N e a t for t h e ir in te re st a n d s u p p o r t w h ic h m e a n t so m u c h for loca l progress. -------------- • m i --------------

L .N .E .R . T h e C e n t r e S e c r e t a r y in h is re p o r t fo r th e y e a r e n d e d J u n e 3 0 t h , 1 9 4 5 , s t a t e s t h a t 1 2 9 c l a s s e s w e r e c o n d u c t e d in th e a r e a a s f o l l o w s : D a r l i n g t o n 1 7 , H u l l 12, L e e d s 15, M i d d l e s b r o u g h 2 3 , N e w c a s t l e 42 , Y o r k 20. T h e n u m b e r o f s t u d e n t s w h o w e r e s u c c e s s f u l in p a s s i n g th e e x a m i n a t io n d u r i n g th e sessio n w e r e : C e rtificate s 1 1 6 , v o u c h e r s 1 2 4 , m e d a l l i o n s 9 0, l a b e l s 1 , 5 0 4 , a d e c r e a s e o f 4 5 9 on the p rev io u s year. In v ie w of th e stra in of n e a rly six y e a r s o f w a r , t h i s d e c r e a s e is n o t c o n s i d e r e d a m a t t e r f o r despondency. T h e to ta l n u m b e r of c a s e s tr e a te d sin c e J a n u a r y , 1896, is 2 ,3 6 3 ,6 1 1 . T h e D ig n ity of S e rv in g B roth er has been b estow ed upon s i x m e m b e r s in r e c o g n i t i o n o f t h e i r s e r v i c e s t o t h e S . J . A . A . o v e r a lo n g perio d of years. O w i n g to th e in t e r n a t io n a l s itu a tio n th e i n t e r - R a i l w a y a n d E n g la n d v. S c o tla n d co m p e titio n s w e r e a g a i n d isc o n tin u ed . T h e D is tric t co m petitio n s, N o rth E a s te rn A re a F in a l a n d G r o u p c o m p e titio n s w e r e held u n d e r p r e - w a r co n d itio n s, a n d w e r e r e p o r t e d in o u r l a s t i s s u e . D u r i n g t h e y e a r 92 m e d a ls , 3 7 2 0 - y e a r s ’ b a r s , 1 7 25y e a r s ’ bars, 7 30 -years’ bars, and 1 40 -years’ b a r h av e been approved. A s u it a b le c e r tific a te h a s b een is s u e d to th o s e co n ce rn e d , w h ic h w ill be e x c h a n g e d for th e re la tive g o ld to k e n a s so o n a s c ir c u m s t a n c e s p erm it.

S t a r t i n g a Medical C o m f o r t s D e p o t. F ro m D iv . S u p t. W . S. C lu tte rb u c k , G lo u c e ste r C o m p a n y D i v i s i o n , 49, H i g h S t r e e t , G l o u c e s t e r .

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D epo t. “ W h i le w e h a v e th e u s u a l in fo r m a tio n a v a ila b le from H e a d q u a r t e r s , w e s h o u l d l i k e t o g e t in t o u c h w i t h a D i v i s i o n t h a t h a s h a d s o m e e x p e r i e n c e in t h e r u n n i n g o f a M e d i c a l C o m fo rts D ep o t. A s w e in te n d to e m b a r k u p o n a fa ir ly l a r g e s c a le , w e feel s u r e t h a t w e c a n g a i n m u c h u se fn l in fo r m a tio n r e g a r d i n g w h a t to s t o c k , c h a r g e s , e tc ., fr o m a D iv is io n t h a t h as b een o p e ra tin g th is s c h e m e for so m e years. “ I tru st th at t h r o u g h th e m ed iu m of F i r s t A id y ou w ill be a b le to p r o v id e m e w it h th e i n fo r m a tio n w e r e q u i r e . ” W e s h a ll b e g r a t e f u l to r e a d e r s w h o w ill b e g o o d e n o u g h to sen d th e re q u ire d p a r tic u la r s , e ith e r to S u p t. C l u t t e r b u c k d irect, or to th is o ffice.— E d i t o r .

F i r s t A id t o th e I n ju r e d . SO UTH ERN S t e y n in g . — A t a la r g e g a t h e r in g of A m b u la n c e m em b e rs a n d th eir frien d s h eld at th e R a i l w a y H o te l, S te y n in g , r e c e n t l y , L o n d o n C e n t r a l D i v i s i o n a l S u p t . M r . C . J. C . L a t h a m p res en te d a m b u l a n c e a w a r d s to n in e te e n s u c c e s s fu l c a n d id a t e s , a n d a s p e c ia l ce rtific a te of m e r it for s e rv ic e s re n d ered to th e A m b u la n c e c a u s e to M r. E . P a v e y th e C la ss Secretary. M r. L a t h a m c o n g r a tu la te d e a c h recipien t an d s p o k e of th e w o r k as an e x c e lle n t h o b b y — n o th in g cou ld be f i n e r t h a n b e i n g r e a d y t o h e l p s o m e o n e in n e e d . M r. G o d d a r d , D is t r ic t S e c r e ta r y , p resided , a n d M rs. C r o c k e r , B . R . C . S . , in a v e r y c h a r m i n g s p e e c h , s a id th a t d u r in g th e w a r the B . R . C . S . a n d th e S .J .A .B . h ad w o rk e d a d m ira b ly to g e th er and she s a w no reason w h y th at co-opera tio n sh o u ld not c o n tin u e . S h e c o n g r a t u l a t e d t h e c la s s on its 10 0 p e r c e n t , s u c c e s s a t e x a m i n a t i o n s a n d w i s h e d t h e c l a s s

w e ll for the future. M r. T r o tt rep resen tin g the C e n tre S ecretary, th an k e d bo th M r. L a t h a m a n d M rs. C r o c k e r fo r th eir in te re st and

S u b j e c t to s u ffic ie n t m e m b e r s b e i n g e n r o lle d , a c o u r s e of i n s t r u c t i o n in t h e a b o v e s u b j e c t w i l l b e h e l d a t t h e A l d e r s g a t e W a r d S ch o o l, 18 1, A ld e r s g a t e Street, L o n d o n , E . C . I . The c o u rse w ill c o m m e n c e on T u e s d a y , S e p te m b e r 1 1 t h , 1945, at 6.0 0 o ’ c l o c k p . m . a n d c o n s i s t o f t w e l v e l e c t u r e s , s i x o f w h i c h w ill be g iv e n by a S u rg e o n . T h e fe e for t h e co u rse , i n c lu d in g th e e x a m i n a t io n fo r th e c e r t i f i c a t e o f t h e S t . J o h n A m b u l a n c e A s s o c i a t i o n , w i l l b e 5/-. T h e c o s t o f t h e t e x t b o o k t o b e u s e d a t t h e c o u r s e is 2/-. L a d i e s w ill b e a d m it t e d to th e c la s s a n d s e p a r a te a c c o m m o d a t io n for p r a c tic e w ill be p r o v id e d . I n s t r u c t i o n to th e fe m a le stu d en ts w ill be u n d e rta k e n b y the L a d y D iv ision a l S u p e rin te n d e n t a n d m e m b e rs of th e N o . 6N (H o sp ita l S a t u r

d a y F u n d ) D ivisio n . A p p lic a tio n fo r e n r o lm e n t in th e c la s s s h o u ld be m a d e t o t h e C l a s s S e c r e t a r y , A m b u l a n c e O f f i c e r J. H . C h a p m a n , 2, Y o r k R o a d , N e w S o u t h g a t e , N . H .

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Y o u r re p ly to W . L . ( A u stra lia ) w a s in te re stin g , b u t s u r e l y y o u r q u e s t i o n e r h a d n ’t r e f e r r e d t o o r d e r s o f A u g u s t , 1 9 4 2 — Cadet O fficers D r i ll— “ I n a c c o r d a n c e w i t h C a d e t R e g u la t io n s , C a d e t O fficers w h o a tte n d the re q u ire d n u m b e r of C a d e t D i v is io n a l m e e t i n g s a r e r e c o r d e d a s efficien t, a t the s a m e t i m e i t is r e c o m m e n d e d t h a t t h e y s h o u l d a l s o a t t e n d w h e n e v e r p ossib le, th e d rills a n d le c tu re s o f th eir a d u lt D i v i s i o n , f o r b y d o i n g s o , t h e y w i l l b e k e p t in t o u c h w i t h t h e a ctivities of th a t D iv isio n , an d the k n o w le d g e a n d p ractice g a in e d , w ill h a v e an im p o rta n t b e a rin g on the soun d and u p-to-d ate tr a in in g of th eir c a d e t s .” In the la tte r d irectio n no d ou bt the C a d e t Su pt. a tte n d in g a d u lt co m m ittee m ee t in g s co u ld k e e p th em in fo r m e d of r e le v a n t m atte rs. I th in k that w h en our co llea g u e s “ d o w n under ” g e t t h e i r 7 5 7 o f M a r c h , 1 9 4 5 , it w i l l s o l v e m a n y a “ b u r n i n g ” q u estion . T h e i s s u e o f t h i s o r d e r h a s fil le d a l o n g n e e d e d w a n t — o u r A u s tra lia n frien d s h a v e sta te d a fe w of the i m p o s itio n s v e r y n ic e ly a n d t h e y w i ll b e g l a d to k n o w n o w , th a t all O ffic e r s of th e C a d e t s s h a ll b e r e c o g n is e d a s O fficers of the B r i g a d e — b y a ll r a n k s — a n d treated w ith th e c o u rte s y a n d re sp ect d u e to a n O ffic e r of th e B r ig a d e , e tc ., etc. R e c o g n i t i o n a t l a s t !— Y o u r s f a i t h f u l l y , “ E

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I h a v e r e a d t h e a r t i c l e u n d e r t h e a b o v e t i t l e , in y o u r J u n e issu e, w it h m u c h a p p r o v a l. A s a f ir s t a i d e r o f 1 6 y e a r s e x p e r i e n c e , m o s t o f i t s p e n t in i n d u s t r i a l c o n c e r n s a n d r e c e n t l y in a h o s p i t a l o r g a n i s a t i o n d e a l i n g w i t h t h e t r a n s p o r t o f s i c k a n d i n j u r e d p a t i e n t s , I c o n s i d e r it is h i g h t i m e t h a t t b e a r t of first a id w a s b r o u g h t u n d e r S t a t e r e g i s t r a t i o n , on a p a r w ith th e n u r s in g a n d allied p rofession s. I w o u ld lik e to s u g g e s t a n i m p r o v e m e n t o f D r . B o w m a n E d g a r ’s g r a d i n g o f fir s t , s e c o n d a n d t h i r d y e a r s y s t e m w i t h r e g a r d t o f i r s t a i d e r s w h o h a v e b e e n in “ p r a c t i c e ” f o r a n u m b e r of years. N a tio n a l sc h o o ls cou ld b e set u p w ith a s ta n d a rd sy llab u s to c o v e r a period of tr a in in g a s la id d o w n by, s a y , a N a tio n a l B o a rd o r S o c ie ty , a n d a t the end of th e p erio d the stu d e n t c o u ld sit for th e e x a m . H a v i n g b e e n s k ille d e n o u g h to q u a lify , this c o u ld b e fo llo w e d b y a b i-a n n u a l post g r a d u a t e c o u r s e t o k e e p t h e fir s t a i d e r c o n v e r s a n t a n d e f f i c i e n t w i t h the p ro g re ssiv e treatm en ts. A n o t h e r b u g b e a r to e ffic ien c y t h a t m u s t b e r e m e d ie d s o o n e r o r l a t e r is t h e v a r i a t i o n o f e q u i p m e n t a t p r e s e n t in use. A m b u la n c e s a nd eq u ip m e n t m u st be “ s t a n d a r d is e d ” t o f a l l in l i n e w i t h t e a c h i n g a n d f o r t h e p u r p o s e o f i n t e r ch an geability. I h a v e s e e n m u c h u n n e c e s s a r y s u f f e r i n g c a u s e d to p atien ts a s a re su lt of la c k of in te rc h a n g e a b ility d u r in g transport. T h i s is m o s t l y p r e v a l e n t i n s t r e t c h e r d e s i g n a n d it s a l l i e d f i t m e n t s in a m b u l a n c e s . I c o u ld g o on to g r e a t le n g t h on th is su b je c t b u t suffice f o r n o w , I s h a l l p r o b a b l y b u t t in a t a f u t u r e d a t e . F o r ce rtain re a so n s I r e g r e t I c a n n o t id en tify m ys e lf p u b licly, but e n clo se m y card fo r y o u r re fe re n c e .— Y o u r s faith fully, W .A .W .

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I h a v e r e a d w i t h m u c h i n t e r e s t S i r H e n r y L . M a r t y n ’s a rtic le en titled a s above. T h e r e is a n o t h e r tro u b le , e q u a l l y d is t r e s s i n g to th e p a t ie n t a n d to t h e first a id e r , w h i c h h e d o e s n o t m e n t i o n — asthm a. T h e r e h a v e been se v eral of th ese c a s e s on pu b lic d u ty recen tly. I w e l l r e m e m b e r o n e in 1 9 3 7 , o n b o a r d s h i p r e t u r n i n g from O ste n d on A u g u s t B a n k H o lid a y , w h er e I h ad been w ith a party of lim b less e x serv ice m en v isitin g the w a r graves. A m a n , n ot of o u r p a rty , h ad a v e r y b a d a t t a c k , so s e r i o u s w a s it t h a t a l t h o u g h h e h a d h i s c a r a t D o v e r w e h a d t o b r i n g h i m u p t o L o n d o n a n d s e n d h i m h o m e in a n a m b u lan ce. F o rtu n a te ly I h ad a D iv isio n a l S u r g e o n w ith m e and w a s th u s relieved of m u c h of the re s p o n s ib ility .— Y o u r s faithfully, G.

reen

(D /S /O No. 1 D ist., S .J .A .B .).

P u b lic D u t y O fficer.

St. Andrew’s Ambulance Association. H ig h p raise for th e tre m e n d o u s v o lu m e of w o r k u n d e rta k e n in S c o t l a n d b y t h e S t . A n d r e w ’ s A m b u l a n c e A s s o c i a t i o n w a s g i v e n b y th e D u k e of B u c c l e u c h , t h e p r e s id e n t , w h e n h e p r e s i d e d a t t h e a n n u a l m e e t i n g in G l a s g o w o n A u g u s t 1 s t . T h e in te n tio n of th e A s s o c ia t io n to fo l lo w a n e x p a n s i o n i s t po licy b y s e ttin g u p n e w a m b u la n c e c en tres w a s in d icated by M r. T h o m a s M offat, C h a ir m a n of C o u n c il. A co m m ittee h ad b een a p p o in te d , he said, w ith th e a im of m a k i n g the n a m e of th e A sso c ia tio n k n o w n t h r o u g h o u t S c o tla n d , an d s c h e m e s w e r e u n d e r c o n s id e r a t io n fo r e x t e n d i n g s e r v ic e s to th e sm a ll a s w e ll a s th e la r g e to w n s of th e c o u n try . The A sso c ia tio n h a d a lre a d y t a k e n o v er th e w o r k i n g of the a m b u la n c e s e r v ic e s in P a is le y , a n d n e w c o m m it t e e s h a d been form ed at B i g g a r and C lyd eb an k .

Reviews. B a illie r e 's N u r s e s C om plete M e d ic a l D ic tio n a r y . M a r g a r e t E. H itc h , S. R. N. & Cox. P r ic e j s . 6d.

London:

R e v ise d by B ailliere, T in d a ll

T h a t th is little b o o k fulfils a n e ed o f th e N u r s i n g p r o f e s s i o n is p r o v e d b y t h e f a c t t h a t a n e l e v e n t h e d i t i o n h a s n o w b een issu ed . Its m a in se ctio n — th e d ic tio n a ry of m ed ica l t e r m s — is a l l e m b r a c i n g a n d c o m p r e h e n s i v e , a n d s e t s o u t t h e co rrec t p ro n u n cia tio n of w o rd s a n d te rm s, m a n y of w h ic h a re n o t in e v e r y d a y u s e . T h r o u g h o u t , t h e b o o k is f u l l y a n d f r e e l y i l l u s t r a t e d w i t h c l e a r d i a g r a m s ; a n d i t s v a l u e is f u r t h e r e n h a n c e d b y no less th a n 21 A p p e n d ic e s w h ic h in c lu d e su c h ite m s a s a list of n e w te c h n ic a l w o r d s , u r in e te s t in g , m e t h o d s of g iv in g d ru g s , a lteration of d oses a nd so on and w h ic h w ill g o fa r t o w a r d k e e p i n g t h e p r a c t ic e of th e a r t a n d s c ie n c e of n u r s i n g u p to d ate. E a c h y e a r a d d s s o m e th in g to o u r k n o w le d g e . T h is has b e e n d u l y r e c o r d e d in s u c c e e d i n g e d i t i o n s o f t h i s b o o k w h i c h c a n b e c a r r i e d in t h e p o c k e t o r b a g a n d is c o n s e q u e n t l y a lw a y s at h a n d fo r lo o k in g up ite m s of in fo rm a tio n at a m o m e n ts n otice. O n c e a g a in , th erefore, w e c o m m e n d the d i c t i o n a r y t o a l l r e a d e r s o f F i r s t A i d , w h o w i l l fi n d w i t h i n i t s p a g e s t h e s o l u t i o n s o f t h e m a n y d i f f i c u l t i e s e n c o u n t e r e d in th e n u r s in g of th e s ic k a n d in ju red .

F I R S T

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375

V I R T U E & C o ., L td ., (F .A . D e p t .) , C r o w n C h a m b e r s , U p p e r P a r lia m e n t S treet, N o ttin g h a m .

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ADDRESS.

P H Y S IC IA N

S e n d th is f o rm in u n s e a le d e n v e lo p e , s ta m p e d Id .

w ith o u t any

F I R S T

Queries and Answers to Correspondents

R I D t h a t it s f u n c t i o n is e n d e d . F o rtu n a te ly , h o w e v e r, th e vessel h a s a c o lla te ra l (or “ b a c k - d o o r ” ) c ir c u la tio n t h r o u g h c e rta in sm a ll arteries w h ic h g r a d u a lly e n la r g e a n d t a k e o v er the w o r k of the d estro y e d m ain a rtery . — N . C . F .

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 ie s m u s t b e m a r k e d o n th e top left-h a n d co rn e r of th e en ve lo p e “ Q u e r y , ” a n d ad d ressed to F i r s t A i d , 46, C a n n o n -street, L o n d o n , E . C . 4. 2 .— A ll Q u e r ie s m u s t b e w r itte n o n o n e sid e of p a p e r only. 3 .— A ll Q u e r ie s m u s t be 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 of Q u e r ie s fr o m a b r o a d , fr o m a r e c e n t issu 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 i s c o lu m n is th e 39th (19 3 7 ) E d itio n of th e S . J . A . A . M a n u a l of F ir s t A id to th e In ju re d .

T reatm en t of O p iu m

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R . T . ( H a c k n e y ) . — ( 1 ) P l e a s e t e l l m e if t h e T e x t b o o k in it s d escrip tio n of th e tre a tm e n t of p o is o n in g by op iu m and it s p r e p a r a t i o n s ( R u l e 2, p. 1 7 4 ) i n t e n d s u s t o g i v e t e n g r a in s of p o ta ssiu m p e r m a n g a n a t e dry. A t least, the s e m i - c o l o n in t h e m i d d l e o f t h e p a r a g r a p h m a k e s t h e i n s t r u c t i o n s r e a d a s if t h i s r e m e d y is n o t t o b e g i v e n d i l u t e d w ith w ater. A l s o (2) t h e B r i t i s h P h a r m a c o p o e i a t e l l s u s t h a t t h e m a x i m u m d o s e o f p o t a s s i u m p e r m a n g a n a t e is t h r e e gra in s. S o I a s k w h y t e n g r a i n s a r e o r d e r e d in t h e Textbook. W e a w a i t y o u r re p lies w i t h in terest, a n d w e t h a n k y o u fo r y o u r k in d help. ( 1 ) T h e s e m i - c o l o n is a m i s p r i n t . S o d e l e t e it a n d d i l u t e b oth ten g r a in s of p e r m a n g a n a t e of p o tash a n d tw o ta b le s p o o n f u l s o f C o n d y ’ s f l u i d in a p i n t o f w a t e r , p r e f e r a b l y w arm . (2) A l a r g e d o s e is r e c o m m e n d e d b e c a u s e t h e d r u g is in d ic a te d a s a n tid o te for c a s e s of o p iu m p o is o n in g ; a n d a n y p o s s i b l e ill e f f e c t s a r e a v o i d e d b y a d m i n i s t e r i n g it w e l l d i l u t e d in a p i n t o f w a t e r . I n c i d e n t a l l y t h o u g h a f e w g r a i n s of p e r m a n g a n a t e of p o ta s h t a k e n o n a n e m p t y s t o m a c h h a v e b e en k n o w n to c a u s e s e r i o u s s y m p t o m s in s o m e p a t i e n t s , o t h e r s h a v e r e c o v e r e d after s w a llo w in g from 2 5 0 t o 3 00 g r a i n s . — N . C o r b e t F le tc h e r.

E x a m in a tio n H o w le r. M .R . (C a n n o n S t.) .— In a recen t e x a m in a tio n the doctor a sk e d one ca n d id a te h o w he w o u ld treat a m a n w h o h ad ju st been stu n g by a w asp . H e lo o k e d su rprised w h e n t h e c a n d i d a t e r e p l i e d — “ E x t r a c t the w a sp stin g by p r e ss in g a s m a ll w a tch key ov er the site o f in je ctio n ! " The d o c t o r t h e n t r i e d t o ’ h e l p t h e c a n d i d a t e b y a s k i n g if a w a s p d i d in f a c t l e a v e i t s s t i n g b e h i n d ; b u t t h e l a t t e r s t u c k t o h i s g u n s a n d s a i d — “ N e v e r th e le s s / w o u ld s t i l l u se the -watch key in case t h a t w a sp d id lea ve h is stin g in

the w o u n d ! ” Good!

N e x t , p l e a s e ! !— N . C . F .

H u m o u r in F irst A id . L. D . (B e ig h to n ) .— A t a recen t D iv isio n a l P ractice a m em b e r a s k e d w h a t w o u l d b e t h e b e s t f i r s t a i d t r e a t m e n t if h e h a d to t r e a t a m a n w h o w a s s h o t t h r o u g h th e s t o m a c h , th e b u llet s e v e r in g th e a b d o m in a l ao rta, s h a tte rin g the l u m b a r v e r t e b r a e a n d a ft e r d efle ctio n , t e a r i n g its w a y t h r o u g h th e r i g h t k id n e y a n d liver. M y r e p l y w a s :— " A p p l y c o ld com p resses to y o u r h ea d — a n d m i n e ! " W h a t c o m m e n t h a v e y o u to m a k e p le a s e ? Good !

N e x t , p l e a s e ! !— N . C . F .

B u r n s D u e to C o r r o s i v e s . B . D . ( P ly m o u th ) .— A t a recent e x a m in a tio n , one of o u r m e m b e r s w a s a s k e d t h e f o l l o w i n g q u e s t i o n “ W h a t is t h e d i f f e r e n c e in t h e a p p e a r a n c e o f a b u r n c a u s e d b y a c o r rosive acid a n d one c a u sed b y a co rro siv e a lk a li ? ” So f a r w e h a v e b e e n u n a b l e t o fin d t h e a n s w e r . W e t h a n k y o u fo r y o u r p r e v io u s help. C o r r o s i v e a c i d s a n d a l k a l i s in s o m e c a s e s p r o d u c e s i m i l a r effects. T h u s , h yd ro ch lo ric ca rb o lic a n d o x alic a cid s ca u se a w h itis h s ta in , s u lp h u r ic a c id a n d c a u s t ic s o d a a b l a c k sta in a n d n itric acid a y e llo w stain. W h i l e t h e s e f a c t s m a y b e i n t e r e s t i n g , it s h o u l d b e n o t e d th a t th e c o lo u r of th e b u rn is of little v a lu e fo r d ia g n o s tic p u rp o se s a n d th a t th e la b el on th e b o ttle m a y b e a m o re certain g u id e .— N .C . F .

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J . B . ( S t o c k p o r t ) . — A p p e n d i x I I I in t h e T e x t b o o k t e a c h e s u s h o w w e s h o u ld a p p ly th e T h o m a s S p lin t for fr a c tu r e d fem ur. P l e a s e t e l l m e h o w it is u s e d f o r f r a c t u r e s o f b o n e s of le g . W e t h a n k y o u in a d v a n c e f o r y o u r k i n d reply. I t i s n o t u s u a l f o r t h e T h o m a s S p l i n t t o b e u s e d in t h e t a e a t m e n t o f f r a c t u r e s o f t i b i a a n d f i b u l a e x c e p t in t h e S e r v i c e s w h e n l o n g a n d s l o w t r a n s p o r t is a n t i c i p a t e d a n d o n l y t h e n f o r c a s e s in w h i c h t h e l o c a l i n j u r y is e x t e n s i v e . If, h o w e v e r , y o u d i d u s e t h i s s p l i n t f o r f r a c t u r e s o f t h e b o n e s o f t h e l e g , t h e n y o u w o u ld a l t e r th e p o s itio n of the G o o c h s p lin tin g a n d b a n d a g e s to c o n fo r m to th e illu stratio n in F i g . 5 1 o f t b e T e x t b o o k . — N . C . F .

P o is o n in g b y C a rb o n M o n o xid e . G . F . ( C o v e n t r y ) . — I n t h e l a s t p a r a g r a p h o f y o u r a n s w e r to th e q u er y w h ic h w a s p u b lish ed u n d e r th e a b o v e h e a d in g in t h e J u l y i s s u e o f F i r s t A i d , it is s t a t e d in s e c t i o n ( 4 ) t h a t o x y g e n w it h 5 p e r ce n t, c a r b o n m o n o x i d e s h o u ld be adm in istered. T h o u g h the co n te x t c le a rly s h o w s that t h i s is a p r i n t e r ’ s e r r o r f o r “ o x y g e n w i t h 5 p e r c e n t , of ca rb o n d io x id e ,” I sen d th is letter w h ic h w ill g iv e you a n o p p o rtu n ity to c o r r e c t th e error. Y o u r letter a n d co rrec tio n a re d u ly a p p re c ia te d .— N . C .F .

T o rn F e m o ra l A rtery. T . R . (C a is te r ).— If the fe m o ra l a rte r y be c o m p letely torn as th e r e s u lt of a w o u n d d o e s th e v e s s e l r e s u m e its n o r m a l fu n ctio n a fte r tre a tm e n t. Y o u r k in d e x p la n a tio n w ill be g r e a tly appreciated . If th e fe m o ra l a r te r y b e c o m p le te ly sev ered th e o n ly p o s s ib le t r e a t m e n t is to l i g a t u r e th e to rn e n d s, w h i c h m e a n s

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and o t h e r R e s p ir a t o r y S uffe rers sh ou ld c o m m un ic a te w i t h British M ed ica L a b ora to ri e s, Ltd., f o r pa rticulars o f “ S anol en ” t h e m ost efficaciou s H o m e R e m e d y k n o w n t o Medical S c ie n c e : N o w b ein g used w it h r e m a r k a b l e s u cce ss e v e r y w h e r e : E n d o r se d by t h e M edica l P rofe ss io n .

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T h e reliance w hich f a c to r y workers place in their Welfare Nurse is com parab le w ith t h a t which she in turn places in her First A i d equipmen t. R a p id relief from pain and distress is no less essential in the N a t io n a l interest th an to the sufferer, and calls for the prom pt administration o f a safe analgesic and sed ative. T h a t is w h y '•A n a d in ,’ a ba la nced co m bin ation in the aspirinphenacetin-caffeine group, is regarded as indispensable in F a c t o r y W elfare work.

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T h e h e a t r e t a i n e d in t h e m e t a l w h i c h c a u s e d t h e b u r n w o u l d n o t b e s u ffic ie n t to boil t h e q u a n t i t y of w a t e r in w h i c h th e in ju red part w a s im m erse d . B riefly, th erefore, tre a tm e n t s h o u l d b e c a r r i e d o u t a s l a i d d o w n in T e x t b o o k . — N . C . F .

W o m a n w ith F ra ctu red L e g . R . D . ( W e llin g t o n , N e w Z e a la n d ) .— R e c e n t ly I d iscu sse d the tre a tm e n t of a w o m a n w ith a sim p le fr a ctu re of le g w ith th e se n io r m e m b e r of o u r cla ss w h o h as d evoted tw e n ty y e a r s to first a id . H e in sisted th a t w ith a w o m a n p a tie n t y o u s h o u ld d is p e n s e w it h th e in n e r splin t. A s t h e r e is n o s u c h i n s t r u c t i o n in t h e T e x t b o o k I s h a l l w e l c o m e a n d t h a n k y o u for y o u r ru lin g . Y o u r s e n i o r m e m b e r is e v i d e n t l y b e h i n d t h e t i m e s . The i n s t r u c t i o n , w h i c h h e q u o t e s , u s e d t o f i g u r e in t h e e a r l i e r e d i t i o n s o f t h e T e x t b o o k b u t it w a s o m i t t e d in t h e c u r r e n t ed ition b e c a u s e th e la d ie s no lo n g e r w e a r s k irts w h ic h reach th e a n k le s a n d co n s e q u e n tly ca n be tre ate d for fr a c tu re d le g s w ith o u t d isp la c e m e n t of th e s k ir t s .— N . C . F .

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R a b id A n im a l.

W . L . ( N e a t h ) .— A t a re c e n t c o m p e titio n held lo c a lly h ere, o n e o f t h e q u e s t i o n s w a s t h e f o l l o w i n g :— “ W h a t d i f f e r e n c e is t h e r e in t h e w a y in w h i c h t h e f o l l o w i n g a r e i n t r o d u c e d i n t o t h e h u m a n s y s t e m ( a) T h e v e n o m o f a s n a k e ; (b) T h e v i r u s o f a r a b i d a n i m a l . ” T h e T e x t b o o k s t a t e s t h a t t h e v i r u s o f r a b i e s is c o n v e y e d a lo n g th e n e rv e s to th e c e n tra l n e rv o u s sy ste m . A fte r a g o o d d iscu ssio n so m e of the m o re a d v a n c e d m e m b e r s w e r e of th e o p in io n th a t th e v ir u s is m o s t p r o b a b l y i n t r o d u c e d t o t h e s y s t e m m a i n l y , i n t h e fi r st pla ce , t h r o u g h th e ly m p h a t ic v esse ls th e n ce to th e h e art f r o m w h i c h it i s c o n v e y e d t o a l l p a r t s o f t h e b o d y i n c lu d in g th e b ra in , a n d th a t h a v i n g b een th u s d istrib u ted , it t h e n a t t a c k s n e r v o u s t i s s u e in a l l p a r t s o f t h e b o d y . I f t h i s is c o r r e c t , is n o t t h e T e x t b o o k s t a t e m e n t m i s l e a d i n g a n d a p t to m a k e k e e n s t u d e n t s o f a n a t o m y a n d p h y s i o l o g y i n c l i n e d t o r e g a r d n e r v e s a s if t h e y w e r e tu bes ? W h e n a s n a k e a t t a c k s , it f ir s t d r i v e s i t s f a n g s t h r o u g h the s k in a n d th en in jects its p o iso n t h r o u g h the tu b e w ith in the fa n g s. I n s h o r t , it p l a c e s i t s v e n o m w e l l b e n e a t h t h e sk in . O n t h e o t h e r h a n d t h e v i r u s o f h y d r o p h o b i a is c a r r i e d o n t h e t e e t h o f t h e i n f e c t e d a n i m a l a n d it t e n d s t o r e m a i n s u p e r fic ia l b e c a u s e th e s k in r e m o v e s th e v iru s fr o m th e teeth. T h e v ir u s , th e r e fo r e , is n o t so li k e l y to be c a r r ie d d ee p w it h i n th e tissu es a s h a p p e n s w ith th e ven om in tro d u ced b y s n a k e b it e . N e r v e e n d in g s a r e fo u n d im m e d ia te ly b e n e a th th e s u r f a c e o f th e s k i n a n d a r e li k e l y to b e c o m e in fe c te d w i t h the v e n o m of rab ies a t a n e a r ly s t a g e . S o t h e r e is n o n e e d to b r i n g in t h e l y m p h a t i c s w h i c h a r e b e y o n d t h e s c o p e o f fir s t aid. — N .C . F .

R ate o f A rtificia l R esp ira tio n . D.

R . ( B a r r o w - in - F u r n e s s ) . — It h a s r e c e n t ly b een sta te d ( T i n g l e y , B r it is h M e d ic a l J o u r n a l, 1 9 4 4 , S e p t . 1 6 , 3 6 6 - 7 ) th a t th e e ffectiv en ess of artificia l re sp ira tio n ca n be g r e a t ly in c re a s e d b y q u a d r u p lin g the u s u a l rate, pro v id e d th e r e is no lo ss of v o lu m e . I f t h i s is t r u e , it d e s e r v e s w i d e p u b li c i t y a m o n g s t first a id e rs . I sh o u ld be g r a t e f u l if y o u w o u l d k i n d l y g i v e y o u r v i e w s o n th e su bject.

A t th is d ate , I h a v e no k n o w l e d g e of th e c irc u m s ta n c e s w h i c h g a v e ris e to th e s u g g e s t i o n t h a t th e r a t e o f a rtific ia l re sp ira tio n c o u ld be effectively q u a d ru p le d . I note, h o w e v e r ,

A I D t h a t t h i s is q u a l i f i e d b y t h e s t a t e m e n t t h a t t h e r e m u s t b e n o loss of vo lu m e. In a n y m e th o d of a rtificial re sp ira tio n th ere m u s t be a p a u s e a f t e r t h e i n s p i r a t o r y m o v e m e n t t o p e r m i t a i r t o fin d its w a y in to th e tu b e s w h ic h le a d to th e a ir cells (see C l a u s e 2 (c ) o n p. 1 4 8 o f t h e T e x t b o o k ) . I f t h e n e e d f o r t h i s p a u s e is r e c o g n i s e d , t h e n it w i l l b e a p p r e c i a t e d t h a t it is i m p o s s i b l e t o c a r r y o u t t h e c y c l e o f m o v e m e n t s a t t h e r a t e o f 48 p e r m i n u t e ! 1— N . C . F .

T r e a t m e n t o f S n a k e B ite. K .S . ( T w ic k e n h a m ) .— 1 w a s re ce n tly a s k e d by a h ik er, the c o r r e c t t r e a t m e n t f o r s n a k e b i t e a s h e h a d t r o d d e n on one th at w eek-end. I told h im th e t r e a t m e n t a s g i v e n o n p a g e 13 2 of the T e x t b o o k ; a n d th en , w h ile I w a s id ly t h in k in g over th e su b je c t, th e t h o u g h t s t r u c k m e a s to w h y b le e d in g is e n c o u r a g e d in t h e c a s e o f a b i t e b y a r a b i d a n i m a l w h e n t h e v e n o m a f f e c t s t h e n e r v e s , b u t o m i t t e d in t h e t r e a t m e n t of s m a ll b ite w h e n t h e v e n o m e n te r s th e b lood s tre a m . W o u ld not the v en o m be w a s h e d o u tw a rd s by b l e e d i n g in t h e l a t t e r a s w e l l a s t h e f o r m e r ? 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 r e p l y a n d a l s o f o r y o u r m a n y l u c i d r e p l i e s t o o u r q u e r i e s in F i r s t A i d . I n t h e t r e a t m e n t o f s n a k e b i t e t h e r e is n o s p e c i f i c i n s t r u c t i o n in t h e T e x t b o o k t o p r o m o t e b l e e d i n g , b u t y o u a r e told to p la c e a c o n s t r ic t io n h i g h u p on th e lim b . In p r a c tic e t h i s w o u l d h a v e t h e e f f e c t o f c a u s i n g s o m e i n c r e a s e in h a e m o r r h a g e b e c a u s e of th e o b s tr u c tio n to th e re tu rn of blood in t h e v e i n s . T h i s b l e e d i n g m a y p r o v e b e n e f i c i a l ; b u t it m u s t b e r e m e m b e r e d t h a t w h a t e n t e r s t h e b l o o d s t r e a m is q u ic k ly carried a w a y fro m th e poin t of entry. I n t h e c a s e o f h y d r o p h o b i a , t h e v i r u s is n o t i n j e c t e d d e e p l y i n t o t h e w o u n d ( a s it is in s n a k e b i t e ) , b u t is p l a c e d s o m e w h a t s u p e rfic ia lly ro u n d the in cisio n m a d e b y th e teeth o f the in fe cte d a n im a l. T h e r e is, t h e r e f o r e , g r e a t e r p o s s i b i l i t y o f f r e e h a e m o r r h a g e r e m o v i n g t h e i n f e c t i o n , a n d fo r th is r e a s o n th e T e x t b o o k tells y o u to p r o m o te b l e e d i n g . — N .C .F .

T reatm en t of H aem orrhage. A . W . ( R o m fo r d ) .— T h e fo llo w in g q u estion h a s c a u s e d a d ifferen ce of opinion a m o n g th e m e m b e r s of o u r D i v i sio n ; a n d w e s h o u ld b e g l a d to h a v e y o u r v a lu e d a d v ic e a n d r u l i n g :— “ If a p a t ie n t h a d b e e n s u f f e r i n g fr o m s e v e r e a r te r ia l b le e d in g (not in tern al), a n d th at b le e d in g h a d b een co n tro lled , w o u ld th e g i v i n g of s t im u la n ts , s u c h a s tea, m ilk , e tc ., a ls o h a v e a t e n d e n c y to c a u s e f u r t h e r b le e d in g ? ” T h e f in a l p a r a g r a p h in C h a p t e r I I o f t h e T e x t b o o k t e lls y o u t h a t t h e t r e a t m e n t o f s h o c k is “ a n e s s e n t i a l p a r t of f ir s t a i d a n d m u s t b e f o l l o w e d in a l l c a s e s , ” a n d in t h e t h i r d p a r a g r a p h of C h a p t e r I V t h a t s h o c k w ill b e i n c r e a s e d by loss o f b l o o d , w h i c h r e a l l y m e a n s l o s s o f b o d y f lu id . In th e c a s e of a rte r ia l b le e d in g w h ic h h a s b een effec t i v e l y c o n t r o l l e d , it i s m o s t u n l i k e l y t h a t a d m i n i s t r a t i o n o f s t i m u l a n t s in t h e t r e a t m e n t o f s h o c k w i l l c a u s e f u r t h e r bleed in g. M o r e o v e r , t h e a d m i n i s t r a t i o n o f f l u i d s w i l l be b e n e f i c i a l , b e c a u s e t h e s e w i l l r e p l a c e s o m e o f t h e flu id a lr e a d y lost fro m the b o d y .— N . C . F .

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CONTENTS

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S E P T E M B E R , 1945.

LII.

NOTIC E

W ALTER

S tatistics make dry reading, but they are most useful, inas much as they are indicative of the activities which are taking place in any given direction in all parts of the Kingdom. We have before us the report which was approved at the last annual meeting of the St. Andrew’s Ambulance Association of Scotland. In Glasgow alone, it appears, there were 24,277 calls, involving 24,921 cases, which shows a slight decrease compared with the previous year. Of these, 12,984 cases were due to accident, and 11,977 to illness, the turn-out calls representing an average of 66'51 daily. The very high number of accidents due to motor traffic continues to throw a heavy burden on the work of the ambulances, and the number of accidents in which motor vehicles were involved during the year was 2,139 of which 254 were due to private cars or taxis, 719 to com mercial motors, 36 to motor cycles, 528 to buses and 602 to tramcars. Owing to the comparatively restricted area in which the cases occurred, the figures seem almost incredible ; but they do show unmistakably the immense importance attaching to first aid and ambulance work. Continuing the record in the Glasgow report, the ambulances had transported no fewer than 59,455 patients and had travelled 732,487 miles during the year, which represents one case every ten minutes on everyday throughout the year, figures which provide ample evidence of the amount of work undertaken in the relief of suffering throughout Scotland, as else where. First aid work has now an invaluable ally in that latest product of science, blood transfusion, and Glasgow is well to the foreground in this work. Here, ambulance units had turned out 2,508 times and had covered 20,010 miles. The amount of blood which has been transported was 39,255 pints, in fact, in the words of the Duke of Buccleugh, the president of the Association, the volume of lifesaving from this fine voluntary effort has been tremendous. What effect the atomic bomb will have on first aid work remains to be seen, although it would seem, from the early reports, that the First Aid in Glasgow.

F I R S T

bomb will make a clean sweeping, leaving nothing to be “ cleared up.” May we be protected from the realisation of such a ghastly horror !

C o m m o n E r r o r s in First A id . B y A. D A V I D B E L I L I O S , M .B ., B .S ., D .P .H . L ectu rer, B a tte rsea P o lytech n ic and W im b le d o n T e ch n ical C o lle g e ; P h y sicia n , W im b le d o n H osp ita l.

( R e p rin te d from the F e b ru a ry , 1945, issue o j “ T he P r a c titio n e r ” by h in d perm issio n oj the E d it o r .) ( C o n tinu ed from page i y )

B u rn s.

M is t a k e s o c c u r ch ie fly t h r o u g h fa ilu re to d is tin g u is h c a s e s w h i c h r e q u i r e a c t i v e t r e a t m e n t f r o m t h o s e in w h i c h f ir s t a i d s h o u l d b e r e s t r i c t e d t o b a r e e s s e n t i a l s . E xp erien ce s h o w s t h a t in civ il life a ll e x c e p t m in o r b u r n s fall in to th e la tter c a te g o ry . F irs t aid fo r se v er e or e x te n s iv e b u rn s s h o u ld b e c o n fined to m o r p h in e , t r e a t m e n t fo r s h o c k , a n d s p e e d y r e m o v a l of th e p a tie n t to h o sp ita l. A n y a tte m p t a t m ore a m b itio u s t r e a t m e n t m u s t b e s t r o n g l y d e p r e c a t e d , e x c e p t i n c a s e s in w h i c h t h e r e is l i k e l y t o b e d e l a y i n r e a c h i n g a c e n t r e w h e r e m e d ic a l fa cilities a re a v a ila b le . I n th is e v e n t, first a id s h o u ld in c lu d e th e im m e d ia t e a p p lic a tio n of 1 per cent, g e n t ia n v io let o r trip le d y e je lly (trio fa x). T h is sh ou ld be a p p lie d w ith o u t p re v io u sly c le a n s in g th e burn. A s e r io u s p r o b le m in first a id fo r s e v e r e or e x t e n s iv e burns i s : w h o is t o g i v e t h e m o rp h in e ? O b vio u sly, t h e l a y fir s t-a id e r c a n n o t b e a l l o w e d to, b u t w h a t o f t h a t e v e r - g r o w in g b o d y of tra in ed n u rses, m a n y e x-h osp ita l s i s t e r s , w h o a r e n o w r e s p o n s i b l e f o r t h e f i r s t a i d w h i c h is u n d e r t a k e n in t h e f a c t o r i e s ? A s the la w sta nd s, w o r k s m e d ic a l officers a re p r ec lu d e d fr o m s u p p l y in g th eir n u rse s w ith this, the m o s t im p o rta n t r e m e d y req u ired fo r th e tr e a t m e n t of b u rn s. S o m e m e d ic a l officers g e t r o u n d th e diffi c u lty b y s u p p ly in g an a n ti-s h o c k m ix tu re c o n ta in in g tin cture o f c h l o r o f o r m a n d m o r p h i n e ( e q u i v a l e n t t o 1/8 g r a i n ) t o b e g i v e n b y t h e m o u t h in a n e m e r g e n c y . W oun ds.

T h e c h i e f e r r o r i n t h e t r e a t m e n t o f w o u n d s l i e s in a t t e m p t i n g to d o d o too m u c h w h e n th e fa c ilitie s a r e u n su itab le. T h u s the th o ro u g h cle a n s in g , p ro b in g and stitch i n g o f w o u n d s d o e s n o t c o m e w it h i n th e s c o p e of tru e first aid, w h ic h s h o u ld b e co n fin ed to the a p p lic a tio n of a te m p o ra ry d ressin g. S u i t a b l e d r e s s i n g s , s i m i l a r to t h e “ first fie ld ,” c a n b e o b ta in e d u n d e r th e titles of “ s t a n d a r d d r e s s in g s , N o s . 1 a n d 2, N . H I . ” N o . 1 is m a d e f r o m s t e r i l i s e d g a u z e , a n d N o . 2 f r o m l i n t ; t h e d r e s s i n g s a r e p u t u p in p a c k s r e a d y f o r i m m ed ia te use. F o r la r g e r w o u n d s, m in e d re ssin g s, m a d e of g a m g e e , a re m ost valu a b le. F irs t-a id e rs a re ta u g h t, before a p p l y i n g th e d r e s s i n g , to p a in t th e w o u n d a n d s u r r o u n d i n g s k i n w it h a n a n tis e p tic , s u c h a s d etto l o r s u r g i c a l spirit. T h i s , i n t h e a v e r a g e c a s e , i s q u i t e u n n e c e s s a r y a n d is b e t t e r o m i t t e d , e x c e p t w h e n t h e r e is l i k e l y t o b e c o n s i d e r a b l e d e l a y in o b t a i n i n g m e d i c a l f a c i l i t i e s . If, fo r a n y r e a s o n , h o w e v e r , p a i n t i n g o r c l e a n s i n g of a w o u n d h a s to b e u n d e r ta k e n , th e c o m m o n e rro r of s w a b b in g from th e sk in i n w a r d s t o w a r d s t h e w o u n d i n s t e a d o f vice versa s h o u l d b e avoid ed.

Removal oj Joreign bodies

is a n o t h e r s u b je c t o n w h ic h

A I D a w o r d of c a u tio n is r e q u ire d . W h e n t h e f o r e i g n b o d y is l y i n g l o o s e in t h e w o u n d , t h e r e is n o h a r m in r e m o v i n g it, b u t if t h e r e is a n y q u e s t i o n o f it b e i n g i m b e d d e d — p a r t i c u l a r l y if a l o n g t h e c o u r s e o f a n i m p o r t a n t b l o o d v e s s e l — it m a y b e a s k i n g f o r t r o u b l e t o r e m o v e it in t h e a b s e n c e o f fa c ilitie s to c o n tr o l a p r o fu s e h e m o r r h a g e w h i c h m a y follow . W h e n a fo r e ig n b o d y, su c h a s a n eed le, b r e a k s , le a v in g a f r a g m e n t u n d e r t h e s k i n , a r u le of first a i d — o fte n o v e r l o o k e d — is t o p r e s e r v e t h e r e m a i n d e r f o r i n s p e c t i o n s o t h a t th e s u r g e o n w ill h a v e s o m e id ea of the size of the f r a g m e n t f o r w h i c h h e is s e e k i n g . H

aemorrhage.

F ir s t a id m e th o d s for s t o p p in g b le e d in g c a n be cla ssified a s f o l l o w s :— (1) D irect pressure :

(a) D i g it a l. (b ) P a d a n d b a n d a g e . (c) R i n g p a d . (2 ) I n d i r e c t p r e s s u r e : ( a ) P r e s s u r e p o i n t s . (b) T o u r n i q u e t s . (c ) F l e x i o n a n d o t h e r m e t h o d s . It w ill b e r e a d il y u n d e r s to o d t h a t w it h so m a n y m e th o d s , e rro r s o c c u r, n ot o n ly t h r o u g h fa u lt y a p p lic a tio n b u t also t h r o u g h fa ilu r e to a p p r e c ia t e th e ir in d ic a tio n s . D ire c t d ig ita l p ressu re .— P r e s s u r e w i t h t h e f i n g e r s d i r e c t l y o n a w o u n d is g e n e r a l l y s u c c e s s f u l . I t is , h o w e v e r , o n ly of v a l u e a s a n in itia l p r o c e d u r e , a n d fo r th is r e a s o n a l o n e is u n d e s i r a b l e , e x c e p t i n t h e e x t r e m e e m e r g e n c y ; it d o e s n o t g i v e t h e f i r s t - a i d e r a n y o p p o r t u n i t y of e x a m i n i n g t h e w o u n d b e f o r e it is a p p l i e d ; m o r e o v e r , it is often u n d e r ta k e n w it h o u t a n y c o n s id e r a tio n of clea n lin e ss , e .g ., in te rp o sin g a su itab le d re ssin g b e tw e e n the fin ger and the w o u n d . I n a n y c a s e , it c a n o n l y b e u s e d f o r w o u n d s o f lim it e d size. P a d an d bandage.— D i r e c t p r e s s u r e w i t h a p a d a n d b a n d a g e , e . g . , a m i n e d r e s s i n g , is w i t h o u t d o u b t t h e b e s t m eth o d of m a in ta in in g con tro l of b le e d in g . It m u s t n ot be a d o p te d , h o w e v e r , u n til th e w o u n d h a s b e e n e x a m i n e d to ex c lu d e th e co n tra -in d icatio n s ; these a re th e p resen ce of a fractu re or a foreign body. F o r t h i s r e a s o n , it c a n n o t b e used as a n im m ed ia te procedure. If u se of a p a d a n d b a n d a g e does not a p p e a r to h a v e b e en s u c c e s s fu l, a s s h o w n b y th e o o z in g of blood th r o u g h t h e d r e s s i n g , i t is a m i s t a k e t o r e m o v e it a n d a p p l y a n o t h e r ; a s e c o n d p a d a n d b a n d a g e s h o u l d b e p l a c e d o v e r t h e fir s t a n d se c u re d e v e n m o r e firm ly. D eep w ounds, how ever, m a y h a v e t o b e p a c k e d w i t h g a u z e u p to t h e s u r f a c e b e f o r e th e p a d a n d b a n d a g e is a p p lie d . R in g p a d , — T h i s is a m e t h o d w h i c h is o n l y a d v o c a t e d in s t a n d a r d f i r s t a i d f o r w o u n d s o f t h e s c a l p w h i c h a r e co m p lica ted b y the presen ce of a fra ctu re or a fo re ig n body. A fter c o v e r in g the w o u n d w ith a lig h t d r e ssin g , e .g ., g a u z e , th e r in g p a d sh o u ld be ap p lied so th a t th e w o u n d is w i t h i n t h e c e n t r e o f t h e r i n g a n d t h e p a d d i n g t a k e s u p p r es su r e all r o u n d . T h e r i n g p a d is f i n a l l y s e c u r e d b y a b ro a d or n a r ro w b a n d a g e ap p lied firm ly ro u n d the head. I t is n o t g e n e r a l l y a p p r e c i a t e d t h a t a r i n g p a d c a n b e e m p lo y e d for o th e r p a r ts of th e b o d y w h e n u se of a p a d a n d b a n d a g e is c o n t r a in d ic a t e d b y a f o r e i g n b o d y . In this e ven t, th e r in g pad sh o u ld be a p p lie d as d escrib ed an d s e c u r e d b y a b a n d a g e tied fir m ly on to a s p lin t on th e o p p o s ite s u r f a c e of t h e lim b . Pre ssu re p o in ts.— A p r e s s u r e p o i n t i s v a l u a b l e a s a n i m m e d i a t e m e a s u r e b e c a u s e it c a n b e q u i c k l y a p p l i e d a n d le a v e s th e first-aid er free to e x a m i n e the w o u n d th o ro u g h ly , or even to u n d e rta k e tre a tm e n t w h ile th e b le e d in g re m a in s u n d e r con trol. A c o m m o n f a u l t is t h e u s e o f t h e w r o n g p r es su r e poin t ; the o n e c h o se n s h o u ld be th a t w h ic h is t h e n e a r e s t a v a i la b le to th e w o u n d . M oreover, the th u m b s h o u ld b e u s e d w h e n e v e r p o s s ib le , s in c e it is t h e s t r o n g e s t d igit.

F I R S T

P r o lo n g e d u s e o f a p r e s s u r e p o in t, u s i n g r e la y s of a s s i s t a n t s , is u n d e s i r a b l e , s i n c e i t is l i a b l e t o c a u s e h a r m f u l effects, s im ila r to th o s e p r o d u c e d b y a to u rn iq u e t.

T o u r n iq u e ts . — T h e t o o f r e q u e n t u s e o f t h e t o u r n i q u e t h a s b een su fficiently c o n d em n e d d u r in g th e w a r . It s h o u l d b e e m p l o y e d o n l y w h e n d i r e c t p r e s s u r e is u n s u c c e s s ful o r is c o n tr a in d ic a te d . N e v e r t h e l e s s , it m u s t s t i l l b e c o n s i d e r e d a m o s t v a l u a b l e i n s t r u m e n t , p r o v i d e d it is a p p l i e d effic ien tly. E rro rs arise th ro u g h fa u lty a p p lication a n d th ro u g h not o b s e rv in g the preca u tio n s w h ic h h a v e so often been e m p h a s i s e d in c o n n e c t i o n w i t h i t s u s e . S o f a r a s a p p l i c a t i o n is c o n c e r n e d , it s h o u l d b e n o t e d t h a t t h e s t a n d a r d f i r s t a i d to u r n iq u e t, i .e ., t h a t p r o v id e d w it h a p a d , c a n o n ly be a p p lie d to th e b r a c h ia l, a n d to th e u p p e r th ir d of th e fe m o r a l, a iteries. A n im p ro v ise d tou rn iq u et, m a d e b y t y in g tw o k n o ts n e ar th e m id d le of a n a r r o w b a n d a g e can, h o w ev e r, be u se d for th e a rterie s of th e w rist an d a n k le . T h e usual f a u l t in a p p l y i n g a t o u r n i q u e t is f a i l u r e t o a d j u s t t h e p a d a c c u r a t e l y to th e s u r f a c e m a r k i n g of th e b lo o d v e s s e l or, h a v i n g d o n e s o , o m i t t i n g t o n o t i c e t h a t it h a s s l i p p e d d u r i n g tr a n s p o r t o f th e p a tient. M a n y ru le s h a v e b een la id d o w n to g o v e r n th e u se of the to u rn iq u et. T h o s e w h ich a re m ost freq u en tly b rok en a r e a s f o l l o w s :— ( 1 ) T h e t w i s t e r m u s t b e a d j u s t e d s o t h a t t h e p r e s s u r e is

on ly ju s t s u f f i c i e n t t o s t o p t h e b l e e d i n g . (2) E v e r y q u a r t e r o f a n h o u r t h e i n s t r u m e n t m u s t b e lo o s e n e d to a l l o w th e b lo o d to c i r c u l a t e t h r o u g h th e lim b a n d to s e e if th e b le e d in g r e m a in s u n d e r c o n tro l. I f it is n e c e s s a r y to re -tig h te n , the pa d sh o u ld be m o v e d d o w n w a r d s to w a r d s th e w o u n d befo re re -ad ju stm e n t. T h is giv es the tissu e s a t th e se a t of a p p lic a tio n a c h a n c e of re co v e ry fr o m th e d a m a g i n g effects of p ressu re. (3) W h e n e v e r p ossible, the to u rn iq uet sh ou ld be ap p lied o v e r a la y e r of flannel, o r th e c lo th in g , to p rev e n t “ b itin g .”

F le x i o n a n d other m ethods . — F l e x i o n is a m e t h o d o f s to p p in g the pop liteal a n d th e b ra ch ia l a rte r y a t th e e lb o w . It c o n s is ts o f a p p l y i n g a p a d in to th e fle x u re a n d fo r c ib ly fl e x i n g th e joint, s e c u r i n g it in th is p o s itio n b y a fig u r e-o feig h t b a n d a g e rou n d the th ig h a nd le g, or the a rm and fo rea rm resp ectiv ely. T h e m e t h o d is f a r f r o m s a t i s f a c t o r y , a n d is o n ly r a r e l y e m p lo y e d . F o r a rre stin g the axillary a r t e r y a s o m e w h a t s i m i l a r m e t h o d is a d o p t e d . It co n sists o f p l a c i n g a s m a l l r o u n d p a d h i g h u p in t h e a r m p i t a n d s e c u r i n g it b y a f i g u r e - o f - e i g h t b an d age around the sh o u ld er a n d o p p osite a x illa . F i n a l l y , t h e a f f e c t e d a r m is firm ly a d d u c te d b y m e a n s of a b ro a d b a n d a g e ap p lied from the l o w e r p a rt of th e a rm , ro u n d the b o d y a n d tied on th e o p p o site side, th e f o r e a r m b e i n g fle x e d to a r i g h t a n g le . T h i s m e t h o d o f t e n f a i l s b e c a u s e t o o l a r g e a p a d is u s e d a n d is n o t f o r c e d s u f f i c i e n t l y h i g h u p in t h e a x i l l a . M oreover, th e b a n d a g e s a r e n o t tied su fficie n tly firm ly , e s p e c ia lly th a t w h ich passes rou n d the body. In a n y c a s e , its e ffe cts a r e s im ila r to th o se of a tou rn iq u et. T

uture

I t w i l l b e s e e n f r o m t h e f o r e g o i n g t h a t f i r s t a i d is in f a c t a s i m p l e s u b j e c t , b u t i t is a g r a v e m i s t a k e t o a s s u m e t h a t it c a n b e p r a c t i s e d o r t a u g h t e f f i c i e n t l y w i t h o u t m a k i n g it i n t o a “ s p e c i a l s t u d y ” l i k e t h e o t h e r b r a n c h e s o f m e d i cin e a n d s u r g e r y , e . g . , sk in , ear, n o se a n d th ro at, an d eyes, w h ic h a re so co n sisten tly n eg le cte d b y th e a v e r a g e m ed ica l student. W it h th e a d v e n t of peace, th e p u b lic w ill r i g h t l y e x p e c t a n a m b u la n c e o r g a n is a t io n c o m p a r a b le in e f f i c i e n c y t o t h a t a t t a i n e d in w a r t i m e . T h i s m a y in vo lve co m p lete re o rg a n isa tio n — sta tio n in g a ccid en t a m b u la n c e s a t h o s p it a ls a n d s e n d i n g t h e m to a n in c id e n t, n o t o n l y w i t h a s tr e tc h e r p a r ty of tra in ed first-aid ers b u t a ls o w it h a c a s u a l t y h o u s e s u r g e o n in a t t e n d a n c e . A n d a l r e a d y t h e r e is t a l k of a N a tio n a l A m b u l a n c e S ervice.

R I D

S t.

J o h n

A m b u la n c e

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HEADQUARTERS AND DISTRICT REPORTS. No. I (Prince of Wales’s) District C 1 4 ( E r it h a n d D is t r ic t ) .— T h e a n n u a l so cial, co n c e rt a n d p r es en ta tio n of a w a r d s of th is C a d e t D iv is io n , w a s h eld on S a tu r d a y , A u g u s t 1 1 t h , a t E le c tric ity H o u s e , E rith . T h e c o m p a n y in clu d ed th e M a y o r a n d M a y o re s s of E rith , C a d e t S u p t. H . R . C o llin s, C a d e t O fficer B . R . C h ild , t o g e t h e r w it h officers a n d m e m b e r s of th e s e n io r D iv is io n (49th E rith ) a n d th e p a re n ts a n d frien d s o f th e c a d e ts. T e a w a s s e r v e d in t h e h a l l , a f t e r w h i c h t h e c a d e t s g a v e a d isp la y. A c o n c e r t b y B illy D a y a n d h is v e r s a tile a rtists fo llo w ed. D u r i n g th e in te rva l th e C h a ir m a n (C d . S u p t. C o llin s) introd u ced the M ayo r. T h e M a y o r s p o k e o f t h e p l e a s u r e it g a v e h e r t o b e a m o n g s t th e y o u n g a n d to se e t h e k e e n n e s s s h o w n in so n ob le a w o rk . T h e r e c o u ld be no g r e a t e r se rv ice t h a n th a t of v o lu n ta rily h e lp in g the u n fo rtu n a te m em b e rs of the c o m m un ity. P r e lim in a ry a n d re -e x a m in a tio n certificates w e r e th en presented , also band a w a r d s a n d the C a d e t D iv isio n a l C u p s. C a d e t O ffic e r C h ild th en a s k e d th e M a y o r to m a k e a p resen ta tio n on b e h a lf of th e c a d e ts to C d . S u p t. C o llin s. It w a s his s ilv e r w e d d i n g a n n iv e r s a r y . M a k i n g th is p resen ta tio n (a silv e r salver), the M a y o r h o p e d t h a t it w o u l d b e a r e m i n d e r o f m a n y p l e a s a n t a s s o c i a tion s, a n d of th e fa c t th a t h is w o r k h a d b een a p p re c ia te d . S u p t. C o llin s, a c k n o w l e d g i n g th e g ift, a s s u re d th e m the p r e s e n t w o u l d fi n d a p l a c e o f h o n o u r in h i s h o m e . D iv . S u p t. H a r b o ttle, E lth a m D iv isio n , ex p re sse d the t h a n k s of th e c a d e ts ‘to th e M a y o r, th e c a d e ts a lso p a y in g v o cal tribu te. H e a ls o th a n k e d th e c a d e ts fo r th eir h ospitality. D u r in g the seco n d h a lf of the concert, a b r e a k w a s m a d e for D istrict O fficer H a llo c k , S o u th e rn A re a , w h o b ro u g h t a m e s s a g e fr o m th e A r e a C a d e t O fficer. T h e la tte r g r e a tly r e g r e tte d h is in a b ility to a tte n d , b u t c o n g r a t u la t e d C 1 4 D i v i sion o n th e ir s p len d id a c h ie v e m e n t s .

County of Berkshire. H u n g e r f o r d . — O n S u n d a y a fte r n o o n , J u ly 29th, a t th e C o rn E x c h a n g e , H u n g e r fo r d , th e a n n u a l in sp ectio n to o k p la ce of H u n g e r fo r d A m b u la n c e a n d N u r s in g D iv isio n s. T h e in s p e c tin g officer w a s th e C o u n t y C o m m is s io n e r (M r. C. A. P o o le) w h o w a s a c c o m p a n ie d b y m e m b e rs of the C o u n ty S taff. T w e l v e officers a n d m e m b e r s of th e A m b u la n c e D iv isio n w e re on p a ra d e u n d e r th e c o m m a n d of D iv . S u p t . M a r t in , a n d s i x officers a n d m e m b e r s of th e N u r s i n g D iv isio n u n d e r D iv . S u p t. M rs. N e ate , J .P . A fte r th e in sp e ctio n , th e C o u n t y C o m m is s io n e r said h o w p lea sed h e w a s w ith th e k e e n n e s s a n d efficien cy of the A m b u la n c e D ivision .

K i n t b u r y . — O n S a tu r d a y e v e n in g , J u ly 29th, at th e C o ro n a tio n H a ll, K in tb u r y , th e a n n u a l in sp e ctio n of K in t b u r y N u r s in g D iv is io n w a s h eld. T h e in s p e c t in g officer w a s the C o u n ty C o m m issio n e r, w h o w a s a c c o m p a n ie d b y m e m b e rs of th e C o u n ty S taff. F o u rteen m em b ers w ere on parad e under th e c o m m a n d of C o u n t y O fficer L a d y S p ic k e rn e ll. T h e C o m m i s s i o n e r s a i d h o w v e r y p l e a s e d h e w a s t o fin d K i n t b u r y s u c h a v e r y efficien t D iv is io n a n d c o n g r a t u l a t e d t h e m , p a r t i c u l a r l y o n t h e i r s m a r t n e s s in d r i l l i n g .

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S a t u r d a y a f te rn o o n , J u l y 28th,

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A m b u l a n c e H a l l , C h a t h a m S t r e e t , a c o m p e t i t i o n in f i r s t a i d a n d h o m e n u r s i n g for th e D r . H o w i t t C u p , w a s h eld b e tw e e n t e a m s fr o m th e D iv i s i o n s of R e a d i n g N u r s i n g C o r p s . F ive t e a m s e n tered , th e w in n e r s b e in g te a m N o . 3 fro m R e a d i n g P o s t O ffice N u r s in g D ivision , cap tain ed by A m b u la n c e O ffic e r M r s . W o o lle y , w it h 13 9 m a r k s o u t of 168. T h e cu p , w h ic h w ill be held for 12 m o n th s, w a s p r e s e n t e d to t h e w i n n i n g t e a m b y th e C o u n t y C o m m i s s i o n e r . A fte r th e co m p e titio n , a silv e r c u p w a s h a n d e d to the C o u n ty C o m m is s io n e r b y C o u n ty O fficer M iss D . K . G ib b in s w h i c h h a s b e e n g i v e n to th e N u r s i n g C o r p s b y M is s E . C l in c h a s a t h a n k o ffe r in g for h e r r e c o v e r y fr o m a s e r io u s a c c id e n t. T h i s c u p w ill be th e tro p h y fo r a ch ild w e lfa re co m petitio n . M is s C l in c h w a s w a r m l y t h a n k e d for h e r w o n d e r f u l g ift.

W o o l h a m p t o n . — O n S u n d a y a fte rn o o n , J u ly 29th, at W o o lh a m p to n S ch ool, W o o lh a m p to n a n d B rim p to n N u r s in g D iv is io n h eld th eir a n n u a l in sp ectio n . T h is w a s carried out by the C o u n ty C o m m issio n e r. E i g h t o fficers a n d m e m b e r s w e r e on p a ra d e u n d e r th e c o m m a n d of D iv . S u p t. M rs. Bow den. A fte r th e in spectio n , th e C o u n ty C o m m is s io n e r presen ted fiv e m e d a llio n s to m e m b e r s , a n d s a id h o w p le a s e d h e w a s to w e l c o m e t h e m a s t h e y o u n g e s t D i v i s i o n in t h e c o u n t y a n d t o f i n d t h e m s o e f f i c i e n t in e v e r y w a y .

R e a d i n g . — D u r i n g t h e w e e k A u g u s t 1 1 t h — 1 8 t h , f if t y t w o officers a n d m e m b e r s of T o w n “ A , ” T o w n “ B ” a n d T h e a le A m b u la n c e C a d et D iv isio n s a tten d ed a c a m p w h ich w a s h eld a t S ta m fo r d E n d F a r m , S w a llo w fie ld , t h r o u g h the k i n d n e s s of M r. D a n c e . A v e r y e n jo y a b le tim e w a s spent, t h e a c t i v i t i e s i n c l u d i n g f i r s t a i d t r a i n i n g , b a t h i n g in t h e L o d d o n a n d a r a m b l e to W e l l i n g t o n M o n u m e n t . W e d n e s d a y w a s v i s i t o r ’s d a y , a n d d u r i n g th e a f t e r n o o n , d i s p l a y s o f s q u a d d rill, p h y s i c a l e x e r c i s e s a n d first a id w e r e g iven . R a c e s w e r e h eld fo r the v isito rs a n d th e d a y en ded w i t h a c a m p fire s i n g - s o n g . T h e c a m p w a s in c h a r g e o f C a d e t S u p t . F . G . C a r t e r a s s i s t e d b y C a d e t O f f i c e r s J. L o a d e r a n d H . L . W i c k e n s .

County of Hampshire. ISLE

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E . C o w e s . — T h e J. S . W h i t e s e c t i o n o f t h i s D i v i s i o n h e ld its 3 rd a n n u a l c o m p e t it io n fo r t h e “ M iln e C u p , ” a t S o m e r to n W o r k s , on S a t u r d a y , A u g u s t 25th ; fo u r te am s com peted. A v e r y fin e d is p la y of first a id w a s g i v e n , a n d the sp e c ta to rs in clu d ed A s s is ta n t C o m m is s io n e r D r. K e n n e d y , C o u n t y O ffic e r B a k e r , a n d C o l. a n d L a d y S u p t. S p ice r, d o n o rs of “ S p ic e r C u p , ” a c u p to b e co m p e ted for a n n u a l l y in I . O . W . T h e J u d g e s w e re D iv . S u r g e o n W . K e lly a n d Supt. L o w e i n ; p rizes a n d c u p w e r e p r es en te d b y M rs. M iln e, w ife o f d o n o r o f c u p , w h o is a l s o P r e s i d e n t o f t h e D i v i s i o n a n d M a n a g i n g D i r e c t o r o f J. S . W h i t e , S h i p b u i l d e r s , C o w e s . T h e c u p w a s h eld b y S o m e r to n w h o w e re a g a in w in n ers. T h e r e s u l t w 'a s 1 s t , S o m e r t o n W o r k s ; 2 n d , E n g i n e W o r k s “ A ” ; 3rd, B o a t B u i ld i n g D e p t. C o l. S p ic e r p resen ted L a y C e r ti f ic a t e s to C o r p o r a ls M a c d o n a l d a n d L a v e r y , a n d g a v e a p l e a s i n g a c c o u n t o f first a id on t h e I s l a n d . T h e s e c t i o n is r u n n i n g a M e d i c a l C o m f o r t s D e p o t , a s c h e m e is a l s o u n d e r w a y f o r a m o t o r a m b u l a n c e , s o t h a t u n d e r A m b . O f f i c e r W . T u fT t , a b r i g h t f u t u r e s e e m s in C o w es

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County of Lancashire. A t i i e r t o n . — T h e e n ro lm e n t c e re m o n y of th e A th e rto n A m b u l a n c e a n d N u r s in g D iv is io n s to o k p la ce on S a tu rd a y , A u g u s t 18th. D iv . S u r g e o n E . W . M . S h a w (B u ry ) w ish e d t h e C a d e t s l u c k a n d s t r e s s e d t h e n e e d o f S t . J o h n ’s A m b u

R I D la n c e m e m b e r s a s w e lf a r e w o r k e r s in m in e s a n d fa cto rie s. S h e s a id th e r e w a s p le n t y of w o r k to be d o n e a n d t h e y w o u ld b e a b o o n a n d a b l e s s i n g t o d o c t o r s if t h e y d i d t h e i r f i r s t a i d w o r k w ell. C h a ir m a n of th e C o u n c il, C o u n . J M a sse y , m o v in g a vote o f t h a n k s to D i v . S u r g e o n S h a w , s a id th e S t. J o h n ’s m e m b ers h ad proved th eir v a lu e tim e a n d tim e a g a in , a n d th ey w e r e p le a s e d to k n o w th e y o u n g e r g e n e r a t i o n w e r e f o l l o w i n g in t h e i r f o o t s t e p s . C o u n . H . P a r t i n g t o n m o v e d a v o te of t h a n k s to the P residen t of the D iv tsio n , C o u n . C. F le tch er, J . P . , O .S t .J ., for p re s id in g a t th e cere m o n y . C e r t i fi c a t e s w e r e p r e s e n t e d b y D i v . S u r g e o n S h a w for fi r st a i d , h o m e n u r s i n g , c h i l d w e l f a r e , A . R . P . , fi re f i g h t i n g a n d k n o w le d g e a n d ca re of a n im a ls. P roficien cy b a d g e s w e r e a ls o p r e s e n te d to s e v e r a l c a d e ts . A play ‘ ‘ T h e y never fa il,” w a s g iv e n by the cadets s h o w i n g h o w m e m b e r s of the B r ig a d e rise to a n e m e r g e n c y . T h e y also g a v e a d e m o n stra tio n of the M a lte se C ro ss, e x e c u t e d in b a n d a g e s . R e fr e s h m e n ts w e re served, fo llow ed b y d a n c in g .

County of Warwick. S t o c k i n g f o r d . — T h e th ird a n n u a l c a m p of the S t o c k in g ford C a d e t s w a s h eld fr o m A u g u s t 4 th to 1 1 t h in c lu siv e , at W a r w i c k , u n d e r th e c o m m a n d of C a d e t S u pt. A s h b y assisted by P riv a tes P a r k e r a n d K e m p of the sen ior D ivision . A c a m p in sp ectio n w a s held on S u n d a y , A u g u s t 5th, b y th e C o u n ty C o m m is s io n e r M a jo r E . S. Ph illips, D . S . O . , C o u n t y O ffic e r G . J. F o w le r , C o r p s O ffic e r N . E . N e w a ll, and Supt. F. G azeley. A m o n g o t h e r s p r e s e n t w e r e M r . A . J. P e a rc e (P resid en t) a n d S e r g e a n ts A. S tan field a n d A. V e a s e y . T h e c h u r c h p a r a d e w h i c h fo llo w e d a t S t. M a r y ’s C h u r c h , L e a m in g to n S p a , w a s h ea d ed b y the C a d et B u g le B a n d , and on th e re tu r n to th e c a m p th e in s p e c t in g officers ( w ith th e exc ep tio n of th e C o m m issio n e r w h o h a d a previo u s e n g a g e m en t) w e r e e n ter ta in e d to lu n ch . O n S u n d a y e v e n in g a vio le n t th u n d e r s to r m d evelo p ed , a n d the ca d e ts w e r e e v a c u a te d to th e L e a m in g t o n S p a St. John A m b u la n c e H e a d q u a rte rs w h er e th ey spent the n igh t, t h a n k s to th e C o m m is s io n e r a n d S u p t. C h e c k l e y o f L e a m i n g ton D iv isio n . F u ll a d v a n t a g e w a s t a k e n of b a t h i n g facilities w h ic h w e re m a d e a v a ila b le b y the L e a m in g t o n B o r o u g h C o u n cil. O n F r i d a y e v e n in g a lo r ry full of so ld ie rs p u lled up s h a r p ly to a v o id a n a c c id e n t a n d th e m e n w e r e t h r o w n into a h e a p a n d b a d ly b ru ised a n d s h a k e n . T h e C a d e t Supt. and C a d e t s re n d e r e d first a id w h e r e n e c e s s a r y a n d w e r e d u ly th a n k e d for th eir services. A lto g e th e r a re a lly e n te r ta in in g a n d in stru ctiv e c a m p w e e k w a s e n jo y e d b y a ll co n ce rn e d , sp o rts a n d c o n c e rts w e r e a r r a n g e d a n d i n s t r u c t i o n o n fir s t a i d k e p t t h e b o y s w e l l o ccu pied . T h e w e e k ’s festiv itie s w e r e b r o u g h t to a clo se w it h h u g e b o n fire s a r o u n d w h ic h a ll jo in e d in s i n g i n g w ell k n o w n songs. T h e w h o le c o m p a n y w a s co n g ra tu lated by the C o m m issio n e r, w h o p a id th ree visits to th e c a m p d u r i n g the week.

County of Worcester. H a l e s o w e n . — T h e e n r o lm e n t c e r e m o n y o f this n e w l y f o r m e d C a d e t A m b u l a n c e D i v i s i o n w a s h e l d r e c e n t l y , in t h e B ir m in g h a m S tre e t M eth od ist S ch o o l R o o m , H a le s o w e n . C o u n ty O fficer W in b o w a d d re sse d th e b oys on the H i s t o r y o f t h e O r d e r , a n d s u c c e e d e d , in t h e c o u r s e o f a n in t e r e s t in g ta lk , in s h o w i n g th e b o y s th e h i g h id e a ls a n d tru e p u rp o se of th e m o v e m e n t to w h ic h th e y w e r e n o w b e in g a d m itted . T h e fifteen b o y s w h o w e r e to b e en ro lled w e r e th e n lin ed u p befo re C o u n ty O ffice r W in b o w a n d repeated a fte r h im the

F I R S T oath of a lleg ien ce. M r. W i n b o w th e n p r e s e n te d to th e c a d e t s t h e i r fir s t a i d c e r t i f i c a t e s a n d b a d g e s a n d c o n g r a t u l a ted a ll th e b o y s on th eir p e r fo r m a n c e a n d a p p e a r a n c e . A n e x h i b i t i o n o f fir s t a i d w a s g i v e n b y t h e m e m b e r s o f th e n e w D iv isio n , a n d tea a n d re fr e s h m e n ts w e r e pro vid ed b y m em b e rs of th e A m b u la n c e D iv isio n a n d served by the m e m b ers of th e C a d e t N u r s i n g D iv isio n .

T h e N o r th W o r c e s te r s h ir e C o r p s held th eir e lim in a t in g r o u n d o f t h e L e c h m e r e C u p in t h e c a n t e e n o f M e s s r s . T . W . L e n c h L t d ., B l a c k h e a t h , on S a t u r d a y , S e p t e m b e r 1st. T h e r e w e re 5 co m p e tin g team s, v i z .: S te w a rts & L loyds, L a n g le y , T . W . Len ch, R o w le y R e g is , H aleso w en . The J u d g e s w e r e D iv . S u r g e o n R . M . B a r r o n , t e a m test, a n d D iv . S u r g e o n N . V . H e p p le , in d iv id u a l tests. O n e x a m in a tio n , th e patient, a y o u n g g ir l a g e d 12 w h o w a s s u p p o s e d to h a v e b e en t h r o w n fr o m a h o rse, w a s fo u n d to b e s u f f e r i n g fr o m a w o u n d of t h e left l e g a c c o m p a n i e d b y arterial h a e m o r r h a g e a nd a n em b ed d ed fo reign body, a w o u n d on th e rig h t tem p le w ith a rterial h a e m o r r h a g e , a fr a c tu r e d left c o lla r b o n e a n d f r a c tu r e d left fo r e-a rm . C o rp s Supc. T . C. L e n c h a n n o u n c e d th e re s u lts as f o l l o w s :— T . W . L e n c h , 2 5 2 m a r k s ; S t e w a r t s & L l o y d s , 227 ; H a l e s o w e n , 206 ; R o w l e y R e g i s , 17 8 ; L a n g l e y , 162. M r . L e n c h s a i d t h a t h e w i s h e d t o t h a n k t h e j u d g e s fo r t h e i r p a r t in t h e c o m p e t i t i o n , a n d h e w a s v e r y g r a t i f i e d t h a t o u t o f 6 D i v i s i o n s in t h e C o r p s , 5 h a d e n t e r e d t e a m s . C o u n t y S u r g e o n G . C . C a m p b e l l p r o p o s e d t h a n k s to C o rp s S u p t. T . C . L e n c h fo r a l l o w i n g th e m th e u se of th eir c a n t e e n in w h i c h t o h o l d t h e c o m p e t i t i o n , a n d a l s o f o r p r o v id in g s u c h a n e x c e lle n t tea.

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p resen ta tion of a w a r d s u n d e r th e c h a ir m a n s h ip of th e M a y o r of F o w e y (C o u n c illo r P. H . R o w e ), t o o k p l a c e in t h e T o w n H a l l . M r . J. S . P . P e a r s o n , d i s t r i c t traffic m a n a g e r , M r. A . W . H . C h r is tis o n , d iv is io n a l lo c o m o tive su p e rin te n d e n t, a n d M r. E. L a k e , d ivis io n al e n g in e e r , h a n d e d the a w a r d s to m e m b e r s of th e ir re sp e ctiv e d e p a r t m en ts, a n d M r. F. M. D a v i s , a s s is ta n t d istric t traffic m a n a g e r , p resen ted certifica te s to m e m b e r s of th e F o w e y D iv isio n , St. Joh n A m b u la n c e C a d ets. M r. A. B. O pie, q u a y su p e rin te n d e n t, M r. A llen , s ta tio n m a s te r , P a r, M a jo r W . J. D o u g l a s , p r e s i d e n t o f t h e S . J . A . B . , F o w e y , a n d M r . D . C o lm a n , cla ss s ecreta ry, w e re a lso present. A n e n jo yab le e n t e r t a in m e n t w a s a r r a n g e d b y M is s W in if r e d N ile. F

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T a u n t o n .— T h e a n n u a l co m p e titio n for th e “ L u ttre ll ” C u p w a s held a t T a u n t o n a n d yield ed the f o l lo w i n g re s u lts : “ B ” t e a m , 48 m a r k s ; “ C ” t e a m , 4 7 m a r k s ; “ A ” t e a m , 40 m a r k s . T h e a ju d ic a to r w a s D o c t o r G riffin , of H e m y o c k , a n d th o se p resen t in clu d ed M r. F. H o lla n d , d ivisio n al e n g in e e r , M r. H . A. G . W o rth , d ivisio n al su p e rin te n d e n t, a n d M r. A. W . H . C h ris tiso n , d ivis io n al lo c o m o tiv e s u p e r intendent. M rs. G riffin p res en ted the c u p to the w i n n i n g te a m , a n d a vote of t h a n k s to D r . a n d M rs. G riffin w a s p ro p o s e d b y M r . J. P a u l a n d s e c o n d e d b y M r . M o r r i s .

L.N.E.R. L a n g w i t h , w it h 24S£ p o in ts, w o n th e B u lw e ll a n d D i s tric t R a i l w a y m e n ’s A m b u l a n c e C h a l l e n g e C u p c o m p e t it io n h e l d in t h e g o o d s y a r d a t B u l w e l l C o m m o n L . N . E . R . S t a t i o n , after a b r e a k of six years.

O r d e r o f St. J o h n . T h e K i n g h a s s a n c t i o n e d t h e f o l l o w i n g p r o m o t i o n s in, a n d a d m i s s i o n s to , t h e O r d e r o f S t . J o h n o f J e r u s a l e m :— D a m e G r a n d C r o s s . — L a d y L o u is M oun tb atten (Superin te n d e n t-in -C h ie f, N u r s i n g C o r p s a n d D iv is io n s , S t. J o h n A m b u la n c e B rig a d e at hom e).

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P r i o r y f o r W a le s. T h e f o u r fir s t a i d c o m p e t i t i o n s a t t h e N a t i o n a l E i s t e d d f o d of W a le s , held at R h a s l l a n e r c h a n g o g , on M o n d a y , A u g u s t 6 th, w e r e w o n b y t e a m s fr o m T r e d e g a r , M o n m o u t h s h i r e . T h e “ L a d y L e w i s ” C u p a n d F i r s t A i d in C o a l M i n e s w e re w o n by P o ch in C o lliery, T r e d e g a r . T h e “ L a d y B ute ” C u p w a s w o n b y T r e d e g a r N u r s in g D iv isio n , a nd T r e d e g a r m a le C a d e ts w o n the “ I s c a ” S h ield.

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A l o n g - f e l t w a n t h a s b e e n fil l e d b y t h e p u b l i c a t i o n o f t h e a b o v e M a n u a l , b u t e n li g h t e n m e n t o n th e r e a s o n s of s o m e of its c o n t e n t s w o u ld b e w e lc o m e . O n p a g e 9 it s t a t e s t h a t “ A l l C a u t i o n a r y a n d E x e c u t i v e w o r d s o f c o m m a n d a r e in c a p i t a l s ” ; t h e r e s e e m s t o b e m a n y o t h e r w o r d s in c a p i t a l s t h a t c o u l d n o t b e u s e d in t h i s m a n n e r . I n t h e “ S q u a d D r i l l in T w o R a n k s ” s e c t i o n , s i z i n g a n d n u m b e r i n g (p. 29) a r e t h e la st m o v e m e n t s m e n t i o n e d . In “ F o r m a t i o n o f T h r e e s , ” s i z i n g ( p . 30 ) o c c u r s after t h e d r e s s i n g ; a n d t h e r e is n o m e n t i o n o f “ R e f o r m - l i n e ” a f t e r “ A d v a n c e i n s i n g l e f i l e ” (p. 30). T h e r e i s a l s o a r e v o l u t i o n a r y c h a n g e in t h e S t r e t c h e r E x e r c i s e s ; u p t ill n o w it h a s a l w a y s b e e n t h e p r a c t i c e t o h a v e th e ta lle s t a n d s t r o n g e s t m a n a s b e a r e r a t th e h e a d of th e stretch er, w h e r e a s n o w the sm a lles t m a n of each sq u a d b e c o m e s th e re a r b e a re r ; a n d th e a lte rn a tiv e w a y of liftin g t h e p a t i e n t o n t o t h e s t r e t c h e r (p. 5 7 ) s e e m s i m p o s s i b l e , u n l e s s a p r i n t e r ’s e r r o r h a s o c c u r r e d h ere. P e r h a p s o t h e r s l i k e m y s e l f h a v e t h e i r q u e r i e s , w h i c h if b r o u g h t to l i g h t w o u ld b e to o u r m u t u a l b e n e fit.— Y o u r s fa ith fu lly , “ F .R .G .”

R I D m in u tes, a nd w o u ld m a k e m y d em o n stra tio n s rea listic a n d a c t u a l l y p a in t w i t h w o r d s p ic t u r e s of t h e c i r c u m s t a n c e s of ca ses w ithin m y k n o w le d g e . I w o u ld question m y stu den ts a t every perio d — e n c o u r a g in g a lw a y s — n ever rid ic u lin g — a lw a y s en co u rag in g . I w o u ld c u t a n d co llect n e w s item s, re fe r to p e o p le k n o w n to u s, r e fe r to th e c a u s e s of d e a t h of g r e a t m e n , e tc ., a n d in e v e r y w a y s h o w th a t th e s t u ff I t e a c h is e v e r y d a y l i v i n g r e a l i t y . If I w e re a n in stru c to r I w o u ld g iv e r e g u la r h o m e w o r k ; I w o u l d m a r k it a n d c o r r e c t it f a i t h f u l l y , a n d p r a i s e t h o s e w h o did w e ll a n d h old t h e m u p a s g o o d e x a m p le s — b u t I w o u ld n ever m a k e a b ad “ e x a m p le ” of an yon e. H o m e w o r k w o u ld be fa m ilia r e x a m p le s — p la c e n a m e s ; c o m m o n e v e r y d a y acciden ts, a n d a s k fo r sim ple l a n g u a g e a n d stra ig h t t h i n k i n g in t h e i r a n s w e r s . I f I w e r e a n in s t r u c t o r 1 w o u l d d e v e lo p th e a b il it y to d r a w pictu res on the b la c k b o a rd , a n d w ith colou rs a n d w o rd s re a lly “ pain t a p ic tu re .” I f I w e r e a n in s t r u c t o r I w o u l d tell m y s tu d e n ts th e a rt of s t u d y i n g . “ A little a t a tim e, b u t o f t e n .” If I w e re an in stru cto r I w o u ld k n o w th e e ye lea rn s better th a n the ear. I w o u ld “ d o ” m ore th a n I w ou ld “ ta lk .” If I w e r e a n in s t r u c t o r I ’d t h e s t u d e n t s , n o t “ tell ” t h e m .

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I f I w e r e a n i n s t r u c t o r I w o u l d s a y to m y s t u d e n t s c e r ta in t h i n g s w e r e to b e d is c u s s e d n e x t p e r io d a n d c e r t a in in ju r ie s o r s it u a t io n s to b e h a n d le d . If I w e r e a n in s t r u c t o r I w o u ld b e o v e r jo y e d to le a rn o f o n e o f m y s t u d e n t s d o i n g s o m e t h i n g f i n e — s a v i n g a lif e , b e i n g p r a is e d b y a d o c t o r for s o m e t h i n g d o n e — a l w a y s p r a is in g h im .

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I w o u ld k n o w th at I had picked m y it h a d b e e n c o m p le t e d , I w o u ld w a n t to w h o m I a m a c c o u n t a b l e to see jo b .

I f I w e r e a n i n s t r u c t o r I ’d w a n t m y s t u d e n t s to k n o w m e b y n a m e ; to feel fr e e to c a ll on m e fo r h elp , y e t to k n o w t h a t 1 a m f o r e v e r w a t c h i n g f o r t h o s e w h o “ c a n n o t d o it rig h t.” If I w e r e a n in stru cto r I w o u ld w a n t th e best w a y a v a il a b le to p r e s e n t m y s u b je c t m a tte r , to feel c o m p le t e ly a s s u r e d th at s tu d e n ts a re not le a v in g th e lectu re h all w ith d ou bt, m i s u n d e r s t a n d i n g a n d c o n f u s i o n in t h e i r m i n d s . If I w e r e a n i n s t r u c t o r I w o u l d m a k e a n o c c a s io n a l s u r v e y of m yself. T h e s u rv e y w o u ld be con fid en tial, bu t I w o u ld h o p e to m a k e th e a n s w e r k n o w n to m y a s s o c ia te s . F ir s t , I w o u ld a s k m y c o n s c ie n c e if I w e r e d o i n g th e job to th e b e st of m y a b ility . I w o u ld t a k e m y s e lf on in spection tour. I w o u l d g o to th e c la s s r o o m w it h m ys e lf, sit on the sid elin es, a n d w a t c h th e re sp o n s e w h ile I t a u g h t . If they a ll w e re alert a n d g iv in g e n th u sia stic resp on se I w o u ld b e g i n to k n o w . If, h o w e v e r , I s a w o n e s t u d e n t s lo u c h e d d o w n in h i s s e a t ; o n e d o o d l i n g t h e t i m e a w a y ; a n o t h e r g a z i n g in to s p a c e w ith a ll th e b la n k n e s s th a t c o u ld b e fo u n d in a s ta r le s s s k y , I w o u ld a ls o b e g in to k n o w . I w o u ld k n o w t h a t th o se b la n k fa c e s n eed ed s o m e t h in g to e ra se th o se d is o r g a n is e d t h o u g h t s a n d p rep are a cle a n sla te u p on w h ic h I c o u ld w rite th e d esired im p ressio n s. are

I f I w e r e a n i n s t r u c t o r I w o u l d tell m y c la s s w h a t t h e y e x p e c t e d t o d o — I w o u l d p r e p a r e m y l e c t u r e f o r 45

T h e St. Joh n A m b u la n c e B r ig a d e o n ce m ore, A r e a g a i n , a s a l w a y s , to t h e fore, A g a i n w e ’re in th e p u b lic eye, B u t s t i c k t o g e t h e r , w e ’ ll g e t b y . W e m ust stand togeth er, each and everyone, R e a d y , in t h e t r u e s p i r i t o f S t . J o h n . N e v e r s a y y o u a r e d e a d b e fo re y o u d ie, J u s t s t i c k t o g e t h e r , w e ’ ll g e t b y . T h e p u b lic k n o w o u r w o r k a n d re n o w n , W e k n o w th a t th e y w o n ’t let u s d o w n , A n d th at se e m s to m e th e re a so n w h y , I f w e s t i c k t o g e t h e r , w e ’ ll g e t b y . L e t ’s c a rry on w ith our g o o d w o rk , L e t p e o p le s e e t h a t w e d o n ’t s h i r k , W e w o n ’t g i v e in w it h o u t a try. J u s t s t i c k t o g e t h e r , w e ’ ll g e t b y . W e h a v e g o o d m e n a t o u r h e a d to lead, B e r e a d y th en th eir ca ll to heed, A n d let th is be o u r b a ttle cry, W e ’ ll s t i c k t o g e t h e r , w e ’ ll g e t b y . S o b e p r e p a r e d t h e n , o n e a n d a ll, R e a d y to a n s w e r w h e n th e y call, W i t h h e a d s e re c t a n d held on h ig h , W e ’ ll s t i c k t o g e t h e r , w e ’ ll g e t b y .

P h i l i p A y l w a r d i n t h e Irish Ambulance Gazette.

F I R S T

R I D

I nvisible armour Y dipping his hands in biniodide— a form of iodine— the surgeon is able to operate w it h out rubber gloves under emer gency conditions. T h e invisible film of bacteria-proof armour pro vided b y the iodine is sufficiently strong to allow him to do this w ith complete safety. F ew antiseptics could make such a claim as this. A n d certainly no antiseptic serves m ankin d in such a v a r ie t y o f w ay s as iodine. I t is a specific in the treatm ent of goitre ; it is used in the trea tm ent o f 200 hum an diseases and 150 animal diseases. In industry its uses are legion. Iodine can be used in the manufactu re o f heat-sensi tiv e paint, films, polaroid, coloured

marble, brass wire, steel, silver-plate, dyes, tele graphic receiving papers and ca tgut. All t h a t is kn ow n to dat e abou t iodine has been recorded and collated b y the Iodine E d u c a tional Bureau. T his organization gives in forma tion and advice on the uses o f iodine in Medicine, In d u st r y and Ag riculture. T h e B u reau is r ead y to assist a n y in stitution or commercial en ter prise. There is no charge for this service.

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A I D to rn o ff b u t m e r e l y lifted , th e n a c t a s b e fo r e b u t r e p l a c e s c a lp in p o s i t i o n , i n t e r f e r i n g w i t h it a s l i t t l e a s p o s s i b l e a n d a w a i t th e d o c t o r ’s a r r i v a l . — N . C . F .

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 ie s m u s t b e m a r k e d on th e top left-han d co rn e r of th e en ve lo p e “ Q u e r y , ” a n d ad d ressed to F i r s t A i d , 46, C a n n o n - s t r e e t , L o n d o n , E . C . 4 . 2 .— A ll Q u e r ie s m u s t b e w r it t e n o n o n e sid e of p a p e r only. 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 fr o m th e c u r r e n t is s u e of t h e J o u r n a l, or, in c a s e of Q u e r ie s fro m a b ro ad , fro m a recen t issue. 4 .— T h e T e x t b o o k to w h i c h r e fe r e n c e m a y b e m a d e in th is c o l u m n i s t h e 3 9 t h ( 1 9 3 7 ) E d i t i o n ot t h e S . J . A . A . M a n u a l of F ir s t A id to th e In ju re d .

A n E x a m in a tio n E p iso d e. T . H . ( H a r r o g a t e ) .— H e r e w it h I se n d a rep o rt of a n episode w h i c h o n c e o c c u r r e d a t a f ir s t a i d e x a m i n a t i o n , in t h e h o p e t h a t it w i l l i n t e r e s t r e a d e r s o f F i r s t A i d :—

E x a m in e r — I w a n t y o u t o i m a g i n e t h a t y o u r w i f e h a s , a t y o u r r e q u e s t, b e e n a s k e d to fe t c h y o u a g l a s s of w ater. C a r r y i n g t h e g l a s s s h e s l i p s o n t h e fl o o r , b r e a k s th e g la s s a n d su sta in s a severe c u t on th e p a lm w ith a rterial h a e m o r r h a g e . W h a t w o u ld yo u do ? C an d id ate — B a n d a g e i t t i g h t l y . E x a m in e r — W h a t w o u l d y o u l o o k f o r b e f o r e b a n d a g in g the h a n d ?

C an d id ate — I d o n ’ t k n o w . E x a m in e r — M i g h t n o t t h e r e b e s o m e g l a s s i n t h e wound ?

T r e a tm e n t o f D ro w n in g . P .O . ( W o r t h i n g ) .— R e c e n tly so m e frien d s a n d I w e re d is c u s s in g th e f o l lo w in g p r o b lem b u t, a s w e failed to re a ch a g r e e m e n t , w e d e c i d e d t o p u t it b e f o r e y o u f o r y o u r k i n d d e c i s i o n :— I f a h o s p i t a l is o n l y 1 0 0 y a r d s a w a y a n d a s t r e t c h e r s q u a d i s a v a i l a b l e w h e n a m a n is t a k e n o u t o f t h e w a t e r not b r e a t h in g a n d a p p a re n tly d r o w n e d , sh o u ld w e be j u s t i f i e d in l o a d i n g h i m o n t h e s t r e t c h e r a n d r e m o v i n g to h o sp ita l w it h o u t fu r t h e r d e l a y ? N o ! S c h a f e r ’s o r i g i n a l i n s t r u c t i o n s w e r e to c o m m e n c e a r t i f i c i a l r e s p i r a t i o n :— “ im m e d ia te ly a fte r rem ova l from the ■water." T h e T e x t b o o k (p. 1 4 4 ) m o d i f i e d t h e s e a n d r e a d s : “ I j n a tu r a l b rea th in g is seen to be J a il i n g o r ca n n ot be d is

cern ed, a r tijic ia l m ean s of r e sto r in g it m ust be reso rted to at 07ice. ” In o t h e r w o r d s y o u m u s t c o m m e n c e a c ti o n on th e s e a sh o re ; a n d the s u g g e s t io n of lo a d in g stretch er a n d im m e d ia te t r a n s p o r t t o h o s p i t a l , h o w e v e r n e a r t h i s is , w i l l i n v o l v e d e l a y w h i c h m a y ro b th e p a tie n t o f his la s t c h a n c e of re s u s c ita tio n . — N.

C orbet

C an d id ate — Y e s. E x a m in e r — W h a t w o u l d y o u d o t o fin d o u t if t h e r e w a s g l a s s in t h e w o u n d ?

C an d id ate — I t h i n k t h e b e s t w a y w o u l d b e t o p i e c e t h e b r o k e n b i t s t o g e t h e r a n d if a n y p a r t w a s m i s s i n g it w o u ld b e in th e w o u n d . Good!

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1— N . C . F .

H u m o u r in F irs t A id . E . J . ( B o u r n e m o u t h ) . — A t a r e c e n t fir s t a i d l e c t u r e t h e d o c t o r u s e d a s k e l e t o n i n h i s d e m o n s t r a t i o n o f t h e b o n e s of th e sk u ll, t r u n k a n d lim b s. T h e lectu re h a d a lm o s t en d e d w h e n a m e m b e r of th e c la ss c a u s e d u s a ll to b u rst o u t l a u g h i n g w h e n s h e a s k e d — “ P le a se doctor, do w e a ll

h ave clip s in o u r sh u lls ? ” Good!

N ext, p lea se!

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F le tc h e r.

W h is k y a s A n tisep tic.

E x a m in a tio n H o w le r. E . V . ( B o s c o m b e ). — In a re ce n t e x a m in a t io n the d octor a sk e d o n e c a n d i d a t e h o w s h e w o u l d r e m o v e a m a n ’s t r o u s e r s if s h e h a d to tr e a t h im fo r c o m p o u n d f r a c t u r e of l o w e r en d of th ig h . H e w a s g r e a t l y a m u s e d w h e n s h e rep lied — “ W ith m y eyes sh u t tig h tly / ” Good!

N e x t , p l e a s e 1 1— N . C . F .

T r e a t m e n t o f I n j u r y to S c a lp . M .N . ( Y o r k ) . — S u p p o s in g th a t w e h a d to tre at a w o m a n w h o h a d b e en c a u g h t by a r e v o lv i n g w h e e l w ith the resu lt t h a t h e r s c a l p h a d b e e n t o r n off. W e w o n d e r w h a t is th e p r o p e r m e t h o d of r e n d e r i n g first a id ; a n d w e a w a i t y o u r r u l i n g w ith in terest. T r e a t in a c c o r d a n c e w it h G e n e r a l R u l e s fo r T r e a t m e n t of W o u n d s ( T e x t b o o k , C h a p t e r I X ) . C o n tro l h a e m o r r h a g e at first o p p o r t u n i t y w i t h full a n t i s e p t i c p r e c a u t i o n s ; a n d s u m m on m ed ica l a ssista n c e w ith o u t a m o m e n ts delay. Then t r e a t s h o c k a n d r e l e a s e s c a l p f r o m p u l l e y , p r o t e c t i n g it f r o m fu rth e r c o n ta m in a tio n sin ce the d o cto r w ill p ro b a b ly d ecide t o s t i t c h it b a c k in p o s i t i o n . I f, h o w e v e r , t h e s c a l p is n o t

O . M . ( E d i n b u r g h ) . — I h a v e b e e n t o l d t h a t w h i s k y is m o r e e f f i c i e n t in a n e m e r g e n c y t h a n b r a n d y , a s a n a n t i s e p t i c in t h e t r e a t m e n t o f w o u n d s . P l e a s e b e g o o d e n o u g h to t e ll m e if t h i s is a f a c t a n d a l s o w h a t s t r e n g t h o f s p i r i t sh o u ld be used. W h i s k y a n d b r a n d y a re useful as e m e r g e n c y an tisep tics b e c a u s e th ey co n ta in alco h o l. It h as b een c la im e d th at w h i s k y — b e in g a d istilla tio n p r o d u c t of th e fe r m e n ta tiv e e x tr a c t fro m m alte d an d u n m a lte d cereals, po tato es a n d o th er starch b e a r i n g m a t e r i a l — is m o r e e f f i c a c i o u s f o r c l e a n s i n g w o u n d s b e c a u s e b r a n d y — w h i c h is d i s t i l l e d f r o m f e r m e n t e d g r a p e ju ic e — con tain s oth er a g e n t s (in clu d in g c o lo u rin g m atter) w h ic h lim it th e a c tiv ity of a lc o h o l fo r th is p u rp o se. W h i s k y and b ra n d y can be used con cen trated a s pre s e n t e d i n t h e b o t t l e , t h e b e s t w a y t o u s e it b e i n g t o s p o n g e th e w o u n d w ith a m o p of c o tto n w o o l s o a k e d in th e spirit. — N .C .F .

T r e a t m e n t o f W a s p S tin g. E .I . ( G lo s s o p ) .— W it h re fe re n ce to th e E x a m in a t io n H o w le r w h ic h w a s subm itted by y o u r corresp on d en t M .R . (C a n n o n S t . ) a n d p u b l i s h e d in t h e A u g u s t i s s u e o f F i r s t A i d , m a y I s a y th a t I do n ot t h in k th a t th is w a s a h o w le r ? A fe w y e a r s a g o I w a s s t u n g b y a w a s p ; a n d , w h ile I w a s b e in g stu n g , m y m o th er k n o c k e d the w a s p off m y

F I R S T

ASTHMA, BRONCHITIS CATARRH, HAY FEVER

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I G L O- F DI R SI TN- A EI D “ It d o e s n ’ t h u r t In t h e le ast ” — Iglod ine can b e app lie d t o an o p e n w o u n d w i t h o u t pain. T h is safe, b u t p o w e r f u l antiseptic cle a n s es and heals cu ts, w o u n d s , b ru is e s, scald s and b u rn s.

and o t h e r R e s p ir a t o r y Su ff ere rs sh ou ld c o m m un ic a te w i t h British M ed ica L a b o ra to rie s, Ltd., f o r pa rticula rs o f “ S an olen ” t h e m o st efficaciou s H o m e R e m e d y k n o w n t o Medical S c ie n c e : N o w b ein g used w i t h r e m a r k a b l e s u cce ss e v e r y w h e r e : E n d o r s e d by t h e M ed ical Profe ss io n .

The PAINLESS Antiseptic U sed b y F a cto rie s, H o sp ita ls, and A m b u lan ce A u th o ritie s through o u t G r e a t B rita in .

B R IT IS H M E D IC A L A B O R A T O R IE S LTD. ( D e p t. Z .A .3 ) H e a t h c o t e R oad, B oscom be, B o u rn e m o u th .

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Tu n st all B and ag e W i n d e r eac h 6/6 S p lin t e r F orc e ps , pair 3/6

A N A T O M IC A L D IA G R A M S A N D C H A R TS FOR LEC TU R ES

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Fitted Pou ch es and H a v e rsa c k s a lw a y s in s t o c k . L e t us q u o t e f o r y o u r F irst A id r e q u i r e m e n t s . 4 5 , OX FORD S T R E E T , L O N D O N , W .l. ’ G r a m a j “ B ayleaf, L o n d o n /* ’P h o n e : G e r r a r d 3 1 8 5 & 2 3 1 3 .

FIRST AID — A Synopsis o f W a r -t im e Training b y J O H N F E N T O N , m .b ., B .c h ., b . a .o ., d . p .h . and L . A . H . S N O W B A L L , m . r . c .p ., F.R.c.s.(Ed.) FOR

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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 .

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A S e r i e s o f 1 5 C h a r t s c o v e r i n g all the d utie s o f a F i t s t A i d W o r k e r , g i v i n g fu ll inst ru ct io n s as t o A i r R a id effects a n d p r e c a u tions, re c o g n it io n and tre at m en t o f injuries. T h o I d e a l W a l l C h a r t . S i z e 2 2 J in . x 1 4 £ i n . , h a s b e e n p r e p a re d fo r u s e in A i r R a i d S h e lte 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 ll p l a 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 ir e d . P r i c e 7 s . 6d . P o s t a g e 6d. T h e H o m e C h a r t . 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 i n 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 . p o s t 3d.

P rin ted on stron g p a p er and m ou n ted on roller fo r hanging O b ta in a b le fro m D a l e , R e y n o l d s & C o . , L t d . , 4 6 , C a n n o n S t r e e t , L o n d o n , E .C .4 .

T h e r e l i a n c e j w h i c h f a c to r y workers place in their W elfare Nurse is co m parable w ith t h a t w hich she in t urn places in her F ir st A i d eq uip ment. R a p i d relief from pain and distress is no less essential in the N a t io n a l interest th an to the sufferer, and calls for the p rom pt ad m inis tr ation o f a safe analgesic and sed ative. T h a t is w h y ‘' A n a d i n , ’ a bala n ced co m b in atio n in t h e aspirinphen ac etin-caffeine group, is reg arded as indispensable in F a c t o r y W elfare work.

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n e c k a n d k i l l e d it. T h e s t in g cou ld be seen a n d w a s e x t r a c t e d b y th e s a m e m e t h o d ( n a m e l y b y m e a n s of a w atch key). W h e n e x t r a c t e d , I e x a m i n e d it ; a n d I fo u n d t h a t it w a s lik e a h y p o d e r m i c s y r i n g e — a s h o r t b a rre l w ith n eed le a t end. In cid en tally, a w a tc h k e y ca n be sterilised a s e a s ily a s a n eed le ; a n d p r e s s in g a w a t c h k e y o v e r th e site of th e s t in g d r a w s ou t th e s t in g w ith o u t fu rth e r p u n c tu r in g the sk in . T u t ! T u t ! W h a t next ? In spite of y o u r p rotest th e h o w l e r is s t i l l a h o w l e r b e c a u s e it d e a l t w i t h a w a s p w h i c h liv e d to s t i n g a g a i n . O n the oth er h an d , yo u r exp erien ce re la te s to a w a s p w h ic h w a s k ille d a t the m o m e n t of s t in g in g a n d w a s s e p a r a te d fr o m its s t i n g . — N . C . F .

R I D ro u n d th e a n k le s o n ly. I s t h i s p r a c t i c e c o r r e c t ; a n d if s o , is t h e r e a n y s p e c i a l r e a s o n w h y t h e T e x t b o o k d o e s n o t r e f e r t o it ? W e w e lco m e y o u r k in d ru lin g. Y o u r m e t h o d is n o t c o r r e c t , b e c a u s e a b a n d a g e r o u n d t h e a n k l e s is n o t a s e f f e c t i v e i n f i x i n g l i m b t o l i m b a s a b a n d a g e r o u n d a n k le s a n d feet. C o n s e q u e n tly the la tte r sh ou ld a l w a y s b e a p p l i e d , if a t a l l p o s s i b l e . F u r t h e r , it is n o t t r u e — a s m a n y first a id e r s i m a g i n e — t h a t th e f ig u r e - o f- e ig h t b a n d a g e w ill c a u se e xte n sio n of th e co m p o u n d fr a c tu re .— N .C . F.

E v e r s io n o f F oot. A sso ciatio n A w a rd s . R .N . (S o u th S h ie ld s ).— O u r C o rp s, v iz., S m ith s D o c k s A m b u l a n c e C o r p s , w h i c h is p u r e l y A s s o c i a t i o n , w a s e s t a b l i s h e d In 1 9 3 0 , t h e f i r s t e x a m i n a t i o n b e i n g h e l d in 1931. T h r e e fo u n d e r m em b e rs, in c lu d in g m yself, h a v e b een s u c c e s s fu l in p a s s i n g a ll 15 e x a m i n a t io n s d o w n th e years. M a y I r e s p e c t f u l l y a s k y o u if t h e r e is a n y a w a r d f r o m th e St. J o h n A s s o c ia t io n fo r s u c h s e r v i c e ? O n th e R a i l w a y s , a m b u l a n c e w o r k is c a r r ie d on b y m e m b e r s w h o a r e “ p u r e l y A s s o c i a t i o n ” ; a n d in s p e c i a l c a s e s s o m e h a v e b e en m a d e m e m b e r s of T h e O r d e r of S t. J o h n ( o n t h e r e c o m m e n d a t i o n o f t h e i r s u p e r i o r o f f i c e r s ) in r e c o g n itio n of th eir g o o d w o r k o v er m a n y years. Presum a b l y , t h e r e f o r e , s i m i l a r c o n s i d e r a t i o n w o u l d b e g i v e n to m e m b e r s o f y o u r C o r p s if t h e r e h a v e b e e n c a s e s o f c o n s p i c u o u s s e r v i c e a n d if t h e f a c t s w e r e b r o u g h t t o t h e n o t i c e o f t h e a u t h o r i t i e s a t S t. J o h n ’s G a t e . — N . C . F .

F racture on R a ce C ourse. R .N . (S o u th S h ie ld s ).— A t a re ce n t c o m p etitio n , the team t e s t w a s a n a c c i d e n t o n a R a c e C o u r s e in w h i c h t w o le a d i n g rid ers w e re t h r o w n w h ile t a k i n g the h urdles. O n e p a tie n t h ad a fr a c tu re of le g . B oth cases w ere d o n e u p o n th e spo t. Y e t t h e j u d g e , in s u m m i n g u p , s a id t h a t n o o n e h a d m o v e d th e p a t ie n t s to t h e s id e of t h e C o u r s e b e fo re a tte n tio n w a s g iv e n to th e in ju ries, th is b e i n g n e c e s s a r y o n a c c o u n t of th e d a n g e r fr o m o th e r h o rses j u m p i n g the h u rd les. M y o p i n i o n i s t h a t a ll h o r s e s w o u l d h a v e b e e n o v e r h u r d l e s b e f o r e a n y f ir s t a id e r c o u ld h a v e g o t to th e p atients. M a y I h a v e y o u r o p in io n on th is test, sir, b e c a u s e to m y w a y of t h i n k i n g it g o e s a g a i n s t th e t e a c h i n g of the T e x t b o o k ? P e n d i n g this, I te n d e r m y b e s t th a n k s . Y o u r c o m p e titio n j u d g e a lo n e k n e w all th e c ir c u m s t a n c e s on w h ic h th e te a m test w a s fr a m e d ; a n d e vid e n tly he v isu alised s t r a g g le r s c o m in g late over the h u rd les. A lso h e w a s b e a r i n g in m i n d t h e l a s t p a r t o f R u l e 1 in t h e G e n e r a l R u l e s f o r T r e a t m e n t o f F r a c t u r e s ( T e x t b o o k p. 6 6 ) w h e r e y o u a r e told t h a t th e fr a c tu r e m u s t re c e iv e a tte n tio n on th e spot u n l e s s l i f e is in d a n g e r f r o m s o m e o t h e r c a u s e . F urther, I t a k e it t h a t h e w o u l d h a v e a n s w e r e d a n y e n q u i r i e s a s t o w h e th e r or not the C o u r s e w a s clea r w h e n y o u rea ch e d the p a tien ts. I n o t h e r w o r d s , h i s r u l i n g w a s , in m y o p i n i o n , g o o d first a id a n d p e rfec tly s o u n d . — N . C . F .

H . L . ( C a r d i f f ) . — I s h a l l b e g r e a t l y o b l i g e d if y o u w i l l k i n d l y tell m e w h y t h e foot u s u a l l y lie s o n its o u t e r s id e w h e n t h e r e is a f r a c t u r e o f t h e f e m u r . T h e n a t u r a l p o s iti o n of o u r fe e t w h e n w e lie on o u r b a c k s , a n d o u r l o w e r l i m b s a r e u n b r o k e n , is “ t o e s u p . ” E v e r s i o n o f t h e f o o t is d u e p a r t l y t o t h e W 'e ig h t o f t h e fo o t a n d p a r tly to th e a n a t o m i c a l a r r a n g e m e n t o f th e m u s c l e s a t t a c h e d t o t h e f e m u r ; a n d it t a k e s p l a c e w h e n t h e c o l u m n o f t h e l o w e r l i m b is b r o k e n . W h e n p r e s e n t , t h e r e f o r e , it is a lm o s t p ositive e v id e n c e of fr a c tu re of the n e c k of th e fe m u r ; b u t it is s o m e t i m e s s e e n w i t h f r a c t u r e o f t h e s h a f t o f t h e fe m u r a n d also w ith fractu re s of both bo n es of the l e g . — N .C .F .

H u m o u r in F irs t A id . G .J . W . ( H u ll) .— D u r in g the w a r , a t th e C ivil D e fe n c e F .A . P ., I u s e d t o h a v e s o m e v e r y i n t e r e s t i n g t a l k s o n fir s t a i d w it h a pal w h o w a s k n o w n t h r o u g h h is e fficien cy at in c id e n t s , to be a first c l a s s first a id e r. O n e tim e he surprised m e by s a y in g th at he a lw a y s c a r r i e d a f l a s k o f b r a n d y w i t h h i m in c a s e o f n e c e s s i t y . W i t h a t w i n k l e in h i s e y e s , h e a d d e d “ I j u s t take a nip.

I c a n 't b ear to see oth er p e o p le su ffer ! " Good!

N ext, p le a se !

P o is o n in g b y C a rb o n M o n o xid e. R . F . (V a n c o u v e r, B .C .) .— D o u b tle ss so m e one w ill h a v e p o i n t e d o u t t h e p r i n t e r ’s e r r o r i n y o u r r e p l y w h i c 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 J u l y i s s u e o f F ir st A id . O f cou rse you w ro te “ o x y g e n w ith 5 per cent, ca rb o n d io x id e .” F o r y o u r in fo r m a tio n , on th is c o n tin en t, fo r the p a st t w e lv e y e a r s or so, th e p e r c e n t a g e o f c a r b o n d io x id e u se d fo r this p u rp o s e h a s b e en 7 p e r cen t, in s te a d of the fo r m e r 5 per cent. T h a n k s fo r letter. M is fo r tu n e still p u r s u e s th e re p ly p u b l i s h e d in t h e J u l y i s s u e , b e c a u s e in t h e c o m m e n t t h e r e o n , w h i c h a p p e a r e d in t h e A u g u s t i s s u e , t h e r e is a l s o a n u n im p o r ta n t a n d self e v id e n t m is q u o ta tio n .— N . C . F .

“

C o m p ou n d F racture of L eg. J .M . ( W e y m o u t h ) .— In th e c a se of a c o m p o u n d fra c tu re of th e lo w e r lim b in w h i c h th e b o n e p r o tr u d e s , a n d for w h i c h e x t e n s i o n is n o t t h e r e f o r e a t t e m p t e d , it is t h e p r a c tice in th is D iv is io n n ot to a p p ly a fig u r e -o f-e ig h t b a n d a g e r o u n d a n k l e s a n d feet, b u t to b e c o n t e n t w i t h a b a n d a g e

!— N .C .F .

Q U E R Y

F I R S T

an d

A I D

R E P L I E S

” C O U P O N .

To be cut out and enclosed with a ll Queries. Sept., 194 5 .

M AN U ALS OF FIR ST A ID By N. CORBET FLETCHER, O.B.E., M.B., B.C., M.A.(Cantab.>, M.R.C.S. A ID 8

T h e

F IR ST -A ID .

S e v e n th E d i tio n . I s . 3 d . p o s t 2 d . F irs t-A id S im p lifie d a n d T a b u l a t e d , w ith A id s t o

M em o ry .

Col. Sir James Cantlie contributes an introduction and we endorse his good opinion of the book."— L a n c e t , A ID 8

H O M E -N U R SIN G .

T h i r d E d i tio n . P r ic e 1 a . 2 d . , p o s t fre e . H o m e - N u r s i n g S im p lif ie d a n d T a b u l a t e d , w i t h A id s t o

“

M em o ry .

This booh wonderfully simplifies a complex subject and should be read by students. ” — L . & N . W . R v . G a z b t t b . E F F IC IE N C Y

H e a lin g H a n d ’

F IR ST -A ID .

F o u r th E d itio n . P r ic e 1 s . 3 d . p o s t 2 ^d. P r o b le m s in S t u d y , T r e a t m e n t a n d E x a m in a t io n s o lv e d / o r S e n i o r S t u d e n ts . “

Without doubt the book will be or JP'e&t service in the training of thosefo> whom it is designed. ’ — B r i t i s h M e d i c a l T o u r n a l . C O M M O N

E R R O R S

T h i r d E d i ti o n .

F IR ST -A ID .

I s . 3 d . p ost 2 d .

E r r o r s In F ir s t- A id D e ta ile d a n d E x p la in e d .

11This bookgives a clearer insight into the methods anddifficulties o/ emergency treatment by laymen than the official Textbook itself. " — L a n c e t . A M B U L A N C E

C O M P E T IT IO N

T E ST S.

( S tr e tc h e r , I n d iv i d u a l a n d Q u e s t io n — S ix F o ld e rs ^ . P r ic e 6 fo r 3s . p o s t 3 d .. E a c h F o l d e r c o n ta in s s p e c ia l a r t i c l e o n C o m p e titio n s : N o . i , T r a i n i n g o f C o m p e titio n T e a m s ; N o . 2, C o n d u c t o f T ^ a m in C o m p e ti ti o n R o o m ; N o . 3, C o m m o n E r r o r s in C o m p e ti ti o n ; N o . 4, F u r t h e r E r r o r s in T r e a t m e n t ; N o . 5 , H i s t o r y o f C o m p e titio n T e s ts ; N o . 6, P r e p a r a t i o n o f T e s ts .

W H Y

A N D

W H E R E FO R E

F IR ST -A ID .

F i f t h E d i tio n . I s . 3 d . p o s t 2 d . D if fic u ltie s In S tu d y a n d T r e a t m e n t s o lv e d b y Q u e s tio n a n d A n s w e r.

11We commend this H IN T 8

book to Lecturers and Students who will find it of &rext service.”— F i r s t A i d . FOR

H O SP IT A L

O R D E R L IE S.

P ric e 9 d . P o s ta c e 2 d . O r d e r ly D u tie s S im p lif ie d a n d T a b u l a t e d , w i t h A id s t o

M em o ry .

A most compact brochure . . contains much useful information.”—P r b s c r i b e r To be obtained from 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 .

C la ss ifie d

A d v e rtis e m e n ts.

A d v e r t is e m e n t s w it h re m it ta n ce sh o u ld be sent t o F i r s t A i d , 3d . p e r w o r d , m in im u m 4 / 6 .

46, C a n n o n S tre et, L o n d o n , E . C 4 .

200 C o n c e r t T i c k e t s 5/6. M e m o s , R u b b e r S ta m p s , R o ll T ic k e ts , S am ples-T iC E S , 1 1 , O a k la n d s G ro ve , L o n d o n , W .1 2 .

FIR ST -A ID

C O M PE T IT IO N

T R A IN IN G .

H E best g u id e for c o m p etito rs. B a s e d on a c tu a l exp eri‘ ence. l i d . P o s t f r e e ( 8 /- d o z e n ) F o u n t a i n P r e s s , 46 , C h a n c e r y L a n e , L o n d o n , W . C . 2.

D O I S O N S C H A R T — H a n d y Q u ic k R eferen ce— T re a tm e n t I a n d R e m e d i e s f o r 30 d i f f e r e n t p o i s o n s . H a w k i n s , l i d . P o s t f r e e ( 8 /- d o z e n ) . F o u n t a in P r e s s , 46, C h a n c e r y L a n e , L o n d o n , W . C . 2.

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19 4 5 .

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O IN TM E N T

O n e o r o t h e r o r all o f the three races o f g e r m s , S t r e p io c p 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 rc f o u n d in e v e r y sk in in fe ctio 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 in is) o f these g e r m s . H e a li n g is e xp e dit e d b y the p r o v e d in g re d ie n ts o 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 pr e v e n te d b y its a n t iv ir u s ste rile 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 nsu rp ass ed f o r B U R N S a nd S C A L D S , f o r it is m ic r o b ic id e a nd n on -a dh esi ve, and d r e s s in g s d o n o t r e q u ir e to be c h a n g e d e v e r y d a y . W O U N D S , B U R N S , e t c , W I L L N O T T U R N S E P T I C i f treated w i t h A N T I P E O L O I N T M E N T .

O P H TH A L M O -A N T IP E O L i s a semi-fluid o in t m e n t , m o r e co 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 ocu la r infections a nd lesions. 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 st im m ed ia tely b y the a ppli 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 ntiv ir 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 .

R H IN O -A N TIP E O L affords rapid re li e 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 the a n tib od ie s o f the g e r m s c o m m o n to in fection s o f the n o s e and ph a r y n x (S taph ly lo co cci, S tre p to co cci, 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 . cata rr h alis , B. Pfeiffer), R b i n o - A n d p e o l is n o t ju st a pa lliative , b u t is a r e m o v e r o f the cause o f the infect ion. D u r i n g epid e m ic s it is the ideal p r e v e n ti v e o f m ic r o b e d ev e lo pm e n t.

C lin ic a l S a m p le * o n r e q u e s t f r o 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 I E S L T D ., C a r g r e e n R o a d

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CONTENTS

F .R .S a n .l.,

O CTO RFR 1943

V oi TTI VOL. L itl.

N O TIC E

SC O TT,

M uch

attention has been di-

Remission of rected of late in the press to the Training. shortage of nurses, and it cer

tainly is disquieting to read, for example, that the Royal Hampshire County Hos pital, Winchester, which has a waiting list of 900 patients, may have to close 80 beds because of short age of nurses and domestic staff. Among state ments which have been made is one to the effect that at the present time this country needs 30,000 more nurses. Hospital wards remain closed for lack of nursing staff, and waiting lists for admis sion to hospitals are mounting, and, in default of an authorised denial, the statement, made as it has been by a duly qualified medical practitioner, must be accepted as somewhere near the mark. All that one can hope is that it is not an under statement. Much'has been done in recent years by way of bettering the lot of trained nurses, but very much remains to be done. Such an announcement as that recently made, “ wartime nurses who satisfy certain conditions will be allowed six months’ remission in their training for State registration,” is not likely to operate as an incentive to recruiting into the ranks of the pro fession. During war much valuable help has been given to the Service hospitals and the E.M .S. hospitals by such organisations as the V .A .D ., St. john Ambulance Brigade, nursing auxiliaries, and latterly the A .T.S. Many of the women in these are intelligent, well-educated and have heen quick in learning their job. Many have served in hospitals for six years, and have attended lec tures and demonstrations sufficient to make them trustworthy and competent in their work, and it does seem unreasonable to offer such nurses a mere six months’ remission in their training as a reward for six years’ work, to expect them to do 2 £ more years of the discipline and restrictions of a nurses’ institutional life, and to repeat unneces sarily much of the drudgery that they have done so willingly during the war. Here surely, it has been said, by a high authority, is “ a chance for a generous gesture on the part of the nursing ad ministrators by offering ‘ those who satisfy certain

F I R S T

conditions ’ a six months’ intensive tutorial course of lecture demonstrations, unhampered by ward work, and at the end of this time to sit for the S .R .N . examination, the question for which ought to be of an essentially practical nature.” Is it too much to expect some concession of this nature? That shortage of entrants to nursing is unavoidable at present is undoubted, but the dis banding of the women’s services should free many young women who would be promising recruits. Unfortunately, it appears that, up to the present, nursing has not attracted them. And who can wonder !

First A i d and th e Diabetic. B

SIR

H EN RY

M A R T Y N . K .C .V .O ., F .R .C .S .

I t h a s a l w a y s b e en a m y s t e r y to m e w h y th e s u b je c t of d i a b e t e s r e c e i v e s n o r e f e r e n c e w h a t e v e r in t h e s t a n d a r d t e x t b o o k s on first a id . S in c e th e in tr o d u c tio n of in su lin , the e d u c a t io n of t h e v ic t im s of th e d is e a s e a n d th e r e la tiv e s a n d fr ien d s w ith w h o m th e y live h a s b een m o s t c a r e fu lly d ire cte d t o w a r d s th e fu llest p o s sib le k n o w l e d g e of the con d ition and h o w to p r e v e n t a n d tre a t th e c o m p lic a tio n s a n d e v e n e m e r g e n c ie s to w h i c h th e s e p a tie n ts a r e lia b le. N o in stru ctio n w h a t e v e r is g i v e n t o t h o s e p r a c t i c i n g f i r s t a i d , in s p i t e o f t h e fa ct th a t th ey m a y m eet w ith su c h ca se s at a n y hour, a n y d a y a n d a n y p la ce. I t is d i f f i c u l t , m o r e o v e r , t o c o n c e i v e o f a n y v a lid o b je c tio n to th e in c lu s io n of th e s e c a s e s w it h i n th e s c o p e o f fi r st a i d o n t h e g r o u n d t h a t o n l y a d o c t o r c a n d i a g n o s e e ith e r th e co n d itio n o r the tr e a tm e n t n e c e ssa ry , sin ce the v a s t m a jo r it y of d ia b e tics c a r r y on th eir pe rso n s a c a rd s t a t i n g b o th th e n a t u r e of t h e ir illn e s s a n d th e t y p e o f c o m p lic a tio n to w h ic h th e y a r e m o s t lia ble. B u t th e first a id e r m u s t o b v i o u s ly b e t a u g h t w h a t to lo o k for a n d h o w to u t i l i s e t h e i n f o r m a t i o n w h e n h e h a s g o t it. L e t u s c o n s i d e r f i r s t w h a t is d i a b e t e s a n d o f w h a t d o e s in su lin tre a tm e n t con sist. In a h e a lt h y in d iv id u a l a ll c a r b o h y d r a t e foods, i.e., s ta r c h e s , s u c h a s b re a d , p o ta to e s , rice, e tc., a n d s u g a r s a r e b r o k e n u p in t h e i n t e s t i n e , a b s o r b e d a s s u g a r , a n d s t o r e d in t h e l i v e r in t h e f o r m o f a s u b s t a n c e c a l l e d g l y c o g e n . W hen s u g a r is n e e d e d b y t h e m u s c l e s a n d t i s s u e s o f i h e b o d y , t h e s t o r e d g l y c o g e n is a g a i n b r o k e n d o w n i n t o s u g a r a n d c a r r i e d t o t h e m in t h e b l o o d s t r e a m . T h e b lood th er efo re a lw a y s c o n ta in s a certa in q u a n tity of s u g a r , u s u a lly a b o u t 1 per cent. T h i s e n t i r e m a c h i n e r y in t h e h e a l t h y i n d i v i d u a l is c o n t r o l l e d b y a s e c r e t i o n k n o w n a s i n s u l i n , w h i c h is p r o d u c e d in th e p a n c r e a s o r s w e e t b r e a d . W h e n t h i s s e c r e t i o n is a b s e n t o r d e f i c i e n t , t h e e n t i r e m e c h a n is m b re a k s d o w n an d d iab etes resu lts. 'T h e s u g a r , a b s o r b e d fr o m th e food , is n o lo n g e r stored in t h e l i v e r a s g l y c o g e n b u t a c c u m u l a t e s in t h e b l o o d a n d is e x c r e t e d in t h e u r i n e . T h e v o lu m e o f the u rin e a n d the f r e q u e n c y w i t h w h i c h it is p a s s e d i n c r e a s e s , t h e p a t i e n t su ffers from in ten se th irst a n d h un ge^ , a n d loses w e ig h t ra p id ly . F i n a l l y , o t h e r p o i s o n o u s s u b s t a n c e s a p p e a r in h i s b l o o d s t r e a m a n d t h e p a t i e n t d i e s in c o m a , g e n e r a l l y , i f h e h a s a c q u ire d the d ise a s e as a y o u n g in d ivid u al, w ith in a co u p le of years. * I t w i l l b e c l e a r , t h e r e f o r e , t h a t d i a b e t e s is d u e t o a d eficie n cy of th e in su lin u s u a lly p ro d u ce d b y th e p a n cre as, a n d , u n til th e d is c o v e r y b y B a n t i n g of a m eth o d b y w h ic h p u r e in s u lin c o u ld b e e x t r a c t e d f r o m th e s w e e t b r e a d s of a n im a ls , d ia b e te s r e m a in e d a lm o s t in e v ita b ly fatal.

T h e d is c o v e r y of h o w to p r e p a r e in su lin , to s t a n d a r d i s e it a n d t o a d m i n i s t e r it t o t h e d i a b e t i c b y h y p o d e r m i c i n je c tio n w a s o n e of th e t r i u m p h s of m e d ic in e . It m u s t be a p p r e c i a t e d , h o w e v e r , t h a t it is n o t a c u r e o f t h e d i s e a s e , it is m e r e l y t h e m e a n s o f r e p l a c i n g a r t i f i c i a l l y a s e c r e t i o n of w h ic h th e p a tie n t d o e s not p r o d u c e su fficien t fo r his o w n n e e d s , a n d , in t h e m a j o r i t y o f c a s e s , a d m i n i s t r a t i o n m u s t be c o n t i n u e d f o r t h e r e m a i n d e r o f t h e p a t i e n t ' s li f e . T h e f i r s t t h i n g t h a t is d o n e w h e n a d i a b e t i c is t o be s t a r t e d o n i n s u l i n t r e a t m e n t is t o d e t e r m i n e w h a t d o s e of the d r u g w ill be necessary. A d i e t is w o r k e d o u t a d e q u a t e f o r t h e p a t i e n t ’ s n e e d s c o n ta in in g e x a c tly w e ig h e d q u an titie s of ca rb o h yd ra tes, f a t s a n d p r o t e i n s f o r e a c h m e a l , a n d t h e d o s e w h i c h is n e c e s s a r y t o d e a l w i t h t h i s d i e t is t h e n p r e s c r i b e d t o be g iv e n , g e n e ra lly , tw ic e a d a y h alf a n h o u r before the m o rn in g an d e v e n in g m eal. T h i s ro u tin e of in je ctio n s and r i g i d l y w e i g h e d d i e t m u s t b e r e g u l a r l y m a i n t a i n e d , a ft d , p r o v i d e d it b e s o , t h e p a t i e n t w i l l p r o b a b l y c o n t i n u e fit a n d w ell a n d c a p a b le of liv in g an d w o r k in g n o rm ally. It is o b v i o u s , h o w e v e r , t h a t if a p a t i e n t is f o o l i s h a n d o m it s to t a k e h is in s u lin , th e b a l a n c e b e t w e e n th e q u a n t it y of th e d r u g t a k e n a n d th e q u a n t i t y o f food w h i c h h a s to be d ig e s te d w ill be upset, the e x c e s s of s u g a r w ill a c c u m u la te in t h e b l o o d a n d a l l t h e s y m p t o m s o f t h i r s t , f r e q u e n c y , e t c . , w ill at on ce return . A n e x a c t l y s i m i l a r r e s u l t w i l l e n s u e if t h e p a t i e n t is g r e e d y a n d fa ils to restric t h is c a r b o h y d r a t e s to th e q u a n tity perm itted. I f e i t h e r o f t h e s e f a u l t s w e r e p e r s i s t e d in f o r a n y l e n g t h of tim e, all th e d a n g e r o u s c o m p lic a tio n s of a d v a n c e d d ia betes, c o m a and even d eath m ig h t en sue. . In t h e s e d a y s of th e e a r ly d i a g n o s i s of d ia b e t e s , i m m e d ia t e in su lin t r e a t m e n t a n d c a r e fu l e d u c a t io n of p a tie n ts a n d r e l a t i v e s , t h i s f o r m o f c o m p l i c a t i o n is e x t r e m e l y r a r e . T h e p a t i e n t h i m s e l f is g e n e r a l l y w a r n e d b y a r e t u r n o f h is f o r m e r s y m p t o m s o f f r e q u e n c y a n d t h i r s t t h a t h i s b a l a n c e is u p set lo n g before the d a n g e r o u s co m p lica tio n of c o m a has t im e to d e v e lo p , a n d , a l t h o u g h h y p e r g l y c a e m i a — i .e ., e x c e s s o f s u g a r in t h e b l o o d , c a n n o t b e i g n o r e d a s a c a u s e o f u n co n scio u sn ess, the ch a n c e s of m ee tin g w ith su ch a ca se are s m a l l in t h e e x t r e m e . In c o n t r a s t to th e c o m p lic a t io n s to b e d e s c r ib e d la ter d u e t o p o i s o n i n g f r o m a n e x c e s s o f i n s u l i n t h e o n s e t of s y m p t o m s is g r a d u a l , a n d o f t e n a c c o m p a n i e d b y v o m i t i n g a n d a b d o m in a l pain. A s a f u r t h e r d i a g n o s t i c a i d , it s h o u l d be re m e m b e r e d t h a t a po iso n k n o w n a s a c e to n e a c c u m u la t e s in t h e p a t i e n t ’ s b l o o d , a n d c a n b e r e a d i l y d i s t i n g u i s h e d b y t h e s m e l l o f p e a r d r o p s in t h e b r e a t h . S u c h a c a s e sh ould o f co u rse , b e se n t at o n ce w ith the u tm o s t u r g e n c y to h os p i t a l , w h e r e i n s u l i n t r e a t m e n t is f r e q u e n t l y s u c c e s s f u l in s a v i n g life. W h e n t h e b a l a n c e s w i n g s in t h e o p p o s i t e d i r e c t i o n — t h a t is t o w a r d s a n e x c e s s o f i n s u l i n in t h e b l o o d , t h e q u a n t i t y o f s u g a r t h e r e i n is r e d u c e d s o m e t i m e s a s l o w a s 02 pe r cent. V e r y urgen t sym p tom s, k n o w n as h y p o g ly c a e m ia — i.e ., to o little s u g a r , d e v e lo p w it h g r e a t r a p id ity , a n d u n less t r e a t e d m a y e n d a n g e r li f e . C le a r ly , th e co n d itio n m a y r e s u l t f r o m e i t h e r a n a c c i d e n t a l o v e r d o s e o f i n s u l i n or fr o m too little c a r b o h y d r a t e c a u s e d b y a m is s e d or d elayed m e a l, o r o n e t a k e n a w a y fr o m h o m e n o t c o n t a i n i n g the a n tic ip a te d q u a n tity of sta rc h or s u g a r . P ro b a b ly, h o w ever, th e m o s t c o m m o n c a u s e of h y p o g l y c a e m i a is th e s u d d e n p r o d u c tio n b y th e p a t ie n t ’s o w n p a n c r e a s of a n in creased q u a n t it y of h is o w n in su lin . P r a c t i c a l l y a l l d i a b e t i c s p r o d u c e s o m e i n s u l i n o f th e ir o w n , a n d t h e q u a n t i t y m a y b e u n e x p e c t e d l y i n c r e a s e d as th e re su lt of e xercise, e m o tio n , or e x c ite m e n t. S o m e d ia b e tic s a r e p e c u lia rly lia b le to th is d a n g e r o u s c o m p lica tio n to a m u c h g r e a t e r e x te n t th a n o th ers, a n d a t t a c k s m ay o c c u r w i t h g r e a t s u d d e n n e s s in t h e m o s t v a r i e d a n d a w k w a r d c ir c u m s ta n c e s , a n d often w ith no a p p a r e n t cause. T h e s y m p t o m s g e n e r a l l y c o m m e n c e w i t h a f e e l i n g of

F I R S T f a i n t n e s s o r w e a k n e s s , t r e m o r ol t h e l i m b s , i m p a i r e m e n l o f vision , eith e r f lu s h in g or pa llor, a n d often p r o fu s e p e r s p ir a tion . If u n treated, th e v ictim m a y s t a g g e r a s t h o u g h in tox icated , m u scle tw itc h in g s a n d co n vu lsio n s occu r, an d fin a lly h e m a y b e c o m e c o m p le t e ly u n c o n s c io u s . If the a t t a c k o c c u r s d u r i n g sleep, th e p a tie n t is o fte n n ot a w a k e n e d b y t h e e a r l y s y m p t o m s , a n d t h e f ir s t w a r n i n g t h a t r e l a t i v e s m a y r e c e i v e is t h e n o i s e m a d e b y t h e p a t i e n t in violen t co n vu ls io n s. S o l o n g a s t h e p a t i e n t is c o n s c i o u s , t h e i m m e d i a t e a d m in istratio n of h alf-a-d o zen lu m p s of s u g a r , fo llo w e d by h a l f a n h o u r ’s r e st, w ill c u r e m o s t c a s e s . T h i s t r e a t m e n t is often t a k e n b y th e p a tie n t h im s e lf a s so o n a s h e feels s y m p to m s c o m m e n c in g , a n d th e m a jo rity of d iab etics w ith a t e n d e n c y t o h y p o g l y c a e m i a c a r r y in t h e i r p o c k e t s b o t h l u m p s u g a r a n d a c a r d r e q u e s t i n g t h a t it b e g i v e n t o t h e m if necessary. O ften , h o w e v e r, th e a tta c k s d ev e lo p w ith su ch r a p i d i t y t h a t t h e p a t i e n t is t o o w e a k , t r e m u l o u s a n d f a i n t t o a d m i n i s t e r s u g a r t o h i m s e l f , a n d it is u n d e r t h e s e c i r c u m s t a n c e s t h a t k n o w l e d g e o f t h e c o n d i t i o n a n d i t s t r e a t m e n t is s o n e c e s s a r y t o t h e s t u d e n t o f fir s t a i d . O n c e a p a tie n t h a s lost c o n s c io u s n e s s t h e e x i s t e n c e of a c a r d s t a t i n g t h e c o n d i t i o n is o f v i t a l i m p o r t a n c e . W ith o u t th is v e r y n e c e s s a r y p r e c a u tio n p a tie n ts m a y be m is t a k e n l y c h a r g e d w i t h d r u n k e n n e s s , or, if i n v o l v e d in a n a c c i d e n t , b e rushed off to h osp ita l a n d e ven o p e ra te d on u n d e r a m is ta k e n d ia g n o s is of c e re b ra l in ju ry. S u g a r c a n n o t be g i v e n , o f c o u rse , b y m o u t h to a n u n c o n sc io u s p atient, but a n in jectio n of a d r e n a lin w ill g e n e r a lly restore the p atien t w ith in ten m in u tes. T h i s c a n o n ly b e g i v e n b y a d o c t o r , b u t it is u p t o t h e fi r st a i d e r t o k n o w e n o u g h o f t h i s c o n d i t i o n to s u s p e c t it in a n u n c o n s c i o u s p a tie n t a n d to lo o k fo r c o n fir m a ti o n o r o th e r w is e . Let us c e a s e to r e g a r d d ia b e t e s a n d its c o m p lic a t io n s a s o n e of th o s e m y s t e r io u s c o n d it io n s w h i c h a r e b e y o n d th e s c o p e of fir st a i d .

Reviews. H andbook o j T r a in in g fo r O fficers a n d N . C . O .'s . Creech, S .B .S t.J ., C o u n t y of B ristol.

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W e h a v e r e c e i v e d a c o p y o f t h i s b o o k , w h i c h is w r i t t e n in v e r y c l e a r l a n g u a g e a n d h a s b e e n p r e p a r e d w i t h t h e o b j e c t of g i v i n g a c o n c is e g u i d e fo r th e t r a i n i n g of O ffic e r s a n d N . C . O . ’s of th e C o u n t y o f B r is to l, S . J . A . B . It r e p r e s e n ts the m in im u m k n o w l e d g e re q u ired, a n d k e e n w o r k e r s w ill fin d m u c h v a l u a b l e i n f o r m a t i o n in m o r e d e t a i l e d t e x t b o o k s . M r . C r e e c h a s k s u s t o e m p h a s i s e t h a t t h i s h a n d b o o k is in n o w a y in c o m p e t i t i o n w i t h t h e O f f i c i a l H a n d b o o k , w h i c h w i l l , o f c o u r s e , s u p e r c e d e t h e l o c a l p u b l i c a t i o n n o w t h a t it is finally issu ed . H e fe e ls, h o w e v e r , t h a t th e r e a r e s o m e p a rts of h i s h a n d b o o k w h i c h h a v e n o c o u n t e r p a r t in t h e o f f i c i a l m a n u a l, a n d W h ic h w ill still, t h e r e fo re , h a v e a v a l u e a p a r t from th e d rill sectio n s. A s t h e r e a r e still s o m e c o p ie s fo r sa le , t h e s e c a n b e o b t a i n e d b y p e r s o n a l a p p l i c a t i o n t o M r . G . J. C r e e c h , S t . J o h n H e a d q u a r t e r s , U n i t y - s t r e e t , S t . P h i l l i p s , B r i s t o l , 2. The p r i c e o f t h e h a n d b o o k is 1 / 3 p e r c o p y .

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No. I (Prince of Wales’s) District N o. 5 5 n ( S o u t h a l l ) . — T h e S o u th a ll N u r s in g D iv ision c e le b r a te d its 2 1 s t b ir t h d a y w ith a s o c ia l a t H o l y T r i n i t y H a ll, S o u th a ll, on S a tu r d a y e v e n in g Sept. 22nd. D u r i n g a n i n t e r v a l in a c o n c e r t p r o v i d e d b y t h e M e r r y M a k e rs C o n cert P a rty, L a d y Su pt. M iss F. M. G ib b s cu t an iced b irth d a y c a k e a nd w a s a ssisted by m em b e rs w h o had b e e n in t h e D i v i s i o n s i n c e i t s c o m m e n c e m e n t o n S e p t . 2 2 n d , 1924. T h e D e p u t y M a y o r ( C o u n c i l l o r J. M . S t u r g e o n ) e x p r e s s e d t h e b o r o u g h ’s a p p r e c i a t i o n o f t h e w o r k o f t h e N u r s i n g D i v i sion, p a r t ic u la r ly d u r i n g th e w a r y e a r s. D r . G . R . H . W r a n g h a m ( A s s i s t a n t C o m m i s s i o n e r ) , in c o n g r a t u l a t i n g t h e D i v i s i o n o n r e a c h i n g it s 2 1 s t b i r t h d a y , said th a t w ith the n e w s c h e m e s t h a t w e r e c o m i n g fo r w a r d th e r e w a s a t r e m e n d o u s lot of w o r k befo re t h e m , a n d h e u r g e d t h e m to d o th e ir b est to e n l a r g e th e D iv is io n . M iss G ib b s sta te d th a t of th e fourteen o rig in a l m e m b e rs of th e D iv is io n th e y still h a d s ix a c ti v e m e m b e r s , t o g e t h e r w i t h f o u r o t h e r m e m b e r s w it h fifteen y e a r s ’ s e r v ic e , a n d o n e m e m b e r t r a n s f e r r e d fr o m V Vitley B a y w i t h 25 y e a r s ’ s e r v ic e . S h e t h o u g h t th at w a s a sp len d id record. T h e D iv ision s t a r t e d in 1 9 3 5 a H a y e s s e c t i o n , w h i c h w a s n o w a D i v i s i o n , a n d in 1 9 2 8 r e g i s t e r e d a N u r s i n g C a d e t D i v i s i o n a n d o p e n e d th e 'm e d ic a l co m fo rts depot. B o t h w e r e still g o i n g s t r o n g . T h e y h a d a ls o sta rte d a N u r s in g sectio n a n d a C a d e t section at H eston. D is tric t O ffice r M iss W e s t , w h o a d d e d h er c o n g r a t u la t i o n s , s a i d s h e t h o u g h t t h e r e w a s n o N u r s i n g D i v i s i o n in t h e W e s te r n A re a w ith a s m a n y m e m b e rs w ith the lo n g serv ice m ed a l a s th e S o u th a ll D ivision . O n S u n d a y e v e n in g , m e m b e rs of th e D iv isio n a n d c a d e ts a t t e n d e d s e r v i c e a t S t . J o h n ’s C h u r c h , S o u t h a l l .

N o. 17 ( W im b l e d o n a n d M e r t o n ).— A m ost happ y and m em o ra b le e v e n in g w a s sp en t b y so m e 150 m em b e rs and g u e s t s a t S t. G e o r g e ’s H a l i , W i m b l e d o n , o n T u e s d a y , S e p t. 1 8 th , to c o m m e m o r a t e th e 50th a n n i v e r s a r y o f th is D iv is io n , p ro ud ly k n o w n a s th e “ S h in y S e v e n t e e n t h .” A m o n g o th e r d is t in g u is h e d g u e s t s this im p o r t a n t so cia l e ven t w a s h o n o u red w ith the p resen ce of th e M a y o r and M a y o re ss of W im b le d o n . A G u a r d of H o n o u r fo r m e d at th e e n tra n c e of th e M a in H a ll, u n d e r th e c o m m a n d of S ta ff S g t. H iley. E n te r ta in m e n t w a s provid ed b y th e “ Im p e ria l C o n ce rt P a r t y , ” a n d a p len tifu l a n d v arie d a r r a y of r e fr e s h m e n ts w e r e served d u r in g the in terval. E n jo y m e n t w a s the k e y n o te of th e e v e n in g , so sp e e ch e s w e r e r e d u c e d to a m in im u m . A p a rtic u la rly in te re stin g e ven t w a s th e d istrib u tio n of a d e s c r ip tiv e b o o k le t c o v e r i n g th e a c tiv itie s o f th is D iv is io n for t h e p a s t 50 y e a r s , w h i c h f o r m e d a m o s t a p p r o p r i a t e m e m e n t o of the e v e n in g . It is in te n d e d to s e n d a c o p y to a ll s e r v i n g m e m b e r s of the D iv is io n , o v e r 60 o f w h o m a r e s till w it h H .M . Forces. A m o s t n o t ic e a b le a n d p l e a s i n g f e a t u r e w a s t h e s p i r it of u n ity a n d co-operatio n e x is t in g b e tw e e n the A m b u la n c e an d N u r s i n g D i v i s i o n s w h i c h m u s t re flect to t h e b enefit o f th e pu b lic. T h e D i v i s i o n m e e t s e v e r y T u e s d a y e v e n i n g in t h i s s a m e H a ll a n d n e w m e m b e rs w ill be w e lc o m ed .

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the a ftern oon , a n d th ere w e r e m a n y sid e -s h o w s w ith opena ir d a n c i n g a n d f i r e w o r k s in th e e v e n in g . M e m b e rs of the A m b u la n c e a n d N u r s in g a d u lt a n d C a d e t D iv isio n s w e re on duty. T h r e e p a t ie n t s h a d to b e r e m o v e d b y a m b u l a n c e to h o s p ita l, a n d m a n y m in o r in ju rie s w e r e tre a te d o n th e spo t. G r e a t a s s i s t a n c e w a s g i v e n to m e m b e r s of th e a d u lt D i v i sion s b y th e A m b u la n c e a n d N u r s in g C a d ets.

T r a n s p o r t C p l . F . G r e e n h a s l e f t t h e D i d c o t D i v i s i o n to r e t u r n to h is h o m e in S o u t h s e a . A s a t o k e n of a p p r e c ia t io n , th e m e m b e rs of th e D iv isio n g a v e h im a lea th e r w a lle t in s crib e d w ith h is in itials a n d the S . J . A . B . B a d g e . W h e n he c a m e t o D i d c o t in 1 9 3 9 , a l t h o u g h in h i s 7 0 t h y e a r . T r a n s p o r t C p l. G r e e n a t o n ce a tta c h e d h im se lf to th e B r ig a d e . D u rin g h is 5£ y e a r s o f t r a n s p o r t d u ty , h e m a d e 1 ,2 3 9 j o u r n e y s w it h th e a m b u la n c e , c o v e r i n g a to ta l d is ta n c e of 3 9,630 m ile s a n d a tt e n d in g 1,8 3 1 p atients. T / C p l. G re e n h a d p rev io u sly s e r v e d f o r 45 y e a r s in t h e R o y a l N a v y . H is se rv ice s w ill be g r e a t l y m i s s e d in D i d c o t .

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. — O n M o n d a y e v e n in g , S e p t e m b e r 24th, a t the A m b u la n c e H a ll, C h a th a m Street, R e a d in g T o w n “ A ” and R ead in g- T o w n “ B ” A m b u l a n c e C a d e t D iv is io n s h eld a jo in t e n r o lm e n t c e r e m o n y a n d p a r e n t ’s e v e n i n g . T h e C o un ty C o m m i s s i o n e r ( M r . C . A. P o o l e ) e n r o lle d e le v e n n e w c a d e ts . A b o u t fifty p a r e n t s a n d fr ie n d s w e r e p r es en t. B efo re the c e re m o n y , c a d e ts of T o w n “ A ” D ivisio n f o r m e d t h e e i g h t p o in te d c r o s s of t h e O r d e r . A fte rw a rd s the C o m m is s io n e r p res en te d th e prizes to th e w i n n i n g te a m -fo r the best tent at C a m p . T h e te a m w a s led b y C a d e t C p l. R . P ip e r of T o w n “ B ” D iv is io n . D u r in g the even in g, item s b y c a d e t s o f T o w n “ A ” D i v i s i o n in c lu d e d a c o m ic first aid s q u a d a n d a s k e t c h a d a p te d b y C a d e t C p l. H a r r is ca lled “ H i s F i r s t P a i r o f L o n g ’ U n s , ” a n d a first a id d i s p l a y g i v e n b y tw o t e a m s ; o n e c o m p le t in g a jo b w ith full k it a n d the o th er im p ro v isin g. T h e M isses Iv o r y M o rris a nd M a r y B ru c e Jones g a v e a t a p d a n c in g d isp la y, and M r. J a c k D i c k y th rilled the a u d ie n c e w it h his l i g h t e n i n g s k e t c h e s . T w o c o m ic turns w e re g iv e n b y M r. Y o u n g a n d M r. L id d ia rd , a n d the e v e n i n g en ded w ith g a m e s for th e p a ren ts. R efresh m en ts w ere p r o v id e d t h r o u g h th e k i n d n e s s of M r. P r e w a n d h is C o m m ittee. R

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County of Hampshire. B o u r n e m o u t h . — T h e B o u rn e m o u th C o rp s w a s recen tly h o n o u r e d w h e n t h e S u r g e o n in C h i e f , D r . N . C o r b e t F l e t c h e r , O . B . E . , e tc ., visited th eir H e a d q u a r t e r s . A fte r g i v i n g a b rief t a l k on v a r io u s s u b je c ts c o n c e r n in g f ir s t a i d , D r . C o r b e t F l e t c h e r i n v i t e d q u e s t i o n s w h i c h r e s u l t e d in q u i t e a h e a l t h y d i s c u s s i o n o n t h e v a r i o u s t y p e s o f a n t i septics, the u se of a crifia vin e, th e tre a tm e n t of stin g s by “ w e a v e r s , ” c r a m p , a n d artificia l re sp ira tio n , etc., etc. T h e m e e tin g w a s w ell atte n d ed by A m b u la n c e , N u r s in g an d C a d e t m em b ers of the B rig ad e. T h e C h a ir w a s ta k e n by th e A sst. C o u n ty C o m m is s io n e r M a j o r J. A . C o g h l a n , s u p p o r t e d b y D r . F . C . B o t t o m l e y , C o u n t y S u r g e o n , D r . H . I. M a r r i n e r , C o u n t y C a d e t O ffic e r , D r. C. H e y g a t e V e r n o n , C o rp s S u r g e o n , C o u n t y O fficer A. J. C u f f , C o r p s S u p t . W . J . T r e w a n d L a d y C o r p s S u p t . M i s s W . H . A ish .

County of Warwick. C o v e n t r y M o r r is E n g i n e s .— T h e a n n u a l com petition s fo r th e “ M a r v ill ” te a m tro p h y a n d “ H a m m o n d ” in d ivid u al m e r i t c h a l l e n g e c u p s , w e r e h e l d in t h e D i v i s i o n a l H e a d q u a r t e r s a t C o u r th o u s e G re e n , on T h u r s d a y , S e p te m b e r 27th, b e fo re a fa ir ly la r g e c r o w d of v isito rs. T h e ju d g e s w ere D iv isio n a l S u r g e o n A . C a lco tt E d w a r d s

R I D

(M o rris E n g in e s D iv isio n ), C o u n ty O fficer H a r ris , C o rp s S u p t. B o o th , C o rp s O fficer O r m e a n d tim e k e e p e r, A m b u la n c e O fficer K n i g h t (C o u rta u ld s D ivisio n ). A fte r v ery k ee n co m p etitio n , th e resu lts w e re Team T r o p h y w in n ers, “ C ” team ca p tain ed b y C o rp ora l B eau foy, a nd the w in n er of th e In d iv id u a l M erit C u p , P riv a te H . B ostock. F o l l o w i n g a sp e e ch of t h a n k s b y D iv is io n a l S u p t. Cleob u r y , C o u n t y O ffic e r H a r r i s p r es en te d th e prizes.

County of Worcester. T w o v e r y i n t e r e s t i n g S . J . A . B . c o m p e t i t i o n s w e r e h e l d on S a t u r d a y , S e p t e m b e r 8 t h , in t h e H i g h S c h o o l f o r G i r l s , S to u rb rid ge. T h e s e w e re th e A re a F in a ls of th e L e c h m e r e and N ew to n Cups. T h e L e c h m e r e C u p is o p e n f o r c o m p e t i tio n a m o n g A m b u l a n c e a n d N u r s i n g D iv is io n s , w h ils t the N e w t o n C u p is c o m p e t e d f o r b y C a d e t t e a m s b o t h A m b u l a n c e and N u rsin g . T h r e e t e a m s c o m p e t e d in t h e L e c h m e r e C u p c o m p e t i t i o n a n d t w o in t h e N e w t o n C u p . In the L e c h m e r e C u p co m p etitio n , th e p atien t w a s foun d to be s u ffe r in g fr o m a s im p le fr a c t u r e of th e left l e g a n d s h o c k . \ T h e t e a m s h a d to d e s c r ib e h o w t h e y w o u ld g e t th e p a tie n t into bed. T h e y a lso h a d to d ea l w ith a b a b y w h o h a d b u rn t its feet o n a n u n c o v e r e d h o t w a t e r bottle. In th e c a d e t c o m p e titio n , th r e e p a tie n ts h a d to b e tre a te d , o n e patient w a s not b re a th in g , a n o th e r h a d a la ce rate d w o u n d of the r i g h t l e g w ith a r te r ia l h a e m o r r h a g e , w h ils t th e third patien t h a d a fra c tu re of th e r ig h t a rm . C o u n ty O fficer A. W in b o w a n n o u n c e d the resu lts as f o l l o w s :— L e c h m e r e C u p . — B r i e r l e y H i l l A m b u l a n c e , 2 2 5 m a r k s ; T . W . L e n c h ’ s, 2 1 9 ; H a l e s o w e n N u r s i n g , 205£ . N e w t o n C u p . — B r ie r l e y H i l l C a d e t N u r s i n g , 2S5£ m a r k s ; B r i e r l e y H i l l C a d e t A m b u l a n c e , 2 1 5£. M r. W in b o w c o n g r a tu la te d th e w in n er s an d w ish ed them l u c k in t h e f i n a l s . A t t h e c o n c l u s i o n o f t h e c o m p e t i t i o n , t e a w a s s e r v e d to th e t e a m s a n d o fficials b y m e m b e r s o f th e S t o u r b r id g e N u r s in g D ivisio n .

T h e la st tw o C o u n ty F in a l co m p e titio n s for th e present s e a s o n o f t h e S . J . A . B . in t h e c o u n t y o f W o r c e s t e r , w e r e h e l d in t h e S h i r e h a l l , W o r c e s t e r , o n S a t u r d a y , S e p t e m b e r 2 9 t h . T h e s e w e re for th e L e c h m e r e C u p a n d th e N e w to n C u p . T h e r e w e r e t w o c o m p e t i n g t e a m s in e a c h o f t h e c o m p e t i tion s, o n e fr o m th e n o rth a n d o n e fr o m th e s o u th o f the county. T h e p a t i e n t in t h e L e c h m e r e C u p c o m p e t i t i o n w a s f o u n d to be s u ff e r in g fr o m a n in c ise d w o u n d left fo r e a r m w ith a r t e r i a l h a e m o r r h a g e , w i t h g l a s s e m b e d d e d in w o u n d , s i m p l e f r a c t u r e s of left p a te lla a n d left rib s a n d b a d ly s h o c k ed . T h e r e w a s no a m b u la n c e a va ila b le and th e doctor w a s out so t h a t t h e t e a m s h a d to t r e a t t h e p a t ie n t a n d g e t h im in to bed. In the N e w t o n C u p c o m p e titio n the p atient, M r. C u r n e w , h a d lo st s o m e to e s in th e b a ttle of A r n h e im , a n d t h e te a m s h a d t o t r e a t t h i s i n j u r y a s if it h a d j u s t o c c u r r e d . L a t e r in th e te st a b o y h a d to b e tr e a te d fo r a f r a c t u r e d c o ll a r b o n e . C o u n t y C o m m is s io n e r D r . F . L . N e w t o n a n n o u n c e d the r e s u l t s a s f o l l o w s :— L e c h m e r e C u p . — B r i e r l e y H i l l A m b u la n ce , 266 m a r k s ; B r o m s g r o v e N u r s in g , 2 1 1 . N ew ton C u p . — B r ie r l e y H ill C a d e t N u r s i n g , 236 m a r k s ; R e d d it c h C a d e t A m b u la n c e , 166. L a d y D e e r h u r s t p resen te d th e trop h ies to th e w in n in g te a m s, a fter w h ic h tea w a s served.

T h e d e a t h t o o k p la c e o n S e p t e m b e r 1 1 t h , a t t h e a g e of 74 ye ars, of A ld e rm a n D . M . C h a p m a n , J . P . , w h o w as A s s is ta n t C o m m is s io n e r for the n o rth ern a r e a of th e cou n ty of W orcester. A s s i s t a n t C o m m i s s i o n e r C h a p m a n t o o k h i s f i r s t a id

F I R S T c e r t i f i c a t e in 1 8 9 2 w i t h t h e G r e a t W e s t e r n R a i l w a y . In M a y l 9 1 7 , he receiv ed a certificate for “ e x c ep tio n a l e ffic ien cy” i n fi r st a i d w o r k i n C r a d l e y H e a t h . H e w a s on e of the fo u n d ers of th e R o w le y R e g is A m b u la n c e D iv isio n an d w as i t s fi r st D i v . S u p t . In 1930 he b e c a m e C o rp s S u p t. of the N o r t h W o r c e s t e r s h i r e C o r p s a n d in F e b r u a r y 1 9 3 3 , h e w a s m a d e a S e r v in g B ro th e r of th e O rd e r. H e w a s ap p o in ted an O f f i c e r o f t h e O r d e r in 1 9 4 3 a n d in 1 9 4 4 w a s p r o m o t e d t o t h e r a n k of A ss ista n t C o m m issio n e r, a fte r b e in g m ad e C o u n ty O f f i c e r f o r t h e n o r t h e r n a r e a o f t h e c o u n t y in 1 9 4 0 . T h e r e s p e c t in w h i c h t h e l a t e M r . C h a p m a n w a s h e l d , w a s e v id e n c e d b y th e l a r g e a tt e n d a n c e a t his f u n e r a l. There w e r e 7 6 f l o r a l t r i b u t e s i n c l u d i n g a s t r i k i n g o n e in t h e f o r m of th e S t. J o h n C r o s s fr o m th e C o u n t y O fficers.

West Riding of Yorkshire. C l e c k h e a t o n . — T h e C le c k h e a to n St. Joh n A m b u la n c e a n d N u r s in g C a d e ts assisted by H e c k m o n d w ik e , B r ig h o u s e , M irfield , B a tle y , B i r k e n s h a w , E a s t B ie rle y , D e w s b u r y , a n d H u d d e r s f ie ld C a d e t D iv is io n s , h e ld t h e ir first c h u r c h p a r a d e on S u n d a y , S e p t. 16th. T h e p a r a d e led b y th e B r i g h o u s e S .J .A . C a d e ts D r u m a n d B u g le B a n d , m o v e d off from the M a r k e t P la c e v ia W e s t g a t e to St. L u k e s C h u r c h , w h e r e an im p r e s s i v e s e r v ic e w a s c o n d u c t e d b y t h e R e v . J. A . S i m p s o n . T h e service open ed w ith th 6 h y m n “ F ig h t the G o o d F ig h t w ith all T h y M i g h t ” a n d e n d e d w ith “ O n w a r d C h ris tia n S o ld ie rs.” A fte r th e service, th e p a r a d e m a r c h e d b a c k v ia W e s t g a t e , N o r th g a t e , S c o tt L a n e , B r a d fo r d R o a d to th e M a r k e t P lace, w h e r e th ey w e re d ism isse d by C a d e t O ffice r F . L o n s dale, w h o t h a n k e d th e v is it in g A m b u l a n c e a n d N u r s in g C a d e t s C o r p s f o r t h e i r s p l e n d i d c o - o p e r a t i o n in m a k i n g C l e c k h e a t o n ’s first c h u r c h p a r a d e a h u g e s u c c e s s . H e h o p e d to see m o re g ir ls a n d b oys jo in in g th e A m b u la n c e M o v e m e n t.

4 i

A I D

M rs. N o rris s p o k e of th e e n th u s ia s m s h o w n b y the m e m b e rs , a n d c o m p lim e n te d th e m on th eir efficien cy. M r. M ile s p resen te d th e n e w “ E x o n ” c u p to M r. W a l t e r s for w i n n i n g th e c la s s in d iv id u a l first a id c o m p e titio n . A n e n j o y a b l e f u n c t i o n s u p p o r t e d b y o v e r 200 o f t h e s t a f f a n d t h e ir f r ie n d s w a s b r o u g h t to a c lo se.

F e l t h a m . — T h e a w a r d s g a in e d b y the su ccessfu l m e m bers o f th e a b o v e c la s s w e r e p r e s e n te d b y M rs. E . S. M o o re , in t h e P a r i s h H a l l , F e l t h a m , re c e n t ly . M r. A . B a r r o w ( D is t. S e c r e ta r y ) p resided , a n d the R a i l w a y Q u e e n , M iss G r e ta R ic h a rd s , w a s a m o n g th ose present. M r. B a r r o w d r e w a tte n tio n to th e m a n n e r in w h ic h th e R a i l w a y Q u e e n h a d p e rfo rm e d h e r d u ties, a n d a s k e d M r. O x l e y to p r e s e n t a c y c le to h e r, s u i t a b l y i n s c r ib e d fr o m th e r a ilw a y m e n of F e lth a m . M iss R ic h a rd s exp re ssed her a p p re c ia tio n of th e gift. M r. E. S. M o o re p a id trib u te to th e efficien cy of th e c la ss a n d of the g r e a t a ssista n ce w h ich h ad b een ren d ered lo ca lly a fte r e n e m y a ction. H e w a s p le a s e d to s e e s u c h a l a r g e n u m b e r of s ta ff fro m th e m o tiv e p o w e r d e p a r tm e n t, e s p e c ia lly th e i n c r e a s in g n u m b e r of la d ie s in t h e c la ss. T h e fu n ctio n w a s b r o u g h t to a clo se b y an e n te r ta in m e n t p r o v i d e d b y t a l e n t e d a r t i s t e s , w h i c h w a s a r r a n g e d b y M r . J. Read.

C O M P E T IT IO N S . By

CO RBET

FLETCH ER, M .R .C .S .,

O .B .E .,

M .A .,

M .B .,

S u rg e o n -in -C h ie f, St. J o h n A m b u la n c e B r ig a d e A t- H o m e .

R a ilw a y

A m b u la n ce

N ew s.

( A n A d d ress g iv e n on Ju n e ib th a t the

C adet O fficers'

C onference.)

SOUTHERN C a l s t o c k . — T h e a w a r d s in c o n n e c t i o n w i t h t h e C a l s t o c k c la s s w e r e p r e s e n te d b y L a d y D i a n a A b d y , w h o , r e f e r r i n g to th e fu n ctio n s of t h e R e d C r o s s a n d St. J o h n W a r O r g a n i s a t i o n , p o i n t e d o u t h o w n e c e s s a r y it w a s t o h a v e q u a l i f i e d f ir s t aiders.

M r. S t o c k b r id g e g a v e a re su m e of the h isto ry of the c l a s s , s t a t i n g t h a t i t c o m m e n c e d 20 y e a r s a g o a n d w a s s t i l l flo urish ing . A g o o d n u m b e r of th e c la ss m e m b e rs received a w a rd s , a n d M r. S to c k b r id g e , H on . S e cre ta ry , w a s p resen ted w ith th e M e r ito r io u s L o n g S e r v ic e C e r tific a te in r e c o g n itio n of h is l o n g a n d c o n t i n u e d i n t e r e s t in fir s t a i d w o r k .

B a sin g sto k e .— T h e B a sin g sto k e Sou thern R a ilw a y M in s tr e ls g a v e th e ir first c o n c e rt o n S e p t e m b e r 1 3 th a t B a s in g s t o k e , an d d u r in g th e in terval M r. N . R . T u r n b u ll (Asst. C o u n ty C o m m issio n e r, S .J .A .B .) p resented the a w a r d s g a i n e d b y t h e m e m b e r s o f t h e first a id c la s s . M r. C . M e r ritt w h o presided , referred to th e la r g e n u m ber of ca ses th at h a d b een treated a t B a s in g s to k e d u r in g the past year, a n d u rg e d th e d esira b ility of sta ff t a k i n g u p a c o u r s e o f first a id . A m o n g th e a w a r d s presen ted w e re t w o for p a s s in g e x a m i n a t io n s fo r 21 y e a r s , s ix m e m b e r s for 14 y e a r s , a n d o n e m e m b e r for 7 years.

T h r e e B r i d g e s . — T h e c la s s e ve n t th is y e a r to o k the fo r m of a c o n c e r t a n d d a n c e h eld re c e n tly , d u r i n g w h ic h th e a m b u la n c e a w a r d s w e re presen ted by M rs. N. F . N o rris

W it h th e c o m i n g o f p e a c e in E u r o p e , c o m p e t it io n s w ill so o n r e s u m e t h e i r p l a c e in a m b u l a n c e t r a i n i n g . It h as therefore b e en s u g g e s t e d t h a t I s h o u ld t a l k to y o u on th is s u b je c t, m o re e sp e c ia lly a s th e re a listic d e v e lo p m e n t of c o m p e titio n s h a s o c c u r r e d in m y f i r s t - a i d l i f e t i m e . I.

ist o r y

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P e r h a p s I s h a ll s u r p r is e m o s t of y o u w h e n I tell y o u th a t co m p e titio n s h a v e b e en a fe a tu r e of a m b u la n c e w o r k sin ce t h e e a r l i e s t d a y s o f t h e A s s o c i a t i o n , w h i c h w a s f o u n d e d in 1877. In d eed , h isto ry relates th a t S u r g e o n - M a jo r G e o r g e H u t t o n , a s O r g a n i s i n g C o m m i s s i o n e r of t h e A s s o c ia tio n , did h is u t m o s t in h is t r a v e ls u p a n d d o w n th e c o u n t r y to e n c o u r a g e c o m p etitio n s, w h ic h w e r e w e ll a n d tru ly estab lish e d w ith in th ree y e a rs of th e b irth of th e A sso ciatio n . In the ea rly d ays, h o w ev er, co m p etitio n s w e re m a in ly te sts of b a n d a g i n g , m a r c h i n g a n d d rill. M y p erson a l re co l le c tio n s g o b a c k to 1908, in w h i c h y e a r I w a s c a jo le d b y a k e e n first a id e r in to g i v i n g a c o u r s e of le c tu r e s ( w h ic h I re a d fr o m th e T e x t b o o k ! ) to m e m b e r s of th e o ld L . & N . W . R a ilw a y A m b u la n c e Centre. I n th e s a m e y e a r I j u d g e d m y first c o m p e t i t io n , t h e d e t a i l s o f w ' h i c h a r e s t i l l v i v i d in m y m e m o r y . O n e m o rn in g m y f i r s t a i d M e n t o r , w ' h o is t o - d a y m y B r i g a d e S e c r e t a r y , c a lle d o n m e, told m e t h a t t h e j u d g e fo r a c o m p e titio n th a t a f t e r n o o n h a d f a i l e d h i m , a n d a s k e d m e t o d o it. H e over ru led m y d iffid en ce of d o i n g a jo b of w h ic h 1 knew ' n o t h in g , a n d a s k e d m e to n a m e tw o in ju rie s— a fra ctu re a nd a w o u n d . S o , b e i n g u p t o d a t e , I r e p l i e d t h a t w'e w o u l d i m a g i n e a m a n fa llin g o u t of a b allo o n , f r a c t u r i n g h is p elvis a n d s u s t a i n i n g

F I R S T

a w o u n d w h ic h tore h is r ig h t b r a c h ia l a rtery . W h e n I a rriv e d fo r th e c o m p e titio n h e h a n d e d m e a h a lf-sh e e t of n o te p a p e r o n w h i c h m a r k s w e r e a l l o c a t e d f o r s o m e t w e n t y p o i n t s in tre a tm e n t ; an d I re m e m b e r h o w a m a z e d I w a s at th e sk ill w ith w h ich the com p etitors treated a nd transported the su p posed victim , and h o w h a lfw a y th ro u g h the com p etition m y M e n t o r w h i s p e r e d e x c i t e d l y in m y e a r t h a t I m u s t s a v e s o m e m a r k s b e c a u s e t h e c r a c k t e a m s w e r e fif th a n d s i x t h o n h i s lis t . It s a y s m u c h for th a t o ld - tim e -m a r k in g sh eet th a t the f i g h t d i d , in f a c t , t a k e p l a c e b e t w e e n t h e s e t e a m s ! T h e m ain fe a tu re s of th e m a r k i n g sh eet of th o se d a y s w e r e : ( 1 ) s p e c if ic a t io n of a ll in iu r ie s r e c e iv e d ; (2 ) a l l o t m e n t o f m a r k s i n b u l k , i t e m s b e i n g a w a r d e d in t e n s a n d t w e n t i e s a t t h e w h i m o f t h e j u d g e ; a n d (3) i n c l u s i o n o f w h a t w e r e e u p h e m i s t i c a l l y c a l l e d “ e x t r a s , ” t h e s e b e i n g in e f f e c t a c o n fe ssio n th a t t h e test w a s not c o m p le te ly so lved. F u r th e r , it w a s d i f f i c u l t t o a r r i v e a t a t o t a l o f 100 m a r k s u n l e s s m a r k s for “ e x t r a s ” w e r e in clu d ed . O n e cu riou s resu lt w a s that c o m p e t i t o r s o fte n t r e a t e d th e lim b on t h e w r o n g sid e, a n d la t e r w e r e p e n a lise d for s o d o in g , b e i n g a llo w e d o n ly o n e -th ird of th e m a r k s a c tu a lly ob tain ed . F a t e d ec re ed th a t m y e a rly a sso c ia tio n s sh ou ld be w ith th e R a i l w a y C e n tre s ; a n d I p a y trib u te to the part w h ic h r a i l w a y f i r s t a i d e r s h a v e p l a y e d in t h e a d v a n c e m e n t o f c o m p e titio n s a s p r a c tic a l tests. W o r k i n g w ith th em , I rea lised ( 1 ) t h a t , if t h e t e s t s w e r e t o b e r e a l i s t i c , p r o b l e m s in d i a g n o s is m u s t b e in t r o d u c e d ; a n d (2) t h a t t h e m a r k i n g s h e e ts m u st be m a d e m ore elaborate, and set out a co m p lete so lu t i o n o f t h e t e s t s if j u s t i c e a n d f a i r p l a y w e r e t o b e g i v e n t o t h e co m p e tin g team s. I n t h i s c o n n e c t i o n it is a n i n t e r e s t i n g f a c t t h a t t h e a u t h o r i t i e s a t S t . J o h n ’s G a t e o f t h o s e d a y s w e r e u n s y m p a th e tic , a n d th at so m e tim e ela p se d before th ey a c c e p te d th e in e vita b le . C o n s e q u e n t l y , in 1 9 2 3 , w h e n I h a d b e e n a D i v i s i o n a l S u r g e o n fo r s ix y e a r s , I w a s p r iv ile g e d to p r e p a r e a n d to j u d g e t h e f ir s t s t a g e d t e a m t e s t in t h e D e w a r S h i e l d C o m p e t i t i o n . F o r t h i s I c h o s e a m o v a b l e li f t , w h i c h w a s m a d e f r o m im p ro v ise d m a te ria l and w h ic h w a s su p p o se d to be d efe ctive a n d lia b le to c r a s h , a p p r o p r ia t e s o u n d b e in g p ro vid e d b y an O ffic e r w h o , a rm e d w ith a m allet, s tru c k a la r g e d in n er g o n g e a c h t i m e t h e l i f t fe ll . T w o y e a r s l a t e r it w a s a l s o m y f o r t u n e to a c t s i m i ' a r l y in t h e I n t e r - R a i l w a y F i n a l , f o r w h i c h w e i m p rovised a c o tta g e , a r ic k e ty shed, an d a b u r n in g b u sh ! II.

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E x p e rie n c e t a u g h t m e (1) th a t in th e ch o ice of team an d i n d iv id u a l te sts, s im p le e m e r g e n c i e s a ffo rd th e b e st m e a n s of d is c r im in a tin g b etw een th e c o m p e tin g tea m s and in d i v i d u a l s ; a n d (2) t h a t e m e r g e n c i e s w h i c h h a v e a c t u a l l y o c c u r r e d a n d o f w h i c h t h e j u d g e is f u l l y c o g n i s a n t , g i v e t h e b e st resu lts. F u rth e r, I a m not a m o n g th ose w h o ch oose e m e r g e n c i e s in w h i c h t h e r e a r e t h r e e o r m o r e c a s u a l t i e s , f o r th e sim p le reason th at no ju d g e ca n k e e p w a tch fu l e ye sim u l t a n e o u s l y on m o r e th a n t w o p a tie n ts, w h o s h o u ld , if p o s sible, be k e p t w ith in a s m a ll circle. F i n a l l y , in a t e a m c o m p e t i t i o n in w h i c h t h e r e a r e i n d i v i d u a l a n d a l s o v i v a v o c e t e s t s , I co n sid er th a t th e te a m test sh o u ld ca rry h alf th e a v a ila b le m a r k s — th e a llo c a tio n b e in g : te a m , 250 ; in d iv id u a l, 15 0 ; a n d v i v a v o c e q u e s t i o n s , 10 0 . III.

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R I D l i n e in a m a r k i n g s h e e t t h e d e t a i l s a s c o n t a i n e d in t h e T e x t bookL a s t l y , s o m e j u d g e s in t h e i r m a r k i n g s h e e t s m i x u p e x a m i n a t i o n a n d t r e a t m e n t , w h e r e b y d i f f i c u l t i e s in l o c a t i n g q u ic k ly item s d u r in g the com p etitio n a re a ccen tu a te d . Per s o n a lly , I fa v o u r a g e n e r a l s c h e m e w h ic h h a s served m e w ell d o w n t h e y e a r s a n d c o v e r s :— (1) C a r d of In tro d u c tio n , in c lu d in g n otes on a ctio n a n d s t a g i n g of tests. (2) I m m e d i a t e A c t i o n , i n c l u d i n g v a r i o u s p o i n t s , s u c h a s ca llin g doctor and a m b u lan ce. (3) E x a m i n a t i o n o f P a t i e n t . (4) T r e a t m e n t o f P a t i e n t . (5) T r a n s p o r t a n d A f t e r - c a r e o f P a t i e n t . T h e m o d e r n te a m a n d in d iv id u a l tests s h o u ld be re p r o d u c tio n s of e m e r g e n c i e s a s fa r a s p ossib le. R e a l i s m in c o m p e titio n s , t h e r e f o r e , c a lls fo r (I ) f a k i n g of a ll in ju r ie s , (2 ) t r a i n i n g of a ll p a t ie n t s a n d s u p p o s e d b y s t a n d e r s , a n d (3 ) s t a g i n g of a ll p r a c tic a l tests. A t B r ig a d e H e a d q u a rte rs w e h a v e lo n g realised th at g o o d t e a m - w o r k is e s s e n t i a l in t h e s e l e c t i o n a n d p r e s e n t a t i o n of tests for the B r ig a d e F in a l C o m p etitio n s. T o th is end, M r . J. G r o s s m a n , o f A s s o c i a t e d B r i t i s h P i c t u r e s , L t d , h a s b e en r e s p o n s ib le for s t a g i n g a n d p r o v id in g a c to r s a n d a c t r e s s e s , M r . H . J. W r i g g l e s w o r t h , a s A s s i s t a n t B r i g a d e S e c r e t a r y , for t h e o r g a n i s a t i o n of t h e c o m p e t it io n s , a n d m y se lf fo r th e t e c h n ic a l a s p e c t s of t h e t e sts a n d fo r th e m a r k i n g s h e e ts . Y e a r a ft e r y e a r u p to 19 3 9 w e h a v e s p e n t m a n y h a p p y h o u r s t o g e t h e r ; a n d if t h e r e h a v e b e e n a d v e r s e c o m m e n t s o n the re su lts of o u r c o m b in e d efforts w e n e ve r h e a rd th em ! IV .

oints

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ests.

T h e r e a r e fo u r c h ie f p oin ts, a tte n tio n to w h ic h m a k e s (and n e g le c t of w h ic h m ars) th e re p u ta tio n of th ose w h o a re i n v i t e d t o a c t a s j u d g e s in c o m p e t i t i o n s . F irst, th e ju d g e m u s t h a v e a co m p le te w o r k i n g k n o w le d g e of the test a n d be re a d y to g iv e a p p ro p ria te a n s w e r s on m in o r p oin ts w h ic h m a y arise th erefrom . S e c o n d ly , th e j u d g e m u s t b e p r e p a re d for a lt e r n a t iv e s o l u t i o n s t o t h e v a r i o u s p r o b l e m s in t h e t e s t , a n d b e r e a d y t o a l l o t fu l l m a r k s o r s u c h p r o p o r t i o n o f t h e p o s s i b l e m a r k s a s h e co n sid e rs th a t th e tre a tm e n t re n d ered m erits, e v e n t h o u g h t h i s is d i f f e r e n t f r o m t h a t s e t d o w n in t h e m a r k i n g s h e e t . T h i r d l y , t h e j u d g e m u s t b e a b s o l u t e l y i m p a r t i a l in h i s decision s, a n d n eith er b y a c tio n nor lo o k cre a te the im p re s s i o n t h a t h e is f a v o u r i n g a n y t e a m . S u c h id e a s a re fostered w h e n , a s s o m e ti m e s h a p p e n s , th e j u d g e sits d o w n a n d m a r k s h i s c o m p e t i t i o n s h e e t w h e n t i m e is c a l l e d a n d t h e t e s t e n d s . M y c u s t o m is t o a l l o t a l l m a r k s a s t h e t e s t p r o c e e d s , a n d t h e n t o p a s s t h e s h e e t t o t h e s t e w ' a r d a p p o i n t e d t o c o l l e c t it a s th e te a m le a v e s the co m p e titio n a r e a ; a n d I a lw a y s refu se to a d d u p m a r k s . L a s tly , the ju d g e m u s t c o n c e n tr a te on the job before h im , a n d resist all d is tr a c tio n s — a m o n g w h ic h I in clu d e c h a t s w i t h fr ie n d s or o t h e r officials d u r i n g t h e p r o g r e s s of th e test, a n d a ls o to o m u c h a tt e n tio n to th e r e a c t io n s of th e Spectators.

heets.

T i m e w a s w h e n j u d g e s o fte n d e l a y e d th e p r e p a r a t io n of th eir m a r k i n g sh eet u n til a n h o u r or t w o before th e c o m p e tition . I n t h e s e la t te r d a y s it t a k e s s e v e r a l h o u r s of s t e a d y w o r k to d r a w u p a d e ta ile d m a r k i n g s h e e t c o m p o s e d of s e c t i o n s a n d s u b - s e c t i o n s . M y c u s t o m is t o a d o p t a u n i t o f t w o o r th re e m a r k s a n d th e n to m a r k u p th e v a r io u s ite m s on this s c a le . N e x t I stre ss th e im p o rta n c e of s e ttin g d o w n d etails d irect fro m th e o pen T e x t b o o k , an d th ereb y of a v o id in g ris k s o f e r r o r w h i c h w i l l i n v a r i a b l y r e s u l t if t h e j u d g e r e l i e s o n h i s m e m o r y . I n t h i s c o n n e c t i o n , it is r e m a r k a b l e h o w t h e w o r d i n g of th e T e x t b o o k le n d s itself to s e t t in g d o w n lin e u p on

H o m e N u r s i n g . — S u b je c t to su fficient m e m b e r s b e in g en ro lled , a c o u r s e of in s tr u c tio n in th e a b o v e s u b je c t w ill be h eld at th e A ld e r s g a t e W a r d S c h o o l, 10 1, A ld e r s g a te -s tr e e t, London, E .C .I. T h e c o u rs e w ill c o m m e n c e on T u e s d a y , J a n u a r y 1 5 t h , 19 4 6 , a t 6 o ’c l o c k p . m . , a n d c o n s is t of 12 le ctu re s, 6 of w h ic h w ill be g iv e n b y a s u r g e o n . L a d ies w ill b e a d m it t e d to th e c la s s a n d s e p a r a te a c c o m m o d a t i o n for p ractice w ill be provid ed. F u rth e r p a rtic u la rs from t h e C l a s s S e c r e t a r y , A m b . O f f i c e r J. H . C h a p m a n , 2, Y o r k road, N ew S o u th g ate, N . l l .

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HOUSEHOLD PHYSICIAN D e s c r i b e s in s im p le la n gua ge w i t h helpful c o l o u r e d pla te s and d ia gr am s

The COMPLAINTS OF MEN, WOMEN AND CHILDREN. T h e i r C a u s e , T r e a t m e n t and C u r e .

A j e w ot the S u b jects t r e a t e d : H o w to K e e p W e l l , F i r s t A id W h a t t o D o in E m e r g e n c i e s I n f lu e n z a , C o ld s , etc. M ea sle s, M u m p s , C a ta r rh C orns and W arts P h y sica l C u ltu re T r e a t m e n t for a ll S k i n D is e a s e s T h e L u n g s , P leu risy H y g ie n e , A n atom y, P h arm a cy THE

YOUNG

T h e P r in c ip le s of N u r sin g T h e E ye, 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 , the M uscles Infant W elfa re H o m o ep ath y, N eurasth enia 3 75 P r e s c rip tio n s , e tc ., etc.

W I F E w i l l find ju st the in fo r m a tio n sh e re q u ir es.

M O T H E R S w h o w i s h th eir d a u g h t e r s t o d e v e l o p n atu ra ll y w i l l find e x a ctly the t eac hing t h e y need. W OM EN OVER discussed.

40 w ill find

th eir difficulties r e g a r d in g

P R E S C R I P T I O N S — 375 p r o v e d remedies.

! h u n d r e d s

;; j o f

t e s t im o n ia l s

" I t 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.”

“ F irs t A id in a F e w W o r d s .” Q u e s tio n s and A n s w e r s . Ba se d o n the 39th E d i t i o n o f the T e x t B o o k o f th e St. J o h n A m b u l a n c e A ss o c ia t io n . Pric e 6 d . each ( P o s t a g e id .) o r 5 s. p e r d oz. ( P o s t Free).

S ix S e ts o f C a d e t C o m p e t it io n P a p e rs. Each

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V I R T U E & C o ., L td ., (F .A . D e p t .) , C r o w n C h a m b e r s , U p p e r P a r lia m e n t Street, N o ttin g h a m . .

1 1

P le ase 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 t o p u r c h a s e .

N A M E .......................................................

1 1

health f r a n k l y

HO USEHO LD

P H Y S IC IA N

w ith o u t any

S e n d th is f o rm In u n s e a le d e n v e lo p e , s ta m p e d Id .

ADDRESS.

ADAM, ROUILLY & CO., Human Osteology, Anatomy, etc.,

F I T Z R O Y S TR EET , F I T Z R O Y S Q U A R E , L O N D O N . W . l TELEPH O N E :

S e t in clu des F ir s t A i d , H o m e N u r s i n g , G e n e r a l E ffic ie nc y a nd D r i l l , f o r tr a in in g p u rp o s e s .

M U SE U M 2 7 0 3 .

TH E

H O U SE

FOR

P r ic e 7 d . each , o r C o m p l e t e Set o f Six, P o s t F re e 3s.

HUM AN

The above may be obtained from : C o u n t y O f f i c e r F. A . T R O T T , 16, H u r s t R o a d , H o r s h a m , S u s s e x .

(A rticu la ted

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E T C .,

D a t e w ill be a n n o u n ce d later.

FIR ST

& D isarticu la ted )

H A L F -S K E L E T O N S ,

“ H in ts o n C o m p e t it io n T r a in in g .” B y the same A u t h o r .

SKELETONS

d .p . h .

p .R .c .s .( E d .)

E T C .,

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Obtainable from D a l e , R e y n o l d s 85 C o . L t d . , 46, C a n n o n St., E . C . 4

S K I N

I N J U R I E S

Be prepared for an emergency and keep Cuticura Brand Ointment in your First Aid Kit It brings in stant soothing relief to cuts, burns, skin lacerations - prevents spread of infection, quickly heals Obtain able at all Chemists and Stores.

F I R S T

Queries and Answers to Correspondents

R I D a m a n su ffe r in g fro m fr a c tu re of the spine. H e w as m u c h a m u s e d w h e n s h e r e p l i e d :— “ I w o u l d ap p ly a long < s p lin t fr o m h ea d to buttocks , a n d so keep the sp in e J r ig id ! ” Good !

N e x t , p l e a s e ! !— N . C . F .

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 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 top left-h an d co rn e r of th e en velo p e “ Q u e r y , ” a n d ad d ressed t o F i r s t A i d , 46 , C a n n o n - s t r e e t , L o n d o n , E . C . 4 . 2 .— A ll Q u e r ie s m u s t b e w r it t e n o n on e sid e of p a p e r only. 3 .— A ll Q u e r ie s m u s t be 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 , i n c a s e of Q u e r ie s fr o m a b r o a d , fr o m a r e c e n t issu e. 4 .— T h e T e x t b o o k to w h i c h r e fe r e n c e m a y b e m a d e in th is c o l u m n is t h e 3 9 t h ( 1 9 3 7 ) E d i t i o n o f t h e S . J . A . A . M a n u a l of F ir s t A id to th e In ju re d .

Thanks to the Doctor. In the October 1915 issue of F i r s t A i d , consequent on the illness and subsequent death of Dr. Frank Christian who for five years had acted as our Hon. Medical Correspondent, there appeared a new name after the answers to queries sub mitted by readers. This was not well-known, and belonged to a surgeon who for seven years had been working with a circle of Rail way first aiders. Later, when the volume of queries increased beyond anticipations, the name gave way to initials which have appeared in the journal for thirty years through times of stress and illness. Not once have they been absent from the 360 issues of F i r s t A i d ; and to-day they are accepted throughout the British Empire as the authority on all matters appertaining to first aid and kindred subjects. W e do not attempt to assess the amount of time and trouble which N .C . F . has given and taken during his thirty years of service as Honorary Medical Correspondent to F i r s t A id . W e do know, however, that it has been a labour of love and that his one desire is to help the conscientious first aider who is anxious to have some difficulty explained. W e cannot, therefore, let this opportunity pass without extending to Dr. N. Corbet Fletcher the most sincere and most cordial thanks of our readers and ourselves, for the magnificent work which he has done on behalf of the first aid movement throughout the world. He has done more than any one individual to advance the science of first aid ; and by his wisdom and encouragement he has played a leading part in furthering the knowledge and the enthusiasm of the voluntary first aider.— E d i t o r . T r e a tm e n t o f B ru ises.

C .C . (Fulham).— According to the books which I have read, Tincture of Arnica can be used on bruises successfully, provided that the skin is not broken. T he Leader of our W orks First Aid Party, however, maintains that it can be used even when the skin is damaged ; but I am under the impression that it will cause an unpleasant rash if u'rongiy used. As we always have this preparation in our cabinet I would be very pleased to accept your ruling on this point. Tincture of Arnica, diluted with water, is an old fashioned remedy used in the treatment of bruises. It has, however, fallen into disrepute owing to the risk of causing acute inflamation of the skin ; and I, personally, have never seen it used. In these circumstances I advise you not to use this remedy but to content yourself with the treatment for bruises as outlined in the T extb o o k .— N . C o r b e t F l e t c h e r

S ch afer or S ilv ester M eth od . C . C . ( F u l h a m ) . — F u r t h e r to th e q u e r y w h i c h y o u a n s w e r 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 , if a m a n ’ s f a c e is b a d l y b u r n e d a n d if h e h a s c e a s e d to b reath e, w o u ld not the b u rn e d face be sufficient rea so n fo r s e l e c t i n g S i l v e s t e r ’s m e t h o d w h i c h , a s y o u s ta te d , “ is o n l y t o b e u s e d w h e n it is i m p o s s i b l e t o t u r n t h e p a tie n t on to h is fa c e ” ? O n c e a g a in I w e lc o m e yo u r ru lin g, a nd I th a n k you f o r a l l t h e v a l u a b l e h e l p w h i c h I h a v e g a i n e d in t h e p a s t fr o m y o u r replies. A b a d l y b u r n e d f a c e in a n a s p h y x i a t e d p a t i e n t is n o t a c o n t r a in d ic a t io n to th e u s e of S c h a f e r ’s m e t h o d w h i c h s h o u ld be c o m m e n c e d at the earliest m o m e n t, d u e p ro tectio n b e in g g i v e n to th e fa c ia l i n ju r ie s .— N . C . F .

B u rn or Scald. W . L . (S o u th S h ie ld s ).— W it h re fe re n ce 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 A u g u s t - issu e of F ir s t A i d , I h a v e d ea lt w ith a co n sid e ra b le n u m b e r of b u rn s c a u s e d b y m olten m eta l. M y m o s t s e r i o u s c a s e w a s o n e in w h i c h t h e p a t i e n t p u t his b u r n e d feet in to w a t e r w h ile th e r e w a s still m e t a l in th e s h o e s . W h e n th e boot w a s rem o ved , the burned tis s u e a n d flesh ca rp e a w a y w it h the m eta l, l e a v in g th e f o o t in a v e r y s e r i o u s c o n d i t i o n . T h i s w a s d ue, I th in k , to s t e a m g e n e r a t e d b e t w e e n th e m e ta l a n d th e foot, w h e n it m a d e c o n t a c t w i t h t h e w a t e r . T h e foot h a d a w h ite scald ed a p p e a r a n c e an d not the u su al b ro w n b u rn t su rface. I n c i d e n t a l l y t h i s w a s t h e o n l y c a s e in w h i c h I h a v e s e e n th e flesh c o m e a w a y w h e n th e b u rn w a s e x a m i n e d for tre atm e n t. In c o n c lu sio n m a y I t h a n k y o u for y o u r v e r y in te re s t i n g r e a d i n g in F

ir st

B e s t t h a n k s for y o u r v e r y in t e r e s t in g le tte r a n d a c c o u n t of y o u r p e r s o n a l e x p e r ie n c e w ith th is ty p e of i n j u r y . — N . C . F

S.J.A . A s s o c i a t i o n A w a r d s . B . T . ( C a tfo r d ) .— I h a v e been in fo rm ed b y a m e m b e r of a r e c e n t l y f o r m e d D i v i s i o n o f t h e B r i g a d e t h a t h e is to r e c e iv e a m e d a llio n a f t e r le s s t h a n a y e a r ’s s e r v ic e a n d t h a t e v e r y three m onths t h e y a r e a b l e t o t a k e a n e x a m i n a t io n . W h e n , s e r v i n g w ith th e 74th D iv isio n I w a s o n ly a l l o w e d to p a s s o n e e x a m i n a t i o n e a c h y e a r , a n d I t o o k 3 y e a r s ( not m on ths) t o o b t a i n t h e m e d a l l i o n . Is th is fair to o ld er m e m b e r s ? H o w d oes y e a rly E fficiency stand (viz., J a n . to D e c . ) u n d e r th is a r r a n g e m e n t ? In m y p r e s e n t D iv is io n w e hold to th e y e a r ly rule. C ould you k i n d l y t e l l m e if t h i s is a n e w a r r a n g e m e n t t o o b t a i n e a r l y p r o f i c i e n c y o r if I h a v e b e e n w r o n g l y i n f o r m e d ? Y o u s e e m t o h a v e b e e n m i s i n f o r m e d w i t h r e f e r e n c e to th e in te rv a l b e tw e e n e x a m i n a t io n s for A s s o c ia tio n a w a r d s , a l t h o u g h w e a r e told t h a t th e p erio d b e tw e e n s u c h e x a m i n a t i o n s h a s b e e n r e d u c e d f r o m t w e l v e to e i g h t m o n t h s a s a w a r em ergency. T h is , h o w e v e r , d o es not affect th e q u es tio n of B r ig a d e E f fi c ie n c y w h i c h still a l l o w s o n e y e a r fo r e a c h y e a r of s e r v ic e in t h e B r i g a d e . — E d i t o r .

E x a m in a tio n H o w ler.

B r ig a d e U n ifo rm .

M.B. (Cambridge).— In a recent examination the doctor asked one candidate how he would act if he had to treat

J .P . ( C h a r lt o n ).— H e r e w it h th ree q u erie s w h ic h I h a v e just received fro m m y son, a m e m b e r of th e B r i g a d e n o w

F I R S T

ASTHMA, BRONCHITIS CATARRH, HAY FEVER

R I D

I G L O- F DI R SI TN- A EI D “ It d o e s n ’ t h u r t in t h e least ” — Iglod ine can be ap plie d t o an o p e n w o u n d w i t h o u t pain. This safe, b u t p o w e r f u l antiseptic cle an es and heals cuts, w o u n d s , b ru is e s, scalds and bu rn s.

and o t h e r R e s p ir a t o r y S uffe rers sh ou ld c o m m un ic a te w i t h British M edica La b ora to ri es, Ltd., fo r pa rticulars o f “ S an olen ” t h e m os t effic acious H o m e R e m e d y k n o w n t o Medical S c ie n c e : N o w being used w i t h r e m a r k a b l e su cce ss e v e r y w h e r e : E n d o r s e d by t h e M ed ical P rof ess ion .

The PAINLESS Antiseptic U sed by F a cto rie s, H o sp ita ls, and A m b u lan ce A u th o rities th rou gh o u t G r e a t B ritain .

■ B R IT IS H M E D IC A L A B O R A T O R IE S LTD. (D e p t. Z .A .3 ) H e a th c o te R oad, B oscom be, B o u rn e m o u th .

P R O F E S S IO N A L S A M P L E S E N T O N R E Q U E S T

From C hem ists— I/-, l/IO±, 2/ II . T h e I g lo d in e C o . L td ., N e w c a s t le u p o n T y n e .

W. H.

B A IL E Y &

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c om pris in g 3 Finger, 16 F o r e A r m , 16 U p p e r A r m , I S e t (3 sizes) A n g u la r A r m Splints, 6 A s s o r t e d L e g and T h ig h ranging fr o m 24"— 54", (44 Splin ts in all) - - - PRICE 21/-.

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Fitted Pou ch e s and H a v e rsa c k s a lw a y s in s t o c k . L e t us q u o t e fo r y o u r First A id r e q u i r e m e n t s . 4 5 , OX FO RD S T R E E T , L O N D O N , W .l. 'G r a m a : ‘ ‘ B ayleaf, L o n d o n .” 'P h o n o : G e r r a r d 3 1 8 5 & 2 3 1 3 .

CALLING

ALL

AMBULANCE

SERVICE

WORKERS. Jo in t h e A m b u l a n c e sp ecia lise d W e lfa re

sectio n

S e rv ice s

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the

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G u ild , th e

H osp ital (A ffiliated

and to

th e T .U .C .)

Full particulars from th e G en eral S ecreta ry , 38, A rgyle Squ are, London, W .C .I. ( I n t e r e s t e d p e r s o n s s h o u ld w r it e fo r t h e U n i o n ’s s t a t e m e n t a n d p r o p o s a l s in r e f e r e n c e t o a C e n t r a l i s e d A m b u l a n c e S e r v i c e in t h e p o s t w a r f u t u r e . )

BYPROGRESS TOPOOJPEBrtY

IN S T IT U T E O F C E R T IF IC A T E S KNd D I P L O M A S

WELFARE

WISDOM

T h e reliance w hich f a c to r y workers place in their Welfare Nurse is com parab le with t h a t which she in turn places in her First A i d equipmen t. R a p i d relief from pain and distress is no less essential in the N atio n al interest than to the sufferer, and calls for the prom pt admin istration o f a safe analgesic and sedative. T h a t is w h y <• A n a d i n , ’ a bala n ced co m bin atio n in the aspirinphenacetin-caffeine group, is regarded as indispensable in F a c t o r y W elfare work.

AN A I) IN

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\ serving overseas and to which I shall be most grateful if you will supply the necessary answers :— ( 1) Is the Brigade uniform classified as K i n g ’s uniform ? (2) Is the Brigade a proper military organisation, i.e., do its members really come under K i n g ’s R e g u la tions when dressed and on duty ? (3) Do we disgrace the K in g if improperly dressed or misbehaving ourselves ? T h e Brigade is a civilian organisation which was established to deal with civilian emergencies and which pro vides reserves for the Medical Services of Army and Navy. It follows, therefore, that in civilian life its uniform does not come within the scope of K i n g ’s Regulations. If, however, a member wearing Brigade uniform whilst engaged on duties which are normally connected with service in H . M . Forces, then K i n g ’s Regulations would definitely apply. Incidentally, throughout its long history, members of the Brigade have been proud of their organisation and have been careful to avoid any action which would bring disgrace on t h e uniform.— E d i t o r .

T re atm e n t o f F ra ctu red C la v ic le . J . M . (Plymouth) — Please tell me why the Textbook (p. 8 1 )

tells us to remove the coat of a man suffering from frac ture of the clavicle. There are three reasons why in the treatment of fractured clavicle the coat should be removed at an early moment :— ( 1) T o alleviate pain caused by the weight of the coat on the injured shoulder ; (2) T o ensure the placing of the large pad well within the armpit ; and (3) T o assist subsequent treatment because the coat must be removed before the patient can receive medical aid. — N .C . F .

T r e a tm e n t o f C r u s h e d H and.

J.M. (Plymouth).— T h e Textbook on p. 86 tells us when treating a patient for crushed hand to secure the hand fir s t Surely if we do this we run the risk of having the weight of the splint h angin g on the damaged hand. I shall be grateful for your comments. In the General Rules for Treatment of Fractures (Chap ter V I of Textbook) you are told in Rule 3 to steady and support the injured limb so that further movements of the injured part are prevented. If this is done, there will be no risk of “ the weight of the splint ha ngin g on the damaged hand.” — N .C . F .

B rig ad e C h u rch P arad es.

W . L . (Belmore, N ew South Wales).— T w o friends, Am bu lance Officers in their respective Divisions of the Brigade, and I, would be pleased to know the answers to the following two queries :— (1) W hat is the Brigade procedure on Church Parade from the time the order is given to “ Fall in ” to the time when the parade is dismissed ? (2) Do the members of the Colour Party remove their head-dress when entering the church ? If not, at what time is the head-dress removed ? W e have consulted military textbooks but have found nothing which is of guidance to Officers in charge of Church Parades. In our difficulties, therefore, we turn once more to you. T h e usual procedure is for the head-dress of members of the Colour Party to be kept on until the colours are handed over to the officiating clergyman. T h e head-dress is then removed because obviously the members are not then acting as a Colour Party. T he reverse holds good for the ceremony of reclaiming the colours. In other words, the head-dress is

w o r n w h i l e t h e c o l o u r s a r e in a c t u a l p o s s e s s i o n o f t h e C o l o u r P a rty .— N .C .F . B rig a d e M a n u a l o f D rill. G . P . ( C o v e n tr y ).— A t a D iv is io n a l P r a c tic e th is w e e k , I w e n t th r o u g h the n e w S tre tc h e r D r ill fro m the latest M a n u a l o f D r ill, fr o m w h i c h th e r e w a s a lo t of d is c u s s io n a s to th e p l a c i n g of p a tie n t o n s t r e t c h e r u n d e r th e n e w w a y of fo ld in g the b la n k ets. O n p a g e 57, u n d er the h e a d in g “ B l a n k e t S t r e t c h e r , ” it s t a t e s t h a t b l a n k e t N o . 2 i s to b e f o l d e d i n t o 3, e t c . , a n d o n p a g e 5 9 i t s a y s l o w e r p a tie n t g e n t l y on to s tr e tc h e r . N o m e n t io n is m a d e of o p e n i n g B l a n k e t N o . 2, a s s h o w n w i t h p a t i e n t t h e r e i n o n p a g e 58. Y o u r r u l i n g a s to w h e t h e r B l a n k e t N o . 2 is to be o p e n e d to t a k e p a t ie n t w o u l d b e v e r y w e lc o m e . We t h a n k y o u fo r a ll y o u r k i n d l y r e p lies to q u e r ie s in F i r s t A id w h ic h a t a ll tim e s a r e m o s t h e lp fu l to th o se w h o read them . T h e o b j e c t o f t h e M a n u a l o f D r i l l is t o t e a c h d r i l l a n d n o t first a id , w h e r e a s t h e d e t a ile d in s t r u c t i o n s w i t h r e fe r e n c e to b l a n k e t i n g a p a t ie n t b e l o n g to t h e r e a l m of first aid . T h e se co n d b la n k e t m u s t of c o u rse be o p e n e d o u t before t h e p a t i e n t is l o w e r e d o n to t h e s t r e t c h e r . I t is t h e n f o l d e d a s in t h e m i d d l e r i g h t d i a g r a m o n p. 58 o f t h e M a n u a l , a f t e r w h i c h t h e l o w e r e n d i s f o l d e d o v e r t h e p a t i e n t ’s f e e t a s is s h o w n in t h e l o w e r l e f t d i a g r a m . — N . C . F . P ro tectio n o f A b d o m in a l O rg a n s. M .M . ( P ly m p to n ) .— (1 ) D u r in g a series of q u estion s a t D iv i s i o n a l P r a c t i c e I w a s a s k e d w h a t p r o t e c t i o n is p r o v i d e d for th e fr o n t of th e a b d o m e n ( e x c lu d in g p e lv ic b a sin , etc.). I re p lie d th e m u s c u l a r w a lls , b u t w a s s u r p r is e d to b e told t h a t it w a s t h e g a n g l i a . (S o lar p lex u s w a s m en tion ed.) I a m o f t h e o p i n i o n t h a t a g a n g l i o n is i t s e l f a d e l i c a t e o r g a n a n d n eed s p ro tectio n . A m I rig h t ? (2) F u rth e r, I a m u n d e r the im p ressio n th a t the g a n g li a a re situ ated fu rth e r b a c k to w a r d s th e verteb rae. I w o u ld lik e to k n o w th e lo c a tio n of th e s o la r p le x u s . (1) Y o u r a n s w e r w a s p e rfec tly co rr ec t ; a n d y o u cou ld h a v f r q u o t e d f r o m t h e T e x t b o o k (p. 4 0 ) — w h e r e t h e t r u n k a n d i t s c o n t e n t s a r e d e s c r i b e d — “ a n d in f r o n t a n d a t t h e s i d e s b y m u scu la r w a lls .” I n c i d e n t a l l y a g a n g l i o n is o n l y a c o l l e c t i o n o f n e r v e c e l l s on th e c o u r s e of a n e r v e a n d c a n t a k e n o p a r t in th e p r o te c tion of a b d o m in a l o r g a n s from violence. (2) T h e l o c a t i o n o f t h e s o l a r p l e x u s i s d e s c r i b e d in C h a p t e r X I I (p. 1 5 3 ) o f t h e T e x t b o o k — “ in t h e u p p e r p a r t o f a b d o m e n b e h i n d t h e s t o m a c h ” o r in o t h e r w o r d s in f r o n t o f th e co m m e n c e m e n t of the a b d o m in a l a o rta . I t is f o r m e d b y t w o sem i lu n a r g a n g li a a n d by a n u m b e r of in te r la c in g n erve cord s w h ic h su rro u n d the g a n g l i a . — N . C . F . W e a r i n g o f B r ig a d e U n ifo rm . G . G . ( H u n t l e y , N e w Z e a l a n d ) . — P l e a s e t e l l m e if i t is in o r d e r f o r t h e d r i v e r o f a n a m b u l a n c e w h i c h is o w n e d a n d o p e r a t e d b y a lo c a l D i s t r i c t C o m m i t t e e to w e a r th e u n ifo rm of th e B r i g a d e o f w h i c h th e d r iv e r is a m e m b e r . T h e d r iv e r is p a id a full tim e w a g e fo r th e jo b .

A m e m b e r o f t h e B r i g a d e is n o t p e r m i t t e d t o w e a r h i s u n ifo r m fo r h is d a ily jo b e x c e p t (an d un til) h e h a s o b tain ed p e r m is s io n fr o m t h e - O f f i c e r - i n - C h a r g e o f th e D i s t r i c t (or C o u n t y ) to w h ic h his D iv is io n b e l o n g s .— E d i t o r .

44 F Q U E R Y

and

I R S T

A I D

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7 o be cut out and enclosed with a ll Queries. Oct., 19 4 5 .

M AN U ALS OF FIR ST A ID By N. CORBET FLETCHER, O.B.E., M B., B.C., M.A.(Cantab.), M.R.C.S. A ID 8

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S e v e n th E d i tio n . 18 a 3 d , p o s t 2 d . F ir s t- A id S im p lif ie d a n d T a b u l a t e d , w i t h A id s t o

M em o ry .

Col. S ir James Cantlie contributes an introduction and we endorse his good opinion o f the book. " — L a n c e t ,

A ID S

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T h ir d E d itio n . P r ic e 18 . 2 d . v p o s t f r e e . H o m e - N u r s i n g S im p lif ie d a n d T a b u l a t e d , w i t h A id s t o

M em o ry . “ This book wonderfully simplifies a complex subject and should be read bv students." — L . & N . W . R v . G a z e t t e .

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F o u r th E d i tio n . P r ic e 18 . 3 d . p o s t 2 ^ d . P r o b l e m s in S t u d y , T r e a t m e n t a n d E x a m i n a t i o n s o l v e d / o r S e n i o r S t u d e n t s . “ W ithout doubt the book w ill be or great service in the training o f those fo whom it is designed. ' — B r i t i s h M e d i c a l I o u r n a l .

C O M M O N

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18 . 3 d . p o s t 2 d .

E r r o r s )n F irs t-A id D e ta ile d a n d E x p la in e d . “ This book gives a clearer insight into the methods and difficulties o; emergency treatm ent by laymen than the official Textbook itself . " — L a n c e t .

A M B U L A N C E

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(

j e

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( S tr e tc h e r , I n d iv i d u a l a n d Q u e s tio n —S ix F o ld e rs ) . P r ic e 6 for 3 s . p o s t 3 d .. E a c h F o l d e r c o n ta in s s p e c ia l a r t i c l e o n C o m p e titio n s N o . 1, T r a i n i n g o f C o m p e titio n T e a m s ; N o . 2, C o n d u c t o f T e a m in C o m p e ti ti o n R o o m ; N o . 3, C o m m o n E r r o r s in C o m p e ti ti o n ; N o . 4, F u r t h e r E r r o r s in T r e a t m e n t ; N o . 5, H i s t o r y o f C o m p e titio n T e s ts ; N o . 6, P r e p a r a t i o n o f T e s ts .

W H Y

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F i f t h E d itio n . I s . 3 d . p o s t 2 d . D if f ic u ltie s In S tu d y a n d T r e a t m e n t s o lv e d b y Q u e s t io n a n d A n s w e r . “ We commend this book to Lecturers and Students who w ill fin d it o f grext service. ” — F i r s t A i d .

H IN T S

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To be obtained from 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 .

C la ss ifie d

A d v e rtis e m e n ts.

A d v e r t is e m e n t s w it h rem it ta n ce sh o u ld be sent t o F i r s t A i d , 3d . p e r w o r d , m in im u m 4 / 6 .

46, C a n n o n S tre e t L o n d o n , E . C 4 .

2 00 C o n c e r t T i c k e t s 5/6. M em os, R u b b e r S ta m p s , R oll T i c k e t s , S a m p l e s - T i C E S , 1 1 , O a k l a n d s G r o v e , L o n d o n , W . l 2.

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TR A IN IN G .

H E best g u id e for co m p etito rs. B a s e d on a c tu a l e x p e ri ence. l i d . P o s t f r e e ( 8 /- d o z e n ) F o u n t a i n P r e s s , 46 , C h a n c e r y L a n e , L o n d o n , W . C . 2.

O I S O N S C H A R T — H a n d y Q u ic k R eferen ce— T re atm e n t a n d R e m e d i e s f o r 30 d i f f e r e n t p o i s o n s . H a w k i n s , l i d . P o s t f r e e ( 8 /- d o z e n ) . F o u n t a i n P r e s s , 46 , C h a n c e r y L a n e , L o n d o n , W . C . 2.

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O V E L Y T e d d y Bears. R e a d y to m a k e , sen d l i s t , T o y k r a f t , 1 9 ; R o u n d h a y R o a d , L e e d s , 7.

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O P H TH A L M O -A N T IP E O L ib a semi-fluid oin tm 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 infecrions a nd lesio ns. E y e s affected b y s m o k e a nd d u s t are s o o t h e d a lm o s t im m e d ia te ly b y the a p p li ca tio n o f O p h t h a l m o - A n t i p e o l , a nd the a n tiv ir u s p r e v e n ts g e r m s f r o m d e v e lo p i n g .

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F I R S T A I D T O I N J U R E D A N D S I C K R e v is e d a nd R e w ritten b y H A L L I D A Y S U T H E R L A N D ; M .D . F orty-F ifth E d i t i o n . 88 p a g e s . 46 illu st rat io n s 9 d . n e t . p o s t a g e 2d .

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a N .B .—T o e n s u r e p e r f e c t lo c k in g r C s h o u ld b e c o r r e c tl y I n s e r te d In C E R T A IN T H A T T H E IN C U R V E D E N G A G E S W IT H T H E T R A N S V E R SE

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CONTENTS

F.R.S.A.

N O V EM B ER , 1945.

LII.

N OTIC E

F.R.San.l.,

...

I n spite of the dictum of the poet there is much, apart from scent, in a name, and the reflec tion brings to our mind the offensive appellation of “ Nanny.” We are glad to see that from now on only State-registered nurses, enrolled assistants and certain of other classes will be allowed to subscribe themselves as nurses. “ Nannies,” unless so qualified, will not be allowed to use the title, and it is only right that they should be prohibited from using it. When Romulu$ and Remus were suckled, it was not by a she-goat but by a she-wolf. The fabulist could not bring himself so low as to allow them to derive their sustenance from a “ Nanny.” But the name seems to be good enough to describe the nurses of children, irrespective of age, and our wonder is that nurses do not rebel against the use of such a humiliating name. The word nurse is derived from a verb meaning to nourish, and, speaking of wet nurses, nourishment from a she-goat (or a “ nanny”) does not strike one as desirable, how ever nourishing it may be. How the word arose it is not easy to say, but it is possibly a corruption of the Hindustani NANI, meaning a maternal grandmother. It has taken on, however, and the word has permeated through the whole of what are known as the superior classes. To us, the word so maltreated is highly offensive, and it puts the nurse, who may be both refined and educated, in the same category as the inmates of the servants’ hall. The matter is certainly a trivial one, and scarcely seems worth wasting space upon, but it affords an example of the fallacy of the poet’s dictum. While on the ques tion of names, reference might be made to that nauseous contraction of tuberculosis into T.B. The disease is a fell one, and does not seem to lend itself into a couple of humourous initials. Unfortunately, this initialisation has “ caught on,” and, in reading one’s daily papers, one comes across scores of them, to the utter confusion of the reader. The worst example we know is U.O. B. T. A. A.B.S.O .G .B. A.I.M .O ., which signi fies “ United Operative Bricklayers’ Trade, Acci

Nurses and “ Nannies.”

5°

F I R S T

dent and Burial Society of Great Britain and Ireland, Manchester Order.” The Society was registered as “ The Three Kingdoms Bricklayers’ Trade, Accident and Burial Society.”

T h e A sso cia tion and th e Science o f First A id . By

CO RBET

FLETCH ER,

(S u rg eo n -in -C h ief,

The

St.

. b . e . , M .A ., m . b . , m . r . c . s .

John A m b u lan ce

B rig ad e

A t-H o m e .)

( A n A d d ress g iv e n on Septem ber 2<)th a t the A n n u a l D is trib u tio n o f A w a rd s o f the L . P . T . B . A m b u lan ce C entre. J

I t h as been

s u g g e s t e d t h a t t h is a ft e r n o o n I s h o u ld tell y o u th e p a rt w h ic h th e St. Joh n A m b u la n c e A sso cia tio n h as p l a y e d in t h e r i s e a n d p r o g r e s s o f f i r s t a i d , w h i c h a p p l i e d to in d u stry , h as tw o p r im a ry o b je cts— (1 ) the trea tm en t on the s p o t of s i c k a n d in ju r e d p e r s o n s , a n d (2) t h e a v o i d a n c e of lo s s o f p r o d u c tiv e tim e. C y n i c s h a v e i n s in u a t e d t h a t first a id s a v e s c o m p a n ie s f r o m p a y i n g o u t h i g h e r s u m s in c o m p e n s a t i o n a n d t h a t f ir s t a id e r s a r e w e ll r e m u n e r a t e d for t r e a t in g th e p a tie n ts. There is , o f c o u r s e , s o m e t r u t h in t h e f i r s t s u g g e s t i o n ; b u t , w h e n it o c c u r s , it is a m e r e c o i n c i d e n c e . T h e r e is , h o w e v e r , n o t r u t h in t h e s e c o n d , b e c a u s e , l i k e t h e K n i g h t s o f S t . J o h n w h o s e e x a m p l e t h e y e m u l a t e , th e v a s t m a j o r i t y of first a i d e r s g iv e freely of th eir k n o w le d g e a n d e x p e rie n c e w ith o u t fee or fin a n c ia l r e w a r d ; a n d in d eed th e y a r e often a c tu a lly o u t of pocket.

The Order of St. John. T h e S o v e r e i g n O r d e r o f S t . J o h n w a s d i s p e r s e d in 1 7 9 8 w h e n N a p o le o n to o k M a lta a n d w a s n ever re-estab lish ed . In 1 8 3 1 , h o w e v e r , step s w e r e t a k e n to re v iv e th e E n g lis h B r a n c h w h i c h for t h e n e x t fo r ty y e a r s e x is t e d a s a s m a ll a n d p r iv a te p h ila n th ro p ic b o d y w ith o u t a n y o u ts ta n d in g ob ject of e x is t ence. I n d e e d , in 1 8 7 0 , t h e c h i e f i n t e r e s t s o f t h e m o d e r n K n i g h t s o f S t. J o h n w e r e (1) d ie ts for c o n v a le s c e n t p a tie n ts a n d (2) th e t r a i n i n g of w o m e n a s n u rse s. T h e o pp o rtu n ity , h o w e v e r, c a m e w ith the e n d in g of the F r a n c o - G e r m a n W a r of 1870 d u r in g w h ic h the princip les of th e F ir s t G e n e v a C o n v e n ti o n of 1864 w e r e p u t to th e test. I n th is c o n flic t la y a s s i s t a n c e to s i c k a n d w o u n d e d so ld ie rs w a s fo r t h e first t i m e o ffic ia lly s a n c t i o n e d w it h m o d e r a t e resu lts. C o n s e q u e n tly , th o se re sp o n s ib le fo rm e d th e opinion t h a t , t o b e o f r e a l a s s i s t a n c e in w a r t i m e , l a y p e r s o n s s h o u l d b e t r a i n e d in r e n d e r i n g a i d t o s i c k a n d i n j u r e d c i v i l i a n s d u r i n g y e a r s of peace. T h e y , th erefo re, in vited th e B ritis h N a tio n a l S o c ie t y for A id to S i c k a n d W o u n d e d (from w h ic h th irty y e a r s la te r th e B ritish R e d C r o s s S o c ie ty t o o k o rig in ) to u n d e r ta k e t h i s t a s k w h i c h it d e c l i n e d a s t o o a r d u o u s .

The St. John Ambulance Association. T h e O r d e r o f S t . J o h n in E n g l a n d , h o w e v e r , s a w a n d s e i z e d t h e o p p o r t u n i t y , t h e r e s u l t b e i n g t h a t in 1 8 7 7 t h e S t . Jo h n A m b u la n c e A s s o c ia tio n w a s fo u n d ed a n d a n e w scien ce ( la t e r c a lle d “ first a id ” ) w a s b r o u g h t in to e x i s t e n c e . T h a n k s , th erefo re , to th e fa r s e e in g w is d o m a n d in itia tiv e of Joh n F u rley, S ir E d m u n d L e ch m ere and M a jo r F ra n cis D u n can , th e O r d e r h a d n o w a n o u ts ta n d in g ob ject of e x isten c e w h ic h

A I D a p p e a l e d t o a l l c l a s s e s o f t h e c o m m u n i t y a n d w h i c h in c o u r s e o f t i m e c o n v e r t e d it i n t o a w o r l d w i d e o r g a n i s a t i o n o f i n t e r n a t i o n a l r e p u t e a n d w o n f o r it R o y a l P a t r o n a g e a n d a Charter. T o the A ss o cia tio n w a s d ep u ted th e ta s k of te a ch in g , e x a m i n i n g a n d c e r t i f y i n g l a y p e r s o n s in f ir s t a i d a n d a l l i e d s u b j e c t s ; a n d f r o m it s f o u n d a t i o n t o t h e p r e s e n t d a y it h a s s o u g h t to fu r t h e r th e s p r e a d of a m b u l a n c e m a t e r ia l. W ithin s i x m o n t h s it h a d r e g i s t e r e d 1,0 0 0 s t u d e n t s , o f w h o m w o m e n w e r e in t h e m a j o r i t y o f 3 t o 1 a n d c a u s e d a c y n i c i n t h e e a r l y d a y s t o d e s c r i b e t h e M o v e m e n t a s " a n ep h em era l fe m in in e

fa s h io n ." T h e e n th u sia sm w ith w h ic h th e A ss o c ia tio n w a s g re e te d h a s n e v e r l a g g e d a n d its c e r tific a te s (a n d o t h e r a w a r d s ) a re still h i g h l y prize d . In the e a rly d a y s of th e A m b u la n c e M o v e m e n t th ere w e r e tw o o th e r v o lu n te e r o r g a n is a t io n s — the fire b r i g a d e a n d t h e s o ld ie r. O f t h e s e t h e fi re b r i g a d e a c c ep ted h elp from (and w a s ta k e n o v er by) the m u n icip al auth o ritie s, the so ld ier w a s a ssiste d fin a n c ially b y th e S ta te a n d b e c a m e a u n it of th e T e r r ito r ia l A r m y , w h ile the a m b u la n c e e n th u sia st a lo n e re m a in e d a v o lu n te e r to th e p resen t day. I t s first s u r g e o n s w e r e D r . F r a n c i s F a l w a s s e r w h o p r e p a r e d th e first s y l l a b u s o f first a id a n d S u r g e o n - M a j o r P e t e r S h e p h e r d w h o c o m p i l e d t h e f i r s t t e x t b o o k p u b l i s h e d in 1 8 7 8 . I n h is p r e f a c e D r . S h e p h e r d r e fe r s to th e h e lp of “ k in d a n d a b le c o a d ju to r s ” w h ic h a c k n o w l e d g m e n t w a s a m y s t e r y u n til s o m e t w e n t y y e a r s a g o , w h e n b y c h a n c e I le a r n e d its e x p l a n a tion. H a p p e n i n g ' t o m e e t a D r . M i t c h e l l B r u c e in c o n s u l t a tio n I w a s told b y h im th a t D r . S h e p h e r d (b efo re his d e p a r tu r e to S o u t h A f r i c a on a c t i v e s e r v ic e fr o m w h i c h he n e ve r re tu rn e d ) h a n d e d o v e r the r o u g h notes of h is p ro po sed t e x t b o o k to D r . J a m e s C a n t lie a n d h im s e lf for co m p le tio n . C o n s e q u e n tly , th e la tte r , w h o is d e s e r v e d ly c a lle d “ T he F a th e r of F ir s t A i d " h a d a p a r t in t h e f i r s t c o m p i l a t i o n o f t h e t e x t b o o k w h i c h h e r e v i s e d a n d p r a c t i c a l l y r e - w r o t e in 1 9 0 1, w it h th e re s u lt th a t h e e s ta b lis h e d fo r a ll t im e the s c ie n c e a n d p r a c t ic e of first aid . •

The Science of First Aid. A scie n ce h a s b een defined a s k n o w l e d g e a r r a n g e d u n d e r g e n e r a l p rincip les a n d tru th s. T h i s b e i n g s o , fi r st a i d is t h e ( 1 ) i m m e d i a t e (2) t e m p o r a r y a n d (3) e f f i c i e n t a s s i s t a n c e re n d e r e d in c a s e s of s u d d e n illn e s s a n d a c c id e n t. I t is i m m e d i a t e in t h a t it is r e n d e r e d o n t h e s p o t , t e m p o r a r y in th a t o n ly th o se th in g s w h ic h a r e a t h a n d ca n be u sed, a n d e ffic ien t in t h a t it a c t u a l l y a c c o m p l i s h e s its o b je c t s a n d d o e s n o t m a k e w o r s e th e v ic t im ’s c o n d itio n o r in ju ries. T h e o b je c t s of first a id a r e e q u a l l y w e ll d efin e d , b e i n g ( 1 ) p r e s e r v a t i o n o f lif e , ( 2 ) p r e v e n t i o n o f a g g r a v a t i o n o f i n j u r y o r c o n d i t i o n , a n d (3) p r o v i s i o n o f p r o p e r m e t h o d s o f transport. O f th es e, o p p o r tu n ity to a c h ie v e th e first r a r e ly f a lls to t h e lo t of t h e a v e r a g e first a i d e r w it h t h e r e s u lt t h a t th e se c o n d a n d th ird b e c o m e all im p o rta n t. T h e s c o p e o f f i r s t a i d is a l s o l i m i t e d a n d i s e x c e l l e n t l y c o v e re d b y th e m n e m o n ic M . I . S . H . A . P . S . w h ic h 1 d evised y e a r s a g o a n d w h ic h in clu d es M a im s (fractures, d islo ca tio n s a n d sp rain s), In s en sib ility , S c a ld s a n d all lo ca l in ju ries, H a e m o rrh a g e , A sp h yx ia , P o iso n in g and S h o ck. T h e T e x t b o o k te lls h o w th e a p p lic a t io n of first a id c a n b e s t b e effected . A s th e d efin ition ju s t q u o te d te a c h e s us, f i r s t a i d is k n o w l e d g e a r r a n g e d u n d e r g e n e r a l p r i n c i p l e s a n d tru th s of w h ic h th e la tte r a re th e g e n e r a l ru les of tre atm e n t a n d t h e q u a lif ic a t io n s of first a id e r s . In th e efficien t p r a c tic e o f first a id , th er efo re , th e g e n e r a l ru le s h a v e to be m o d ified in a c c o r d a n c e w i t h t h e p r i n c i p l e s b y t h e p r o p e r e x e r c i s e o f t h e q u a lific a tio n s of first a id e rs. F i n a l l y , first a id m u s t be s tu d ie d a n d m a s te r e d a l i k e b y l a y p e r s o n s a n d b y d o c t o r s w h o a r e n o t t a u g h t it in h o s p i t a l , the fo rm er ra isin g , a nd the latter lo w e r in g a nd m o d ifyin g , th eir k n o w l e d g e to th e req u ired sta n d a rd . L i k e all scien ces, f i r s t a i d is q u i c k l y f o r g o t t e n u n l e s s s t e p s a r e t a k e n t o k e e p u p to d a te b y c o n s t a n t p r a c tic e a n d b y s u b m is s io n to p erio d-

F I R S T i c a l t e s t s , o n t h e p a r t o f l a y p e r s o n s , a s c a n d i d a t e s in t h e e x a m in a tio n room , a n d on the part of d o cto rs a s lectu rers and com petition ju d g es. T h is fa c t ra ise s th e q u estio n a s to h o w o n e c a n b est a s s i m i l a t e in a l l i t s d e t a i l s , t h e t e a c h i n g o f t h e T e x t b o o k . T o s o m e , tip s a r e u s e fu l a s m n e m o n i c s b u t to o th e r s t h e y a r e u tter ly u seless. P e rs o n a lly , I con fess th at I h a v e a lw a y s fo u n d th e m m o st h elp fu l, w h e th e r I a m le c t u r in g o r e x a m i n in g , a s, for e x a m p le , w h e n I a m c o rr e c tin g th e w ritte n p a p ers for th e la y in stru cto r ce rtificate ; a n d as s o m e of yo u k n o w , m y first b o o k w a s e n t i r e ly d e v o t e d to tips. T h e real v a l u e o f s u c h a i d s t o m e m o r y h o w e v e r , is t h a t e a c h s h o u l d p r e p a r e h is o w n m n e m o n ic s ; bu t, w h e t h e r w e u s e tip s or n o t , t h e g r e a t e s s e n t i a l t o s u c c e s s is t h a t w e s h o u l d a l l s t u d y t h e T e x t b o o k in s e a s o n a n d o u t o f s e a s o n .

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HEADQUARTERS AND DISTRICT REPORTS. No. I (Prince of Wales’s) District N o . 54 ( H a m p s t e a d ) . — O n M o n d a y , O c t o b e r 8th, t h e C a d e t N u r s i n g D i v i s i o n h e l d a n e n j o y a b l e p a r t y i n h o n o u r of H a m p s t e a d ’s f i r s t G r a n d P r i o r C a d e t s , A n n e S m i t h a n d A n n a W isla . T h e y re ce iv ed th eir B a d g e s a n d c o n g r a t u la tion s fro m D is tric t S u pt. M iss M . W o r k m a n , M . B . E A m o n g th ose present w e re D istrict O fficer M rs. R a y n e r , A re a C a d e t O fficer M rs. D o v e , D iv . S u p t. M iss F in c h , and C a d et Supt. M iss H y m a n . T h e p a rty in clu d ed g a m e s , a n d te a m ra ce s, a n d a s u c cessful concert a rr a n g e d and presented by th e cadets. O n M o n d a y , O c to b e r 15 th , A re a C a d et O fficer M rs. D o v e n sp ected th e D iv isio n , a n d also en ro lled 8 cadets.

Letters to the Editor. W e a r e in n o w a y r e sp o n s ib le fo r th e o p in io n s e x p re sse d , or the sta tem en ts m ad e, b y C o rresp o n d en ts.— E d it o r .

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I w a s v e r y in te re ste d in y o u r c o r r e s p o n d e n t ’s le tte r fro m I t a l y in J u l y i s s u e o f F i r s t A i d , d e s c r i b i n g t h e i n d i f f e r e n t a ttitu d e of b y sta n d e rs to street a ccid e n ts. A s a n A m b u l a n c e O f f i c e r in S . J . A . B . , I, to , w a s s u r p r i s e d b y t h e a t t i t u d e o f b y s t a n d e r s in B e l g i u m , w h o d i s p la y e d a s im ila r l a c k of initiative. I w e ll r e m e m b e r o n e a c c id e n t in v o lv in g 4 p ers o n s , all o f w h o m w e r e l y i n g in a p o o l o f b l o o d in t h e m i d d l e o f t h e road. W h e n 1 a rriv ed , IS m in u te s a fte r th e a ccid e n t, I fo u n d a c r o w d of p eop le sile n tly g a z i n g a t th e v ic tim s . A l t h o u g h t h e s e p e o p j e h a d c o m e f r o m h o u s e s in t h e v i c i n i t y of th e a c c id e n t, n o m o v e h a d b e e n m a d e to re n d e r th e slig h test assistance. I e c h o o u r N . Z . c o l l e a g u e w h e n h e s a y s i t is a p i t y t h e r e is n o t a n e f f i c i e n t o r g a n i s a t i o n s i m i l a r t o VS . J . A . B . o n t h e C o ntin en t.. I h a v e been a r e g u la r rea d er of y o u r in va lu a b le jo u rn a l s i n c e 1 9 3 0 , a n d a m s t i l l g e t t i n g it h e r e i n G e r m a n y . Good l u c k , k e e p it g o i n g . — Y o u r s t r u l y , J .E .E . IP E N IC IL L IN D

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in th e R . A . M . C . in I n d ia h a s s e n t th e th e c u re of a ca se of S m a llp o x b y the h e t h o u g h t it w o u l d b e o f i n t e r e s t to o f t h e g r e a t s t r i d e s m a d e in t h e u s e o f

“ A c o u r s e o f P e n i c i l l i n o v e r 9 d a y s , h a s b e e n u s e d in th e t r e a t m e n t o f S m a l l p o x in th e w a r d I a m o n a t p resen t. T h e c o u r s e is of o n e in je c tio n e v e r y 3 h o u r s , m a k i n g a to tal o f 7 0 i n j e c t i o n s , e a c h o n e o f 1 5 , 0 0 0 u n it s * o f P e n i c i l l i n . I t h o u g h t it m i g h t b e a n i n t e r e s t i n g p o i n t ; it is g i v e n d u r i n g th e s e c o n d a ry (papu lar) s t a g e of th e d isease. I t is a n a c t u a l c a s e of w h ic h I h a v e th e reco rd s before m e n o w . “ H e w a s a v e r y b a d c a s e , c o v e r e d f r o m h e a d t o f o o t in t h e p a p u l e s b u t in a f e w d a y s s h o r t o f 2 m o n t h s h e is c o m p l e t e l y c u r e d a n d g o e s o u t in t w o d a y s t i m e t o c o n v a l e s c e n c e . “ Pot. Per. M a n g . b a th s w e re a lso g iv e n of th e s tr e n g th o f a p p r o x i m a t e l y 1 :8,000 a n d t h e r o u t i n e i s o l a t i o n n u r s i n g . — Pte. L . E. C o o k , R . A . M . C . , In d ia C o m m a n d .” Y o u r s faith fully, M

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(S.J.A .B ., Borough of Romford).

N o . 5 8/5 ( W e s t e r n P o s t a l & S r . M a r y l e b o n e ) . — O n T u e s d a y , O c to b e r 23rd, th e A m b u la n c e D iv isio n and the 1 1 5 (S t. J o h n ’s W o o d ) N u r s i n g D i v i s i o n , h e ld t h e i r s e c o n d c o m b i n e d w e e k l y m e e t i n g a t 30, G l o u c e s t e r - p l a c e , W . l . A f i r s t c l a s s fi l m s h o w w a s p u t o n b y t h e M i n i s t r y o f I n fo rm a tio n F ilm U n it. F iv e film s w e r e s h o w n — T h e H is t o r y of D . D . T . , T h e B lo o d T r a n s fu s io n S e rv ic e , F ir s t A id on the S p o t , C h i n a in B r i t a i n , a n d t h e S u b j e c t D i s c u s s e d . A ll w e re w e ll received a n d e n jo y e d b y th e s ix t y odd m em b e rs present. I t is h o p e d t o c o n t i n u e t h e s e m e e t i n g s d u r in g the w in ter season.

N o . 93 ( F i n c h l e y ) . — T h i s D ivisio n h a s ca rried on d u r in g th e w a r d espite the fa ct th a t h a lf of th e m e m b e rs are in H . M . F o r c e s . T h o s e r e m a i n i n g , m a n a g e d t o fill m o s t o f th e n ig h t ly d u tie s a t fo u r local c in e m a s a n d th e L o n d o n C o lise u m T h e a tr e , besid es sp e cia l d u ties as d irected b y h e a d quarters. W i t h the end of th e w a r th e y d ec id e d on a little r e l a x a tion , w h ic h t o o k th e fo r m of a so c ia l e v e n i n g a t S t. P h ilip s H a ll, F in c h le y , recen tly. M em b e rs and th eir w iv e s a nd frien d s a tten d ed . T h e r e w a s p len ty of d a n c in g , a lso g a m e s a n d p rizes fo r th e ch ild re n , a n d a n e x c e e d in g ly g o o d s h o w of d a n c in g a n d s i n g in g b y the D o lo re s tro u p e of ju v e n ile dancers. A g e n e r a l k n o w l e d g e q u iz w a s w o n b y th e ladies b y o n e point. D i v . Supt.- W o o d t h a n k e d th e socia l a su cce ss.

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County of Bedford. L u t o n . — T h e th ird c e r t ific a t e o f m e r it of t h e O r d e r of S t . J o h n t o b e a w a r d e d in B e d f o r d s h i r e s i n c e t h e o u t b r e a k o f w a r w a s p r e s e n te d to M r . W m . A . S t e v e n s , S u p t . of th e L u to n W a r d o w n D iv isio n , a t a D iv isio n a l so cia l e v e n in g , h e ld at C o m m e r C a r s c a n te e n on S a t u r d a y , O c t o b e r 13 th . M r. S te v e n s received th e a w a r d for se rv ice re n d ered w h en C o m m e r C a rs canteen w as d a m a g e d a n d so m e n e ig h b o u r i n g h o u s e s w e r e d e m o lis h e d a fte r a r o c k e t in c id e n t on N o v e m b e r 6 th , 1 9 4 4 .

M a k i n g th e p resen ta tion, C o u n ty O fficer W . H . W e a th e r h e a d t o l d h o w M r . S t e v e n s , in c h a r g e o f t h e f i r m ’ s A . R P . C a s u a l t y S e r v ic e , w o r k e d c e a s e l e s s l y r e n d e r i n g first a id to v ic tim s of th e in cid ent. C h a ir m a n of th e D iv isio n socia l c o m m itte e , M r. T e d C a n n o n , sa it f M r . S t e v e n s c a m e t o L u t o n i n 1 9 1 1 , a n d w a s o n e o f t h e p i o n e e r s o f t h e B r i g a d e in t h e t o w n . D u r in g the w a r , h e h a d help ed 730 m en a n d w o m e n to g a i n ce rtificates.

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County of Birmingham. Y a r d le y .— On

T h u r s d a y even in g, O cto b er 11th , m e m b ers of the fo llo w in g D iv isio n s m et a t the h e a d q u a rte rs of th e Y a r d l e y D i v i s i o n fo r a first a id q u iz : D e r i t e n d , Y a r d l e y a n d B .S .A (S m a ll H e a th ) A m b u la n c e D iv isio n s, a n d S m a ll H e a t h , D e rite n d an d Y a r d l e y N u r s in g D iv isio n s. D r. A. B e a u c h a m p w a s q u estio n m a ste r a n d w a s assisted b y D rs. M a r s t o n , V . G r if fit h s a n d J. H . M c B r o o m . A la rg e n u m b e r o f o fficers w e r e p r es en t, a n d a b i g a u d ie n c e h a d a m o s t e n jo y a b le e ven in g.

County of Bristol B r i s t o l E a s t . — O n M o n d a y , O c t o b e r 29th, a se co n d a ll-s o u n d e xh ib itio n of m e d ic a l film s w a s s h o w n at th e B risto l E a s t C e n t r e b y th e D iv . S u r g e o n D r . A . J. S t r u lh e r s , fo r the b e n e fit of t h e A m b u l a n c e , N u r s i n g a n d C a d e t s e c tio n s o f th e D ivision . T h e r e w e r e a b o u t 70 m e m b e r s p res en t, a n d th e film s s h o w n w e r e : W o r k e r a n d w a r f r o n t N o . 8, B r e a t h o f d a n g e r , T h e n o s e h a s it, A B C D o f h e a l t h , D e f e a t T . B . , B a c k to n o rm a l. S u b je c t d iscu ssed . T h e s h o w l a s t e d f o r a b o u t 1^ h o u r s a n d w a s t h o r o u g h l y a p p r e c ia te d b y all presen t.

County of Dorset. D o r c h e s t e r . — In th e h a llo w e d a c r e a d j o i n i n g A ll S a i n t ’s C h u rc h , D o r c h e ste r, a n im p re ssiv e c e re m o n y w a s w itn essed on S u n d a y , O c t o b e r 14 th , a t a s p e c ia l s e r v ic e a r r a n g e d for t h e d e d ic a tio n o f t h e m o to r a m b u la n c e p res en te d to th e D o r c h e s te r D iv ision . S u b s c r i b e d f o r b y A m e r i c a n f r i e n d s in m e m o r y o f C a p t . S c o t t C a m e r o n , o f N e w Y o r k C i t y , it w a s p r e s e n t e d o n b e h a l f of th e A m e r ic a n R e d C ro ss, to D o r c h e s t e r R u r a l. D is trict C o u n c i l fo r A R . P . w o r k , a n d s u b s e q u e n t ly p r e s e n te d (on th e c e s s a t i o n of h o stilitie s) to t h e D o r c h e s t e r D iv is io n . B esid es the D o r c h e ste r D iv isio n , re p resen ta tives w e re p res en t from W e y m o u t h , W a r e h a m a n d S w a n a g e n u rs in g a nd a m b u la n c e D iv ision s, a n d the P o o le a n d W h iteh ea d s corps. T h e service w a s con d ucted b y C a n o n H . B o w e rs, O . B . E . ( R e c t o r of A ll S ain ts).

County of Kent. F o l k e s t o n e . — A p le a s in g ce re m o n y to o k p la ce a t the C o rp s h e a d q u a rte rs on M o n d a y , O c to b e r 15 th , w h e n p re lim in a r y c e rtifica te s w e r e p res en ted to c a d e ts a n d lo ca l s co u ts b y L a d y C o u n ty O fficer M iss C u rzo n S m ith , the e x a m in a tion fo r th es e w a s c o n d u c te d by D r . C. E . M c C a u s la n d . M iss C u r z o n S m ith w a s in tro d u ced b y C o rp s O fficer S m i t h , w h o s t r e s s e d t h e i m p o r t a n c e o f a l l f u t u r e c a d e t s to c o n t i n u e t h e i r t r a i n i n g a n d t h e r e b y g a i n f u r t h e r a w a r d s in th e y e a r s to c o m e . A fte r the p resen ta tio n the L a d y C o u n ty O fficer g a v e an in s p i r i n g a d d r e s s of e n c o u r a g e m e n t to a ll th e c a d e t s a n d p r o s p e c tiv e m e m b e rs , a lso to th e b o y scou ts. C o r p s O f f i c e r S m i t h p r o p o s e d a h e a r t y v o t e o f t h a n k s to M iss C u r z o n S m ith for p res id in g , se c o n d ed b y D iv is io n a l S u p t . H u n tl e y , w h o in th e c o u r s e of h is r e m a r k s , s a id he w o u l d a l w a y s b e p l e a s e d t o g i v e h i s a s s i s t a n c e in l e c t u r i n g th e c h ild ren .

County of Surrey. G u i l d f o r d . — A t a r e c e n t m e e t i n g o f th e officers of th e G u ild fo rd C o rp s, C o u n ty S ta ff O fficer C. E. C h a p lin , O .S t .J ., on b eh a lf of th e C o u n ty C o m m issio n e r, p resen ted C o rp s O ffic e r M is s P h illip s w ith h e r s e c o n d b a r to the L o n g S e r v ic e M e d a l , r e p r e s e n t i n g 25 y e a r s ’ s e r v ic e , a n d C a d e t S u p t . M is s R e e v e s w i t h t h e fir s t b a r r e p r e s e n t i n g 2 0 y e a r s ’ s e r v i c e .

A I D

A sa le of w o r k o rg a n ise d b y D iv isio n a l S u p t. M rs. F arler, A m b u l a n c e O ffic e r M iss C o llie r ( S e c r e t a r y ) a n d m e m b e r s of N o. 1 N u r s in g D iv isio n , B o r o u g h of G u ild fo rd C o rp s, r e c e n t l y r e s u l t e d in a n e t t o t a l o f n e a r l y £ i 02 b e i n g r e a l i s e d , p a rt of w h ic h is b e i n g d ev o te d to r e s t o c k i n g th e M e d ic a l C o m fo rts D epo t. C o u n t y S u p t . M r s . C . T h o m a s , S . S . S t . J . , in p e r f o r m i n g the o p e n in g ce re m o n y, e m p h a sise d the im p o rta n ce of m ed ica l c o m f o r t s in t h e B r i g a d e ’ s p o s t - w a r w o r k , a n d c o n g r a t u l a t e d t h e D i v i s i o n in m a k i n g s u c h a n e f f o r t s o c l o s e t o t h e e n d of hostilities, a n d a fte r s ix m o s t e x a c t i n g y e a r s . T h e n u m e r o u s sta lls w e r e w e ll staffed b y D iv is io n a l m e m b e r s , a n d did a b r is k tra d e . R efresh m en ts w ere under the su p e rv isio n of A m b u la n c e O ffice r M rs. E d e, a n d a d a n c in g d is p la y g iv e n b y th e tin y p u p ils of the C o r o n a S ch o o l of D a n c in g , w a s m u c h en joyed.

County of Worcester. T h e a n n u a l D iv is io n a l c o m p e titio n for th e c u p p r es en te d b y C o r p s S u p t. T . C . L e n c h , w a s held on S a t u r d a y , O c t o b e r 13 th , b y the m e m b e r s of th e T . W . L e n c h A m b u la n c e D iv i s i o n o f t h e N o r t h W o r c e s t e r s h i r e C o r p s , a t t h e w o r k s of T . W . L en ch L td ., B la ckh eath . T h e co n test e v o k e d th e e n th u sia sm of th e D iv isio n , w h ic h w a s proved b y th e fa ct th a t fo u r te a m s en tered for the trophy. “ D ” t e a m w a s d e c la r e d th e w i n n e r w it h a to ta l of 270^ m a r k s ; “ B ” t e a m w e r e s e c o n d w it h 2 47 ; “ A ” te a m , 2 4 4 ; a n d “ C ” t e a m , 3 28 £. T h e c u p w a s p r e s e n te d to th e w i n n i n g te a m b y the d o n o r, w h o a ls o e x p r e s s e d his p le a s u r e a t s e e in g fo u r t e a m s en tered from the D iv isio n . C o rp s S u p t. L e n c h also presen ted four lo n g service b ars a n d on e lo n g se rv ic e m e d a l ribbon.

D u d l e y . — A v e r y in t e r e s t in g c o m p e titio n w a s held a t the h e a d q u a r te r s of th e D u d le y A m b u la n c e D iv isio n on W e d nesday, O cto b er 17th. T h i s w a s for th e “ B o s c a w e n ” c u p w h i c h w a s g i v e n b y S i r A . G r i f f i t h s - B o s c a w e n in 1 9 0 8 f o r a n n u a l co m p e titio n a m o n g te a m s fro m th e D iv isio n . T w o t e a m s e n t e r e d fo r th is y e a r ’s c o m p e t it io n , a n d th e re s u lt w a s “ A ” te a m , 232 m a r k s ; “ B ” te a m , 187. T h e c u p w a s h a n d e d to th e le a d e r of the w in n in g te a m b y C o rp s O fficer W a t k in s , w h o c o m m e n te d th at h a rd w o r k w o u l d b e n e c e s s a r y if t h e y w e r e t o k e e p it n e x t y e a r .

East Riding of Yorkshire. H u m b e r s id e C o r p s .— T h e final c o m p e titio n fo r th e B la c k b u r n A m b u l a n c e c u p w a s held a t B r o u g h on S a t u r d a y , O c t o b e r 20th. T h e t e a m te st w a s 'se t a n d ju d g e d b y D r. N. A. R y m e r, C o u n ty S u r g e o n , a n d D r. Y u ille w a s the ju d g e fo r th e in d iv id u a l test. T h r e e t e a m s q u a lifie d fo r t h e final, a n d after a k ee n a n d in te re s tin g co m p etitio n , retu rn ed the fo llo w in g scores : S w a n la n d A m b u la n c e D iv isio n , 1 1 1 m a rk s; B l a c k b u r n A ir c r a ft N u r s i n g D iv is io n , 102 ; B l a c k b u r n A ir c r a f t N o . 1 A m b u l a n c e D i v i s i o n , 80. S w a n la n d A m b u la n c e D iv isio n w a s th erefore d eclared the w in n e r and after c o m m e n ts b y the ju d g e s on the co m p e ti tion, t h e y w e r e p r es en te d w ith th e c u p b y M r. T . B a n c r o ft on b e h a lf of th e D ir e c to r s of M e s s rs . B l a c k b u r n A ir c r a f t L t d ., the donors. D r. G. T h o m p so n , C orps S u rg eo n , and Corps S e r g t . M a jo r A. H . R a n s o m e c o n veyed th e t h a n k s of the a s s e m b l y to all c o n c e rn e d . T h e in te re ste d s p e c ta to r s in c lu d ed S ir A r t h u r a n d L a d y A tk in s o n , M r. a n d M rs. T . A . B a n c r o ft, C o u n ty O fficers L i d g l e y , M iss C o lliv er a n d M iss L e p p in g to n , m e m b e rs of H u ll A m b u la n c e and N u r s in g C o rp s and H u m b e rsid e Corps.

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F I R S T M rs. Ju stice (C o m m a n d a n ts ) on b e h a lf of th e H a r r o g a t e B . R . C . S . , p resen te d a p a ir of w h ite g a u n t le t g lo v e s to the c a d e t b a n d for u se b y th e D r u m - m a j o r , a s a t o k e n o f a p p r e c ia tion of th e H a r r o g a t e R e d C r o s s fo r th e a s s is t a n c e g i v e n b y th e b an d on n u m e ro u s p arades. In a c c e p t in g th e g lo v e s on b e h a lf of the O r d e r a n d the B r i g a d e , D iv . S u p t. A . R id s d a le re fe rre d to th e h a p p y r e la tion s w h ic h h a d e x is te d b e tw e e n t h e t w o o r g a n is a t io n s d u r i n g th e w a r a n d h oped th a t th ey w o u ld con tin ue.

H e c k m o n d w ik e . — T h e H eck m o n d w ik e S .J .A . and N u rs i n g C a d e t s a ssiste d b y B r i g h o u s e , M irfield , C l e c k h e a t o n , B a tley, G o m e rsa l, D e w s b u r y , B irk e fish a w a nd H u d d ersfield C a d e t D iv is io n s , h eld a c a d e t S u n d a y p a r a d e a n d s e r v ic e on O c to b e r 14th. T h e p a r a d e w a s le d b y t h e B r i g h o u s e C a d e t D r u m a n d B u g le B and, and the S ervice w a s con ducted by P a sto r H . R i l e y in P a r k s i d e M e t h o d i s t C h u r c h . B e fo re th e d is m is s a l of th e p a ra d e , C o u n t y C a d e t O fficer M rs. C u n n i n g h a m B e ll h i g h l y c o m p lim e n te d th e c a d e ts on th eir a p p e a r a n c e a n d b e h a v io u r , th e y h a d all k e p t the h o n o u r s of S . J . A . B . before th e p u b lic eye.

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LONDON, MIDLAND & SCOTTISH T h e t w e n t i e t h a n n u a l r e p o r t f o r t h e y e a r e n d e d J u n e 3 0 th , 1945, s h o w e d th a t th e n u m b e r p a ssin g e x a m in a tio n s d u r in g th e y e a r w a s 6,259. T h e a w a r d of the M erito rio u s F ir s t A id C ertificate h as b een m a d e to 5 m e m b e r s . D u r in g the past tw e lv e m o n th s s e r v ic e s r e n d e r e d to th e A m b u l a n c e M o v e m e n t b y m e m b e r s h a v e b een re c o g n is e d b y the O r d e r of St. J o h n : O fficer ( B r o t h e r ), 5 ; S e r v i n g S is te r , 1 ; S e r v i n g B r o t h e r , 33 ; A ss o cia te S e r v in g B ro th e r, 1 ; V e llu m V o te of T h a n k s , 2 ; P a r c h m e n t V o t e o f T h a n k s , 1. T h e r e h a s b e en a c o n s id e r a b le d e c r e a s e in th e n u m b e r s p a s s in g e x a m in a tio n s sin ce the o u tb re a k of w a r , w h ic h w a s t o b e e x p e c t e d in v i e w o f t h e h e a v y w a r t i m e r e s p o n s i b i l i t i e s of r a ilw a y e m p loyees, b u t w ith the retu rn of m o re n o rm al t i m e s it i s h o p e d t h a t t h e c u r r e n t s e s s i o n e n d i n g o n J u n e 3 0 th next, w ill s h o w a g r e a t im p rovem en t, p a rticu la rly w ith re g a rd t o t h e f o r m a t i o n o f c l a s s e s f o r , a n d t h e r e c r u i t m e n t of , n e w students.

SOUTHERN N e w C r o s s G a t e . — T h e m e m b e rs a n d th eir w iv e s m et f o r t e a in t h e a m b u l a n c e r o o m a t N e w C r o s s o n O c t o b e r 2 7 t h . A ft e r tea, M r. A . E llio tt w e lc o m e d D r. a n d M rs. S co tt. M r. W . L yo n s, C la ss Secretary, th an ked the m em b ers of th e c la s s for th e ir s u p p o r t in m a k i n g th e c la s s th e s u c c e s s it w a s , 100 p e r c e n t , p a s s e s , a n d a p p e a l e d t o a l l t o d o t h e i r b est to s e c u r e n e w m e m b e r s a n d so u p h o ld th e tr a d itio n of

the class. M r s . S c o t t t h e n p r e s e n t e d t h e a w a r d s a s f o l l o w s : 3 f ir s t y e a r c e r t i f i c a t e s , 1 t h i r d y e a r m e d a l l i o n , 1 9 l a b e l c a r d s , 3 7y e a r b ro n ze m ed a ls, 2 14 -y e ar silver m ed a ls. D r. Scott t h a n k e d th e m e m b e r s for a s k i n g h im to le c tu r e to th e cla ss, f o l l o w i n g i n t h e f o o t s t e p s o f t h e l a t e D r . J. S t a n l y D a v i e s . H e c o n g ra tu la te d th e m on th eir su cce ssfu l cla ss a n d a p p e aled t o t h e w i v e s p r e s e n t t o le t t h e i r h u s b a n d s a t t e n d t h e l e c t u r e s r e g u l a r l y , a n d h o p e d t h e r e w o u l d b e i n c r e a s e d m e m b e r s in the n e w c la ss ju s t sta rtin g . A f t e r th e p r e s e n ta tio n , th e w h o l e p a r t y p r o c e e d e d to N e w C ro ss E m p ir e for the 2nd h o u se p e rfo rm a n ce .

R I D

D o r k i n g . — T h e re w as a p le a sin g m ee tin g at D o r k in g on F r id a y , O c t o b e r 26th, w h e n th e A u d it A c c o u n t a n t , M r J. H . L a u n d y , p r e s e n t e d a w a r d s t o t h e s u c c e s s f u l m e m b e r s

of h is staff. A m o n g s t the recipien ts w e re t w o to re c e iv e silver m e d a l s :— M e s s r s . C . H . D e n n i s a n d J . T . T w i t c h e t t . M r. L a u n d y s p o k e a p p re c ia tiv e ly of th e w o r k d o n e b y t h e first a id e r s , b o th fr o m a p e r s o n a l a n d N a t i o n a l p o in t of view . T h e c o n f id e n c e w h i c h t h e first a i d e r g a i n e d fo r h i m se lf in c o r r e c tly d e a l i n g w it h c a s e s o f a c c id e n t a n d su d d e n illn ess w a s reflected b y the p a tie n t r e t u r n in g th e co n fid e n ce, a n d p r o d u c in g g o o d resu lts. I n t h e s e s t r e n u o u s d a y s it w a s a p le a su re to m ee t m e n a n d w o m e n w h o fr e e ly g a v e th eir t i m e t o fit t h e m s e l v e s b y s t u d y a n d p r a c t i c e f o r t h i s a d m i r a b l e w ork. I n w a r t i m e a n d in p e a c e , in t h e o f f i c e , h o m e , o r s p o r t s f ie ld , w h e n t r a v e l l i n g o n b u s i n e s s o r p l e a s u r e , it w a s w e ll to h a v e q u alified p eo p le at h a n d . T h is w a s reco gn ised , a n d e v e r y a s s is t a n c e w o u ld b e g i v e n in f u r t h e r i n g t h e w o r k . A t th e c o n c lu s io n of t h e p r e s e n t a ti o n , t h e C h a i r m a n of th e class, M r. A. W . C o o m b s , v o iced the th a n k s of the m e m b ers to th e A u d it A c c o u n ta n t.

S e l h c j r s t . — M e m b e r s of th e S e l h u r s t c l a s s receiv ed th eir a m b u la n c e a w a r d s a t a re c e n t e x a m in a tio n . M r . E . J. P r e w ( D is t r ic t S e c r e t a r y ) w a s in th e c h a ir , s u p p o r te d b y M e s s r s . J. W h i t e ( Y a r d m a s t e r ) , B a i n e s ( C . M . E . D e p t . ) , a nd C. M erritt (rep resen tin g the C e n tre Secretary). M r . W h i t e , in p r e s e n t i n g t h e a w a r d s , w h i c h i n c l u d e d a s e v e n y e a r m e d a l to M o t o r m a n C . T a y l o r , s a id h o w p le a s e d h e w a s to se e t h a t s e v e r a l m e m b e r s of t h e s t a f f w e r e r e c e iv i n g t h e ir first a id c e rtifica te , a n d h e s in c e r e ly h o p e d t h e y w o u l d c o n t i n u e t o q u a l i f y in t h i s i m p o r t a n t s u b j e c t . T h e re su lt of th e e x a m in a tio n w a s in d eed g r a t if y in g a n d r e f l e c t e d g r e a t c r e d i t o n t h e a b l e s e c r e t a r y (J. B r e t t ) , to w h o m M r . B a i n e s p a s s e d a v o t e of t h a n k s fo r h is w o r k on b e h a lf of th e cla ss d u r in g th e p a st year.

P r i o r y f o r W ales. S o u t h W a l e s B o r d e r . — F o u r D iv is io n s of th e S . W . B. A m b u l a n c e C a d e t s sp e n t a n e n jo y a b le w e e k in t h e d e lig h t fu l H e refo rd sh ire co u n trysid e a t B e lm o n t. C ad et Supt. D. H o w e lls, B eau fo rt, w a s u n a n im o u s ly a p p o in ted C a m p C o m m a n d a n t a n d ju stifie d h is a p p o in tm e n t b y a w e e k of h a rd a n d efficient w o r k . T h e C a m p c o m p r is e d a p e r s o n n e l of 130, as f o l l o w s :— A b e r g a v e n n y , 42 ; B eaufort, 35 ; C w m , 24 ; W a u n l l w y d , 29. T h e c a d e ts m a d e full u se of th e o p p o r tu n ity for m in g lin g w ith th e oth er D iv isio n s a n d a v a lu a b le C o rp s s p irit w a s a tta in e d . O n S u n d a y e v e n in g a w e lc o m e v isit w a s re c e iv ed from C o u n t y O fficer H a r ris, C / S u p t. R u c k a n d m e m b e rs of the H e refo rd D iv ision s. T h e v isito rs m a d e a d etailed in sp ectio n of th e C a m p a n d c o m m e n d e d th e O ffice rs on th e h ig h s ta n d a rd of c o n d u c t a n d c lea n lin ess. A D r u m h e a d S ervice w as h eld a t th e C a m p , c o n d u c te d b y C / O . W . D a v i e s a b l y assisted b y the n ew ly form ed B ea u fo rt C a d et B a nd . T h u r s d a y w a s “ V isito rs D a y ” a n d th e v a rio u s D iv isio n s e n te r ta in e d fo u r ’ b u s lo a d s of visitors to tea. T h e visito rs a p p e a r e d to b e v e r y p le a s e d w i t h th e c a m p a n d m a n y e x p r e s sio n s of a p p re c ia tio n w e r e received fro m paren ts. S a t u r d a y c a m e all too soon . A fter an e arly b reak fa st a ll h a n d s t u r n e d to p a c k i n g for h o m e a n d b y 1 1 . 3 0 a ll D i v i sio n s w e r e a b le to re p o r t “ A ll e q u ip m e n t c h e c k e d , all loca l bills p a id a n d a ll litte r c l e a r e d . ” A n o t h e r C a m p w i t h i t ’s m u t u a l benefit to th e c a m p e r s a n d th e m o v e m e n t, h a d ended. T h e f o l l o w i n g w e e k th e site w a s o c c u p ie d b y t h e E b b w V a l e a n d T r e d e g a r A m b u la n c e C a d e t D iv is io n s a n d for the th ird w e e k b y th e A b e r g a v e n n y a n d B e a u fo r t N u r s i n g C a d et D iv isio n s.

F I R S T

R o u tin e E x a m in a tio n and Diagnosis o f Conscious Patients. D e v is e d b y — J.

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dams

a n d J.

u r g e o n -in -

pproach

h ief,

il l ia m s .

S .J .A .B .

:—

Is there a n y fu rth er d a n g e r ?

Is there a n y reply from the p a tien t ?

If “ y e s ” in fo r m h im th a t y o u a re first-aid ers. T e ll h im to lie p e r f e c tly still a n d n o t to w o r r y . A s k h im w h at has happened. 3.

Is th e r e a n y v isib le h a e m o r r h a g e ?

I f t h e r e is , e x p o s i n g t h e w o u n d a s l i t t l e a s p o s s i b l e , p r o c e e d a s in (C). 4. A r e t h e r e a n y d a m p p a t c h e s o n t h e c l o t h i n g ? A s k if y o u r h a n d s a r e t i n g e d w i t h b l o o d a n d if t h e y a re , e x p o s i n g th e w o u n d a s little a s possib le, p r o c e e d a s in ( C ) . 5. A s k t h e p a t i e n t if a n d w h e r e h e i s in p a i n im m e d ia te ly ste a d y a n d su p p o rt th o se parts. 6. A re th ere a n y m a r k s on th e c lo th in g o r s k in ? 7. Is th er e a n y o b vio u s d e fo r m ity ? (B )

x a m in a tio n

the

ain fu l

egion

and

:—

8. I s t h e r e a n y w o u n d , a b r a s i o n o r p u n c t u r e ? I f t h e r e is p r o c e e d a s in ( C ) . 9. 10.

Is there Is there

11. 12.

Is th ere D id the

(A fter d ia g n o s in g , the h a e m o r r h a g e w ill be treated a s “ F i r s t A id to th e I n j u r e d . ” ) (D )

ia gn o sis

and

reatment

hock

:—

2 7 . W h a t is t h e c o l o u r o f t h e p a t i e n t ’ s f a c e ? 28. I s t h e p u l s e r a p i d a n d f e e b l e ? 29. W h a t is n a t u r e o f b r e a t h i n g ? 30. I s t h e s k i n c o l d a n d c l a m m y ? 31. A r e th e r e b e a d s of cold s w e a t on th e fo r e h e a d ? 32. A s k t h e p a t i e n t if h e f e e l s f a i n t , s i c k o r t h i r s t y .

I f n o n e p r o c e e d to th e p a tie n t a n d s p e a k to h im . I f h e a p p e a r s to be u n c o n s c io u s t r y to ro u s e h im g e n t ly . 2.

A I D

a n y s w e llin g , ir r e g u la r ity ord efo rm ity ? a n y lo ss of p o w e r ?

SH OCK m u s t b e t r e a t e d a t t h e first p o s s ib le m om ent. D o n o t w a i t f o r it t o b e d i a g n o s e d . Cover th e p a tie n t w ith a b la n k e t c a r e fu lly a n d tidily. Undo all t i g h t c lo t h in g . E n s u re p len ty of fresh air. Speak to th e p a tie n t e n c o u r a g i n g l y . E n s u r e fr ee d o m from noise, e x c ite m e n t a n d w o r r y . W’ h e n d i a g n o s e d , f u r t h e r t r e a t m e n t w i l l i n v o l v e :— B la n k e t s u n d e r a n d o v e r th e p atient. A p p lica tio n of tested h ot w a t e r bottles. R a is in g of th e lo w e r lim b s if th e y a r e u n in ju re d . S tim u la n ts. G e n t l e a n d efficient h an d lin g. (E ) E

x a m in a tio n

for

urther

n ju ries.

33.

M a k e q u ite s u r e th a t th e p a tie n t is n o t in p a in else where. 34. A r e t h e r e a n y f o r e i g n b o d i e s o r f a l s e d e n t u r e s i n t h e p a t i e n t ’s m o u t h ? I f y o u s u s p e c t t h e p a t i e n t o f k n o c k i n g h i s h e a d :— 35. E x a m i n e t h e c r a n i u m clo s e ly . 36. A r e t h e r e a n y i n j u r i e s t o t h e f a c e o r n e c k ? 37. Is th e r e s w e llin g , ir r e g u l a r i t y o r d e f o r m ity o f th e upper lim b s ? 38. I s t h e r e f i x i t y o f t h e j o i n t s o f t h e u p p e r l i m b s . 39. I s t h e r e a n y s w e l l i n g , i r r e g u l a r i t y o r d a m p n e s s i n t h e re g io n of th e t r u n k ? 40. I s t h e r e a n y s w e l l i n g , i r r e g u l a r i t y o r d e f o r m i t y o f t h e lo w e r lim b s ? 41. Is th er e fixity of th e jo in ts of th e lo w e r lim b s ? 4 2 . W h a t is t h e a g e o f t h e p a t i e n t ?

I f a f r a c t u r e i s s u s p e c t e d :— a n y s h o rte n in g of the lim b ? patient h e a r a sn a p or c r a c k ?

I f a j o i n t i s i n v o l v e d :— 13. Is th e r e a n y fixity ? 14. C a n th e p a tie n t m o v e h is lim b w it h o u t in c r e a s in g the p a in ? 15. Is th ere a n y d iscolou ra tion ? I f h i s t o r y s u g g e s t s b u r n s o r s c a l d s :—

[ T h e a b o v e R o u t i n e E x a m i n a t i o n is o f sp e c ia l in te re s t to c a d e t s a n d th o s e c o n c e r n e d w it h th e t r a i n i n g of c a d e t s for f i r s t - a i d c o m p e t i t i o n s , a n d s e t s o u t c l e a r l y t h e q u e s t i o n s , in t h e c o r r e c t o r d e r , w h i c h s h o u l d b e a s k e d o f t h e J u d g e in o rd e r to d ia g n o s e th e c o n d itio n of th e s u p p o se d patient. N i c e l y p r in t e d c o p ie s a r e a v a i l a b l e a t 3d. e a c h ( e x c l u s i v e of p o s t a g e ) f r o m 60, P o w y s L a n e , P a l m e r s G r e e n , L o n d o n , N .13 . T h i s is t h e b a r e c o s t o f p r i n t i n g o n l y , a s t h e r e i s n o i n t e n t i o n o f m a k i n g .a n y p r o f i t w h a t s o e v e r o n s a l e s . ]

16. Is the part v er y ten der ? 17. Is th ere a n y re d d e n in g of the s k in ? 18. A r e th er e a n y b liste rs ? I f a s i m p l e f r a c t u r e is d i a g n o s e d , a p p l y e x t e n t i o n t o t h e l i m b , in a l l o t h e r c a s e s c a r e f u l l y s t e a d y a n d s u p p o r t u n til secured . (C) I n C 19.

ases

aemorrhage

:—

B r it is h R e d C ross So ciety E le m e n ta ry A n a to m y an d P h y s io lo g y M a n u a l. B y A . D . B elilio s, M . D . , D . K . M u lv a n y ,

Is th e b lood b r ig h t red a n d s p u r tin g ?

M .S ., and K F. A rm stron g, S .R .N . T in d all & Cox. P r ic e 4I6.

I f i t i s n o t :— • 20.

I s t h e b l o o d f l o w i n g in a c o n t i n u o u s s t r e a m o r o o z i n g

fr o m all p a rts of th e w o u n d ? 2 1 . F r o m w h i c h sid e of th e w o u n d is th e b lo o d i s s u i n g ? 2 2. W h a t i s t h e t v p e o f t h e w o u n d ? 23. W h a t is t h e size o f th e w o u n d ? 2 4. I s t h e w o u n d o b v i o u s l y d i r t y ? 2 5 . A r e t h e r e a n y f o r e i g n b o d i e s in it ? M ake

su re th at

f r a c t u r e is

not

p r e s e n t , b u t if

t h e r e is :— 26.

Reviews.

D o e s t h e b o n e p r o t r u d e t h r o u g h t h e s k i n o r is t h e r e a w o u n d le a d in g d o w n to th e se a t of th e fr a c tu re ?

L o n d o n : B ailliere,

T h e b o o k p r o v i d e s a c o m p l e t e o u t l i n e o f t h e b o d y a n d is w r i t t e n s o s i m p l y t h a t it c a n b e r e a d i l y u n d e r s t o o d b y a n y o n e w h o h a s h a d no p r e v io u s in tro d u c tio n to a m e d ic a l s u b ject. I n t h i s w a y it s u p p l i e s a b a s i c k n o w l e d g e o f a n a t o m y a n d p h y s io lo g y w h ic h c a n n o t b u t be of s u p r e m e v a lu e to e v e ry R e d C r o s s m e m b e r a n d fir s t a i d e r . T h r o u g h it t h e B . R . C . S . i n t r o d u c e s a s t a n d a r d i s e d c o u r s e o f t r a i n i n g in p r e p a r a t i o n fo r a certificate ; a n d w e a re con fid en t th a t th is d ecisio n w ill b e h e a r t i l y w e l c o m e d b y t h e v a s t n u m b e r o f s t u d e n t s o f f ir s t a id a n d h o m e n u r s i n g w h o d es ire to p a s s o n to m o r e a d v a n c e d study.

F I R S T

C A N

A n

I O D I N E

in f o r m

a t io n

S O L V E

s e r v ic e

f o r

A I D

T H E

e v e r y

P R O B L E M

e d ic a l

P r a c t i t io n e r

is used in the treatment of nearly In the Bureau’s files, classified under 500 200 human diseases. A vast store of data main headings are more than 10,000 original about the remarkable properties and diverse papers on iodine and references to a further applications of iodine has accumulated since 20,000. To ensure that this reference lib 1811 when this element was discovered. Each rary is kept up-to-date and complete 7,500 month adds new facts. medical and technical journals in 20 different The Iodine Educational Bureau was formed languages are regularly abstracted. to make this mass of information readily T h e f u ll r e s o u r c e s o f th is te c h n ic a l k n o w available. It offers technical data and advice l e d g e a r e a t t h e d i s p o s a l o f a n y m e d i c a l to members of the medical profession. It has p r a c t i t i o n e r i n t e r e s t e d i n t h e k n o w n o r p o t e n published five books entitled “ Iodine tia l u se s o f io d in e . T h e I o d in e E d u c a tio n a l Facts.” A sixth book, to be issued B u r e a u is n o t a c o m m e r c ia l o r g a n iz a tio n . shortly, will deal with goitre. T h e r e is n o c h a r g e f o r its h e lp .

O DINE

I o d i n e

E d u c a ti o n a l

B u r e a u

S T A N D A R D I Z A T I O N

""“ TH E adv an tag es o f st a n d a rd iza t io n a r e w e ll / r e c o g n i s e d , esp e cia ll y in a lkalin e m ed ic a tio n. ‘ B iS o D o L ’

M o d e m Surgical practice favours an undisturbed dressing and for this pur pose * Elastoplast ’ is used extensively in hospitals. It stays in place, protecting the w o u n d while permitting uninterrup ted healing. ‘ E la s t o p la s t ’ is e la s tic , ad h esive, an tise p tic . U se it w ith confidence for

Powder,

a g a st ric s e d a t iv e and

tr ip l e antacid, is p a rt ic u la rly e ff e c t iv e in t h e t r e a t m e n t o f d ig e s t iv e d i so rd e rs and m o rn in g sickness. T h e c o n s t it u e n t s o f ■B i S o D o L ’ a r e sta nd a rd ize d and, as such, can be re ga rd e d as relia ble. The

p r e p a ra t io n

a g r e e a b ly

fl a v o u r ed

w it h

p e p p e r m in t and is re a dil y m iscib le w i t h m ilk o r w ater.

M o r e o v e r ‘ B i S o D o L ’ gi v e s p r o m p t relief.

all minor injuries.

E l a s t o p l a s t BANDAGES

& PLASTERS

M a d e in E n g l a n d b y T , J . S m ith & N e p h e w L t d ., H u l l .

B iS o D o L LT D .. 12, CH E N I E S STREET, L O N D O N . W . C . I

F I R S T

A I D

THE

. Can teach uou tm aht ofscientific MASSAGE by unique method of Home Study THE CAREER FOR INTELLIGENT MEN 8 WOMEN I f y o u are prepared to study fo r an h ou r or t w o each day y o u can become an expert practitioner in Swedish Massage and enjoy the status, remuneration and comforts o f the professional worker. I f y o u are interested in First A i d y o u w il l readily understand the value o f Massage. D o cto r s, N ur s in g H o m es, H ydros, etc., are all in need o f the trained masseur.

PLAN YOUR PEACE-TIME CAREER NOW Over 25 years o f teaching experience has enabled the S . M . A . E . (Swedish Massage and Electrical) Institute— the oldest training centre in G t . Britain— to secure for its Graduates in all parts o f the w orld an assured future in a profession o f

FASCINATING

W r ite “

N O W

M A N I P U L A T I V E T h is

u n iq u e

F R E E

H o m e

B o o k le t

S tu d y

and

fo r

FREE

T H E R A P Y

te lls

y o u

h o w

yo u

can

e sta b lis h

A th e

ABSORBING

INTEREST

B o o k le t

A S

a c q u ire

AND

art

p riv a te

P R O F E S S I O N o f

sc ie n tific

p ra ctice

o f

M assage yo u r

ft by

o w n .

Rv Ufl T H E L E ASTMH EAR EH E AIDN SSUTR RI ET YU T E

HOUSEHOLD PHYSICIAN D e s c r i b e s in s im p le la n gua ge w i t h helpful c o l o u r e d plates and d ia gr am s

The COMPLAINTS OF MEN, WOMEN AND CHILDREN. T h e i r C a u s e , T r e a t m e n t and C u r e .

A j e w o f the S u b jects tr e a te d : H o w to Keep Well, First Aid T h e Principles of Nursing W hat to D o in Emergencies T h e Eye, the Ear Influenza, Colds, etc. T he Throat, the Nose Measles, Mumps, Catarrh T h e Chest, the Heart Corns and Warts T h e Stomach, the Liver Physical Culture T he Teeth, the Muscles Treatment for all Skin Diseases Infant Welfare T he Lu ngs, Pleurisy Homoepathy, Neurasthenia Hygiene, Anatomy, Pharmacy 375 Prescriptions, etc., etc. THE

YOUNG

W I F E w i l l find ju st the in fo r m a tio n she re q u ir es.

M O T H E R S w h o w i s h th eir d a u g h t e r s to d e v e l o p n atu ra ll y w i l l find e x a c t ly the t eac hin g t h e y need . W OM EN OVER discu ssed.

40 w i l l find

th eir difficulties

P R E S C R I P T I O N S — 375 p r o v e d rem ed ie s.

COUPON To HUNDREDS

OF^ T E ST IM O N IA L S

" I t 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 ju st the thing I have been waiting to obtain for several years."

“ F irs t A id in a F ew W o r d s .” Q u e s tio n s a nd A n s w e r s . Ba se d o n the 39th E d i t i o n o f the T e x t B o o k o f the St. J o h n Am bulance A s s o c ia t io n . Pric e 6d . each ( P o s t a g e i d .) o r 5 s. p e r doz. ( P o s t Free).

fr a n k l y

H u n d r e d s o f su bje cts.

BOOKLET

V I R T U E & C o ., L td ., (F .A . D e p t .) , C r o w n C h a m b e r s , U p p e r P a r lia m e n t Street, N o ttin g h a m .

P le ase 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 t o p u r c h a s e .

HO USEHO LD

P H Y S IC IA N

w ith o u t any

N A M E ..................................................................... S e n d t h is fo rm In u n s e a le d e n v e lo p e , s ta m p e d Id .

ADDRESS.

ADAM, ROUILLY & CO., Human Osteology, Anatomy, etc.,

F I T Z R O Y S TR E ET , F I T Z R O Y S Q U A R E , L O N D O N , W . l TELEPHO NE :

S ix S e ts o f C a d e t C o m p e t it io n P ap e rs. Each

FOR

r e g a r d in g he alt h

S e t in clu d es F ir s t A i d , H o m e N u r s i n g , G e n e r a l Eff ic ie ncy and D r ill, f o r t ra in in g p u r p o s e s .

M U SE U M 2703.

TH E

H O U SE

FOR

P r ic e 7 d . each , o r C o m p l e t e Set o f Six, P o s t F r e e 3s.

HUM AN

The above may be obtained from : C o u n t y O f f i c e r F. A . T R O T T , 16, H u r s t R o a d , H o r s h a m , S u s s e x .

(A rticu la ted

In c o u r s e o f p u b li c a t io n —

b y J O H N F E N T O N , m .b ., B .c h ., b . a .o ., d . p . h . a nd L . A . H . S N O W B A L L , m . r .c .p ., F.R.c.s.(Ed.) C IV IL

DEFENCE

SE R V IC E S, E T C .,

ETC.

EM ERGENCY TREATM ENT

—A Synopsis of W ar-tim e Training

FOR

E T C .,

D a t e w i l l be a n n o u n ce d later.

FIRST AID

& D isarticu la ted )

H A L F -S K E L E T O N S ,

“ H in ts o n C o m p e t it io n T r a in in g .” B y the same A u t h o r .

SKELETONS

TR A IN IN G

P R I C E : 8d . p o s t fr ee (7s. 6d . p e r d oz en )

Obtainable from 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 ., E . C . 4

O F

S K I N

I N J U R I E S

B e p r e p a re d f o r an e m e r g e n c y a nd k ee p C u t ic u r a B r a n d O i n t m e n t in y o u r F i r s t A i d K i t . It b r i n g s in • stant s o o t h i n g r e lie f t o c u t s , b u r n s , sk in l a c e r a t i o n s - p r e v e n t s sp r e ad o f in fe c t io n , q u i c k l y heals. O b t a i n abl e at all C h e m i s t s ' a n d S t o r e s .

fiitic u r a OINTMENT

F I R S T

4. — T h e

T extbook 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.

B la n k e tin g Stretcher.

H . E . (N ortham pton )— -We have recently been studying the new Manual of Drill. T h e diagram on page 58 in bot tom left hand corner seems to be a little confusing in the light of previous instructions when we were taught to have four layers of blanket under the patient and two layers on top. This diagram shows the patient ly ing inside the blanket which is folded into three, thus the patient has two layers underneath and four layers on top. Is this what is intended ? Again, if three blankets are used, the patient has actually six layers on top. Further, if the patient is wrapped inside the second blanket which is folded in three, what is the use and purpose of the V at feet ? Your comments will be greatly welcomed, please. T h e method of blanketing a stretcher described in the T extboo k has been superseded by a new one which is set out in the Manual of Drill and is generally considered as more comfortable to the patient. T h e question of two or four layers of blanket beneath the patient is not vital, the import ant point being that there should be sufficient thickness of material to prevent loss of body heat through the canvas of the stretcher. T h e appearance of the V at the patient’s feet arises from the first fold of the blanket being brought up over the feet before the two sides are folded across the patient. T h e importance of this upward fold will be understood if you stop to consider what would happen if the blankets were not tucked in at the foot of your bed. Since the above note was written, a member of the Drill Manual Sub-Committee has informed me that the lowest diagram on the right side of p. 58 of the Manual of Drill is incorrect ; that the patient should be placed on the top of (and not within) the folded blanket ; and that if this is done the patient would have four layers of blanket beneath and two layers above him, as is shown in Fig. 48 of the R . A . M . C . Train in g Manual No. 3. — N. C o r b e t F l e t c h e r . E x a m in a tio n H o w le r.

R . D . (Leicester).— In a recent examination the doctor asked a candidate what is the difference in signs and symptoms between a pelvic and a spinal fracture. H e replied, to our great amusement : “ W ith a s p in a l Jra c tu re the p a tie n t would, he unconscious below the seat o f in ju ry ! ” W e thought that this joke was good enough for F i r s t A i d ; and so we send it to you. Good!

Next, please !

1— N .C . F .

R I D Textbook in the treatment of fracture of knee-cap. One member suggested that, after carrying out Rules 1, 2, 3 and 4 the limb should be raised and sup ported before applying Bandage D round the knee-cap. Another member suggested that, after we have carried out Rules 1, 2, 3 and 4, the limb should be supported in the position to which it was raised in Rule 1 in order to secure the splint and foot. As there were some Cadets present during the dis cussion, your kind ruling will be greatly appreciated. Rule 1 tells you to straighten and raise the lower limb ; and it is obvious that this must be continued throughout the application of splint and bandages as is shown in Rules 2, 3 and 4. Rule 5 then warns you to keep the limb well sup ported off the ground. In other words, Rules 1 and 5 are complementary ; and Rule 5 warns you to keep the limb well supported off the ground throughout your treatment and transport of patient to hospital. Your two members appear to have missed the real object of raising the limb which ensures relaxation of the muscles attached to the patella and so reduces the risk of further separation of the broken fragments by muscular action.— N .C . F .

M a la ria .

J.G. (Battersea).— N ow that the war is over and a large number of our troops will be returning from the Middle and Far East, we shall no doubt be meeting an ever increasing number of cases of Malaria and its effects. As the T extbook does not give any instructions, I would apppreciate very much any advice which you may be able to giv e in dealing with such cases. First Aid deals with cases of sudden illness and accident for which immediate, temporary and efficient assistance can be given by first aiders. Malaria and many other diseases do not come within this category. Your treatment, therefore, would be to remove a patient stricken with fever or other evidence of illness to home or hospital at the earliest moment and to ensure that medical attention is quickly available.— N. C. F. B u rst V a ric o se V ein and F ra ctu red L e g .

M.J. (Falmouth).— Under the General Rules for Treatment of Venous Haemorrhage the Textbook in Rule 4, p. 128 tells us to apply direct digital pressure. I would, there fore, ask if it would be correct to do this even if there was also a subjacent fracture. Rule 2 with its reference to elevation of the limb except in the case of a fracture shows that the possibility of both injuries occurring simultaneously has not been overlooked. T u t ! T u t ! ! W hat next ? Rule 4 in my Textbook reads :— “ Apply direct digital pressure except over a fracture or foreign body.” — N .C . F .

H u m o u r in N u rsin g.

M .B. (Shrewsbury).— At a recent Divisional Practice it was stated that a patient, who had been attended by two Ambulance Sisters, had died ; that the doctor in charge of patient had congratulated the Sisters on their good work ; and that one of them was now attending two more cases— thus m aking' three in a l l ! Clearly the chances of recovery are not bright for the two further patients 1 ! Good!

Next, please ! !— N .C . F .

T reatm en t of F ractu red K n ee-cap .

D e fe n c e M e d a l R ib b o n .

A. R. (Gorleston).— At Divisional Practice recently a question arose as to the full meaning of Rule 5 on p. 91 of the

F.S. (Northampton).— T h e members of our Division have been discussing of late whether or no it is in order for

F I R S T

ASTHMA, BRONCHITIS CATARRH, HAY FEVER

R I D

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and o t h e r R e s p ir a t o r y Suffe rers s h o u ld c o m m un ic a te w i t h British M ed ica L a b ora to ri e s, Lt d., f o r pa rticu la rs o f “ S an olen ” t h e m o st efficaciou s H o m e R e m e d y k n o w n t o Medical S c ie n c e : N o w b ein g used w i t h r e m a r k a b l e s u cce ss e v e r y w h e r e : E n d o r s e d by t h e M ed ical Profe ss io n .

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The reliance iwhich factory workers place in their Welfare Nurse is comparable with that which she in turn places in her First Aid equipment. Rapid relief from pain and distress is no less essential in the National interest than to the sufferer, and calls for the prompt administration of a safe analgesic and sedative. That is why ‘•Anadin,’ a balanced combination in the aspirinphenacetin-caffeine group, is regarded as indispensable in Factory Welfare work.

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us to w e a r the D e fe n c e M e d a l R ib b o n on o u r St. J o h n u n i f o r m s a s it is n o w b e i n g i s s u e d t o H . M . S e r v i c e s . W e s h a l l t h e r e f o r e b e p l e a s e d if y o u w i l l s o l v e o u r problem . i If y o u a re a w a r d e d the S e rv ic e M e d a l w e see n o re a so n w h y it s h o u ld n o t b e w o r n o n th e le ft b r e a s t of y o u r u n ifo r m in th e s a m e w a y a s o th er m e d a ls issu ed by th e K i n g . You s h o u l d , h o w e v e r , a w a i t B r i g a d e i n s t r u c t i o n s in o r d e r t h a t y o u m a y k n o w t h e p o s i t i o n o f t h i s r i b b o n in r e l a t i o n t o o th ers.— E d i t o r . D i s l o c a t i o n o f Join t.

S.T. ( F i n c h l e y ) . — P le a s e tell m e w h y w it h d is lo c a tio n of a j o i n t t h e p a t i e n t o f t e n c o m p l a i n s o f n u m b n e s s in t h e affected lim b . I a w a it y o u r rep ly w ith in terest a n d , t h a n k y o u in a d v a n c e . W i t h a d is lo c a tio n of a joint the h e a d of the d isp la c e d b o n e o ften p r es se s on th e a d ja c e n t n e rv e s a n d blood vessels. C o n s e q u e n tly th is p r essu re m a y c a u se n u m b n e ss a t th e seat of in ju r y a n d t i n g l i n g (pins a n d needles) s e n s a tio n s b e lo w the jo in t a s th e re s u lt of irritatio n of th e n e rv e s a n d of in te rfe re n ce w ith th e lo ca l b lo o d s u p p ly of th e p a rt a ffe c te d .— N . C . F . C o m p o u n d F racture

of Leg.

G . M . ( E d w a r d s v i l l e , G l a m . ) . — I w a s v e r y i n t e r e s t e d in t h e re p ly w h ic h y o u g a v e to th e q u e r y p u b lish e d u n d e r the a b o v e h e a d i n g in t h e S e p t e m b e r i s s u e o f F i r s t A i d . N o w , s in c e t h e T e x t b o o k in R u l e 4 of t h e G e n e r a l R u l e s for T r e a t m e n t of F r a c t u r e s , d efin itely tells u s not to a tt e m p t e x te n s io n of a c o m p o u n d fr a c t u r e w h e n the b o n e p r o t r u d e s a n d s i n c e it d o e s n o t g i v e t h i s w a r n i n g a n y w h e r e else, a m I c o r r e c t ? (1) In u s in g e x te n sio n to a c o m p o u n d fr a c tu re w h e n t h e b o n e d o e s n o t p r o t r u d e a n d (2 ) in u s i n g e x t e n s i o n for a n im p a c te d fr a c tu re of th e th ig h ? I w o u ld t h a n k y o u for a r u lin g on e a c h of th ese p o in ts a n d fo r a ll th e a s s is t a n c e so fr e e ly g i v e n in th e past. F r o m y o u r q u e r y I t a k e it t h a t y o u r e g a r d it a s a n e a s y t a s k to s t r a ig h t e n a fr a c t u r e b y th e a p p lic a tio n of e xte n sio n . T r u t h t o t e l l , h o w e v e r , it m a y b e a m o s t d i f f i c u l t j o b . A lso, y o u m u s t r e m e m b e r t h e w a r n i n g in R u l e 4 t h a t e x t e n s i o n m u s t b e a t t e m p t e d (1 ) w i t h g r e a t c a r e , (2) w i t h o u t u s i n g f o r c e a n d ( 3) w i t h o u t l e t t i n g g o u n t i l t h e l i m b h a s b e e n se c u re d b y splin ts a n d b a n d a g e s . In t h e s e c i r c u m s t a n c e s th e a n s w e r s to y o u r q u e r ie s a re ( 1 ) t h a t y o u m a y a t t e m p t e x t e n s io n of a c o m p o u n d f r a c t u r e w h e n t h e b o n e d o e s n o t p r o t r u d e a n d ( 2 ) t h a t y o u , a s a fir st aid er, sh o u ld n ever, n e ve r a tte m p t e x te n sio n of an im p a c te d fractu re. In ciden tally, I w o n d er w h a t you m ean w h en you say t h a t t h e T e x t b o o k o n ly w a r n s y o u in o n e p la c e to a vo id a tte m p ts a t e x te n sio n of a c o m p o u n d fra c tu re w h e n bone p rotru d es. — N .C . F. F ractures of C la v ic le and H um erus. F . R . ( K i t c h i n e r , O n t . , C a n a d a ) . — W o u l d y o u p le a s e tell m e th e c o r r e c t t r e a t m e n t for a m a n s u ff e r in g fr o m sim p le f r a c t u r e s o f t h e c l a v i c l e a n d o f t h e h u m e r u s (in m i d d l e o f sh aft), b oth in ju rie s b e in g on the s a m e s id e ? Short sp lin ts a re a v a ila b le . A l s o w o u l d y o u p l a c e t h e p a d in the a rm p it ? W it h th is c o m b in a tio n of in ju ries th e fra c tu re d h u m e ru s is t h e m o r e lia b le t o a g g r a v a t i o n a n d c o n s e q u e n t l y d e m a n d s preferentia l treatm en t. In th ese c irc u m s ta n c e s I sh o u ld treat t h e f r a c t u r e d h u m e r u s a s l a i d d o w n in t h e T e x t b o o k , e x c e p t ' t h a t I w o u l d n o t s u p p o r t t h e l i m b in a n a r m s l i n g b u t f l e x t h e fo r e a r m a t r i g h t a n g l e s to th e a r m a n d a p p ly a b ro a d b a n d a g e ro u n d lim b a n d b o d y to im m o b ilis e th e fr a c tu re d lim b . B y s o d o i n g I s h o u l d k n o w t h a t , s o l o n g a s d u e c a r e is e x e r c ise d d u r in g tra n sp o rt, no a g g r a v a t io n of eith er fra c tu re w o u ld resu lt.

A I D I n r e p l y t o y o u r s p e c i f i c q u e s t i o n 1 w o u l d n o t p l a c e in t h e a r m p i t t h e l a r g e p a d w h i c h i s a n e s s e n t i a l p a r t in t h e t r e a t m e n t o f a n u n c o m p l i c a t e d f r a c t u r e o f t h e c l a v i c l e b e c a u s e , to do so, c o n s id e r a b le m a n ip u la t io n o f th e fr a c tu r e d lim b , w h ic h is b e s t a v o id e d in a n e m e r g e n c y , w o u ld be r e q u ir e d .— 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. N .S .

(S alisb u ry, S. R h o d es ia ).— W fll you k in d ly g iv e me y o u r r u lin g on the f o l lo w in g poin t w h ic h w a s th e su b ject o f m u c h d e b a t e i n m y D i v i s i o n a t a r e c e n t P r a c t i c e :— “ In w h a t position w o u ld a p atien t w ith a spinal f r a c t u r e b e c a r r i e d if h e w a s u n c o n s c i o u s a n d t h e f r a c t u r e w a s d e f i n i t e l y k n o w n t o b e in t h e l u m b a r r e g i o n , th e e x a c t spot h a v in g been d ia g n o s e d ? ” S o m e m e m b e rs t h o u g h t t h a t th e fa ct th a t the p atien t w a s u n c o n sc io u s sh o u ld b e th e g u i d i n g factor a n d a d v o c a t e d c a r r y i n g h i m in t h e s u p i n e p o s i t i o n a s in s t r u c t e d on p a g e 73 of th e T e x t b o o k , b u t o th e r s m a i n t a i n e d t h a t a s t h e f r a c t u r e h a d b e e n l o c a t e d in t h e l u m b a r r e g io n h e s h o u ld be c a r r ie d in th e p r o n e p osition, ir r e s p e c tiv e of w h e t h e r h e w a s c o n s c io u s or not. The d e b a t e e n d e d b y a g e n e r a l a g r e e m e n t to a s k y o u for a ru lin g.

T h e d i a g n o s i s of a f r a c t u r e in th e l u m b a r r e g io n of the s p i n e is o f t e n d i f f i c u l t , b e t h e p a t i e n t c o n s c i o u s o r u n c o n sciou s. If, h o w e v e r , th e r e is d efin ite e v id e n c e o f s u c h fr a c t u r e , I a m o f t h e o p i n i o n t h a t , b e c a u s e t h e p a t i e n t is u n c o n s c i o u s , h e m u s t b e t r a n s p o r t e d in t h e f a c e - u p w a r d s position. — N. C. F. B r ig a d e U n ifo rm . R G . ( W r e x h a m ) .— I a m a m e m b e r of the B r ig a d e ; a n d I h a v e been tra n sferred at m y o w n re q u es t from o n e D iv i sio n to a n o th e r. N o w th e q u e s ti o n h a s a r is e n a s to w h e t h e r o r n o , I r e t a i n m y u n i f o r m o r h a n d it o v e r to m y o ld D iv isio n . I h a v e b e e n in p o s s e s s i o n o f t h e u n i f o r m f o r e i g h t y e a r s a n d h a v e p a i d s e v e r a l b i l l s fo r a lteratio n s and cle a n in g . I s h a l l e s t e e m i t a f a v o u r if y o u c a n e n l i g h t e n m e o n t h i s p o i n t ; a n d I t h a n k y o u in a d v a n c e . F r o m B r i g a d e G e n e r a l R e g u l a t i o n s (par. 32 o n p. 8 a n d p a r . 1 4 o n p. 68 ) w e t a k e it t h a t y o u r u n i f o r m is t h e p r o p e r t y of the D iv is io n from w h ic h y o u h a v e tra n s fe rre d .— E d i t o r . B rig a d e E fficie n cy . W .B . (S u tto n -in -A sh fie ld ).— F o r IS years I h a v e been a m e m b e r of th e B r i g a d e ; a n d d u r i n g th a t p erio d (w ith t h e e x c e p t i o n o f 5 y e a r s in t h e A r m y ) I h a v e m i s s e d o n e re-exa m in a tio n . D u r i n g t h a t y e a r I a t t e n d e d the m a jo r it y of le c tu r e s a n d p a r a d e s ; a n d I did m y three n ig h ts of d u ty e a c h w e e k . N e verth eless, b e c a u se I c o u l d n o t p o s s i b l y a t t e n d t h a t r e - e x a m i n a t i o n , o w i n g to i m p o r t a n t b u s in e s s m a tte r s , I a m to fo rfeit m y S e r v ic e M ed a l. T o m e e t t h o s e c a s e s in w h i c h m e m b e r s o f a D i v i s i o n a r e u n a b le to a tte n d th e r e g u la r a n n u a l re -e x a m in a tio n , a r r a n g e m en ts exist w h er eb y the ca n d id ate m a y be e x a m in e d at a s u p p l e m e n t a r y r e - e x a m in a ti o n of h is/h er D iv is io n or a t the r e g u l a r r e - e x a m in a t i o n o f a n o t h e r D iv is io n p r o v id e d t h a t this ta k e s p la ce w ith in th e B r ig a d e year. S u ch arrang em en ts a r e m a d e b y th e D iv is io n a l S u p e r in t e n d e n t t h r o u g h the C oun ty Surgeon. I n c id e n ta lly y o u h a v e n ot forfeited y o u r S e r v ic e M ed a l t h o u g h y o u w i l l h a v e t o w a i t a n o t h e r y e a r in o r d e r t h a t y o u m a y c o m p le te 15 y e a r s of efficient s e r v ic e .— E d i t o r .

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7 o be cut out and enclosed with a ll Queries.

Nov., 194 5 .

MANUALS

FIRST

AID

;By N. CORBET FLETCHER, O.B.E., M.B., B.C., M.A.(Cantab.), M.R.C.S. AID8

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FIRST-AID.

Seventh Edition. 1« . 3 d . post 2 d . F irs t-A id Sim plified and Ta b u la te d , w ith A id s to M e m o ry .'

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A M B U L A NC E

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200 C o n c e r t ' T i c k e t s S / 6 . M e m o s , R u b b e r S ta m p s , R o ll T i c k e t s , S a m p l e s - T i C E S , 11 , O a k l a n d s G r o v e , L o n d o n , W . 12 . F.

A . C O M P E T IT IO N S are w on b y good co a ch in g .

T H E “ A C O R N ” G u i d e is p r o d u c i n g n e w w i n n e r s . For 1 p a rtic u la rs s e n d s ta m p e d en v elo p e to R . J e f f e r y , S, A v e n u e G a rd e n s, L o n d o n , W .3 .

I O V E L Y Teddy *— l i s t , T o y k r a f t ,

B ears.

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C O R S ale O f f i c e r ’s U n i f o r m , C o s t u m e , g r e a t c o a t h a t d 2 p re s se s, 3 a p ro n s , 3 prs. s ilk s to c k in g s , off d u ty d ress! B u s t 34 , H i p s 38 . £ 7 o r n e a r o f f e r . H o ets, C ro ssan d s, C o llin g w o od R o a d , G t. Y a rm o u th .

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v ‘SS1° n T l c k e t s f o r a11 S . J . A . B . a n d t f . R . C . b . S o c ia l F u n c t i o n s , etc. S a m p le s a n d p rices by re tu rn P r w t l . c i t y , S t . A n d r e w ’s H a l l , A l n w i c k , N o rth u m b e rla n d . r

LEG TROUBLES Try Germolene yourself— and you will.be convinced INFLAMMATION of its power to soothe and RASHES, SPOTS relieve skin complaints. Under the healing hand BURNS, CUTS of Germolene many skin afflictions vanish in a few days — or even hours. But Germolene’s most wonderful victories are recorded in letters like the following:

2d . f o r

1 9 , R o u n d h a y R o a d , L e e d s , 7.

R E D C ross C o m m a n d a n ts U n ifo rm , T u n ic, T ro u se rs , C ap, S a m B r o w n , G t. C o a t. A ll a c c e s s o r i e s . In brand new co n d itio n . .£ 1 0 10 s . H e i g h t S f t . 8 i n . C h e s t 38 i n . A . C i s t , 10, A s h l e y T e r r a c e , W e s t o n , B a t h .

-c le a r s up MANY SERIOUS

‘ RESU LTS HAVE BEEN

W ONDERFUL’

“ I have been troubled with bad legs fo r years . . . I applied Germolene three and sometimes fou r times a day. T he results have been wonderful. I am sure it was only Germolene that got me on my feet again. N o praise is too high fo r your wonderful ointm ent; it is worth more than I can say about it. Y o u m ay publish this letter as you wish.” ( S ig n e d ) C . A . B . (.Mrs.), S hifn a l, Salop.

Heal Skin CLEAN with ASEPTIC OINTMENT

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L A N E ,

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BIOLOGICAL M B L PREPARATIONS A N T I P E O L

CUTAN EOUS VACCINE

O I N T M E N T

O n e o r o t h e r o r a ll o f t h e t h r e e r a c e s 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 l o c o c c i a n d B . p y o c y a n e u s a r e 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 antibodies ( 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 h e o i n t m e n t , a n d s e p d 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 its 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 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 i t 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 r e q u i r e t o b e c h a n g e d e v e ry d a y . W O U N D S , B U R N S , e t c . , W I L L N O T T U R N S E P T I C i f t r e a t e d w i t h A N T I P E O L O I N T M E N T .

O P H T H A L M O - A N T I P E O L is a sem i-fluid o in tm e n t, m o r e c o n v e n ie n t th a n th e o r d i n a r y A n tip e o l o i n t m e n t f o r o c u la r in fe c tio n s a n d lesions. E y e s a ffe c te d b y s m o k e a n d d u s t are s o o th e d a lm o s t im m ed iate ly by the a p p licatio n o f O p h th a lm o -A n tip e o l, a n d the a n tiv iru s p re v e n ts g e r m s f r o m dev elo p in g .

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CONTEN TS

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E d it o r ia l —

...

T h e T r a p p e d C a s u a l t y ...

...

Is T h is a R eco rd ?

...

S .J.A .B . H e a d q u a rte rs a n d D istric t R e p o rts

...

N o s te ll C o llie ry F i r s t A id S o c ie ty

...

R ailw ay A m b u lan ce N ew s

...

R a c ia l S ig n ific a n c e of B lo o d G r o u p s

...

S .J.A .B . O v e rse a s

T h e S ta ff in g of H o s p i ta l s

Q u e r ie s

a nd

...

A n sw ers

...

C o r r e s p o n d e n t s :—

F u n c t i o n of P a te lla

...

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

...

S e n io rity in D iv isio n

...

P h o sp h o ru s P o iso n in g

...

F r a c t u r e s of S p in e a n d S t e r n u m

...

B r ig a d e M a n u a l of D rill

...

E fficien cy of F i r s t A id e rs

...

M e th o d s of J u d g i n g C o m p e titio n s

...

H u m o u r in F ir s t A id

...

B leach O in tm e n t

...

M ala ria

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PR IC E

Pbr

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1945

IS f-ro .

F.R.S.A.

EDITORIAL.

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46,

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D F fF M R F R

L . 1 I .

n o t ic e

SCOTT,

A j o i n t statement by the MinisThe Staffing o f ter of Health, the Secretary of H ospitals. State for Scotland and the Minister of Labour and National Service, has just been published, dealing with the problem of obtaining nursing and domestic staff for hospitals and similar institutions in adequate numbers and under proper conditions of employ ment (from which we extract the following) is the outcome of consultations between the Government and representatives of the hospital authorities and of the various organisations of nurses and do mestic staff. It has the unanimous agreement of all the parties, and describes the various measures which have been taken, and are about to be taken, with the object ol solving the problem. It makes an appeal for new recruits in large numbers, and sets out in the appendices the codes of general conditions of service which all the parties have agreed should be operative in all hospitals and similar institutions now or as soon as circumstances permit of their being.put into force. The Minister of Health is confident that all who are responsible in any degree for the administration of hospitals and similar institutions will co operate whole heartedly in carrying out the measures needed to attain the general object of bringing working conditions everywhere up to the standards indi cated in the agreed Codes. He is aware that there are some things in these Codes that cannot be achieved immediately, but he is assured that hospital authorities will appreciate the desira bility of reviewing immediately their administra tive arrangements, and of undertaking, without delay, any reforms of those arrangements which are practicable in present circumstances and are needed to bring them into line with the agreed Codes. Where hospitals have Certificates of Exemption under the control of Engagement Order covering student nurses, pupil assistant nurses, probationer assistant nurses or domestic workers, the usual procedure should be followed. Where the classes of worker it is desired to en gage are not covered by a Certificate of Exemption, the appropriate Nursing appointments Office or

Local Office of the Ministry of Labour and National Service should be consulted for permis sion to engage, which, unless there are exceptional circumstances, will, it is said, be granted at once. The names and addresses of candidates who apply direct to hospitals and are not engaged should also be passed to the appropriate office of the Ministry of Labour and National Service, which will see whether they cannot be placed elsewhere in the hospital service. It would be most un fortunate for the appeal if there were any number of men and women volunteers who applied and felt there was no need for their services because an individual hospital did not desire to employ them.

Th e Trapped Casualty. By S IR

H EN R Y

M ARTYN,

K .C .V .O ., F .R .C .S .

I n any b ig ra ilw a y accid en t, s u c h a s th a t w h ic h o ccu rred re c e n tly a t B o u rn e E n d , th e g r e a t forces in v o lv ed m u s t h a v e c r e a t e d c o n d itio n s c lo sely r e s e m b l i n g th o s e of b o m b d a m a g e . W ith d e ra ile d e n g in e a n d te n d e r, c o ac h e s ilu n g on th e ir sid es, s p lin te re d a n d to rn , m a n y c a s u a ltie s m u s t h a v e b e e n f o u n d t r a p p e d b e n e a t h d e b r i s f r o m w h i c h it w a s i m p o s sib le to lib e r a te th e m fo r s o m e tim e . O n e c a n n o t h e l p w o n d e r i n g , if s u c h c a s e s d i d i n f a c t e x ist, w h e t h e r th e r e s c u e p a r tie s m a d e u s e of th e le sso n s le a r n e d in w a r fo r th e c o rc e c t h a n d l i n g of th is ty p e of in ju ry . L e t u s c o n s id e r for a m o m e n t w h a t a r e th e p ro b le m s w ith w h ic h w e a re fa c e d w h e n d e a l in g w ith th e so -called tra p p e d casu alty . T h e t y p i c a l c a s e i s o n e i n w h i c h a l i m b is h e l d d o w n b e n e a th a h e a v y w e ig h t p re v e n tin g release. T h e lim b itself n e e d n o t n e c e s s a r i l y s h o w a n y s i g n o f s e v e r e i n j u r y , it n e e d n o t b e a r a n y g r e a t w e i g h t , a n d it m a y be q u ite s u ffic ie n t t h a t c o n s t a n t s l i g h t b u t r e l e n t l e s s p r e s s u i e is e x e r c i s e d o v e r a c o n s id e r a b le p e rio d of tim e . S u c h cases a s th is n a tu ra lly o ccu rre d freq u e n tly w h e n b u ild in g s c o lla p se d a s th e re s u lt of h i g h e x p lo siv e. M any w e re rescu e d w ith lim b s a p p a re n tly u n in ju re d , th ey w ere re m o v e d to h o sp ita l, re s u s c ita te d fro m th e ir sh o c k , a n d a p p e a r e d to b e w e ll o n t h e w a y to r e c o v e r y f o r t h e first th re e o r fo u r d ays. T h e n o m in o u s s ig n s b e g a n to a p p e a r . T h e p a tie n t b e g a n to c o m p la in of h e a d a c h e , h e b e c a m e listless, d r o w s y a n d p e r h a p s v o m ite d . T h e u rin e b ecam e c o n c e n tr a te d , m o r e a n d m o r e s c a n ty , a n d fin ally c ea sed e n tire ly a n d th e v ic tim d ied g e n e ra lly on th e se v e n th or eig h th day. T h e M in is try of H e a l t h u n d e r to o k e x te n siv e re s e a rc h w o r k i n t o t h e c a u s e o f d e a t h i n t h e s e c a s e s , a n d i n M a r c h , 1944 , p u b l i s h e d a n a m e n d e d R e p o r t o f A . R . P . H a n d b o o k , N o . 10 g i v i n g b o th th e r e s u lts of th is w o r k a n d a d v ic e a s to th e b e st m e th o d of t r e a t i n g th e m . T h e y re p o rte d th a t th e k id n e y d a m a g e w h ic h w a s th e c a u s e of a fa ta l te rm in a tio n re s u lte d fro m p o iso n s w h ic h w e r e f o r m e d in th e c r u s h e d m u s c le s , a n d w h ic h w e r e a b s o r b e d fr o m t h e m a f te r e x tr ic a tio n of th e p a tie n t. T h e y s u g g e s t e d , t h e r e f o r e , t h a t , if h e w a s to b e s a v e d , t r e a t m e n t d ir e c te d to th e d ilu tio n of th e s e p o is o n s a n d th e ra p id w a s h i n g of t h e m th r o u g h th e sy ste m sh o u ld be u n d e r t a k e n fr o m t h e e a r lie s t p o s sib le m o m e n t, in s h o r t by th e first r e s c u e p a r t y w h ic h d is c o v e re d th e case. T h e m a i n p o in t c o n s i s ts in t h e a d m i n i s t r a t i o n o f h u g e

q u a n t i t i e s of fluid, u p to 4 p in ts , b y t h e m o u t h , b e fo re re le a se fro m th e d e b ris, a lw a y s p ro v id in g t h a t o n ly a lim b is in v o lv e d a n d t h e r e a r e n o s i g n s of a n y a b d o m i n a l i n ju r y . T w o te a sp o o n s fu ls of b a k i n g p o w d e r ( b ic a rb o n a te of so d a ) d is s o lv e d in a p i n t of c o ld w a t e r is p r o b a b l y t h e m o s t e ffe c tiv e m e a n s o f H u s h i n g t h e k i d n e y s , b u t , if i t b e n o t a v a i l a b l e , t e a , coffee, m a g n e s i a o r a l k a l i n e i n d i g e s t i o n p o w d e r o r e v e n p lain w a te r sh o u ld be g iven. A t th e s a m e tim e th e u s u a l tr e a t m e n t for s h o c k sh o u ld b e c a r r ie d o u t in s p ite of t h e f a c t t h a t n o s i g n s of th is m a y b e a p p a r e n t , s in c e in a ll th e s e c a s e s a s e v e re fall in b lood p r e s s u r e is a p t to o c c u r a f t e r re le a s e . F in a lly , a m a t t e r of v e ry g r e a t im p o r ta n c e . A ll t h e s e c ase s sh o u ld be m o s t c arefu lly m a r k e d b efo re b e in g d is p a tc h e d to h o s p ita l. F a i l i n g s u c h m a r k i n g t h e r e is o f te n v e ry little in th e w a y of v isib le in ju r y to in d ic a te th e u r g e n c y of t h e c a s e a n d t h e v i t a l i m p o r t a n c e of c o n t i n u i n g t r e a t m e n t d i r e c t e d t o w a r d s t h e t h e d il u tio n a n d e l i m i n a t i o n of to x in s. T h e lab el s h o u ld c o n ta in in fo r m a tio n a s to th e l e n g t h of tim e for w h ic h th e lim b h a s b e e n c o m p r e s s e d a n d t h e n a t u r e a n d to ta l q u a n t i t y of flu id s ta k e n . T h e r e is o n e o t h e r d i r e c t i o n in w h i c h t h e c o r r e c t first a i d h a n d l i n g o f t h e s e c a s e s is o f t h e g r e a t e s t i m p o r t a n c e . I f a l i m b h a s b e e n c o m p r e s s e d f o r s e v e r a l h o u r s , i t is o b v i o u s t h a t , t o s a y t h e l e a s t o f it, t h e c i r c u l a t i o n w ill h a v e b een im p aired , a lth o u g h no t n ecessarily co m p letely stopped. T h e w a lls of th e tin y c a p illa r ie s w ill h a v e b een d a m a g e d a n d , w h e n t h e c o m p r e s s i o n is r e l e a s e d , t h e r a p i d flo w o f b lo o d in to t h e p a r t w ill c a u s e t h e e s c a p e of a fluid in to t h e tis s u e s t h r o u g h th e in ju red ep ith eliu m . T h e tis s u e s of t h e lim b w ill r a p id ly b e c o m e w a t e r l o g g e d , th e c irc u la tio n r e ta r d e d a s th e re s u lt of p re s s u re , a n d g a n g re n e m a y read ily ensu e. T o p r e v e n t th is e n g o r g e m e n t it w a s a t first s u g g e s t e d t h a t a to u r n i q u e t s h o u ld be a p p lie d to th e lim b befo re r e l e a s i n g it. T h is cou rse w as, h ow ever, very soon found to d o m o r e h a r m th a n g o od, a n d w a s d isco n tin u ed a n d re p la c e d b y s e v e ra l s te p s to b e t a k e n b o th b y first a id p a r t i e s i n t h e field, a n d s u b s e q u e n t l y i n h o s p i t a l , d e s i g n e d to s lo w u p th e r e t u r n of b lo o d to th e lim b r a t h e r t h a n p r e v e n t i n g it c o m p le te l y . W i t h th is a i m in v ie w t h e l e l e a s e d lim b s h o u l d n o t be w a r m e d a s is t h e r e s t o f t h e b o d y b y b l a n k e t s a n d h o t w a t e r b o ttle s , b u t s h o u ld b e left o u ts id e all c o v e r in g s a n d r a is e d s o m e w h a t u p o n a p illo w , d u r i n g tr a n s f e r e n c e fro m th e in c id e n t to th e h o s p ita l. H e r e e le v a tio n of th e p a r t w ill be c o n tin u e d a c c o m p a n i e d p r o b a b ly b y e la s tic p r e s s u r e a p p lie d to th e lim b b y m e a n s of b a n d a g e s . Ice b a g s m a y b e p la c e d n e a r t h e p a r t a t first a n d th e c ir c u la tio n a llo w e d to re tu rn slo w ly by p ro g re s siv e re d u c tio n of c o m p re ss io n a n d e le v a tio n of te m p e r a tu r e . B y th is m e a n s th e w a lls of th e b lo o d v e sse ls d a m a g e d d u r i n g th e p e rio d of c o m p r e s s io n a r e a l lo w e d tim e fo r re c o v e ry b e f o r e b e i n g s u b j e c t e d to t h e p r e s s u r e of t h e s u d d e n r u s h of r e t u r n i n g b lo o d . T h e e x u d a t i o n of flu id a n d e n g o r g e m e n t o f t h e p a r t is d i m i n i s h e d a n d t h e d a n g e r s o f s u b s e q u e n t g a n g re n e g re a tly red u ced .

Is This a Record ? D u r in g a n in fo r m a l d in n e r h eld

recen tly by th e S to u rb rid g e D iv is io n of th e S . J . A .B ., C o rp s S u p t. J. A. H a r r i s g a v e th e f o l l o w i n g f i g u r e s o f t h e s e r v i c e o f s e v e n o f i t s m e m b e r s :— A m b . O f f i c e r F . V . S m i t h 40 y e a r s , A m b . O f f i c e r W . E . W e a v e r 39 y e a r s , D i v . S u p t . C . D a v i e s 30 y e a r s , S t a f f S e r g t . W . H . H a r p e r 29 y e a r s , P t e . W . H . J o n e s 27 y e a r s , P t e . W . J . T i l b r o o k 21 y e a r s , a n d A m b . O f f i c e r A . E . R o d e n 19 y e a r s , m a k i n g a t o t a l o f 205 y e a r s p u t i n b y t h e s e v e n m em bers. I t is s u g g e s t e d t h a t t h i s c o m b i n e d e ffo rt m a y b e a r e c o r d for th e B rig a d e .

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A m b u la n c e a n d N u r s in g D iv isio n s a n d th e ir frien d s h a d a n en jo y a b le e v e n in g on S a tu rd a y , N o v e m b e r 17 t h , w h e n a d a n c e w a s h e l d i n A l l H a l l o w s C h u r c h H a l l in a id of t h e f u n d fo r b u i l d i n g a lo c a l h e a d q u a r te r s for th e D iv isio n s. A m o n g th e g u e sts p resen t w ere D r. C o rb et F letch er, S u rg e o n in C h ie l, A s s is ta n t C o m m is s io n e r H a r t , D is tric t O fficer M ilb u rn a n d M rs. M ilb u rn , D is tric t O fficer C o llin s, D is tr ic t O fficer M rs. R a y n e r , A re a C a d e t O fficer M rs. D o v e a n d M r. D o v e. I t is h o p e d to a r r a n g e f u r th e r d a n c e s in a id ot th is fu n d . A s p e c i a l i n t e r e s t in t h e e v e n i n g w a s t h e p r e s e n c e of A m b u l a n c e O ffic e r B a ile y , s e n i o r o ffice r of t h e A m b u l a n c e D iv isio n , w h o h a s re c e n tly r e tu rn e d fro m th e F a r E a s t w h e re h e h a s b e e n a p r is o n e r of w a r s in c e t h e fall of B u r m a . I t is g o o d to k n o w t h a t h e is s a f e h o m e a g a i n a n d r e t u r n i n g to h is w o rk w ith th e B rig a d e .

County of Berkshire. O n S u u d a y a f t e r n o o n , N o v e m b e r 18 t h , a t t h e F i r e S tatio n , E g h a m , th e C asu alties U n io n g a v e a d e m o n stra tio n to B e r k s h ir e m e m b e r s of th e S .J .A .B . T here w as a good re p re s e n ta tio n fro m th e co u n ty , th o se p re s e n t in c lu d e d th e C o u n t y C o m m i s s i o n e r , M r . C . A. P o o le . T h e p r o g r a m m e in clu d ed a s ta g e d “ a c c id e n t,” a d ia g n o sis exercise a n d a d e m o n stra tio n of c o m p e titio n tech n iq u e. A t t h e c o n c l u s i o n , t h e o r g a n i s e r , M r. E r i c C. C la x to n , g a v e a b rie f d e s c rip tio n of th e o b je c ts of th e U n io n a n d e x p re ss e d th e ir w illin g n e s s to a ssist th e B rig a d e to th e u tm o s t of th e ir a b ility . T h e C o u n ty C o m m is s io n e r th a n k e d M r. C la x to n a n d h is c o lle a g u e s a n d said h o w p le a se d h e w o u ld be to a c c e p t th e ir k i n d offer of h e lp . T e a w a s p ro v id e d d u rin g th e afte rn o o n .

R e a d i n g . — O n S u n d a y m o r n i n g , N o v e m b e r 11 t h , m e m b e rs of A m b u la n c e a n d N u r s i n g D iv is io n s of th is C o rp s w e re on p a ra d e a t th e C en o tap h . T h e p a ra d e w as u n d e r th e co m m a n d of t h e A s s is ta n t C o u n ty C o m m is s io n e r , M r. F . A. C. J a r v i s , w h o la id a w r e a t h o n b e h a l f of t h e c o u n ty , in m e m o r y of c o m r a d e s w h o fell in t h e t w o G r e a t W a r s .

S o u t h e r n .— O n T h u rsd a y evening, N o v em b er

22 n d , a t t h e A m b u l a n c e H a l l , C h a t h a m S t r e e t , t h i s A m b u la n c e D iv is io n in c o n ju n c tio n w ith th e R e a d i n g S o u th e r n R a ilw a y A m b u la n c e C lass, h e ld th e ir a n n u a l p re s e n ta tio n of a w a r d s a n d social. M r. G a r d , S t a t i o n m a s t e r of t h e S o u t h e r n R a i l w a y a t R e a d in g , p re sid ed . I n w e lc o m in g th e v isito rs, h e sa id h o w p le a se d h e w a s to b e p re s e n t o n th is o ccasio n . M r. E . U z zell, W e l f a r e O ffice r a n d C e n t r e S e c r e ta r y , G e n e r a l M a n a g e r ’s O f f i c e , W a t e r l o o , p r e s e n t e d t h e A s s o c i a tio n a w a r d s . H e s a i d h o w p l e a s e d h e w a s to s e e t h e fine s p irit of c o -o p e ra tio n w h ic h e x iste d b e tw e e n th e A ss o c ia tio n a n d t h e B r i g a d e i n B e r k s h i r e a n d t h a t h e l o o k e d f o r w a r d to m a n y m o r e h a p p y t im e s in th e fu tu r e . The C o u n ty C o m m issio n e r p resen ted th e B rig a d e a w a r d s , a n d s a id h e w a s a lw a y s re a d y to d o h is u t m o s t for th e A sso ciatio n . A c o n c e rt w a s a r r a n g e d by M r. T . Y o u n g a n d th e e v e n in g c o n c lu d e d w ith a so cial a n d d a n c e .

T h e a le ,— On

T h e a le A m b u la n c e a n d N u rs in g C a d e t D iv isio n s h eld th e ir b irth d a y p a rty a t th e P a ris h R o o m , T h e a le . T h e re w ere 120 c a d e ts p re s e n t in c lu d in g g u e sts , a n d a very h a p p y e v e n in g w a s sp en t w ith g a m e s, c o m p etitio n s a n d d a n c in g . R e fre s h m e n ts w e re p ro v id e d . T h e p a rty w a s v isited d u r i n g t h e e v e n i n g by t h e P r e s i d e n t , S i r F e l i x P o le .

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R y d e . — T h e A m b u la n c e D iv isio n p ro m o te d a B all a t th e

T o w n H a l l , R y d e , o n W e d n e s d a y , N o v e m b e r 28 t h , w h i c h p ro v e d v ery su ccessfu l. T h e d a n c e h all w a s b e a u tifu lly prepared. M r. W . L. R e e d p lay ed sele c tio n s on th e B o ro u g h o r g a n a n d c o m b i n e d w i t h T e d W e s t m o r e ’s b a n d i n p l a y i n g for d a n c e s . B e t i ’s o f R y d e s e r v e d r e f r e s h m e n t s . T h e p r o c e e d s , i n c l u d i n g d o n a t i o n s f r o m t h e M a y o r of R y d e , C o l. E lle r y , O . B . E . , T . D . , J . P . , S i r H a n s o n R o w b o t h a m , H . S. P e rc y , E s q ., a n d m a n y o t h e r s u p p o r t e r s , w ill f o r m a n u c l e u s of a f u n d fo r t h e p u r p o s e o f p u r c h a s i n g lo c a l h ead q u arters. T h e a r r a n g e m e n ts w e re m a d e by th e D iv isio n al E n t e r t a i n m e n t s O r g a n i s i n g C o m m itte e , u n d e r th e s u p e r v is io n of D iv . S u p t. A r th u r M a y b u r y . A m o n g th o se p re se n t w ere th e A ssista n t C o u n ty C o m m is sio n e r, D r. F. R . B. H . K e n n e d y , M .B .E ., O .S t .J ., J .P . , a n d M rs. K ennedy.

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D o v e r . — M e m b e r s of th e D o v e r C o rp s a n d frien d s, e n jo y e d a d in n e r a n d so cial e v e n in g rec en tly , a t th e te m p o ra ry h e a d q u a r t e r s a t C u rz o n R o a d S c h o o l, T o w e r H a m l e t s ; th e re w e r e a b o u t 80 p r e s e n t . D u r i n g th e e v e n in g , C o rp s O fficer G. E . W . R e a s o n c o n g r a t u l a t e d t h e G e n e r a l P u r p o s e C o m m i t t e e o n t h e verys u c c e s s f u l e v e n i n g a n d s u g g e s t e d t h a t a N e w Y e a r ’s E v e S o c ia l s h o u ld b e h e ld , w h ic h m e t w ith th e a p p r o v a l of all p resen t. G a m e s a n d d a n c i n g c o n t i n u e d u n t i l 11 p . m . a n d t h e e v e n in g c o n c lu d e d w ith A u ld L a n g S y n e a n d th e K in g .

T h e D o v e r C o rp s w a s in sp ected by th e C o u n ty C o m m issio n er, L o r d H a r r i s , o n W e d n e s d a y , N o v e m b e r 7t h . O w i n g to C o rp s h e a d q u a r t e r s b e in g d a m a g e d b y e n e m y a ctio n , th e in sp ec tio n w a s h eld a t th e D o v e r C o u n ty S ch o ol fo r B o y s a t A sto r A v e n u e, D o v e r. T h e p a r a d e w a s in c h a r g e of C o rp s O fficer G . E . W . R e a s o n , a n d a f te r th e in s p e c tio n of p e rs o n n e l, th e C o m m issio n er in sp ected th e m o to r a m b u la n c e s , a n d w a s p a rtic u la r l y i n t e r e s t e d in t h e A u s t i n m o t o r a m b u l a n c e p r e s e n t e d to th e C o rp s by th e T . W . O. A d i s p l a y o f d r i l l a n d f i r s t a i d w o r k w a s c a r r i e d o u t byall D iv is io n s. L o r d H a r r i s c o n g r a tu la te d t h e p a r a d e o n its s m a r tn e s s a n d effic ie n c y a n d fo r t h e w a y th e y h a d c a r r ie d o n d u r i n g th e s h e ll in g a n d th e d a y s of t h e w a r , h e a lso c o n g r a t u l a t e d th e C a d e t D iv isio n for th e ir w o r k a n d th e w a y th e y w e re g e t t i n g recru its.

County of Lancashire. W a r r in g t o n . — T h e

D iv is io n of th e W a r r i n g t o n C o rp s a s o c i a l e v e n i n g o n F r i d a y , N o v e m b e r 16 t h , a t w h i c h 200 m e m b e r s a n d r e l a t i v e s w e r e p r e s e n t i n t h e C r o s f i e l d C e n t e n a r y I n s titu te , a t w h ic h p r e s e n ta tio n s w e r e m a d e to t h r e e of its C o r p s O ffic e rs w h o w e r e r e t i r i n g a f t e r a l o n g a n d v a rie d serv ice w ith th e B rig a d e . had

T h e O f f i c e r s i n q u e s t i o n w e r e :— M r . J . E . N e w n s , C o r p s T r e a s u r e r , 46 y e a r s ; M r . I. W . W i l l i a m s o n , C o r p s S u p t . o f S t o r e s , 44 y e a r s ; M r , A . E . S p a n n , C o r p s Secre

F I R S T

t a r y , 42 y e a r s . M r. W illia m s o n a lso h a d J y e a r s ’ se rv ic e a t P r e s to n b e fo re b e in g tra n s fe rre d to W a r r in g to n . T h e t o t a l o f 135 y e a r s , c o n s t i t u e s a w o n d e r f u l r e c o r d o f s e r v ic e in a v o l u n t a r y o r g a n i s a t i o n s u c h a s t h e S t. J o h n A m b u la n c e B rig ad e. T h e D is tric t C o m n is sio n e r, M r. W . G. S m ith , w a s u n a b l e to b e p r e s e n t a n d in h i s a b s e n c e t h e p r e s e n t a t i o n s w e re m a d e by th e C o rp s S u p t., M r. E . W . W a r re n . T h e p ro c e e d in g s w e re o p e n ed b y M r. G . F . G re a v es, a D ir e c to r of J o s e p h C ro sfield & S o n s L im ite d , w h o w e lc o m e d th o se p re se n t a n d sp o k e of th e d eep in te re st th e D ire c to rs h a d in t h e A m b u l a n c e m o v e m e n t . H e a lso r e fe rr e d to th e lo n g se r v ic e M r. J. E . N e w n s h a d h a d w ith th e firm a n d th e v ery h ig h r e g a r d th e y h a d fo r h im . M r. W a r r e n , on b eh alf of th e C o rp s, a s k e d M r. G re a v e s to c o n v e y to th e C h a i r m a n t h e g r a te f u l t h a n k s of its m e m b e rs fo r th e u s e of th e I n s titu te t h a t e v e n in g . M r. W a r r e n th e n g a v e a b rief s u m m a r y of th e serv ice s of th e r e t i r i n g m e m b e r s . H e also m e n tio n e d th a t so m e y e a rs a g o fo r th e ir serv ices, M r. N e w n s a n d M r. S p a n n w e re m a d e S e r v in g B r o th e r s of th e O r d e r of S t. J o h n of J e r u s a le m . T h e c lo c k s w h i c h w e r e p r e s e n t e d to e a c h of t h e m b o r e a n in s c r ip tio n g i v i n g th e ir n a m e s , th e n a m e of th e C o rp s a n d l e n g t h of serv ice. In m a k i n g th e p re s e n ta tio n , M r. W a r r e n s a id th a t th e se m e m e n to s of th e ir lo n g a s s o c ia tio n w ith th e C o rp s w e re g iv e n w ith th e affe c tio n a n d e s te e m of th e m e m b e r s a n d th e ir b e st w is h e s for th e f u tu r e w e n t w ith th e m . T h e recip ien ts su ita b ly re s p o n d ed a n d said th ey hoped th a t th e y o u n g e r g e n e ra tio n w o u ld carry on w ith th e g o o d w o r k a n d h e lp to m a k e th e W a r r i n g t o n C o rp s s tr o n g e r th a n ever.

C o u n ty o f Som erset. B ath .— The Sc. J o h n A m b u l a n c e H e a d q u a r t e r s w a s p a c k e d to o v e rf lo w in g o n T u e s d a y , D e c e m b e r 4th , to g iv e a w e l c o m e t o t w o n e w S u p e r i n t e n d e n t s o f t h e m e n ’s D i v i s i o n a n d th e N u r s i n g D iv isio n .

D r. D . L. B e a th , A s s is ta n t C o m m is s io n e r of th e B r ig a d e fo r B a th , s a id th e y w e r e b o th v e ry w ell k n o w n to all th e m e m b e r s a s th e y h a d d o n e a lot d u r i n g th e w a r y e a rs, a n d h a d p roved th e ir w o rth . M r. E r n e s t S m ith h ad been a p p o i n t e d D i v i s i o n a l S u p e r i n t e n d e n t o f t h e m e n ’s D i v i s i o n , a n d M iss A. A p p le b y to t h e s a m e p o sitio n in th e N u r s i n g D iv isio n . T h e y w e re b o th o ld frie n d s . T h e i r p le a s u r e in m e e tin g th e m w o u ld be, p e rh a p s , s o m e w h a t s a d d e n e d b y h a v i n g to s a y “ G o o d -b y e ” to tw o o ld fr ie n d s w h o h a d g iv e n u p th e ir tim e , e n d le ssly , u n selfishly, a n d u n c e a s in g ly to th e w o r k of th e B r ig a d e , M r. S t e n t a n d M is s S t. L o W ilk in s o n . T h e y w e re n o t, h o w e v e r, lo sin g th e m a lto g e th e r, a s th e y w o u ld , h e w a s su re, be at h a n d to h e lp in a n y w a y th e y co u ld . B o th M iss A p p le b y a n d M r th e w ay th e m en a n d w o m en w elco m ed th e m .

S m i th t h a n k e d th e m all fo r of th e tw o D iv is io n s h a d

M r. S m ith g a v e a re s u m e of th e w o rk M r. S te n t h a d c a r rie d o u t. T h e y c o u ld n o t, h e sa id , t a k e le a v e of M r. S te n t w i t h o u t m a r k i n g in s o m e t a n g i b l e w a y , t h e i r g r a t i t u d e to h i m fo r all h e h a d d o n e . T h e C o m m ittee o rg a n isin g a p re s e n t a t i o n to h im felt th e y c o u ld n o t b u y a n y t h i n g of su ffic ie n t v a lu e to g iv e h im o w in g to th e p re s e n t a b n o r m a l p rices, a n d s o t h e y d e c i d e d to g i v e h i m a b lo tte r, a n d o n e of t h e i r C ivil D e f e n c e w o r k e r s h a d m a d e t w o c o v e r s of m a r q u e t r y w o r k in w h i c h t h e l e a t h e r b l o t t e r h a d b e e n i n c o r p o r a t e d , w h i l e it a l s o c o n ta in e d a n illu m in a te d in scrip tio n , w h ic h h e re a d . T h e m a r q u e t r y w o r k in c lu d e d o n th e fro n t, th e b a d g e of th e O r d e r in th e c u s t o m a r y w h ite on a b la c k b a c k g r o u n d , w h i l e o n t h e b a c k w e r e M r . S t e n t ’s i n i t i a l s “ F . R . S . ” a s a m onogram . A c c o m p a n y in g th e b lo tte r w a s a c h e q u e for a handsom e sum . M r. S te n t said h e h a d n o id e a h e w a s g o in g to h a v e th is th ru s t u p o n h im , a n d th e w h o le th in g h a d ta k e n h im c o m

R I D p le te ly b y s u r p r i s e , a n d h e h a r d l y k n e w h o w t o e x p r e s s to th e m h is th a n k s , b u t h e d id t h a n k t h e m all fo r th e w a y th e y h a d s to o d b y h im in e v e r y t h i n g h e h a d tr i e d to c a r r y o u t.

County of Surrey. G u il d f o r d . — T h e d e a t h o f C o rp s S u p t. J u liu s D . R u tte r, S . B . S t . J . o n W e d n e s d a y , N o v e m b e r 7t h , a t h i s h o m e in G u ild fo rd , h a s ta k e n o n e , w h o by h is u n t i r i n g effo rts h a s b u ilt u p a n o r g a n i s a t i o n w h i c h w ill r e m a i n a m e m o r i a l to h is w o r k fo r s o m e tim e. M r. R u t t e r w a s e n ro lle d in th e G u ild fo r d A m b u la n c e D i v i s i o n i n A p r i l 1913 , a n d a p p o i n t e d D i v i s i o n a l S u p e r i n t e n d e n t i n 1920 .

W i t h th e fo r m a tio n of th e B o r o u g h of G u ild fo r d C o rp s i n 1933 , h e w a s a p p o i n t e d C o r p s S e c r e t a r y , a n d i n 1937 h e w a s a p p o in te d C o rp s S u p t., a p o sitio n h e h eld u n til th e tim e of h is d e a th . H e w a s a p p o in te d a S e r v in g B r o th e r of the O r d e r o f S t . J o h n i n 1931 a n d h e l d t h e l o n g s e r v i c e m e d a l w ith th ree b ars. B y h i s d e a t h t h e B r i g a d e h a s lo s t a v e r y v a l u a b l e officer. W h e n a p p o in te d D iv . S u p t. th e D iv isio n h a d o n ly o n e a m b u l a n c e , t o - d a y it h a s f o u r a m b u l a n c e s a n d t w o c a r s f o r s i t t i n g cases. H e w a s a lso re s p o n sib le fo r th e b u ild in g of th e A m b u l a n c e H a l l in L e a s R o a d , w h i c h w a s t h e g i f t of a n a n o n y m o u s donor.

County of Worcester. S t o u r b r id g e .— A v e ry e n jo y a b le a n d c o n v iv ia l ti m e w a s s p e n t by m e m b e r s of th is D iv isio n o n S a tu r d a y , N o v e m b e r 3rd . T h i s w a s a t a n i n f o r m a l d i n n e r a n d w a s h e ld in t h e C o tta g e T e a R oom s. T h e c h a i r w a s t a k e n b y D iv. S u p t. C. D a v i e s ; C o r p s S u p t . H a r r i s p r e s e n t e d l o n g s e r v ic e a w a r d s . C o rp s S u p t. J. A. H a r r is sa id th a t h e w a s v e ry p leased to b e p r e s e n t a t t h a t f u n c tio n . H e w a s v ery m u c h s tr u c k by th e in fo rm a lity a n d h e w a s v ery g la d th a t th e y h a d d ecided to h a v e a s im ila r fu n c tio n e v ery y e a r in th e fu tu r e .

T h e O f f i c e r s a n d N . C . O . ’s o f t h e v a r i o u s D i v i s i o n s c o m p ris in g th e N o rth e rn A re a N u rs in g C o rp s sp en t a very in s t r u c t i v e a f t e r n o o n o n S a t u r d a y , N o v e m b e r 3r d , i n L y e A m b u la n c e H all. T h e o c c a s i o n w a s a h a l f - d a y c o u r s e , a n d a b o a t 30 D i v i s i o n a l O f f i c e r s a n d N . C . O . ’s w e r e p r e s e n t . C o u n ty C o m m issio n er D r. F. L . N ew to n , C .S t.J ., o pened th e p roceed in g s w ith a le c tu re o n “ T h e R u n n i n g of a D iv is io n ,” th is w a s fo llo w e d by drill in s tru c tio n , a le c tu r e on “ D iv isio n a l M e e t i n g s , ” a n d “ M e th o d s o f I n s t r u c t i o n in F i r s t A id a n d H o m e N u rsin g .”

A n in te re s tin g a n d su cc e ssfu l B all w a s e n jo y e d by a b o u t N o v e m b e r 8 th , a n d w a s h e l d in V i n c e n t ’s B a l l r o o m , H u n n i n g t o n , w h i c h w a s m o s t g e n e r o u s l y lo a n e d by S ir H a r r y V in c en t. T h e e v e n t w a s u n d o u b te d ly a g r e a t s u c c e ss , b o th so cially a n d fin an cially . W h e n all a c c o u n ts a r e s e ttle d , M iss P a r t r id g e h o p e s to h a n d to th e H a le s o w e n N u r s i n g D iv isio n , ^ ,8 0 w i t h w h i c h t o c o m m e n c e t h e i r f u n d f o r a m e d i c a l c o m fo rts dep o t.

160 p e o p l e o n T h u r s d a y ,

D u d l e y .— D u d le y A m b u la n c e and N u rsin g C ad ets a tte n d e d a sp ecial C a d e t S erv ice h e ld a t th e O ld M e e tin g H o u s e , D u d l e y , o n S u n d a y , N o v e m b e r 11 t h . In h is a d d r e s s th e R ev . A. S m i th s p o k e of th e im p o r ta n c e of a d v e n t u r e a n d r i s k in a g o o d c a u s e , g i v i n g D r. N a u s e n as a n e x am p le. T h e lesso n s w e re re a d b y c a d e ts R o n a l d H a n c o c k a n d D o r e e n S ilb ey .

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10 t h , a t t h e C h u r c h H a l l ,

F I R S T s e c o n d e n ro lm e n t c e re m o n y of c a d e ts in to th e B rie rle y H ill N u r s i n g D iv isio n . C o u n ty C a d e t O fficer M rs. H u g h R o b in s o n w h o w a s a c c o m p a n ie d by A re a C a d e t O fficer M rs. L a m b p e rfo rm ed th e cerem ony. M rs. R o b in s o n s a id t h a t it g a v e h e r re a l p le a s u r e to be p resen t. S h e w a s p a r tic u la r ly p le a se d to w e lc o m e th e p a r e n ts of th e c a d e ts , a s w ith o u t th e ir c o -o p e ra tio n a C a d e t D iv isio n c o u ld n o t flo u rish . S h e also c o n g ra tu la te d th e c a d e ts on th eir s m a r t a p p e a ra n c e a n d on g a in in g th e ir p re lim i n a r y first a id c e rtific a te s. A fte r th e e n ro lm e n t c e re m o n y ex ce llen t d e m o n s tra tio n s w e r e g iv e n by t h e c a d e ts , i n c l u d i n g “ T h e S t. J o h n C r o s s , ” a first a id c h a r a d e , a n d first a id rh y m e s .

A very in te r e s tin g a n d in s tru c tiv e t r a i n i n g c o u rs e for th e C a d e t O fficers of th e N o r th e r n A re a w a s h e ld on S a tu r d a y , N o v e r n b e r 17 t h , a t B i r m i n g h a m S t r e e t M e t h o d i s t S c h o o l ro o m , H aleso w en . T h e c o u rs e h a d b e en a r r a n g e d b y A re a C a d e t O fficer M rs. L a m b , a n d in c lu d e d a n in te re s tin g le c tu re o n “ C o m p e titio n — p o in ts o n t r a i n i n g a n d m a k i n g u p of p a t i e n t s ,” in s tr u c tio n o n d rill, a n d a s h o r t t a l k o n th e f o r m a t io n of th e “ S t u d e n t D i v i s i o n . ” T h i s w ill b e o p e n to m e m b e r s of C a d e t D i v i s i o n s b e t w e e n t h e a g e o f 16 a n d 20 y e a r s . A fter B rig a d e fo rm s h a d b e en in sp ec te d , te a w a s serv ed b y th e O fficers a n d m e m b e r s of (h e H a le s o w e n C a d e t N u r s i n g D iv isio n .

Nostell Colliery First Aid Society. F o r th e fu r th e r a n c e of th e m o v e m e n t, a n d to re ta in c o n t a c t w i t h i t s m e m b e r s , it w a s d e c i d e d , f o l l o w i n g c l a s s p r a c tice re c e n tly , t h a t a F i r s t A id S o c ie ty be f o r m e d in c o n n e c tio n w ith th e N o stell C o llie ry first a id m o v e m e n t. M r. J a m e s A c k ley , c h a i r m a n of th e E v e n i n g I n s titu te cla ss for colliery w o rk e rs , e m p h a s is e d th e n e ed fo r s u c h a S o ciety , a n d r e m a r k e d t h a t c o n s id e r in g v a rio u s c o n d itio n s w h ich en tailed m e m b e rs b e in g ab se n t, th e a tte n d a n c e h a d been very pleasin g . I t w a s w ith a v ie w to b e t t e r i n g th e first a id m o v e m e n t a t th e C o llie ry t h a t th e fo r m a t io n of th e S o c ie ty h a d b e e n s u g g e s t e d , a n d in a d d itio n , a sy lla b u s w o u ld b e c o m p ile d to in c lu d e v a r io u s a c tiv itie s s u c h a s v isits, so cial fu n c tio n s, o u tin g s a n d c o m p e te n t s p e a k e r s o n th e s u b ject a t m o n th ly m e e tin g s. T h e p ro sp e cts fo r th e fu tu re w e re b r ig h t e r , a n d w ith th e in s titu tio n of a F ir s t A id S o c ie ty p r o b a b l y m o r e m e m b e r s w o u l d b e i n d u c e d to jo in its r a n k s . It w a s u n a n im o u s ly reso lv ed th a t th e S o c ie ty b e fo rm e d , a n d i t w a s d e c i d e d t o a s k M r . VV. L . W h i t t l e , a n H o n o r a r y S e r v i n g B r o t h e r of t h e O r d e r of S t. J o h n of J e r u s a l e m , to b e co m e p resid en t. T h e f o llo w in g a r e to be a s k e d to b e c o m e v i c e - p r e s i d e n t s :— M a j o r J . G . S c o u l a r , M e s s r s . H . H a r t l e y , N. B e a u m o n t, C. W a r d a n d W . B arn sle y . M r. J. A c k ley w a s e lected c h a i r m a n , M r. M . A b b o it v ic e -c h a ir m a n , M r. D . M a k in s o n s e c re ta ry , M r. H . Y e m m a s s is ta n t sec re ta ry , a n d M r. B. R a y n o r t r e a s u r e r . A r r a n g e m e n t s to h o ld a c la ss e x a m in a ti o n u n d e r th e a u s p ic e s of th e S .J .A .A . w e re m a d e . It w as a g re e d th a t m e m b e r s h ip of th e S o c ie ty s h o u ld b e r e s tric te d to p e o p le h o l d i n g a first a id c e rtific a te .

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Railway Ambulance News. SOUTHERN H a il s h a m . — M r. A. L. C ro u c h , C la ss S e c re ta ry , p re sid ed o v er a g o o d a s s e m b ly a t H a ils h a m re c en tly , w h e n th e a w a r d s g a in e d b y th e s u c c e s s fu l m e m b e r s of t h e c la ss w e re p resen ted . T h e C h a i r m a n e sp e c ia lly w e lc o m e d th e w iv e s of m e m b e rs a n d v isito rs, a n d e x p r e s s e d g r a t i t u d e to D is tr ic t O fficer J a r v is a n d th e m e m b e r s for th e ir s u p p o r t d u r i n g th e y e ar. D i s t r i c t O ffice r J a r v i s , in r e p l y i n g , c a l le d a t t e n t i o n to th e in c r e a s in g n u m b e r of ro a d a c c id e n ts a n d s a id a k n o w le d g e of a m b u l a n c e w o r k w a s of g r e a t v a lu e o n s u c h o c c a sio n s. H e c o m p lim e n te d M r. C ro u c h o n th e w o rk h e w a s d o in g fo r th e H a i l s h a m C lass. D r. U m p le b y in t i m a t e d h e r p le a s u r e in b e in g a b le to d o w h a t s h e c o u ld for th e c la ss a n d h o p e d to see a g o o d g a t h e r in g w h e n th e lec tu re s w e re re su m ed . T h e fo llo w in g a w a r d s w ere d istrib u te d by D istrict O f f i c e r J a r v i s :— 3 c e r t i f i c a t e s , 2 v o u c h e r s , 3 l a b e l s , a n d 1 7- y e a r m e d a l . T h e fu n ctio n w as enhanced by th e k in d n ess and g e n e r o s ity of D is tric t O fficer A. D o n a ld J a rv is, O . S t . J . , w h o e n te rta in e d th e w h o le c o m p a n y to d in n e r.

L o n d o n B r id g e .— T h e a w a r d s g a i n e d b y t h e m e m b e r s of th e L o n d o n B r i d g e first a id c la s s w e r e p r e s e n te d o n N o v e m b e r 29th . M r. E . C a rd (S ta tio n M a ste r, L o n d o n B rid g e ) o c c u p ie d th e c h a ir a n d s p o k e of th e e x c e lle n t first a id w o r k w h ic h h ad been p e rfo rm ed by S o u th e rn staff a t L o n d o n B r id g e , a n d u r g e d all n o t to let th e ir in te r e s t in th e w o r k flag . T h e a w a rd s , p re s e n te d by M rs. N u n n , w e re a s u n d e r : 1s t C e r t i f i c a t e 2 , M e d a l l i o n 1 , V o u c h e r 1 , L a b e l s 9 . D u r in g th e p ro c e e d in g s D r. M a ile r (C la ss L e c tu re r) w a s p r e s e n te d w ith a p r o p e llin g p e n cil a s a to k e n of a p p r e c i a tio n of h is v a lu a b le se r v ic e s to t h e c la ss.

N e w p o r t . — T h e a n n u a l d i s t r i b u t i o n of a w a r d s in c o n n e c tio n w ith th e a b o v e c la ss to o k p la c e in th e M e tr o p o lita n H a l l , N e w p o r t , o n N o v e m b e r 29th. M r. G . L . N ic h o ls o n w a s in th e c h a i r a n d w e lc o m e d th e v isito rs a n d c o n g r a tu la te d th e p rize w in n e rs . H e con g ra tu la te d M rs. E. M. A u stin on h e r a w a r d a n d c o m m e n d ed h e r o n t h e e ffic ie n c y o f t h e w o m e n w o r k e r s in t h e I s l a n d . M rs. U zzell p re s e n te d th e a w a r d s , w h ic h w e re a s u n d e r : 7 - y e a r m e d a l 2 , 14 - y e a r m e d a l 2 , 21 - y e a r m e d a l 1, V o u c h e r 2 , M e d a l l i o n 1 , L a b e l s 15 . M r. U z z e ll a n n o u n c e d t h a t it h a d b e e n d e c i d e d to r e s u m e t h e S o u t h e r n R a i l w a y D iv is io n a l A m b u l a n c e C o m p e t i t i o n s in 1946 , a n d h e w o u l d l i k e t o s e e s e v e r a l t e a m s f r o m t h e I s l a n d ta k in g p art

V ic t o r ia . — T h e a w a r d s g a in e d b y th e s u cc e ssfu l m e m b e rs of th e V ic to ria A m b u la n c e c la ss w e r e p r e s e n te d on N o v e m b e r 20 t h . M r. C. J . C. L a t h a m p re s id e d , a n d s a id h o w p le a se d h e w a s to b e a t s u c h a fu n c tio n . H e t h a n k e d all t h e s ta f f w h o w o rk e d in th e a m b u la n c e m o v e m e n t for th e ir h e lp a n d in te re s t, a n d s tre s s e d th e n e c e ssity for th e ir c a n v a s s in g th e ir c o lle a g u e s w ith a v iew to in c re a s in g th e n u m b e rs . M r. T . A. C h a p m a n , S ta tio n M a s te r, V ic to ria , p re s e n te d t h e a w a r d s , w h i c h w e r e a s f o l l o w s : C e r t i f i c a t e 1, 7 - y e a r m e d a l 1 , 14 - y e a r m e d a l 2 , L a b e l s 15 . T h e C e n t r e ’s s p e c i a l M e r i t o r i o u s L o n g S e r v i c e C e r t i f i c a t e w a s p r e s e n t e d to F o r e m a n P. N y e , w h o a c t e d a s S e c r e t a r y to th e V ic to ria c la ss for m a n y y ears.

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T e m p l e c o m b e . — T h e p r e s e n ta tio n of A m b u la n c e a w a r d s to th e m e m b e r s of th e a b o v e c la ss to o k p la c e o n N o v e m b e r 15 t h i n t h e V i l l a g e H a l l a t T e m p l e c o m b e .

M r. P. C. H a y m a n (S ta tio n M aste r) p re sid ed an d t h a n k e d all p r e s e n t fo r th e ir c o n t i n u e d s u p p o r t of th e v a l u a b l e w o r k in c o n n e c t i o n w i t h f u r t h e r i n g t h e i r k n o w l e d g e of first aid . T h e a w a r d s w e re p re s e n te d b y M rs. B ish o p , a s fo llo w s :

21 - y e a r m e d a l 1, 14 - y e a r m e d a l 4 , 7 - y e a r m e d a l 2 , L a b e l s 12 . M r. G eo. B ish o p c o n g ra tu la te d th e C la ss S e c re ta ry , M r. W . S ta c e y , o n h is effo rts in k e e p i n g th e c la s s to g e th e r , a n d th e m e m b e r s for m a i n t a i n i n g a h i g h a n d c o n s is te n t m e m b ersh ip H e h o p e d th e y o u n g e r la d s w o u ld c o m e a lo n g a n d t a k e a n i n t e r e s t in first a id .

C l a p h a m J u n c t io n . — A t a r e p r e s e n t a t i v e g a t h e r i n g of staff of v a rio u s d e p a r tm e n ts a t C la p h a m Ju n ctio n on D e c e m b e r 5tb , M r. R . M . T . R i c h a r d s (T r a f f i c M a n a g e r ) p r e s e n t e d F o r e m a n A. J . M o o d y w ith a g if t fro m th e G e n e r a l M a n a g e r , w h i c h t o o k t h e f o r m of a b a r o m e t e r , a s a t o k e n o f a p p r e c i a tio n of v a lu a b le first a id se r v ic e s r e n d e r e d d u r i n g th e w a r y e ars a t C la p h a m J u n c tio n statio n .

M r. W . G eo . P a p e ( C h a ir m a n of th e S o u th e r n R a ilw a y A m b u la n c e C e n tre ) p re sid ed , b e in g s u p p o rte d by M r. E. U z z e ll, M r . W . G . S u r r y ( A s s t, to D iv . S u p t . ) a n d M r . F . A. T ro tt. M r. P a p e p a id a g e n e r a l trib u te to M r. M o o d y , a n d t h a n k e d h i m fo r h is e x c e lle n t first a id e ffo rts o v e r a n u m b e r of y e a r s . M r. R ic h a r d s , in p r e s e n t i n g th e g ift, c o n v e y e d g r a te f u l t h a n k s to M r. M o o d y fo r a ll h e h a d d o n e in t h e s e r v ic e of h u m a n i t y a n d s a id n o fin er s e rv ic e e x iste d t h a n t h a t of b e in g a b le to r e n d e r first a id to i n j u r e d c o l l e a g u e s w h e n e v e r th is w as needed. M r. M o o d y s u ita b ly re s p o n d e d .

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A s p a r t o f a D o m i n i o n - w i d e e ffo rt, t h e V a n c o u v e r C o r p s of 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 h a s ty p e d a l a r g e n u m b e r of p o te n tia l b lo o d d o n o rs . T h e p u r p o s e is to h a v e re a d ily a v a i l a b l e p e r s o n s w h o s e b lo o d g r o u p i n g is k n o w n . N o t a f e w h a v e w o n d e r e d w h a t t h e s e d if f e r e n c e s in b lo o d ty p e s a r e all a b o u t, a n d w h y o n e m e m b e r of a fa m ily m a y n o t a t a n y tim e d o n a t e b lo o d to a n o t h e r m e m b e r of th e s a m e fam ily . T h e b lo o d of e a c h in d iv id u a l, d e p e n d i n g o n its r e a c t io n w h e n m ix e d w ith b lo o d fro m o th e r p e rs o n s, b e lo n g s to o n e of f o u r l a r g e g r o u p s k n o w n a s O ., A ., B. a n d A .B . T here a r e a lso less im p o r ta n t s u b -g ro u p s . T r a n s m i s s i o n of b lo o d ty p e fo llo w s c lo se ly th e la w s g o v e rn in g h ered ity . B u t, ju s t as a boy m a y h a v e a red h a ir g e n e p a s s e d to h im fro m a r e m o te a n c e s to r w h ile b o th h is p a r e n t s h a v e h a ir of a n o t h e r c o lo u r, so a c h ild w h o s e b lo o d b e l o n g s to g r o u p O m a y fin d h i m s e l f in a fa m ily a ll o t h e r m e m b e r s of w h ic h h a v e b lo o d of a n o t h e r type. I n V a n c o u v e r , t h e r a t i o o f b l o o d t y p e s o f s o m e 3,200 p e r s o n s e x a m i n e d b y th e A m b u la n c e B r i g a d e w a s fo u n d to b e a s f o l l o w s :— O , 4 9 '5 p e r c e n t . ; A , 3 9 '8 p e r c e n t . ; B , 8 "8 p e r c e n t . ■ A .B . 1 '8 p e r c e n t . T h i s , in g e n e r a l , is t h e r a t i o of p e r s o n s w h o liv e in , o r h a v e c o m e f r o m , t h e U n ite d K in g d o m . In o th e r p eo p les th e ra tio m a y be q u ite d ifferen t. I t is g e n e r a l l y h e ld t h a t all m e m b e r s of t h e h u m a n r a c e o rig in a lly b e lo n g e d to g r o u p O . V e ry e arly , ty p e A c a m e in to ex isten ce a s a se p a ra te m u ta tio n . It su p p o sed ly aro se in A sia, w h e n c e it s p r e a d to E u r o p e . I t is a ls o th e d o m i n .

A I D a n t ty p e in c e r ta in p r im itiv e o u tly in g p e o p le s lik e th e A u s t r a l i a n n a t i v e s , s o m e o f w h o s e t r i b e s s h o w t h e r a t i o of t y p e A t o b e a s h i g h a s 61 p e r c e n t . , w i t h a n e n t i r e a b s e n c e of ty p e B. T h e b u s h m e n of S o u th A fric a a r e a lso very h i g h in A ; b u t h e r e it m a y h a v e c o m e in t o e x i s t e n c e a s a sep a ra te m u ta tio n . T h e N e g r o liv in g in th e U n ite d S ta te s s h o w s le ss of A a n d m o r e of O a n d B t h a n d o e s t h e A m e r ic a n w h ite m a n . A s o n e p ro c e e d s e a s t w a r d s fr o m E u r o p e in to A sia, t h e r e is a p r o g r e s s i v e i n c r e a s e in g e n e B. H i g h e s t v alu es a r e f o u n d in C e n t r a l A s i a in t h e v i c i n i t y o f t h e I n d u s a n d G a n g e s riv ers. In a n y d ire c tio n fro m th is c e n tre th e re is f o u n d t o b e a d e c r e a s e i n t h e B t y p e o f b l o o d . Ex cep tio n s a re a few g ro u p s w h ic h h a v e a lw a y s in te rm a rrie d a m o n g th e m s e lv e s , a s th e g y p s ie s of A u s tria a n d th e A in u of J a p a n . T h e en tire p ictu re s u g g e s ts th a t B a ro se as a m u t a t i o n in C e n t r a l A s i a , a n d t h a t f r o m t h e r e it s p r e a d t h r o u g h o u t th e 'w o r l d in all d ire c tio n s. O u r A m e r i c a n I n d i a n s a r e of p a r t i c u l a r in te r e s t, in t h a t w h ile s u p p o s e d ly of M o n g o lia n d e riv a tio n , th e y b e lo n g alm o st ex clu siv ely to g r o u p O, to g e th e r w ith sm all v a r y in g a m o u n t of A. T y p e B , w h ic h is h i g h in th e b lo o d of A s i a t i c M o n g o l i a n s , is h e r e a l m o s t e n t i r e l y a b s e n t . I n 1933 , D r . G e o r g e D a r b y , o f B e l l a B e l l a , t y p e d t h e b lo o d of m a n y m e m b e r s ot th e v a rio u s trib e s a lo n g th e B .C . c o a s t. H i s f i n d i n g s w e r e a s f o l l o w s :— O , 8 6 -7 p e r e e n t . ; A , 12 '7 p e r c e n t . ; B , 0 ’6 p e r c e n t . T h is ratio h a s b een fo u n d to a p p r o x im a te ly h o ld g o o d for th e In d ia n p o p u la tio n of th e e n tire h e m is p h e r e a n d for th e E sk im o s. T h e a b s e n c e of B s u g g e s t s t h a t th e I n d i a n s s e p a r a te d from th e m a in M o n g o lia n tr u n k before th is g e n e w a s in tro d u c e d in to S ib e ria fro m C e n tra l A sia, w h ile th e fa c t th a t th e y p ic k e d u p s o m e of g e n e A b e fo re m i g r a t i n g w o u ld in d ic a te t h a t t h is ty p e is o ld e r t h a n B. A p o ssib le re a so n f o r t h e a b s e n c e of B a m o n g t h e I n d i a n s is a d v a n c e d b y G a te s , of L o n d o n . “ T h e y m a y fo r a l o n g t i m e p r e v io u s to th e ir m ig r a tio n h a v e b e e n co n fin ed a n d iso la te d o n f r in g in g is la n d s a lo n g th e n o r th e a s t c o a s t of A s i a ,” h e said . O u r k n o w le d g e of th e s ig n ific a n c e of b lo o d g r o u p s s h o u ld b e g r e a tly w id e n e d in c o n s e q u e n c e of th e v e ry la r g e n u m b e r of p e rs o n s ty p e d b e c a u s e of th e w a r. In N ew Z e a la n d a n u m b e r of so ld iers w e re re c e n tly te sted fo r th e re la tio n of b lo o d ty p e to m e d ic a l g r a d i n g , d e n ta l d e ca y , a lle rg ic m a n ife s ta tio n s a n d p e rso n ality traits. N o sig n i f i c a n t c o r r e l a t i o n w a s f o u n d . — C a n a d ia n F i r s t A i d .

S.J.A.B. Overseas. R h o d e s ia .— T h e C o m m is s io n e r of th e R h o d e s ia n R a i l w a y s D is tric t (M r. W . J. K . S k illico rn , C .B .E ., C .S t.J ., M . I n s t . T . ) p r e s id e d r e c e n t ly a t t h e a n n u a l m e e t i n g s of th e B u la w a y o R a ilw a y A m b u la n c e a n d N u r s in g D iv isio n s. D u r i n g th e p e rio d c o v ered b y th e a n n u a l r e p o r t of th e A m b u l a n c e D iv is io n , t h e m e m b e r s g a v e first a id a t t e n t i o n to 1,526 c a s e s o f i n j u r y i n t h e R a i l w a y w o r k s h o p s , a n d a t t e n d e d 76 c a s u a l t i e s d u r i n g 792 p u b l i c d u t i e s . A t B u l a w a y o S t a t i o n , 22 s tr e tc h e r c ase s (in v alid p a s s e n g e r s tr a v e llin g b y tra in ) w e re re m o v e d fro m tra in s to a m b u la n c e s o r fro m o n e tra in to a n o th e r. M r. S k illic o r n w e lc o m e d b a c k a n u m b e r of e x -serv ice m e m b e rs , a n d D r. K . M . R o d g e r (D iv is io n a l S u r g e o n ) said th a t m e n w ho, on d e m o b ilisatio n , im m e d ia te ly re s u m e d th eir a s s o c ia tio n w ith o r g a n is a t io n s lik e th e S t. J o h n A m b u la n c e B r ig a d e w ith o u t a n y fu ss a b o u t th e d ifficu lty of s e tt lin g d o w n , w e re to b e c o n g ra tu la te d on th e ir c o m m o n sense. O n t h e N u r s i n g D i v i s i o n ’s s i d e , i t w a s r e p o r t e d t h a t m e m b e r s h a d d o n e a t o t a l o f 1,365 h o u r s ’ v o l u n t a r y h o s p i t a l d u ty a n d a tte n d e d 886 p u b lic d u tie s d u r in g th e y e ar. Ten m e m b e r s q u alified fo r th e re s u s c ita tio n c ertificate of th e R o y al L ife S a v i n g S o ciety .

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4. — T h e T e x tb o o k to w h ich referen ce m a y be m ade in this colum n is th e 39th ( 1937 ) E dition of the S .J .A .A M a n u al of F irs t A id to the In ju red . F u nction o f P atella. P . Y . ( C o v e n t r y ) . — P l e a s e b e g o o d e n o u g h t o t e l l m e ( 1) w h a t i s t h e f u n c t i o n o f t h e p a t e l l a a n d (2) if t h e p a t e l l a a c t u a l l y c o v ers th e k n e e jo in t. ( 1 ) T h e s t r o n g m u s c l e o n t h e f r o n t o f t h e t h i g h is a t t a c h e d t o t h e t o p of t h e p a t e l l a w h i c h in its t u r n is a l s o c o n n e c te d w ith th e h e a d of t h e tib ia b y a s t r o n g lig a m e n t. W h e n , th e re fo re , th e m u s c le o n th e fr o n t of th e th ig h c o n t r a c t s , it p u l l s o n t h e p a t e l l a a n d t h u s i n d i r e c t l y o n t h e tib ia. I n t h i s w a y t h e l e g is e x t e n d e d f r o m a p o s itio n of flexion. A g a i n , w h e n t h e l e g is fle x e d , t h e p a t e l l a is b r o u g h t i n f r o n t o f t h e k n e e j o i n t a n d s e r v e s a s p r o t e c t i o n t o it. ( 2) W h e n t h e l o w e r l i m b is s t r a i g h t ( t h a t is, e x t e n d e d a t th e k n e e jo in t) t h e p a te lla lies a s h o r t d is ta n c e a b o v e th e k n e e jo in t. W h e n , h o w e v e r , t h e l o w e r l i m b is fu lly fle x e d a t t h e k n e e j o i n t ( t h a t is, w i t h h e e l a g a i n s t t h e b a c k o f t h e t h i g h ) t h e n in t h i s p o s i t i o n o n l y d o e s t h e p a t e l l a lie i m m e d i a te ly in f r o n t o f t h e k n e e jo in t.-— N . C o r b e t F l e t c h e r .

E xam in ation H ow ler. B .P . (R h y l).— In w as asked w tak en o th e r sm iled w h e n

a recen t re-e x a m in a tio n a N u rsin g C adet h e r e th e te m p e r a t u r e of a p a tie n t c a n be th a n u n d e r th e to n g u e . T h e Surgeon s h e r e p l i e d — ‘ ‘ I n the a rm p it, in the g r o in a n d also in the rectory ! ” Good !

N e x t , p l e a s e ! !— N . C . F .

S eniority in D iv isio n . R . L . ( O a k d a l e ; . — I n t h e M a y i s s u e o f F i r s t A i d , B . O . 757 ( i s s u e d M a r c h 1945 ) w a s q u o t e d i n a r e p l y p u b l i s h e d u n d e r th e above h e a d in g . P l e a s e te ll ' m e if t h i s B . O . o p e r a te s w ith in th e P r io ry for W a le s . Y es. In c id e n ta lly B r ig a d e H e a d q u a r te r s in fo rm u s th a t t h e r a n k s o f t h e B r i g a d e a s s e t o u t i n B . O . 724 a p p l i e s t o t h e B r ig a d e A t- H o m e in c lu d in g th e P r io ry for W a le s a n d th a t y o u c a n o b ta in in fo rm a tio n w ith re fe re n c e to B r ig a d e O rd e rs fro m y o u r D iv isio n a l S u p e r in t e n d e n t.— E d it o r .

Phosphoru s P oison ing. F . W . ( S w i n t o n ) . — P le a s e te ll m e h o w w e c a n d ia g n o s e p o iso n in g by p h o sp h o ru s. I k n o w t h a t it is a n i r r i t a n t p o i s o n a n d t h a t t h e v i c t i m ’s v o m i t w i l l g l o w if i t i s t a k e n i n t o a d a r k r o o m ; b u t I s h a l l b e g r e a t l y o b l i g e d if y o u w ill tell m e all th e i m p o r t a n t s i g n s a n d s y m p to m s . P h o s p h o r u s a c t s p o w e r f u l l y w h e n a d m i n s t e r e d in a finely d iv id e d s t a t e a s in th e fo rm of r a t p a ste . I t h a s a tw o -fo ld a c t i o n ( 1 ) a s g a s t r o - i n t e s t i n a l i r r i t a n t a n d ( 2 ) , if a b s o r b e d , a s a p o te n t liv e r p o iso n . In th e first g r o u p th e s ig n s a n d s y m p to m s m a y in c lu d e t a s t e of g a r l i c in m o u t h , p a i n s in s t o m a c h w i t h e r u c t a t i o n of p h o s p h o r u s v a p o u r (w h ic h m a y a lso b e p r e s e n t in th e b re a th ) ,

A I D t h i r s t a n d v o m i t i n g w h i c h is u s u a l l y n o t p e r s i s t e n t , w h i l e th e v o m i t e d m a t t e r is l u m i n o u s . In th e se c o n d g r o u p th e s ig n s a n d s y m p to m s (w hich o c cu r a fte r p a rtia l recovery a n d u su ally tw o o r th re e days la te r) m a y in c lu d e e n l a r g e m e n t of liv er w h ile j a u n d ic e m a y d ev elo p a n d be a c c o m p a n ie d b y c o n sid e ra b le g e n e r a l d is t u r b a n c e a n d w e a k n e s s of th e h e a r t. T h ere m ay be a te n d e n c y to h a e m o r r h a g e a s s h o w n b y b le e d in g fro m n ose a n d o th e r p a r ts of th e b o d y w h ile p u r p le s p o ts a n d d is c o lo ra tio n of p a tc h e s of t h e s k in m a y s h o w th e m s e lv e s as re s u lt of e ffu sio n of b lo o d b e lo w o r in th e t e x tu r e of th e sk in . D e a t h m a y o c c u r f r o m c o l l a p s e s u d d e n l y ; a n d ,if p a t i e n t r e c o v e r s , c o n v a l e s c e n c e is m u c h p r o t r a c t e d . — N . C . F .

F ractu res of Spine and Sternum. T . W . (G a te s h e a d ).— I w a s r e a d in g a n a rtic le a few n ig h ts a g o on fra c tu re s a n d th e fo llo w in g s ta te m e n t w a s m a d e o n a f r a c t u r e o f t h e s t e r n u m :— “ T h i s is a n u n c o m m o n a c c i d e n t w h i c h c a n b e m a d e fro m in d ire c t v io len ce d u e to a s u d d e n b e n d in g f o r w a r d m o v e m e n t of t h e s p i n e in t h e th o r a c i c r e g i o n w h ic h o c c u r s w h e n th e r e is a f r a c tu r e of a th o r a c ic v e rte b ra .” N o w , if s u c h a n a c c i d e n t w a s t o c o m e m y w a y , w h a t in y o u r o p in io n w o u ld b e th e c o rre c t w a y to p la c e t h e p a t i e n t o n t h e s t r e t c h e r — in t h e p r o n e o r s u p i n e p o sitio n ? I lo o k fo rw a rd ev ery m o n th to y o u r sp len d id i n s t r u c t i o n g i v e n in a n s w e r s to q u e r i e s a n d h o p e t h a t y o u w ill g iv e m e a re p ly a t y o u r e a r lie s t o p p o r tu n ity . W i t h th is c o m b i n a t i o n of in ju r ie s t h e f r a c t u r e d s t e r n u m is l e s s i m p o r t a n t t h a n t h e f r a c t u r e d s p i n e . C o n seq u en tly , w h e n you m e e t w ith su c h a c a s e you m u s t c o n c e n tra te o n th e t r e a t m e n t c f f r a c t u r e d s p i n e i n a c c o r d a n c e w i t h R u l e B (i i) o n p . 74 o f t h e T e x t b o o k w h e r e i t is l a i d d o w n t h a t “ if t h e p a tie n t is c o n s c io u s b u t c a n n o t m o v e o n e o r b o th le g s o r h a s n o s e n s a tio n in th e m w h ile r e t a i n i n g t h e u s e of h is a r m s , s u s p e c t a f r a c tu r e in th e th o r a c ic o r l u m b a r r e g io n a n d tr a n s p o r t th e p a tie n t in th e fa c e - d o w n w a rd p o s itio n .” — N .C . F.

B rigad e M a n u al of Drill. H . F . ( N o r t h a m p t o n ) .— A c c o r d in g to th e a n s w e r g iv e n u n d e r t h e a b o v e h e a d i n g i n t h e O c t o b e r i s s u e o f F i r s t A i d it is c o n firm e d t h a t in b l a n k e t i n g a s tr e tc h e r a s la id d o w n in th e n e w D rill M a n u a l, th e p a tie n t h a s tw o th ic k n e sse s u n d e r h im a n d fo u r th ic k n e s s e s o n top. O u r T e x tb o o k ( p a g e 2 08 ) c l e a r l y s t a t e s t h a t a p a t i e n t s h o u l d h a v e f o u r th ic k n e ss e s u n d e rn e a th . I h a v e lis te n e d to m a n y lec tu r e s g iv e n b y M ed ic a l O fficers d u r i n g th e W a r y e a r s on t h e t r e a t m e n t of s h o c k a n d b l a n k e t i n g of s t r e t c h e r s a n d th e y w e r e all v e ry e m p h a tic o n th e i m p o r ta n c e a n d th e n e c e s sity of h a v i n g m o r e th ic k n e s s e s of b la n k e t u n d e r th e p a t i e n t t h a n o n top. T h e m e m b e r s of m y D iv is io n a r e a s k i n g w h a t is th e r e a s o n o f t h e c h a n g e ; a n d I s h a l l b e v e r y p l e a s e d if y o u w ill g iv e m e a n y in f o r m a tio n t h a t w ill h e lp m e o n th is su b ject. As I s ta te d in th e N o v e m b e r issu e of F ir s t A id , a m e m b e r of th e D rill M a n u a l S u b - C o m m itte e h a s in fo rm e d m e th a t t h e l o w e s t d i a g r a m o n t h e r i g h t s i d e o f p . 58 o f t h e M a n u a l of D r i l l is i n c o r r e c t ; t h a t t h e p a t i e n t s h o u l d b e p l a c e d o n to p o f ( a n d n o t w i t h i n ) t h e f o l d e d b l a n k e t ; a n d t h a t , if t h i s is d o n e , th e p a tie n t w o u ld h a v e f o u r la y e rs of b l a n k e t b e n e a th a n d t w o l a y e r s a b o v e h i m a s i s s h o w n i n F i g . 48 o f t h e R . A . M . C . T r a i n i n g M a n u a l N o . 3. In cid e n ta lly , a n o th e r c o r r e s p o n d e n t h a s s i n c e a n d r i g h t l y p o i n t e d o u t , t h a t if t h e d i a g r a m o n t h e r i g h t is i n c o r r e c t , s o is a l s o t h e o n e o n th e left ! ! — N .C . F .

E ffic ie n c y o f F irst A iders. J .P . (E lle sm e re P o r t) .— A t a re c e n t D iv isio n al P ra c tic e w e d i s c u s s e d t h e d iff e r e n c e s in t h e s t a n d a r d o f efficien cy

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T h e r e l i a n c e ^ jw h i c h f a c t o r y w o r k e r s p l a c e in t h e i r W e l f a r e N u r s e is c o m p a r a b l e w i t h t h a t w h i c h she in t u r n p la c e s in her F irst A id equ ipm en t. R a p i d r e l i e f f r o m p a i n a n d d is tre ss is n o less e s s e n t ia l in t h e N a t i o n a l in t e r e s t t h a n to t h e s u fferer, a n d ca lls f o r t h e p r o m p t a d m i n i s t r a t i o n o f a s a fe a n a l g e s i c and sedative. T h a t is w h y ‘' A n a d i n / a b a l a n c e d c o m b i n a t i o n in t h e a sp irin p he n a cetin -cafife in e g r o u p , is r e g a r d e d as i n d i s p e n s a b l e in F a c t o r y W e l f a r e w o r k .

A N A D IN @ T a 6 lets A N A D IN

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la id d o w n fo r m e m b e r s of th e B r i g a d e a n d of th e A ss o c ia tio n ; a n d w e w e lc o m e y o u r c o m m e n ts . A m e m b e r o f t h e B r i g a d e , t o b e e f f i c i e n t , m u s t ( 1) p a s s a n a n n u a l r e - e x a m i n a t i o n in first a id , (2) a t t e n d a t l e a s t 12 D i v i s i o n a l P r a c t i c e s , ( 3 ) b e p r e s e n t a t t h e A n n u a l I n s p e c t i o n , (4) a t t e n d P u b l i c D u t i e s t o t h e s a t i s f a c tio n of h is S u p e r i n t e n d e n t , a n d (5) is lia b le to b e d is c h a r g e d f r o m t h e B r i g a d e if h e f a i l s t o b e r e t u r n e d a s efficient fo r tw o c o n s e c u tiv e y e a rs . O n th e o th e r h a n d , a m e m b e r of th e A ss o c ia tio n w h e n he h as passed one ex am in atio n c an carry on w ith ou t ta k in g a sin g le re-e x a m in a tio n ! In deed, th e re are s o m e w h o still p r a c tis e first a id a l t h o u g h th e y h a v e n o t p a sse d a n e x a m in a tio n for ten y e a rs a n d m o re ; a n d yet t h e y c la im to b e e fficien t. W e a s k w h y th is d ifferen ce s h o u ld e x ist ; a n d w e h o p e to be fa v o u re d o n ce a g a i n w ith y o u r k in d a ssista n c e . H is to ry ' te lls u s t h a t t h e A s s o c ia tio n , w h e n it i n t r o d u c e d t h e m e d a l l i o n i n 1881 , r e g a r d e d i t s p o s s e s s i o n a s t h e p r o o f o f t h e p e r f e c t f i r s t a i d e r ; a n d t h a t it d i d n o t i n t r o d u c e a n n u a l r e - e x a m i n a t i o n w i t h “ l a b e l ” a w a r d s u n t i l 1905 , t h u s f o l l o w i n g t h e e x a m p l e s e t b y t h e B r i g a d e w h i c h i n 1889 f i r s t r e q u ir e d its m e m b e r s to be r e - e x a m in e d a n n u a l l y by a Surgeon. In o th e r w o rd s, th e re g u la tio n s w h ich g o v e rn th e B r ig a d e a s a u n if o r m e d a n d d is c ip lin e d b o d y of m e n , w o m e n a n d c a d e t s a r e i n t e n d e d t o e n s u r e a h ig h sta n d a rd of efficiency a n d th e r e b y to m a i n t a i n its r e p u ta tio n . W h i l s t t h e s a m e s t a n d a r d is d e s i r a b l e f o r m e m b e r s of th e A s s o c i a t i o n , i t is n o t p o s s i b l e t o i n s i s t o n t h e a i d s t o e f f i c i e n c y w h ich you h a v e n a m e d . T h e re a re ru m o u rs, h ow ever, th a t, to o v e rc o m e th is, th e re m a y s h o rtly b e issu e d r e g u la tio n s w h ic h w ill c a n c e l fr o m th e A ss o c ia tio n r e c o rd s first a id c e r t i f i c a t e s if a n o t h e r e x a m i n a t i o n i s n o t p a s s e d w i t h i n f i v e years. T h e e f f e c t o f t h e s e i n s t r u c t i o n s w o u l d b e t h a t , if a c a n d i d a te d e s ir e d to q u a lify fo r th e v o u c h e r a f te r th is p e rio d , lie /s h e w o u ld h a v e to s ta r t a g a i n b y t a k i n g th e first c ertificate. — N .C . F.

M eth od s of Ju d g in g C om petition s. A.

F. ( S p a r k b ro o k ) — R e c e n tly w e w e n t to w a tc h a c o m p e ti tio n b e tw e e n m e m b e r s of a facto ry ' h e re . A ll s e e m e d to g o w ell, a n d w e h a d d e c id e d w h ic h s h o u ld b e th e w in n in g team . T h e l a s t t e a m h a d a v e r y g o o d N o . 1, w h o e x a m in e d th e p a tie n t v e ry th o ro u g h ly ' a n d lik e all p re c e d i n g N o . ’s 1 a r r i v e d a t t h e o n l y i n j u r y w h i c h w a s a fr a c tu re d r i g h t tib ia. H e a t o n c e g a v e o rd e rs fo r th is t o b e a t t e n d e d t o b y N o . ’s 2 a n d 3 w h o t h e n c o v e r e d t h e p atie n t. T h e o r d e r to lift p a t i e n t w a s t h e n g i v e n . P e r s o n a l l y , I t h o u g h t t h a t t h e lift w a s d o n e a w k w a r d l y ; a n d I s a w th a t th e re a so n w a s b e c a u s e N o. 4 h a d b o th a r m s u n d e r th e p a tie n t in s te a d of o n e u n d e r a n d o n e over. L a t e r it w a s f o u n d t h a t th e lim b h a d n o t b e en s p lin te d a n d b a n d a g e d c o rrectly . 1 s p o k e to th e a c t i n g p a tie n t tw o d a y s a f t e r w a r d s ; a n d h e offered to s h o w m e a la r g e b ru is e o n h is th ig h w h e r e th e s p lin t h a d d u g in w h ile h e w a s b e i n g lifted b y th is te a m . H e a lso told m e t h a t th is te a m w e re d e c la re d th e w in n ers, b e cau se th e ir N o. 1 h a d a sk e d m o st q u e s t i o n s c o n c e r n i n g t h e p a t i e n t ’s c o n d i t i o n a s s e t o u t i n t h e m a r k i n g sh eet. I a m n o t a m e m b e r of th e B rig a d e , b u t for so m e y e a rs h a v e b e lo n g e d to th e A sso c ia tio n ; a n d I th in k th a t th e p ra c tic al p a rt sh o u ld c o u n t m o st. A lso I h a v e a lw a y s been u n d e r th e im p ressio n th a t even a t th e a n n u a l e x a m in a ti o n , a s tu d e n t w h o d id u p a f r a c tu re in c o rre c tly w o u ld b e failed. I h a v e d o n e m y b e st to w r ite th e b a re fa c ts a n d h u m b ly a s k y o u r o p in io n .

W h i l s t I a p p r e c i a t e t h e a t t e m p t w h ic h y o u h a v e m a d e to d e s c r ib e fu lly t h e f a c ts a b o u t th is c o m p e titio n , I c a n n o t e x p r e s s a n o p i n i o n o n t h e m e t h o d s of j u d g i n g it, b e c a u s e I w a s not p resen t a n d b e cau se I h a v e n o t seen th e m a r k in g sh eet. I d o re a lis e , h o w e v e r , t h a t o n e t e a m m i g h t j u m p to

c o n c lu sio n s a n d tre a t th e in ju r y (o r in ju rie s) co rrectly , w h e re a s by carefu l e n q u irie s a n o th e r te a m m ig h t prove th a t t h e l e a d e r is fu lly a w a k e to t h e p o s s ib il itie s of c o m p l i c a t i o n s a n d t h a t “ h is d ia g n o s i s re s ts o n a so lid b a s i s ” a s th e T e x t b o o k p u t s it i n t h e l a s t p a r a g r a p h o f C l a u s e 2 (p p . 18 a n d 19) — N . C . F .

M alaria. K . L . ( M u n d e s l e y ) . — A s a B r i g a d e S u r g e o n of m a n y y e a r s s t a n d i n g I w o u ld lik e, w ith y o u r p e rm is sio n , to a m p lify th e re p ly w h ic h y o u g a v e to th e q u e r y p u b lis h e d u n d e r th e a b o v e h e a d i n g in th e N o v e m b e r is su e of F ir s t A id . A f i r s t a i d e r can h e l p c o n s i d e r a b l y if o n e o f h i s f r i e n d s o r a n e i g h b o u r i s t a k e n il l a t h i s h o u s e w i t h a n a tta c k of m a la ria . H e s h o u ld b e w ra p p e d u p in tw o o r th r e e b la n k e ts a n d g iv e n c o p io u s d r a u g h t s of w a t e r u n til a d o c to r h a s seen h im . F u r t h e r , I d o n o t h e s it a te to a d d t h a t a v e g a n i n ta b le t c o u ld be g iv e n to e a s e h is d is c o m f o r t o r , if t h i s i s n o t a v a i l a b l e , t w o t a b l e t s o f a s p i r i n . T h e f ir s t s i g n of a n a t t a c k of m a l a r i a is s e v e r e s h i v e r i n g fo llo w ed b y a h ig h te m p e r a tu r e , a fte r w h ic h th e p a tie n t g o e s in to p ro fu se p e rs p ira tio n . S u c h first a id , I a s s u r e you, w o u ld be m u c h ap p reciated . T h a n k s fo r y o u r le tte r. Y o u h av e d ealt w ith th e p ro b l e m o n t h e a s s u m p t i o n t h a t t h e p a t i e n t i s t a k e n il l a t h o m e , w h e r e a s I im a g i n e d h im c o lla p s in g in th e s t r e e t . — N .C . F .

Hum our in F irst Aid. J .M . ( H a ll G r e e n ) .— A s a r e g u l a r r e a d e r of F ir s t A id , I w o u ld lik e to s a y h o w m u c h I e n jo y its c o n te n ts a n d e sp e c ia lly y o u r h u m o r o u s tit- b its in th e Q u e r ie s a n d A n sw e rs C o lu m n . I v e n tu r e to p a s s o n to y o u th is in c id e n t w h ic h h a p p e n e d to a frie n d of m in e a fe w w e e k s ago. W h i l s t w a l k i n g d o w n a d im ly lit s tr e e t a t d u s k , h e t h o u g h t t h a t h e h a d “ g o t h is first c a s e .” H e saw a m a n ly in g in th e g u t t e r o n h is side. ‘ ‘ W h a t's the m atter o ld m a n " h e s a i d . N o rep ly . H e ta p p e d h im on th e s h o u l d e r “ A r e you a l l r i g h t ? ” “ Y e s ,” c a m e t h e r e p l y , “ I 'm tu r n in g o ff the w a ter ! ” Good!

N e x t, p le a s e !

!— N . C . F .

B le a ch O in tm ent. D .S . ( L o m b a r d S t . ) . — O u r first a id o u tfit w a s w ell s to c k e d in t h e e a r l y d a y s o f t h e w a r w i t h a g o o d s u p p l y o f e v e r y th in g d eem ed necessary. W e a re g la d th a t th e m ajo rity of it d id n o t h a v e to b e u s e d . M a n y of t h e i t e m s w ill k e e p u n t i l u s e d u p i n t h e c o u r s e of a t t e n d i n g t o m i n o r in ju r ie s in p e a c e tim e . I a m w o n d e r i n g , h o w e v e r , if y o u c a n tell m e o f a n y u s e to w h i c h b le a c h o i n t m e n t c a n b e p u t, a s w e h a d s e v e ra l d o z e n tins. I h a v e re a d y o u r a n s w e r s to q u e rie s for m a n y y e ars n o w , w ith m u c h profit. W ith r e g re t I c a n n o t s u g g e s t a n y a lte rn a tiv e u s e fo r th e b le a c h o i n t m e n t w h ic h y o u h a v e in s to c k . F u r t h e r , i t is p o s s i b l e t h a t b y t h i s t i m e t h e o i n t m e n t m a y h a v e l o s t its c h l o r i n e c o n t e n t a n d w o u l d , t h e r e f o r e , b e u s e l e s s e v e n fo r its o rig in al p u rp o se .— N .C .F .

“ F IR S T A ID ” QUERY and REPLIES COUPON. To be cu t out a n d en closed w ith a ll Q u eries. D e c . , 1945 .

MANUALS

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AID

By N. CORBET FLETCHER, O.B.E., M.B., B.C., M.A.(Cantab.), M.R.C.S. AID8

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FIRST AID ‘Silje JJntepentanf Journal Jx»r ll)cAmbulance mtb pursing perukes; 619,

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T R A IN IN G

O F

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find

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l „ ]

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P R IC E T H R E E P E N C E 4*. P e r A n n u m , P o s t F re e

A ID

T E A M S

B O Y C E -M E A R S

“ G iv e s clear and constructive advice on selecting and training teams for first aid com petitions, and provides useful tips on individual and team behaviour during c o m p e t i t i o n s ..................should p u b lic.” — Fire Protection.

[ s. “

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M r. B oyce-M ears advises m ost com peten tly on the bu ild in g o f the team , on training fo r co m petition w o r k , w h at to expect in the test, d iagnosis and exam ination routine and com pletes the b o o k le t w ith a very useful and in form ative specim en o f an average ju d g e ’ s m ark sheet. C H A N C E R Y

L A N E ,

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C .

BIOLOGICAL M B f c PREPARATIONS A N T I P E O L

SEER S O I N T M E N T

O n e o r o t h e r o r a ll o f t h e t h r e e r a c e s 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 l o c o c c i a n d B . p y o c y a n e u s a r e 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 antibodies ( 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 h e o i n t m e n t , a n 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 its 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 T 1P 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 i t 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 r e q u i r e t o b e c h a n g e d e v e r y d a y . 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 tr e a te d w i t h A N T I P E O L O I N T M E N T .

O P H T H A L M O - A N T I P E O L i s a sem i-fluid 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 th e o r d in a r y A n ti p e o l o in t m e n t f o r o c u la r in fe c tio n s a n d lesio n s. E y e s a f f e c te d b y s m o k e an d d u s t are s o o th ed alm o st im m ediately by th e ap p lication o f O p h th a lm o -A n tip e o l, a n d the an tiv iru s p re v e n ts g e r m s f r o m developing.

R H I N O - A N T I P E O L affords ra p id re 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 i n i n 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 infectio ns o f th e n o s e a n d p h a ry n x (Staphlylococci, S treptoco cci, B. p y o c y an e u s, p n e u m o c o c c i, p n e u m o b a cilli, e n te ro c o c c i, M . c atarrh a lis, 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 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 i t is t h e ide a l p rev en tiv e o f m ic ro b e dev elo p m en t.

C lin ic a l S a m p le , on r a q u u t fr o m M E D IC 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 rg ra a n R oad

S o u th N o r w o o d , L o n d o n , S.E.25

S T

I Z A

T I O

“ SANOID” INTERLOCKING EXTENSI ON S P L I N T S

(P atent N u m b er S 3 16 5 o f 2 8 1 7 /3 9 .) INCURVED EDGE OF SOCKET /

TRANSVERSE G ROO VE OF .S P L IN T /

INCURVED EDGE OF SOCKET

advantages of standardization are well recognised, especially in alkaline medication. *BiSoDoL’ Powder, a gastric sedative and triple antacid, is particularly effective in the treat ment of digestive disorders and morning sickness. The constituents of ‘ BiSoDoL' are standardized and, as such, can be regarded as reliable. The preparation is agreeably flavoured with peppermint and is readily miscible with milk or water. Moreover ‘ BiSoDoL’ gives prompt relief.

S. 1343

“ S A N O ID ”

IN T E R L O C K IN G

E X T E N S IO N SPLIN TS

W it h M etal s o c k e ts f o r jo in tin g . 2 p ie c e s 2 5 /8 th s . In. x 3 / l6 t h s . In. x 15 In. 2 p ie c e s : 2 5 /8 th s . in. x 3 / l 6 t h s . in . x 134 in. I p ie c e : 2 5 /8 th s . i n x 3 'l 6 t h s . in . x 74 In. I p ie c e : 2 5 /8 th s . in . x 3 / l6 t h s . In . x 6 In. 2 W e b b in g S tr a p s w ith m e ta l b u c k le s : 18 In. x I In. 2 W e b b in g S tra p s w ith m e ta l b u c k le s : 2 7 In. x 14 In. 3 s o c k e ts .

★

By t h is I n v e n tio n S p lin ts m a d e In a n y c o n v e n ie n t le n g th s m a k e rig id c o n n e c tio n s by m e a n s o f I n c u rv e d o p p o s it e e d g e s o f t h e m e ta l s o c k e ts o r s le e v e s firm ly e n g a g in g w i t h t r a n s v e r s e g r o o v e s In t h e s u rfa c e s o f t h e S p lin ts w h e n p r e s s e d h o m e i n to t h e s o c k e t.

★ ★

N .B .—T o e n s u r e p e rf e c t lo c k in g s h o u ld b e c o r r e c tly in s e r te d in C E R T A IN T H A T TH E IN C U R V E D E N G A G E S W IT H T H E T R A N S V ER SE

BiSoDoL

it is im p e r a tiv e t h a t t h e S p lin t t h e s o c k e t, I.e ., BY M A K IN G ED G E O F M ETAL S O C K E T G R O O V E O F T H E S P L IN T .

Prices on applic a tio n . Sole Manufacturers :

CUXSON, CERRARD & CO. LTD.

BiSoDoL LTD.. 12, CHENIES STREET, LO N D O N , W .C.I

First

Aid

Specialists

OLDBURY,

B IR M IN G H A M

18th E d itio n . F ully R evised 232nd T h ousa n d. 3 13 Illu s. S o m e co lo u re d .

A D A M ,

R O U I L L Y

CO.,

W A R W IC K

T U N S T A L L ’S

336 p a g es.

H um an O ste o lo g y , A n ato m y, Etc.,

“ F IR S T

18, FITZROY STREET, FITZROY SQUARE. LO N D O N , W .l

A I D ” aT e

T O T H E IN JU R E D & S IC K . An A d v a n ced A m b u la n c e H a n d b o o k .

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(Size 2 ft. 2 ins. by 3 ft. 4 ins ) Complete Set of 19 sheets on tough cart ridge paper with Roller, 63/- net, postage lOd. ; or Mounted on Linen, 90/- net, postage l/ld.

and

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L E C T U R E R S & A .R .P . CLASSES.

comprising Anatomy. Physiology, Haemorr hage, Dislocations and Fractures. Mounted on linen with roller 27/6 net ; post age 7d.

JOHN

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G a u n t H o u s e , 28 O r c h a r d

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A ID

Jn&penAcnf Jotn-naTfor ti)eAmbulance atufr pursing ^erxrim No.

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A s w e g o to Press, w e regret to learn o f the death o f 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 nnual Subscription is 4 s . post f r e e ; sin gle copies 3 d .

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are sur e a l l o u r reader s w i l l un it e w i t h u s i n e x t e n d i n g the

deepest

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to his

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E D IT O R IA L .

S u bscription s, A dvertisem en ts 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

46,

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t d

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Telegraphic Address — “ Twenty-four, London." Telephone— C ity 3 7 10 .

A p a m p h le t of considerable C o d e s for in terest to the n u r s i n g p ro fes H o s p i t a l S e r v i c e sion has been issued b y the Governm ent under the title “ S ta ffin g the H o s p i t a l s .” In the “ F o r e w o r d , ” w h ic h js s ig n e d jo in tly b y the M in ister of H e a lth , the

CONTEN TS

THIS

N UM BER.

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C o d e s f o r H o s p i t a l S e r v i c e ...

C o m p e titio n s ...

A t h l e t e ’s F o o t . . . L e tte rs to th e E d ito r

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t a i n e d , ” it is s a i d , “ l a r g e n u m b e r s o f p e o p l e r e q u i r i n g tre a t m e n t will be u n a b l e to g a i n a d m i s s i o n t o h o s p i t a l a n d m a n y p a t i e n t s in h o s p i t a l w i l l not receive the attention th e y need, and the G o v e r n m e n t therefore appeal to all men and

O rg a n isa tio n ...

R ailw ay A m b u lan ce N ew s

o r w h o feel t h e y m i g h t d o w ell

N o stell C o llie ry F i r s t A id S o c ie ty

p l a y t h e i r p a r t in t h i s g r e a t field o f s e r v i c e . ”

M in ers’ A m b u la n c e S ch em e

p u r p o s e o f t h e p a m p h l e t is n o t o n l y to e m p h a s i s e the real a n d i m m e d i a t e need for a g e n e r o u s re

women

sponse Q u e r ie s

a n d

A n sw er s

C o r r e s p o n d e n t s :—

sets out

who

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h o s p i t a l s ’ u r g e n t call

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various

this w o r k

it t o c o m e

and The

for help.

m e t h o d s in w h i c h

the G o v e r n m e n t and represen tatives of the o r g a n i

R e v isio n of T e x t b o o k

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

s a t io n s c o n c e r n e d w i t h the h o s p ita l s e r v ic e s are u n a n i m o u s l y a g r e e d , a n d it s h o u l d be closely

S tretch er C a rry in g

s t u d i e d b y all c o n n e c t e d w i t h t h e p r o f e s s i o n .

M e m b e rsh ip of B rig a d e

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accom m odation,

of trainin g, salaries,

duty,

holidays,

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F I R S T

councils, organisations and trade unions, discip line, recreation and social life, domestic work, living out and marriage. There is a separate Code for domestic workers, and it is to be noted that in the former of these Codes the important statement is made that “ nurses should not be called upon to do work which is not an essential part of nursing and which can properly be done by orderly or domestic staff—e.g ., ward sweeping, polishing brass and door handles, washing trays, or clearing away and washing up crockery. Fittings and equipment which cause unnecessary labour should be eliminated.” It is realised that until adequate domestic staff can be obtained, it may not always be possible to relieve nurses entirely from domestic work.

C O M P E TITIO N S . By

“ O L D -T IM E R .”

A I D q u estio n s w h ic h re q u ire a g e n e ra l su rv ey of th e w h o le s u b je c t of first a id , a n d u n le s s th e c a n d i d a t e h a s b e e n p r e p a r e d b y p r o p e r t r a i n i n g h e is f a c e d w i t h a f r i g h t e n i n g s p e c t r e a t a m o m e n t w h e n h e is l e a s t r e a d y to c o n f r o n t it, a n d th e effects m a y b e d i s a s t r o u s to h is te a m . E x a m p le s of th e s e q u e s tio n s a re , of c o u rs e , p le n tifu l, b u t a fe w w ill s e r v e to in d i c a t e t h e ir p o s sib ilitie s . If a little t h o u g h t b e g iv e n to th e w id e sc o p e of th e f o llo w in g e x a m p le s , it w ill s o o n b e c l e a r t h a t th e y r e q u i r e c o n s i d e r a b l y m o r e a t t e n t i o n t h a n t h e e l e m e n t a r y q u e s t i o n : “ W h a t is t h e t r e a t m e n t for o p iu m p o is o n in g ? ” T h e y a re s o m e tim e s f r a u g h t w ith p itfalls a n d m u s t b e a p p ro a c h e d w arily . M o re o v e r, to a c o m p e tito r w h o h a s n o t been tra in e d , th e ir w id e scope m ay n o t a t all be a p p a r e n t a n d h e m a y c o n c e iv a b ly le a v e t h e c o m p e t i t i o n r o o m b l i s s f u l l y i g n o r a n t ( u n t i l h e h e a r s h i s m a r k s !) of t h e f a c t t h a t h e h a s n o t e a r n e d a f r a c t i o n of t h e m a r k s . E xam ples

o f

A dvanced

Q u e s t io n s .

( 1) I f a m a n w e r e s h o t t h r o u g h t h e m i d d l e o f t h e t h i g h , w h a t in ju r ie s m i g h t th e b u lle t c a u s e in its c o u r s e ? ( 2) D e s c r i b e t h e m o s t d i r e c t c i r c u i t of a d r o p of b lo o d f r o m a n a r t e r y in th e left t h u m b to th e c a p illa r ie s o v e r th e r i g h t e y e a n d s a y w h a t c h a n g e s it u i f d e r g o e s in its c o u r s e . ( 3) W h a t a r e t h e s i g n s o f b l e e d i n g ? (4) I n o r d e r t o d e t e r m i n e w h e t h e r a p a t i e n t is s u f f e r i n g from s u n s tro k e o r o p iu m p o iso n in g , d e ta il carefu lly w h a t p o in ts m i g h t a s s is t y o u in y o u r d ia g n o s is . ( 5 ) W ’h e n a r e y o u r e q u i r e d t o r e m o v e c l o t h i n g ?

I n d iv id u a l

O ral

T r a in in g .

O r a l t r a i n i n g is p e r h a p s t h e m o s t n e g l e c t e d p a r t of t h e p r e p a ra tio n for c o m p e titio n s a m o n g s t th o s e te a m s w h o fig u re lo w o n t h e fin al m a r k i n g s h e e ts . I n d e e d , t h a t is g e n e r a l l y t h e r e a s o n w h y th e y f ig u r e lo w . T h e r e a s o n fo r t h is n e g le c t is n o d o u b t t h e f a c t t h a t o ra l t r a i n i n g d e m a n d s o n ly g o o d h a r d s tu d y a n d g iv e s in r e tu r n little of t h a t s a tis f a c tio n w h ic h c o m e s fr o m a p iece of g o o d s h o w m a n s h i p w ell p u t a c ro ss . B u t t h e r e is a m o r e l a s t i n g s a t i s f a c t i o n t o b e g o t f r o m a s o u n d k n o w l e d g e o f t h e m a n u a l ’s co n ten ts. I n t h e f i r s t p l a c e , w h a t i s t h o r o u g h l y m a s t e r e d is n o t e asily fo rg o tte n . I n th e s e c o n d , a m a s t e r y of th e p rin c ip le s of first a id q u ic k ly in s p ire s in th e m e m b e r a s u r p r is in g ly u s e fu l c o n fid e n c e in b o th d ia g n o s i s a n d tr e a t m e n t . O n e m e e t i n g e a c h w e e k s h o u ld b e d e v o te d so lely to o ra l w ork. T h e p r o c e d u r e s u g g e s t e d is t h a t o n e m e m b e r , by p re fe re n c e th e t e a m tr a in e r , q u e s tio n th e b e a r e r s in ro ta tio n . T h e a n s w e rs m u s t, fro m th e o u ts e t be g iv e n a s th e y w o u ld b e in a c o m p e titio n te st. A t th e e n d of e a c h a n s w e r m i s ta k e s m u s t b e c o r re c te d a n d o m is s io n s c a r e f u lly e x p la in e d to th e b earer. B y th is m e th o d e a c h m e m b e r g e ts h is tu rn a n d s o o n le a r n s to o v e rc o m e h is first n e r v o u s n e s s . At th e sa m e t i m e t h e r e m a i n d e r c a n c h e c k u p o n t h e i r o w n a b ility to a n s w e r th e q u e s tio n , a n d c a n pro fit fr o m th e b e s t e x a m p le s in f r a m i n g a n s w e r s to q u e s ti o n s . In th e e a rly s ta g e s th e m a n u a l c a n be d iv ided in to s e c t i o n s e a c h r e p r e s e n t i n g a f a i r w e e k ’s s t u d y , a n d a t t h e e n d of t h e w e e k , q u e s ti o n s s h o u ld b e t a k e n o n ly f r o m t h a t s ec tio n . D u r i n g t h is s t a g e , w h ic h w ill a b s o r b six w e e k s , th e q u e s ti o n s s h o u ld be e le m e n ta r y te sts u p o n th e sec tio n c o n c e rn e d , so t h a t w h e n i t i s c o m p l e t e d e v e r y m e m b e r s h o u l d , if h e h a s d o n e h i s j o b c o n s c i e n t i o u s l y , h a v e a g o o d g r i p of t h e w 'h o le s c o p e of t h e m a n u a l. H e s h o u ld n o w b e a b le to g e t to g rip s w i t h a n y q u e s t i o n , w h e t h e r it i e l a t e s to a p a r t i c u l a r d e ta il o r c o m b in e s t h e s u b je c ts of v a rio u s se c tio n s of th e b o o k . O n c e th e e le m e n ts of th e m a n u a l a r e le a rn t, q u e s tio n s c a n b e c o m e p ro g r e s s iv e ly m o r e difficult a n d b e f r a m e d so t h a t th e a n sw 'e rs m u s t b e d e riv e d fr o m m o r e t h a n o n e p a r t of th e book. G r a d u a lly , th e y c a n be p r e p a r e d to e x e rc ise th e m e m b e r s ’ i n g e n u ity , d e v e lo p in g in th e m a c o n fid e n c e d e s ig n e d to w i t h s t a n d th e n e r v o u s s tr a in of a n y e x a m in a ti o n , a n d th e la c k of w h ic h h a s b e fo re n o w c a u s e d c a n d i d a te s , a t t h e c r i t i c a l m o m e n t , to c o n f e s s t h a t t h e i r m i n d is a b l a n k a n d th a t th e a n s w e r h a s escap ed th em . T h e re a re a lw a y s c ertain

(6) F o r w h a t c o n d i t i o n s w ill ic e b e of s e r v i c e to y o u in t h e t r e a t m e n t of a p a ti e n t , a n d h o w w o u l d y o u u s e it ? T o t h e n o v ic e t h e c o m p le te a n s w e r s to q u e s ti o n s w ill by n o m e a n s b e a p p a r e n t ; a n d lest th e r e a r is e a n y m is ta k e n n o tio n th a t th e y a re e le m e n ta ry q u e stio n s, a brief re fe re n c e to th e p itfa lls of q u e s tio n N o. 3 w ill s e r v e to s h o w th e possib ilities. “ B le e d in g ” m a y b e a rte ria l, v en o u s, c ap illary o r m ix e d , a n d v e n o u s in c lu d e s v a iic o se v ein s, It m a y be in te rn a l o r e x te rn a l a n d m a y in c lu d e a b ru ise. T h e q u estio n calls fo r all th e s ig n s of b o th c o m p r e s s io n a n d a p o p le x y , w 'h e re b l e e d i n g is i n t o t h e c a v i t y of t h e b r a i n . T h e s i g n s of s h o c k a n d c o lla p se b e c o m e in v o lv ed in to th is a n s w e r c o u p le d w i t h t h o s e o f i n t e r n a l h a e m o r r h a g e , i n w h i c h c o n n e c t i o n it m u s t n o t b e o v e r lo o k e d t h a t t h e m a n u a l p re fix e s t h e s i g n s of in te rn a l h a e m o r r h a g e by a s ta t e m e n t w h ic h g iv e s th e clu e th a t sev ere e x te rn a l h a e m o r r h a g e c a u s e s th e id e n tic al results. In a d d itio n , th e p a r tic u la r s ig n s of b le e d in g in to th e lu n g s a n d th e o th e r in te r n a l o r g a n s m u s t all b e d e ta ile d . But e n o u g h h a s b e e n said to s h o w th a t carefu l th o u g h t a n d an a n a l y tic a l s u r v e y of w h o le s e c tio n s m a y b e r e q u i r e d in f r a m i n g a n a n s w e r to a q u e s tio n of th is so rt. F o r s u c h a n a n a l y t i c a l s u r v e y o f t h e m a n u a l i t is o b v io u sly c o n v e n ie n t to h a v e a t h a n d s o m e a id to m e m o ry . W i t h o u t t h i s a i d it is a l m o s t i m p o s s i b l e t o m a k e a c o m p l e t e s u r v e y of th e m a n u a l a t w ill. I t is t h e r e f o r e a d v i s a b l e t h a t a s u ita b le ta b le b e d e v ise d w h ic h c a n be u sed a t a n y tim e, a n d b y m e a n s o f w 'h ic h t h e c o n t e n t s of t h e b l a c k b o o k a r e s o t a b u l a t e d t h a t n o t h i n g is le ft t o c h a n c e o r t h e w h i m s of t h e h u m a n m em ory. T h e f o l l o w i n g is a s u g g e s t i o n w h i c h m a y serv e a s a g u id e to th e f r a m i n g of s o m e th in g to s u it in d iv id u a l ta stes. T h e c o m m e n t s w h ic h a p p e a r in b ra c k e t s a re , of c o u rs e , n o t c o m m itte d to m e m o r y . T h e y h a v e been a d d e d a s n o te s to in d ic a te th e sc o p e of th e k e y w o r d , w h ic h a l o n e is n e e d e d t o j o g t h e m i n d i n t o t h e r e q u i r e d l i n e of th o u g h t. 1. B ones an d M u s c l e s (in c lu d e s frac tu re s , d is lo c a tio n s, s p ra in s , s tra in s). F o r a n a n a l y t i c a l s u r v e y of specific in ju r ie s , v is u a lis e t h e b o d y s u b -d iv id e d in to th e p a r t s : h e a d , t r u n k , u p p e r l i m b f l o w e r l i m b — it is t h e n a s im p le t h i n g to v is u a lise p a r t fo r p a r t, e .g ., c o lla rb o n e , s h o u ld e r b la d e , s h o u l d e r jo in t, h u m e r u s , e lb o w joint, rad iu s a n d uln a, w rist jo in t, c arp u s, m e tacarp u s, p h a la n g e s , fin g e r jo in ts.

F I R S T 2.

B le e d in g .

E x te rn a l a n d in tern al. M o u th , nose a n d ear. B ruises. A b d o m in a l w all in ju rie s a n d ru p tu re . S n a k e b ite a n d h y d ro p h o b ia. (W ith e x te rn a l b leed i n g r e m e m b e r to in c lu d e v a ric o se v ein s, w h ils t in te r n a l b l e e d i n g r e q u i r e s r e f e r e n c e to p a r t i c u l a r o r g a n s , v iz., l u n g s , s t o m a c h , k id n e y s , e tc .). 3. I n s e n s ib ility — A s p h y x ia — O t h e r . T h e pre v io u s e d itio n of th e te x tb o o k in c lu d e d a n e x c e lle n t little tab le. I ts h e a d i n g s a r e still to b e f o u n d in t h e p r e s e n t ed itio n , b u t h o t so c o n v e n ie n tly ta b u la te d th a t th e y a re re a d ily n o ticed . I n c o n s e q u e n c e t h e i r i m p o r t a n c e is u s u a lly m isse d , b u t set o u t a s fo llo w s th e ir v a lu e a s a n a i d t o m e m o r y i s a t o n c e a p p a r e n t :—

A I D

th e a d v an c e d o ral w o rk , he c an be n e ith e r a c o m p lete c o m p e titio n u n it, n o r a c o m p le te p r a c tic a l first a id e r. I n d iv id u a l

W ith C o n v u lsio n s.

A fo r m of q u e s tio n w h ic h s h o u ld b e u s e d o c c a s io n a lly d u r i n g t r a in in g , a n d w h ic h g iv e s g o o d re s u lts in th e a c q u i s i tio n of c o n fid e n c e , is th e “ q u ic k -fire ” s o rt. A s eries of q u e s t i o n s is a s k e d in q u i c k s u c c e s s io n , to e a c h o f w h i c h o n ly a b r i e f a n s w e r is r e q u i r e d . T h e y g iv e a n a i r of s n a p p i n e s s to t h e te s t, a n d c a n b e c u lle d fro m a ll p a r t s of th e b o o k . If th e a n s w e rs a re g iv e n q u ic k ly a n d th e c a n d id a te k n o w s h is b o o k , th e y in c u lc a te a c o n fid e n c e in h im s e lf to b e a b le re a d ily to a n s w e r q u e s tio n s fro m all p a r ts of th e m a n u a l. Such con fid e n c e is i n v a lu a b le . T h e q u e s t i o n s s h o u l d b e g iv e n in a s e rie s of h a lf-a -d o z e n or- m o r e p e r b e a r e r . H e re a re th ree s p e c i m e n s :— W h a t c o l o u r is t h e f a c e in e p ile p s y ? H o w m a n y bo n es fo rm th e k n ee-jo in t ? Is s ta r c h a n d w a te r a n a n tid o te fo r co rro siv e s u b lim a te ? B ea re rs sh o u ld be e n c o u ra g e d , w h e n faced w ith a c o m p e titio n te s t of tw o o r m o r e q u e s tio n s (a n d “ o ra l ” q u e s tio n s a r e i n v a r ia b ly h a n d e d to t h e c o m p e t i t o r ty p e d o n a c a r d ) , first to select th o s e q u e stio n s w h ic h a re o b v io u sly s tr a ig h tf o r w a r d a n d le a v e th e tr ic k y o n e s to th e last. N o o b je c tio n w ill be r a is e d b y t h e j u d g e , a n d it e n a b le s th e c a n d i d a te to s c o re w h a t h e c a n in t h e fu ll flu s h o f h is c o n fid e n c e . T h e rev erse m a y n o t o n ly u n d e r m in e h is c o n fid e n c e, b u t m a y lo se h im v a lu ab le m in u te s w h ile h e p o n d e rs a n in trica te p ro b lem , w ith th e r e s u lt t h a t h e m a y b e u n a b le to a n s w e r t h e s t r a i g h t f o r w a r d q u e s t i o n s b e f o r e t h e t i m e l i m i t is c a lle d . P a r r o t- lik e a n s w e r s a r e to b e d e p re c a te d , b u t a lt h o u g h ev e ry e n c o u r a g e m e n t m u s t b e g iv e n to m e m b e rs to e x p re ss t h e m s e l v e s in t h e i r o w n w o r d s , it is of t h e u t m o s t i m p o r t a n c e t h a t n o d e ta il w h ic h a p p e a r s in th e M a n u a l b e m is s e d in th e answ er. Q u e s tio n a n d a n s w e r m u s t a t all tim e s be s tric tly w ith in th e s y lla b u s o f th e S t. J o h n T e x tb o o k . T h e r e is h a r d w o r k a n d d r u d g e r y in th e e a rly s ta g e s , b u t o n c e th e c a n d id a te r e a c h e s th e a d v a n c e d s ta g e , th e in itia l d r u d g e r y of o ra l t r a i n in g d isap p e a rs a n d th e w o rk becom es a b so rb in g ly in te re st in g . T h e n , fo r th e first tim e , th e first a id e r le a r n s to u n d e r s t a n d t h e s u b t l e t i e s w h i c h f a c e h i m in t h e field o f d i a g n o s i s , a n d th e n h e w ill b e g in to a c q u ire a ra tio n a lis e d k n o w le d g e of h is w o r k w h i c h n o a m o u n t of p r a c t i c a l w o r k c a n , b y iiself, im p a r t to h im . U n til th e first a id e r h a s b e c o m e p ro fic ie n t in

T r a in in g .

(1) t h e i m m e d i a t e c o n t r o l o f a r t e r i a l o r v e n o u s b leed in g ; (2) a t h o r o u g h e x a m i n a t i o n of t h e w o u n d a n d its p ro tectio n (te m p o rarily ) a g a in s t g e r m s ; (3) t h e a t t e n t i o n n o w t o b e g i v e n t o s h o c k a n d o t h e r in ju rie s ; (4) t h e u l t i m a t e d r e s s i n g o f t h e w o u n d .

W ith o n t C o n v u lsio n s.

T h i s t a b le w ell r e p a y s c o m m i t t i n g t o m e m o r y . 4. P o i s o n s . ( T h e s e m u s t b e c o m m i t t e d t o m e m o r y in th e s e q u e n c e in w h ic h th e y a p p e a r in th e m a n u a l) . 5. B u r n s , s t i n g s , f r o s t b i t e s . N e ed le a n d fishhook. F o r e ig n b o d ie s— eye, ear, nose, s to m a c h .

P r a c t ic a l

T h e first p r a c tic a l t r a i n i n g fo r a n y c o m p e titio n s h o u ld ta k e th e fo rm of a th o r o u g h g r o u n d in g in c o rre c t a n d n e a t b a n d a g in g a n d sp lin tin g . T h i s is t h e t i m e to r e m e d y e v e r y f a u lt a n d fo r i n s is t e n c e u p o n e x a c t a n d p e r f e c t w o r k in e v e r y d etail. A t t h e e n d of it th e t e a m c a p t a in s h o u ld k n o w ’ th a t h is b e a r e r s w ill a p p ly b a n d a g e s a n d s p lin ts f a u ltle s s ly a n d t h a t th e r e w ill b e n o h e s i t a t i o n in a n y r o u t i n e w o r k th e y a r e g iv e n to d o. In d u e c o u rse th is m e th o d s h o u ld also be a p p lie d to th e e x a m i n a t i o n a n d t r e a t m e n t of w o u n d s , th e h a n d se a ts, a n d to a rtificial re s p ira tio n . L e t it b e s a id h e re t h a t th e w is d o m of a u n if o r m t r e a t m e n t of w o u n d s c a n n o t b e e m p h a s is e d to o s tr o n g ly . Each m e m b e r s h o u l d b e t h o r o u g h l y g r o u n d e d in t h e r o u t i n e of :

( 1) C o n s t i t u t i o n a l : E p i l e p s y . H y steria. In fan tile. (2) P o is o n in g : S try c h n in e , p ru ssic acid, c y an id e. F u n g i a n d b erries. ( 1) H e a d I n j u r i e s : C o n c u s s i o n . C o m p ressio n . ( 2) O t h e r C a u s e s : S h o c k a n d c o l l a p s e . F a in tin g . A p o p lex y . S u n s tro k e a n d h eatstro k e.

T h i s is t h e o n ly p r o p e r s e q u e n c e , a n d e a c h p ro c e s s s h o u ld b e a p p lie d in t u r n a s a d is tin c t s t a g e in th e t r e a t m e n t of a n y w o u n d ; u n til th e b e a re rs h a v e g ra s p e d th e force of th is f u n d a m e n t a l s e q u e n c e it is u n w i s e t o a t t e m p t t h e i n t r i c a c i e s of a c o m p le te tally . A u n it n o t tr a in e d th u s s y s te m a tic a lly to h a n d le e v ery w o u n d w ill m u d d le h im s e lf b y e n d e a v o u r i n g to c o n c e n tr a te upon th e w o u n d an d o th e r co n d itio n s sim u lta n eo u sly . S y stem atically h an d led , h o w ev er, a w o u n d c a n be e x am in ed m e th o d ic a l ly a n d left te m p o r a r i l y p r o te c te d w h ile d u e a t t e n ti o n is g i v e n to s h o c k a n d o t h e r i n j u r i e s . T h e re u p o n th e fin a l d r e s s i n g c a n b e p r e p a r e d a n d a p p lie d e q u a l ly m e t h o d ically w ith o u t a n y c o n f u s in g in te r r u p tio n n e c e s s ita te d b y th e o th e r c o n d itio n s. T h e ab ility to m a k e a d e ta ile d e x a m in a tio n of a n u n c o n s c i o u s p a t i e n t is a n o t h e r i m p o r t a n t p r e l i m i n a r y to i n div id u al p ra ctical w o rk . In th e in d iv id u a l p ra c tic a l te sts th e c o m p e tito r m u s t m a k e h is o w n d ia g n o s is . In th is re sp ect t h e t r a i n i n g is a k i n to t h a t fo r t e a m w o r k . In d e e d , th e d i a g n o s i s a n d t r e a t m e n t o f a n i n d i v i d u a l t e s t a r e a r e p l i c a in m i n i a t u r e o f th o s e r e q u ir e d in t e a m w o r k . M a n y d e ta ils of p r a c t i c a l t r a i n i n g w ill, t h e r e f o r e , b e le ft fo r d i s c u s s i o n u n d e r th e h e a d of t e a m t r a in in g , a n d o n ly a fe w b rie f h in ts g iv e n h e re w h ic h a re of p a rtic u la r a p p lic a tio n to th e in d iv id u a l tests. A s in t e a m t r a i n i n g , th e w o r k c a n b e d iv id e d in to (a) t h e a p p r o a c h ; (b ) t h e d i a g n o s i s ; (c) t h e t r e a t m e n t ; a n d (d) th e tr a n s p o rt. T h e s e w ill o v e rla p a n d d o v e ta il a s th e c irc u m s ta n c e s vary. Y e t th e re a r e c e r ta in e s s e n tia l d iffer e n ce s fro m te a m w o rk w h ic h s h o u ld be b o rn e in m in d . T he

A pproach .

H e r e t h e r e is n o q u e s t i o n of s q u a d d rill, b u t t h e b e a r e r s s h o u ld b e tr a in e d to re c eiv e th e ir ta lly a n d to m a k e th e ir a p p ro a c h sm artly . A s lo v e n ly a p p r o a c h m a k e s a b a d first im p ressio n . T h e b e a re r s h o u ld le a rn to h a v e h is e q u ip m e n t to h a n d if a t a l l p o s s i b l e . H e m u s t n o t b e c a u g h t b y th e o ld g a g of h a v in g th e e q u ip m e n t y a rd s a w a y a n d th e n h a v e to a p p ly d ig ita l p re s s u re to a p a tie n t w h o c a n n o t b e m o v e d fro m th e sp o t. H e s h o u ld s a tisfy h im s e lf b efo re a n y t h i n g e lse ju s t w h e r e h i s e q u i p m e n t is. If h e m u s t p ro c e ed to th e p a tie n t, h e w ill k n o w h o w to a ct. T h e t i m e l a id d o w n fo r a n i n d i v i d u a l t e s t is l i m i t e d . It is u s u a l l y f r o m five to s e v e n m i n u t e s . S e c o n d s c o u n t, th e re fo re, a n d o n c e t h e ta lly h a s b e e n r e a d a n d t h e first m o v e m a d e , th e r e m u s t b e n o h e s it a tio n in g o i n g r i g h t a h e a d . D e c is io n s m u s t b e m a d e q u ic k ly , a n d n o t a s e c o n d lo st in th e f ir s t i n i t i a l m o v e s . — T he C a ll ( S o u t h A f r i c a ) .

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N o . 7 ( W im bled on & M e r t o n ).— T h e N u r s i n g D iv i s i o n , a s s i s t e d b y N o . 17 A m b u l a n c e D i v i s i o n , g a v e a v e r y e n te r ta in in g e v e n in g , a r r a n g e d by A O . M rs. K in g , on T h e o b je c t of th e effo rt w a s lo fo rm T u e s d a y , D e c e m b e r 4th. a n u c l e u s f o r a s t a l l t h e D i v i s i o n w 'a s p r o v i d i n g f o r t h e f o r t h c o m i n g T o w n B a z a a r in a id o f W i m b l e d o n R e s e t t l e m e n t Fund. T h e D i v i s i o n w 'a s f a v o u r e d b y t h e p r e s e n c e of A s s t . C o m m is s io n e r D r. R a n g h a m , a m o n g o th ers. L a d y S u p t. M iss L e a n e to o k c h a r g e of th e p ro c e e d in g s , W 'e l c o m e d t h e v i s i t o r s a n d i n t r o d u c e d t h e a r t i s t e s . A m o n g o t h e r i n t e r e s t i n g i t e m s w e r e a m o c k film “ C o a l B l a c k L o v e ” in w h i c h a ll t h e “ film s t a r s ” w e r e m e m b e r s of th e tw o D iv isio n s, a n d a very a m u s i n g s k e tc h e n title d “ H e r C ro w n in g G lo ry .” A t th e c lo se of th e e n te r ta in m e n t, M iss L e a n e a n n o u n c e d th e re s u lt of th e co llectio n m a d e d u r i n g th e e v e n in g , w h ic h a m o u n t e d t o £ 7. D r. R a n g h a m c o m p lim e n te d th e D iv isio n s on a m o st su ccessfu l a n d en jo y ab le ev en in g .

N o . 98 ( W a n d s w o r t h & S o u t h f i e l d s ) . — A n i n t e r e s t i n g e v e n i n g w a s p r o v id e d b y m e m b e r s of t h i s D iv is io n a t S t. M i c h a e l ’s H a l l , S o u t h f i e l d s , o n W e d n e s d a y , D e c e m b e r 12 t h . A c o m p a n y of a p p r o x im a te ly o n e h u n d r e d m e m b e r s a n d fr ie n d s w e r e e n te r ta in e d by a n e x h ib itio n o f first aid . A sst. C o m m is s io n e r D r. R a n g h a m to o k th e ch air. T h e p r o g r a m m e o p en ed w ith a n in te re s tin g a c c o u n t by S u p t . B r o w n , o f t h e D i v i s i o n ’s a c t i v i t i e s c o v e r i n g t h e W’a r p e rio d . T h i s w a s fo llo w 'e d b y p r a c t i c a l d e m o n s t r a t i o n s by m e m b e r s o f t h e D i v i s i o n , t h e N . C . O ’s g i v i n g v e r b a l e x p l a n a tio n s of e a c h ite m . D u rin g th e d e m o n stra tio n s, re fresh m e n ts w ere served. A fte r th e p ra c tic a l w o rk , A sst. C o m m is s io n e r R a n g h a m m a d e a f e w c o m m e n t s o n t h e e v e n i n g ’s e n t e r t a i n m e n t . H is a d d r e s s in c lu d e d a n a c c o u n t of h is e x p e r ie n c e s in first a id W 'o r k i n w h i c h , h e t h o u g h t , e n t h u s i a s m p l a y e d a n i m p o r t a n t p art. T h i s e n t h u s i a s m w a s e m p h a s is e d in th e d is p la y g iv e n by th e m e m b e rs p resen t. H e th e n m a d e a n a p p e a l to th e v is ito rs to e n c o u r a g e y o u th to b e c o m e m e m b e r s of th e S t. J o h n A m b u la n c e B rig ad e. In co n clu sio n , D r. R a n g h a m s a id h e h a d a p le a s in g d u ty to p e rfo rm , t h a t of p u b lic ly t h a n k i n g S g t. P e n fo ld fo r h a v i n g c o l l e c t e d t h e s u m o f .£ 3 6 3 i n a i d o f t h e P r i s o n e r ’s o f W a r parcels fund. T h i s w a s a n e x c e p tio n a l a c h i e v e m e n t of w h ic h th e D iv isio n s h o u ld be p ro u d .

A I D T h e S e c r e ta r y of th e M ild m a y C lu b a n d h is w ife (M r. a n d M r s . S . A. P a l m e r ) w e r e h e a r t i l y t h a n k e d t o r t h e i r v a l u a b le a s s i s t a n c e in a s s u r i n g t h e s u c c e s s o t t h e p a r ly . The e v en in g w as conclu d ed w ith g a m ts a n d c o m m u n ity sin g in g .

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T h e a l e .— O n S a t u r d a y e v e n in g , D e c e m b e r 8 th , a t th e P a r i s h R o o m , T h e a l e , m e m b e r s of t h e N u r s i n g D i v i s i o n h e ld a p a r t y in c e l e b r a t i o n o f t h e i r fifth b i r t h d a y . A n iced c a k e w a s p re s e n te d by C a d e t O fficer M rs. E w a r t (D iv . S e c re ta ry ) a n d c u t by th e C o u n ty S u p t., th e H o n . M rs. L eslie G a m a g e . T h e h all w a s b e a u tifu lly d e c o r a te d by th e E n t e r t a i n m e n ts C o m m itte e a n d a very e n jo y a b le e v e n in g w a s s p en t w ith g a m e s a n d d a n cin g .

R e a d i n g , W e s t . — O n T u e s d a y , D e c e m b e r 11 t h , a t t h e A m b u l a n c e H a ll, C h a t h a m S tr e e t, th e N u r s i n g D iv is io n h eld a c o m p e titio n for th e G a m a g e C u p . E leven m e m b e rs e n te re d , a n d th e w in n e r w a s A m b . O lficer M rs. C la rk e , w ith A m b . S is te r M rs. A. C ro s s, r u n n e r - u p .

R e a d in g , E a s t . — T h e N u r s in g D iv isio n h eld a c o m p e ti t i o n o n M o n d a y , D e c e m b e r 17 t h , a t G r e y f r i a r s S c h o o l s , f o r the G a m a g e C up. T h e w i n n e r w a s C p l. M is s E . L u l k i n a n d th e r u n n e r - u p A m b . S is te r M iss J . T o m k i n w h o w a s o n ly o n e m a r k b eh in d . M iss W e e k e s of th is D iv isio n , w h o h a s b e e n w o r k i n g w ith th e J o i n t W a r O r g a n i s a t i o n fo r s o m e tim e , is n o w th e W e l f a r e O fficer of a P r is o n e r - o f - W a r T r a n s i t C a m p n e a r Bom bay.

A sc o t.— T w o n e w D iv isio n s h a v e b e en re g is te re d , th e A sco t N u r s i n g D iv isio n a n d th e A sco t N u r s in g C a d e t D iv i sio n . T h e M e m b e r - i n - C h a r g e is A m b . S i s t e r S ir s . L . C o x .

C adet N ew s. B e a r w o o d .— O n S a tu r d a y a fte rn o o n , D e c e m b e r 8 th , a t th e R o y a l M e r c h a n t N a v y S c h o o l, B e a rw o o d , th e R .M .N .S . N u r s in g C a d e t D iv isio n h eld a n e n ro lm e n t c e re m o n y . E ig h t c a d e ts w e re e nrolled. T h e C o u n t y C o m m i s s i o n e r , M r . C . A. P o o le, a f t e r w a r d s p re s e n te d th e a w a r d s w h ic h in c lu d e d p r e l im in a r y first a id certific a te s. S ix te e n c a d e ts w e re on parade.

H ungerford. — O n W ednesday, D e c e m b e r S th, a n e n ro lm e n t c e re m o n y w a s h eld a t H u n g e rfo rd . N in e N u rs in g C a d e ts w e re e n ro lled . A t t h e p r e lim in a r y first aid e x a m in a ti o n of th is n e w D iv isio n w h ic h to o k p lace in N o v e m ber, th e re s u lt w a s 100 p e r cent. pass.

R ea d in g T o w n N o . 67 c ( M i l o m a y ) . — H i s W o r s h i p t h e M a y o r o f S t o k e N e w in g to n , A ld e rm a n W a tso n , a tte n d ed th e a n n u a l X m a s P a r t y of th e C a d e t D iv isio n a t th e M ild m a v C lu b a n d In stitu te, N e w in g to n G reen , on T h u rsd a y ev en in g , D e ce m b e r 20 t h . T h i s p t r t y w a s th e f o u r th a n n iv e r s a r y of its in a u g u ra tio n . T h e p a re n ts of th e c a d e ts w e re in v ited , a n d a m o n g s t o t h e r s p r e s e n t w e r e M r. W . J. P ilto n , P r e s id e n t. T h e M a y o r s p o k e of t h e g r e a t w o r k r e n d e r e d b y t h e S . J . A B. d u r i n g t h e w a r , a n d c o n g r a t u l a t e d t h e c a d e t s o n fo llo w in g u p th a t g r e a t w o rk . H e a p p e a le d to th o s e n o t a lr e a d y in a y o u th o r g a n i s a t i o n to jo in th e S J .A .B . C a d e ts w ith o u t d elay . A re a C a d e t O fficer S. A n d re w s , in re s p o n d in g , t h a n k e d all p r e s e n t fo r t h e i r i n te r e s t in th e c a d e ts , a n d r e f e r r e d to th e h i g h e s t e e m in w h i c h t h e S t. J o h n u n i f o r m w a s h e l d h v a ll. H e t h e n h a n d e d to th e M a y o r fo r p r e s e n ta tio n , a n u m b e r of a w a r d s to m e m b e rs .

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21 s t , a t t h e A m b u l a n c e H a l l , C h a t h a m S t r e e t , t h e A m b u la n c e C a d e t D iv isio n h e ld a so cial a n d c o n c e rt fo r th e ir p a re n ts a n d frien d s. D u r i n g th e e v e n in g , th e S is te r C ro fts C h a lle n g e C u p w a s p re s e n te d by D r. W illia m s to th e w in n e rs of a r e c e n t first a i d c o m p e titio n , C a d e t S g t. G . H a i n e s a n d C adet D. Evans. T h e co n cert in clu d ed ite m s by th e recen tly fo rm ed B u g le B and. A fte r th e c o n c e rt, re fr e s h m e n ts w e re se rv e d a n d th e e v en in g c o n tin u ed w ith g a m e s a n d d a n cin g .

O b it u a r y .— W e r e g r e t to a n n o u n c e t h e d e a t h of D iv . S u p t . ( R ) M r s . B i t t , f o r m a n y y e a r s S u p e r i n t e n d e n t of R e a d i n g N u r s i n g D ivision. A t th e f u n e ra l w h ic h to o k p lace a t S t . J o h n ’s C h u r c h . W a t l i n g t o n S t r e e t , R e a d i n g , a G u a r d of H o n o u r w a s f o r m e d bv officers a n d m e m b e r s of R e a d i n g A m b u la n c e a n d N u rs in g C orps. A m o n g th o se p re s e n t w ere

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th e A s s is ta n t C o u n ty C o m m is s io n e r , M r. F . A. C. J a r v is , r e p r e s e n ti n g t h e C o u n ty C o m m is s io n e r, a n d C o u n ty O fficer (N ) M iss D . K . G ib b in s re p re s e n tin g th e C o u n ty S u p t.

Letters to the Editor. W e a r e in n o w a y re s p o n sib le for th e o p in io n s e x p re s s e d , o r th e s ta te m e n ts m a d e , by C o rre s p o n d e n ts .— E d it o r .

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o f L a n c a sh ire .

P a d g a t e . — B efore a v ery g o o d a tte n d a n c e of p a re n ts a n d frie n d s , th e a b o v e D iv isio n h e ld a so cia l e v e n i n g in th e S t . O s w a l d ’s H a l l , o n T h u r s d a y , D e c e m b e r 6 l h . M r. T . A sh all (C o rp s S to re k e e p e r) o p e n e d u p th e e v e n in g w ith a v e r y i m p r e s s i v e a d d r e s s o n t h e a i m s of t h e O r d e r , w h i c h w a s t h o r o u g h l y e n j o y e d b y all. T h e b i g m o m e n t of t h e e v e n i n g w a s t h e e n r o l m e n t of th e P a d g a t e C a d e t A m b u la n c e D iv isio n . M r. E. W . W a r re n ( W a r r in g to n D iv isio n al C o rp s S u p t ) w a s th e e n ro llin g O f f i c e r , a n d a l t o g e t h e r 18 c a d e t s w e r e e n r o l l e d . M r s . J . S. H o u g h t o n , J. P ., p r e s e n t e d p riz e s to t h e f o l l o w i n g c a d e t s w h o w e r e s u c c e s s f u l i n a r e c e n t c o m p e t i t i o n :— S e n i o r C a d e t s . — 1, H . P a r s o n a g e , 2 , R . G a r d i n e r , 3 , E . S e e d , 4, R . C h a r le s w o r th a n d R. A d d is o n (tied). Ju n io r C a d e t s . — 1, B . P r o u d , 2 , A . A d d i s o n . M u s i c a l i t e m s w e r e r e n d e r e d b y C p l . H . A. C r e a m e r , w h o a lso a c c o m p a n ie d so lo s g iv e n by M iss N. C la rk e . Re f r e s h m e n ts w e r e se rv e d by th e P a d g a t e N u r s i n g D iv isio n , a n d a m o s t e n j o y a b l e e v e n i n g e n d e d w i t h t h e s i n g i n g of t h e N a tio n a l A n th em .

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F i s h b o u r n e ( C h i c h e s t e r ) . — A n e w C a d e t D i v i s i o n is b e in g f o r m e d of th e a b o v e D iv is io n a tta c h e d to C h ic h e s te r. N i n e t e e n b o y s h a v e a t t e n d e d l e c t u r e s s i n c e O c t o b e r 1s t , 1945 , a n d are m a k in g g re a t p rogress. T h e e x a m in a ti o n for th e A sso c ia tio n C ertific a te w ill be h e ld a t th e ir H e a d q u a r t e r s on J a n u a r y 22 n d . W h e n t h i s D i v i s i o n is d u l y r e g i s t e r e d , s o m e c a d e t u n i f o r m s w i l l b e n e e d e d , a n d t h e y w o u l d b e g l a d if a n y o t h e r D iv is io n w h o h a s a n y to s p a r e , w o u l d sell t h e m ; o r a g i f t of s a m e w o u ld be very accep tab le.

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in th e c u r r e n t issu e of F i r s t ab o v e h e a d in g , w h ich reco rd s th e s e r v ic e of 7 m e m b e r s of t h e S t o u r b r i d g e C o rp s , a n d all h o n o u r to t h e m , it is t r u l y w o n d e r f u l s e r v ic e . M a y I b e a l l o w e d a littl e s p a c e t o r e c o r d s o m e y e a r s of s e r v ic e of m y o w n C o r p s , v iz ., t h e K e t t e r i n g C o r p s . H ere t h e y a r e :— C o r p s S g t . ' M a j o r J . M i l l e r , J u l y 1897 , 48 y e a r s ; C o r p s S u p t . W . D y s o n , M a r c h 1904 , 41 y e a r s ; P t e . W . H . B r o w n , A p r i l 19 0 5 , 40 y e a r s ; C o r p l . F . S w e e t i n g , A p r i l 1906 , 39 y e a r s ; P t e . A . C o l e m a n , M a y 1910 , 35 y e a r s ; S e r g t . E . M u n n , M a y 1910 , 35 y e a r s ; C a d e t S u p t . W . M a u d e v i l l e , J u n e 1911 , 34 y e a r s ; m a k i n g a t o t a l o f 272 y e a r s f o r t h e 7 m em bers. H e r e a r e f u r t h e r m e m b e r ’s r e c o r d s : S t a f f - S e r g t . W . W o o l m e r , J u n e 1911 , 34 y e a r s ; C o r p l . M . F o s t e r , A p r i l 1912 , 33 y e a r s ; D i v . S u p t . E . C l a y p o l e , O c t . 1914 , 31 y e a r s . A l l t h e s e m e m b e r s a r e s till o n t h e a c t i v e list. T h a n k i n g y o u , M r. E d i to r .— Y o u rs faith fu lly , A id , th e p a r a g r a p h u n d e r, th e

W o o lm e r

(S ta ff-S e rg t.).

H e a d q u a r te r s D iv isio n , K e tte r in g C o rp s.

D ear

S ir , —

I w a s v e r y i n t e r e s t e d in t h e l o n g s e r v i c e o f m e m b e r s of t h e S t o u r b r i d g e D i v i s i o n , s e v e n m e m b e r s w i t h a t o t a l o f 205 y e a r s , w h ic h w a s p u b l is h e d in t h e D e c e m b e r i s s u e of F i r s t A id . It w a s s u g g e s te d th a t th is m ig h t be a record. O n g o in g th r o u g h o u r D iv isio n al re co rd s (N o rth a m p to n H e a d q u a r t e r s ) I fin d t h a t w e h a v e e i g h t m e m b e r s w h o s e c o m b i n e d s e r v i c e t o t a l s 337 y e a r s . S / M G . T . H i n e s , 54 y e a r s , A m b . O f f i c e r J . B u t l e r , 49 y e a r s , D i v . S u p t . H . I. E d w a r d s , 44 y e a r s , P t e . R . T y l e r , 42 y e a r s , A m b . O f f i c e r C . P i t k i n , 41 y e a r s , A m b . O f f i c e r H . B l a n d , 37 y e a r s , A m b . O f f i c e r A . E . K i l b y , 35 y e a r s , P t e . A . G a m m a g e , 35 y e a r s . S e v e n of th e s e m e n se r v e d in H . M . F o r c e s d u r i n g th e 1914-1918 w a r . S i x i n t h e R . A . M . C . a n d o n e i n t h e N o r t h a m p to n sh ire T e rrito ria l R e g im e n t. S ev en o u t of th e e ig h t h a v e b een a w a r d e d th e S e rv in g B ro th e r M ed al, a n d A m b. O fficer C. P itk in w a s a w a r d e d th e M e r ito rio u s S e rv ic e M e d a l f o r s e r v i c e , 1914 - 1919 , R . A . M . C . — Y o u r s f a i t h f u l l y , H.

1. E a c h w o r k e r s h o u l d w e a r s a n d a l s o r s i m i l a r f o o t p r o te c tio n to, f r o m , a n d in th e s h o w e r .

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(D iv . S u p t.).

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2 . “ S o a k t h e f e e t f o r 15 m i n u t e s , t w i c e a d a y , i n a n a n t i s e p t i c s o l u t i o n s u c h a s 1 : 3000-5000 p o t a s s i u m p e r m a n g a n a t e , fo llo w ed by t h o r o u g h d ry in g , a n d p o w d e r in g w ith a b la n d ta lc u m p o w d e r.”

3. E a c h b a t h e r s h o u l d t h o r o u g h l y d r y t h e fe e t, e sp e c ia lly b e tw e e n t h e to es. D r y i n g p o w d e r a l s o is h elp fu l. 4 . S o c k s m u s t b e c h a n g e d d a i l y if p o s s i b l e . 5. B o o t s a n d s h o e s s h o u l d b e d i s i n f e c t e d . a t t h e e n d of e ac h , sh ift. N e g l i g e n c e in c o n t r o l l i n g a n d e l i m i n a t i n g th i s d is e a s e m a y r e s u l t in a s e r i o u s e p i d e m i c a n d lo s t t i m e f r o m w o r k . L a s t , b u t n o t l e a s t , i s t h e p a i n s u f f e r e d w h e n t h i s d i s e a s e is ig nored. If th e in fe c tio n is p e r s is te n t h a v e t h e p a tie n t see a d o cto r.

d e sir e of m a n y h o s p ita l a n d h e a l th w o r k e r s h a s a t la s t been realised . D u r i n g th e p a s t few y e a rs m a n y o r g a n i s a tio n s h a v e r e p r e s e n te d th e m s e lv e s a s c a t e r in g for h o sp ita l a n d h ealth w o rk ers. S o m e of th ese w e re la rg e in d u stria l u n io n s. T h e em p lo y ees th em selv es, h o w e v er, h a v in g b een c ry in g o u t for o n e o rg a n is a tio n , s p e c ia lis in g o n ly for h o sp ita l a n d h e a lth em p lo y ees. T h e

T h i s h a s n o w b e e r l s u p p l i e d in “ T h e C o n f e d e r a t i o n of H e a lth S erv ice E m p lo y e e s ” w h ic h o p e ra te s a s a n d fro m J a n u a r y 1 s t , 1946 , a n d i s t h e n e w o r g a n i s a t i o n e s t a b l i s h e d b y th e a m a l g a m a t i o n of tw o e x p e r ie n c e d a n d a c tiv e U n io n s , v i^., t h e H o s p i t a l s a n d W e l f a r e S e r v ic e s U n i o n a n d t h e M e n t a l H o s p i t a l a n d I n s t i t u t i o n a l W o r k e r s ’ L’ n i o n . The m e m b e r s h i p o f t h e n e w U n i o n a t t h e o u t s e t w i l l b e 40,000 a n d t h e v a l u e o f j o i n t a s s e t s a p p r o x i m a t e l y . £ 70 , 0 0 0 , The

F I R S T n e w U n i o n c a t e r s fo r all h e a l th w o r k e r s , by a n d t h r o u g h its G u ild s. T h e G u i l d o f N u r s e s c o v e r s a l l n u r s i n g s ta f f , a n d is co n tro lled a n d m a n a g e d by n u rs e s th em selv es. T h e M ed ical S e r v ic e s G u ild c o v e r s a ll m e d ic a l a n d a llie d staffs. The A m b u la n c e S e rv ic e s G u ild d e a ls so lely w ith a m b u l a n c e p e rs o n n e l o n a s e m i p r o f e s s io n a l b a sis , a s w ell a s t r a d e u n io n pro tectio n . T h e L o n d o n m e m b e r s h ip of th e G u ild r e p re s e n ts a p p r o x i m a t e l y 75 p e r c e n t , o f t h e t o t a l e m p l o y e e s i n t h e L o n d o n A m b u la n c e S erv ices. O th e r s tro n g b ra n c h e s of th e G u ild e x ists a t H u ll, L e e d s, P ly m o u th , C a rd iff a n d o th e r la rg e centres. T h e r e a r e lik e ly to b e s o m e re v o lu tio n a ry c h a n g e s in th e f u tu r e h e a l t h s e rv ic e s of th e c o u n try . I t is f i t t i n g t h a t t h is s tr o n g o rg a n is a tio n s h o u ld n o w c o m e in to ex isten ce, to p ro te c t th e in te r e s ts of so m a n y e m p lo y e e s , lik e ly to b e v ita lly affected . A t t h e h e a d a r e e x p e r i e n c e d o fficials, M r. G e o r g e G i b s o n , L L . D . , is t h e G e n e r a l S e c r e t a r y , M r . G . V i n c e n t E v a n s , F . C . I . S . , is th e F i n a n c e a n d O r g a n i s i n g S e c r e ta r y . A r e a O fficials in c lu d e A ld e r m a n H a r d y , M .P . T h e U n io n h a s five of i t s m e m b e r s i n P a r l i a m e n t , a r e a l g o o d t e a m .

Railway Ambulance News. L O N D O N ,

M ID L A N D

S C O T T IS H

T h e u n d e rm e n tio n e d m e m b e rs of th e L .M .S . staff h av e r e c e n t l y r e c e iv e d r e c o g n i t i o n of t h e O r d e r of S t. J o h n in r e s p e c t of th e ir s e rv ic e s to th e L .M .S . A m b u la n c e C e n t r e : —

P ro m o tio n jr o m S e r v in g B r o th e r to O fficer B ro th er. J. S. J o n e s , G o o d s D e p t., W a t e r lo o D o c k , L iv erp o o l.

A d m is s io n to th e O r d er in the g r a d e o f O fficer B ro th er. D r. H . E . M oore, L .M .S . H o sp ita l, C rew e.

A d m is s io n to the O r d e r in the g r a d e of S e r v in g B roth er. J. H a m m o n d , G oo ds. D e p t., C o n g le to n . A. D . H a r r o p , T r a f fic ,, L u to n . J. H . H ird , T raffic ,, K irk h a m & W . C. W . J a r m a n , G oods ,, N o ttin g h am . T . E. L a w lo r, C. & W , S o u th p o rt. J . C. L o c k e tt, T ra ffic D e p t., L l a n w ty d W ells. J. T . S im p s o n , T ra ffic ,, W o rk in g to n . W . J . S t e p h e n s , E n g i n e e r ’s D e p t . , A s h c h u r c h . W . J . T a y lo r, C. & W ., E u sto n . S O U T H E R N O b it u a r y . — F i r s t a id e r s in th e K e n t a r e a m u c h r e g r e t to le a r n of th e d e a t h of M r. W illia m E d w a r d G a g e , f o r m e r C h e c k e r a t D e a l, a n d S u p t. of th e D e a l D iv isio n , S .J .A .B ., w i t h w h i c h h e w a s c o n n e c t e d f o r 34 y e a r s . A s t a l w a r t in t h e a m b u l a n c e m o v e m e n t , h e w a s t h e p o s s e s s o r o f t h e 14 - y e a r g o ld m e d a l, a n d a certificate of m e rit fro m th e S o u th e rn R a i l w a y , a n d w ill b e s a d ly m is s e d b y a l a r g e circle. A t th e fu rleral, th e S o u th e r n R a i lw a y w a s re p re s e n te d b y M r. H . J. P a s c a ll (S ta tio n M a s te r, D e a l), E . J. B a r ra ll (C lerk ), A. H e a r n d e n , W . G . G a y w o o d (S ig n a lm e n ), P. R ic h a r d s o n , a n d J. E . W illia m s (P o rte rs ). ’ T h e S t. J o h n A m b u la n c e B r ig a d e w a s r e p r e s e n te d by C o u n ty O fficer C. E. E l a m , a n d a g o o d ly n u m b e r of A m b u la n c e O fficers. O u r s y m p a t h y is e x t e n d e d t o t h e w i d o w in h e r b e r e a v e m en t.

L .N .E .R . T h e L . N . E . R . first a id m o v e m e n t in S c o tla n d , h e ld u n d e r t h e a u s p i c e s of t h e S. A .A . A. c o n t i n u e s to re c e iv e g o o d s u p p o r t , a n d i n t h e y e a r e n d e d S e p t e m b e r 30 t h , t h e L . N . E . R . l o n g s e r v i c e g o l d m e d a l s f o r 15 y e a r s e f f i c i e n t a m b u l a n c e w o r k h a v e b e e n a w a r d e d t o 28 e m p l o y e e s i n t h e S c o t t i s h area.

R I D O f th e p re s e n t h o ld e rs of th e g o ld m e d a l, o n e m e m b e r h a s g a i n e d a f i f t h b a r f o r 40 y e a r s p r o f i c i e n c y , a n o t h e r a f o u r t h b a r f o r 35 y e a r s , t w o a t h i r d b a r f o r 30 y e a r s , f o u r a s e c o n d b a r f o r 25 y e a r s , a n d t e n h a v e q u a l i f i e d t o r a f i r s t b a r fo r 20 y e a r s serv ice. S e v e n h u n d r e d a n d o n e e m p lo y e e s h a v e g a i n e d t h e S t. A n d r e w ’s A m b u l a n c e A s s o c i a t i o n r e - e x a m i n a t i o n v o u c h e r o r p a s s e d t h e s e c tio n e fficiency t e s t fo r t h r e e o r m o r e y e a r s t r a i n i n g , a n d 31 S t . A n d r e w ’s A m b u l a n c e A s s o c i a t i o n m e d a l l i o n s ( t w o y e a r s p r o f i c i e n c y ) a n d 42 S t . A n d r e w ’s A m b u l a n c e A ss o c ia tio n first y e a r c ertific a te s h a v e b e e n a w a r d e d . P roficiency a w a r d s w e re a lso g a in e d b y a la r g e n u m b e r of n o n - r a ilw a y e m p lo y e e s to w h o m th e C o m p a n y w e r e a b le to e x te n d fa c ilitie s fo r tr a i n i n g .

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S o c i e t y .

A m e e t i n g of t h e n e w l y - f o r m e d N o s t e l l C o llie ry F i r s t A id S o ciety w a s h e ld a t th e C o lliery B a th s C a n te e n re c en tly , a n d w a s a tte n d e d by th e P r e s id e n t a n d H o n . S e r v in g B r o th e r of t h e O r d e r of S t. J o h n , M r. W . L . W h i t t l e , M r . H . H a r t l e y ( m a n a g e r ) , M r.' N . B e a u m o n t ( u n d e r - m a n a g e r ) , M r. W . B a r n s le y (e n g in e e r), M r. C. W a r d , M r. J. A c k le y (c h a irm a n ), M r. E . H . F e n n (C ro fto n E v e n in g S chool class in s tru c to r a n d C o llie ry first a id o r g a n is e r ) , M r. D . M a k i n s o n (s e c re ta ry ), M r. M . A b b o tt (v ic e -c h a irm a n ) a n d m e m b e rs . M r. W h ittle e x p re sse d th e h o p e th a t th e S o ciety w o u ld m e e t w ith s u c c e ss a n d th a t w o r k m e n a t th e co lliery w h o p o s se ss e d .firs t a id certific a te s w o u ld b e c o m e m e m b e rs . M r. A ck ley s a id th e S o ciety h o p e d to b r in g to g e th e r th o s e w h o w e r e n o t a c tiv e ly e n g a g e d in first a id w o r k , a n d to r e t a i n c o n ta c t w ith p r e s e n t m e m h e r s of th e first a id m o v e m e n t a t t h e co lliery . T h e y w o u ld e n d e a v o u r to in tr o d u c e a b r i g h t e r sid e to w h a t w a s fre q u e n tly lo o k e d u p o n a s a dull su b jec t. M r. A c k le y s a id h e w a s d i s a p p o i n te d to find t h a t o f t h e 700 e m p l o y e e s a t t h e p i t o n l y a f e w w e r e p r e p a r e d t o a v a il th e m s e lv e s of th e o p p o rtu n ity to reliev e h u m a n su ffe r i n g in c a s e of a c c id e n ts . F ir s t a id w a s e sse n tial, a n d h e h o p e d t h e S o c i e t y ’s e f f o r t s w o u l d h a v e m o r e e f f e c t i v e r e s u l t s . M r. M a k in s o n s a id th e y d id n o t e x p e c t im m e d ia te r e s u l t s , b u t t h o u g h t t i m e w o u l d b r i n g a w e l c o m e r e t u r n of th e “ o ld h a n d s ” a n d a s te a d y in flu x of n e w c a n d id a te s d e s ir o u s of q u a lify in g fo r e n r o lm e n t. M e e tin g s of th e S o ciety w o u ld be h eld m o n th ly . M r. M a k i n s o n t h e n g a v e d e t a i l s of th e s y lla b u s fo r th e c o m in g m o n t h s w h ic h in c lu d e d a visit to a L e e d s p a n t o m i m e , le c tu re s a n d d e b a te s , v isits to L e e d s I n f ir m a r y a n d S h e e p b r id g e C o llie r y ; a n n u a l o u t i n g in J u l y a n d c o m p e titio n s in A u g u s t. It w a s d e c id e d to e x te n d a n in v ita tio n to M r. J. P o w e ll to b e c o m e v ic e -p re sid e n t of th e S o ciety , a n d th e fo llo w in g a r e to be a s k e d to serv e o n th e c o m m itte e : M essrs. E. H . F e n n ’ A. A s k e y , J . A b b o t t , A. A. M u r p h y , W . C h a u l k l e y , J . F o l e y , D . M altb y , A. B la c k b u rn , F. B. Y e m m , W . H o w ell, R . A r m s tr o n g a n d J. H o w e ll.

Miners’ Ambulance Scheme. S o u th D e rb y sh ire M in e rs’ W elfa re C o m m ittee, c o m p r is in g e q u a l r e p r e s e n ta tio n of t h e o w n e r s a n d th e e m p lo y e e s, h a s c o n t r i b u t e d a c h e q u e fo r tw o t h o u s a n d g u i n e a s to its A m b u lan ce S chem e. F o r n early tw e n ty years, m in ers a n d th e ir d e p en d en ts, w h e n sic k o r in ju red h a v e been ta k e n by th e se a m b u la n c e s to a n d fro m h o s p ita ls a t B ir m in g h a m , L e ic e ste r, D e rb y , B u r t o n - o n - T r e n t a n d C oalville. W h e n t h e D u k e o f G l o u c e s t e r ’s R e d C r o s s a n d S t . J o h n F u n d c lo sed la s t J u n e , th e m in e rs d e c id e d to c o n tin u e th e ir c o n tr ib u tio n s of tw o p e n c e a w e e k to in c r e a s e th e e n d o w m e n t of t h e i r W e l f a r e A m b u l a n c e S c h e m e , a n d t h e c h e q u e is t h e first d o n a ti o n .

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What is “ tincture of iodine ?

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Has it other uses besides that of an antiseptic ?

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h e r e a r e m a n y m o r e fa c ts a b o u t i o d i n e w h i c h wil l i n t e r e s t y o u . I f y o u feel t h a t a b e t t e r k n o w l e d g e o f i o d i n e w o u l d h e l p y o u , t h e I o d i n e E d u c a t i o n a l B u r e a u will b e p l e a s e d to a n s w e r y o u r q u e s t i o n s . T h i s s e r v ic e is fr e e to a n y m e m b e r o f t h e n u r s i n g p r o f e s s i o n o r f ir st- aid w o r k e r .

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R E S P IR A T IO N E X P L A IN E D By FRANK C. EVE, B .A ., M .D ., F. R .C . P .(L o n d ) C r o w n 8 v o , 80 p a g e s w i t h 26 p h o t o g r a p h i c i l l u s t r a t i o n s . 3s. net. p o s ta g e 4d. In t h is b o o k l e t —f o r t h e f ir s t t im e —all t h e n e w a n d Im p r o v e d m e t h o d s o f A r tif ic ia l R e s p ir a tio n h a v e b e e n b r o u g h t u p t o d a te a n d t h e w h o le s u b je c t fu lly e x p la i n e d s o t h a t It c a n b e c a r r ie d o u t i n te l li g e n t l y r a t h e r th a n as a d r i l l . In t h e c o m p a s s o f o n ly 76 p a g e s . A rtif ic ia l R e s p ir a tio n h a s b e e n e x p o u n d e d , e x p a n d e d a n d lif te d t o a n e w le v e l.

IL L U S T R A T IO N S O F B A N D A G IN G A N D FIR ST A ID B y L O I S O A K E S , S . R . N . , D N . T h i r d E d i t i o n . E x t r a C r o w n 8 vo. 30 0 p a g e s w i t h o v e r 300 p h o t o g r a p h s o f trian g u la r and ro ller bandaging. 6 s. net. p o sta g e 6d. “ T h is is the most complete a n d best illu str a te d g u id e to bandag ing w hich we have read. T r u ly an excellen t book. " — f i r s t a i o .

C A S U A L T Y W O R K F O R A D V A N C E D F IR S T A ID STUDENTS B y A . W . M a c Q U A R R I E , M B „ C h . B . D e m y i 6 m o 2 54 p a g e s f u l l y i l l u s t r a t e d . 4s. 6d. net. p o s ta g e 4d. “ In a sm a ll compass it b n n g s together a mass 0/ inform ation not only w ith extraord in ary d ilig en ce a n d thoroughness, but in a fa sh io n very ea sily understood.”

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By L O IS O A K E S , S . R . N . , D . N . . a n d P r o f . T . B. D A V I E , M . D . S e v e n t h E d i t i o n . 4 6 4 p a g e s . 2 67 i l l u s t r a t i o n s . 4s. net. p o s ta g e 3d. “ A su rp risin g am ount o f inform ation is contained in th is little d ictionary a n d th is new edition j u s t p u b lish ed has been carefu lly rev ised a n d brought up to d a te." r e a d y s h o r tly .

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T h e y are in v a lu ab le fo r

L IV IN G ST O N E ,

16-17 T e v io t P la c e , E D IN B U R G H .

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E la s t o p l a s t TRADE MARK

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If you are prepared to study for an hour or two each day you can become an expert practitioner in Swedish Massage and enjoy the status, remunera tion and comforts of the professional worker. If you are interested in First Aid you will readily understand the value of Massage. Doctors, Nursing Homes, Hydros, etc., are all in need of the trained masseur.

PLAN YOUR CAREER NOW Over 25 years of teaching experience has enabled the S.M .A .E . (Swedish Massage and Electrical) Institute to secure for its Graduates in all parts of the world an assured future in a profession of fascinating and absorbing interest.

NOTHING TO LOSE as it guarantees to coach you until successful at the examination and your Diploma secured, or return your fee in full.

THE OLDEST TRAINING CENTRE IN GT. BRITAIN The S .M .A .E . Institute is the oldest of its kind in Great Britain and has trained many of the leading masseurs and exponents of Manipulative Therapy in the world today.

W rite without delay for FREE Booklet entitled “ M A N IP U L A T IV E T H E R A P Y AS A P R O F E S S IO N ” which tells you how to acquire the art of scientific massage by unique method of Home Study and how you can establish a private practice of your own.

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HOUSEHOLDPHYSICIAN Describes In simple language with helpful coloured plates and diagrams

T h e C O M P L A IN T S O F M E N , W O M E N A N D C H IL D R E N . Their Cause, Treatment and Cure. A j e w o* the S u b jects tre a te d : H o w to K e e p W ell, F ir s t A id W h a t to D o in E m e r g e n c i e s In H u e n z a , C o ld s, etc. M easles, M u m p s, C a ta r rh C orns a n d W arts P h y sical C u ltu re T r e a t m e n t fo r all S k i n D is e a s e s T h e L u n g s , P leu risy H y g ie n e, A n ato m y , P h a rm a c y

T h e P rin cip les of N u rs in g T h e Eye, th e E a r T h e T h ro a t, th e N ose T h e C h est, th e H e a r t T h e S to m a c h , th e L iver T h e T e e th , th e M u scles In fa n t W elfare H o m o ep ath y , N eu rasth e n ia 375 P r e s c r i p t i o n s , e t c . , e t c .

THE Y O U N G W IF E w i l l fi n d j u s t t h e i n f o r m a t i o n s h e r e q u i r e s . M O TH ER S w h o w i s h t h e i r d a u g h t e r s t o d e v e l o p n a t u r a l l y w i l l f i n d e x a c t l y the teaching th ey need.

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Q u estio n s and A n sw e rs B ased o n th e 39th F d i t i o n o f the T e x t B o o k o f t h e St . J o h n A m b u l a n c e A s s o c i a t i o n . P r i c e 6d. e a c h ( P o s t a g e i d . ) o r 5 s . p e r d o z . ( P o s t F r e e ) .

S ix S e ts o f C a d e t C o m p e tit io n Each

Papers.

Set includes F ir s t A id , H o m e N u r s in g , G e n e r a l E f fic ie n c y a n d D r i l l , f o r t r a i n i n g p u r p o s e s .

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V IR TU E & ..C o., Ltd., (F .A . D ept.), C ro w n C h a m b e rs, Upper P a rliam en t Street, N ottin gham .

P le 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 t o p u r c h a s e .

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Human Osteology, Anatomy, etc., 18 FITZROY STREET, FITZROY SQUARE, L O N D O N . W .l TELEPHO NE :

M U SE U M 2703.

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7d. e a c h , o r C o m p l e t e S e t o f S ix, P o s t F r e e 3s .

HUMAN SKELETONS

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County Officer F. A . T R O T T , 16, Hurst Road, Horsham , Sussex. In c o u rse o f pu b licatio n —

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D a t e w ill b e a n n o u n c e d l a t e r .

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— A Synopsis of War-time Training b y J O H N F E N T O N , m . b ., B . c h . , b . a . o ., d . p . h . a n d L . A . H . S N O W B A L L , m . r . c .p ., F . R .c .s .( E d .) C IV IL

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SE R V IC E S , E T C .,

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8d. p o s t f r e e (7s. 6d. p e r d o z e n )

Obtainable from D ale, R eyn o ld s & Co. Ltd., 46, Cann on St., E.C.4

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ETC.

EMERGENCY TREATMENT OF. S K IN I N J U R I E S b e p rep ared fo r an em erg en cy and k e e p C u t i c u r a B r a n d O i n t m e n t in y o u r First A id K it It brings i n stan t s o o th in g relief to ru ts , b u rn s, s k i n l a c e r a t i o n s p i e v e n t s vp r e a d of infection, quickly heals O b t a i n a b l e a t all C h e m i s t s a n d ' t u e s .

(u tic u ra OINTMENT

F I R S T

R I D th e h a n d le s a re p laced o n th e n e a r s h o u ld e rs. W e found in p r a c t i c e h o w e v e r , t h a t t h i s is p r a c t i c a l l y i m p o s s i b l e fo r B e a re rs 1 a n d 2 a n d th a t th e se B e a re rs s h o u ld p lace th e stre tc h er on th e n e a r sh o u ld ers b eh in d th e ru n n e rs. As w e h av e received m u c h useful in fo rm atio n fro m re a d i n g y o u r a n s w e r s t o q u e r i e s i n F ir s t A id , w e s h a l l g re a tly a p p re ciate y o u r o b serv atio n s o n th is query .

Queries and Answers to Correspondents 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 t o p l e f t - h a n d c o r n e r o f t h e e n v e l o p e “ Q u e r y , ’’ a n d a d d r e s s e d t o F i r s t A i d , 46 , C a n n o n - s t r e e t , L o n d o n , E . C . 4 .

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 i n t h i s c o l u m n i s t h e 39 t h ( 1937 ) E d i t i o n of t h e S . J . A . A . M a n u a l of F i r s t A id to th e I n ju r e d .

R e v isio n o f Textbook. E .T . (N o rth e rn C o u n ty ).— N ow th a t o u r m e m b e rs a re re tu rn i n g f r o m H . M . F o r c e s , w e fin d t h a t t h e r e is a f e e l i n g t h a t t h e T e x t b o o k is o u t - o f - d a te a n d t h a t it r e q u i r e s ra d ic a l rev isio n . I n t h e s e c i r c u m s t a n c e s w e a s k , if i n y o u r o p i n i o n , t h i s i s r e a l l y n e c e s s a r y a n d if w e s h o u l d g o o u tsid e th e T e x tb o o k a t o u r D iv isio n al P ractices. T h i s f e e l i n g is p a r t i c u l a r l y s t r e s s e d b y t h o s e m e m b e r s of th e B r ig a d e w h o h a v e b e en a c tin g a s m e d ic al o rd erlies d u rin g th e late w ar. I n c o n clu sio n , w e t h a n k y o u fo r y o u r k in d h e lp so free ly g iv e n in th e p a s t, a n d w e w is h y o u a H a p p y N e w Y ear. I t s h o u ld b e b o r n e in m in d t h a t m e d ic a l o rd e rlie s in th e S e rv ic e s a re fre q u e n tly c alled u p o n to g iv e tr e a tm e n t w h ic h is b e y o n d t h e s c o p e of first a id . O w in g to th e e m e rg e n c y c o n d i t i o n s t h i s is n e c e s s a r y a n d p a r t i c u l a r l y o n b o a r d s h i p s w h ich c arry no su rg e o n s. I n c i v i l i a n life, h o w e v e r , t h i s d o e s n o t a p p ly b e c a u s e d o c to rs a re u s u a lly a n d re a d ily a v ailab le . O u r efforts, th e re fo re , m u s t b e d ire c te d to th e r e - e s ta b l is h m e n t of first a id w ith its tim e h o n o u r e d lim it a ti o n s , e sp e c ia lly a s m e m b e r s of th e B r i g a d e a r e fr e q u e n tly c a lle d to e m e rg e n c ie s for w h ic h th e y h a v e no e q u ip m e n t. W i t h r e g a r d to t h e r e v i s i o n of t h e T e x t b o o k , it m a y i n t e r e s t y o u t o k n o w t h a t a s u p p l e m e n t is i n c o u r s e c f p r e p a r a t i o n a n d t h a t it is l i k e ly t o b e p u b l i s h e d s h o r t l y . T h is w ill in c lu d e a m e n d m e n t s w h ic h a im a t c la rify in g th e te a c h in g of th e T e x t b o o k a n d a t i m p r o v in g c e r ta in m in o r d e ta ils of t r e a t m e n t . P e rs o n a lly , h o w e v e r, I h a v e re a d n o criticism w h i c h c a u s e s m e to c h a n g e m y o p in io n , w h i c h is t h a t in its f u n d a m e n t a l p r i n c i p l e s t h e T e x t b o o k is p e r f e c tly s o u n d ; a n d I f o r o n e w i l l b e p r o f o u n d l y s o r r y if i t u n d e r g o e s “ r a d i c a l ”

T h e s h o u ld e r m e th o d of s tre tc h e r c a r ry in g c a m e in to p r a c tic e d u r i n g t h e first w o r l d w a r w h e n it w a s fo u n d t h a t th e u su al m eth o d w as u n su ita b le over g ro u n d m a d e ro u g h b y sh ell c ra te rs. E x p e r ie n c e p ro v e d t h a t t h e m o s t c o n v e n ie n t p o s itio n for th e r u n n e r s w a s b e h in d th e sh o u ld e rs of th e tw o fro n t b e a r e r s a n d in f r o n t of th e s h o u ld e r s of t h e tw o b e a r e r s in th e r e a r . H e n c e t h e i n s t r u c t i o n s in t h e M a n u a l of D r ill to p la c e t h e h a n d le s on th e sh o u ld ers. T o g e t to th is p o sitio n b o th h a n d s of e a c h b e a r e r s h o u ld be clo se to g e th e r a n d s h o u ld h o ld th e h a n d l e of th e s t r e t c h e r n e a r its e n d . T h i s d o n e , n o d ifficulty w ill be f o u n d b y t h e b e a r e r in t u r n i n g h is b o d y to t h e fr o n t a n d in p la c in g th e h a n d le in p o sitio n o n th e s h o u ld e r . One h a n d of e a c h b e a r e r c a n th e n b e r e m o v e d b u t k e p t in r e a d i n e ss for a g a i n g r i p p i n g th e h a n d le , s h o u ld th e n e ce ssity a rise o w i n g to th e n a t u r e of th e g r o u n d . O ver even g ro u n d h o w e v er, th e u s u a l m e th o d of c a r r y i n g th e s tr e tc h e r a t a r m s le n g th sh o u ld be u s e d .— N .C .F .

M e m b e rsh ip of B rigad e. R .H . (S w a n s e a ).— D u r i n g th e w a r y e a rs I h a d th e p riv ileg e of s e r v in g w ith B r ig a d e m e m b e r s in th e F i r s t A id a n d a l s o t h e R e s c u e P a r t i e s o f S w a n s e a ’s C i v i l D e f e n c e . D u r i n g t h a t tim e I w a s a llo w e d a s a q u a lifie d first a id e r ( 2n d L a b e l ) t o d o B r i g a d e P u b l i c D u t i e s i n S w a n s e a c in e m a s , etc. N o w t h a t t h e C iv il D e f e n c e is d i s b a n d e d , I h a v e n o o p p o r t u n i t y of first a i d d e b a t e s , p r a c tic e s , etc. T h e s o l u t i o n t o t h i s p r o b l e m is o f c o u r s e t o jo in t h e B rig a d e , b u t I h a v e b e e n in fo rm e d by th e lo cal D iv i s i o n a l S u p e r i n t e n d e n t , t h a t b e c a u s e I a m l a m e , it is i m p o ssib le for m e to b e c o m e a B r ig a d e m e m b e r . My “ d i s a b i l i t y ” i s t h a t a s a r e s u l t o f I n f a n t i l e P a r a l y s i s 21 y e a r s a g o , m y left le g h a s to b e s u p p o r te d b y a c a lip e r a n d m y boot raised in ch es. E v e n so , m y a b ili ty to w o r k a n d g e n e r a l l y t o g e t a r o u n d is e q u a l t o t h a t of t h e average m an. A s th i n g s a r e I a m o n ly p e r m itte d to a tte n d th e a n n u a l re -e x a m in a tio n . T herefore I am n o w d e n ie d th e p riv ile g e of d is c u s s io n , p ra c tic e , d u ty , e tc ., th r o u g h o u t th e y e a r. N o w t h a t t h e w a r is o v e r , s t e p s a r e b e i n g t a k e n to w in re c ru its fo r th e B r ig a d e a n d th e re b y to re -e sta b lish its p e a c e -tim e s t r e n g t h a n d e n th u s i a s m . M u st I th e n , s ir — a m a n w ith e x p e rie n c e a n d q u a lific a tio n s to m y c re d it— b e d e n ie d th e o u tle t w h ic h I n e ed to m a in ta in m y “ e f f ic ie n c y ,” e s p e c i a l l y a s m y e n t h u s i a s m is b e y o n d

a lte ra tio n s. F in a lly , I t h a n k y o u for y o u r k in d w is h e s w h ic h a re m o s t c o rd ia lly re c ip ro c a te d ; a n d I h o p e th a t all th o se, w h o w e r e c a lle d to H . M . F o r c e s , w ill r e t u r n to c iv ilia n first a id w ith ren ew ed e n th u sia s m .— N. C o r b e t F l e t c h e r .

d e n ia l ? _ I s h a l l b e v e r y h a p p y if y o u w i l l k i n d l y d efin ite r u lin g o n th is m a tte r so t h a t I m a y in t h e k n o w l e d g e t h a t I h a v e d o n e a ll in m ach iev e B rig a d e m e m b e rsh ip . M ea n w h ile I fo r th e in n u m e ra b le in s ta n c e s in w h ic h th e in s tru c tio n g iv e n in th e Q u e r y C o lu m n of

E xa m in atio n Howler. E.

M. ( H ig h g a te ) .— In a recen t e x a m in a tio n th e d o cto r ask e d o n e c a n d id a te h o w h e w o u ld tre a t a w o m a n w h o h a d a c c i d e n t a l l y s w a l l o w e d s o m e s t r y c h n i n e a n d w a s in c o n v u lsio n s. H e g a sp e d w h e n th e c a n d id a te rep lied — /

w o u ld str ip the la d y a n d su p p ort h e r in a h ot bath u n t il the doctor a r r iv e d ! ” «

Good!

N e x t, p le a s e ! !— N .C . F .

S tretcher C a rr y in g . W .P . (B e d fo rd ).— A t a re c e n t D iv isio n a l P ra c tic e w e tried o u t a n u m b e r of th e d rills in th e n e w D rill M a n u a l a m o n g w h ic h w a s th e sh o u ld er c arria g e . In try in g th is o u t a s p e r th e b o o k , w e fo u n d th a t par. 2 s ta te s th a t

g iv e m e a be c o n ten t y p o w e r to th a n k you ad v ice a n d F

ir s t

h a v e b e en m o s t useful. A m o n g s t t h e q u a l i f i c a t i o n s f o r e n r o l m e n t l a i d d o w n in t h e G e n e r a l R e g u l a t i o n s o f t h e B r i g a d e , i t is s t a t e d t h a t c a n d i d a te s m u s t b e of g o o d c h a r a c te r , of s u ita b le p h y s iq u e , a n d a c c e p ta b le to th e C o m m is s io n e r in all o th e r re sp ec ts. F r o m t h i s i t i s c l e a r ( 1) t h a t t h e d e c i s i o n i n y o u r c a s e d o e s n o t r e s t w ith y o u r local D iv isio n a l S u p e r in t e n d e n t; (2) th a t y o u s h o u l d b e a l l o w e d t o fill i n t h e f o r m o f a p p l i c a t i o n f o r m e m b e r s h i p o f t h e B r i g a d e ; a n d ( 3) t h a t t h i s f o r m s h o u l d be s u b m itte d to y o u r C o u n ty C o m m is s io n e r for h is r u l i n g .— E

d it o r

F I R S T

ASTHMA, BRONCHITIS CATARRH, HAY FEVER

R I D

IG L O D IN E - F I R S T - A I D “ It doesn’t hurt in the least ” — Iglodine can be applied to an open wound with out pain. This safe, but powerful antiseptic cleanses and heals cuts, wounds, bruises, scalds and burns.

T h e P A IN L E S S A n tis e p tic Used by Factories, Hospitals, and Ambulance Authorities through out Great Britain.

B R IT IS H M ED ICA L A B O R A T O R IE S LTD . ( D e p t. Z .A .3 ) H e a th c o te R oad , B o s c o m b e , B o u r n e m o u th .

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V ote of T han ks. J .C . (W itn e y .) — O u r D iv isio n d e sires to re c o rd a v ery co rd ial v o te of t h a n k s to y o u fo r y o u r g r e a t h e lp to o u r m e m b e r s d u r i n g 1945 a n d o u r h o p e t h a t y o u m a y l i v e l o n g to c o n tin u e y o u r g o o d w ork w h ich is v e r y m u c h a p p reciated . B e s t t h a n k s for y o u r re c ip ro c a te d .— N .C. F.

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S izin g in Thxee R anks. R . M . ( S t r e t f o r d ) — A c c o r d i n g to t h e n e w M a n u a l o f D r ill ( p . 30 ) t h e t h r e e r a n k s s i z e i n d e p e n d e n t l y w d t h o u t o p e n in g ra n k s . T h o u g h I h a v e n o t h a d t h e o p p o r t u n i t y of s e e i n g t h i s m o v e m e n t c a r r i e d o u t , I a m of t h e o p in i o n t h a t it is a p h y s i c a l i m p o s s i b i l i t y fo r r a n k s t o size a t o n e p a ce in terv al b e tw ee n each. T h e o b v i o u s s o l u t i o n is p r e v i o u s l y to g i v e t h e o r d e r “ Often ranks, M a r c h . . ” A s, h o w e v e r , n o m e n t i o n of s u c h o r d e r is m a d e i n t h e M a n u a l a n d a s t h e i r is n o o f f i c i a l b a c k i n g f o r it , ' i t s i n t r o d u c t i o n w o u l d l a y o n e o p e n to r e p r im a n d . P le a se , m a y I h a v e y o u r c o m m e n t o n th is p o in t ? A l t h o u g h it w o u l d s e e m t h a t t h e r e is n o t m u c h s p a c e in w h i c h t o c a r r y o u t t h i s m o v e m e n t , i n a c t u a l p r a c t i c e t h e r e is n o re a l d ifficu lty b e c a u s e th e in d iv id u a ls m a k e ro o m fo r e a c h o th e r w h ils t t a k i n g u p th e ir n e w p o sitio n s. T h e alig n m e n t i s t h e n c o r r e c t e d a s s h o w n o n p . 29 o f t h e M a n u a l uf D r ill. I w o u ld a d v i s e y o u to a s k y o u r D iv is io n a l S u p e r i n t e n d e n t to t r y o u t t h e m o v e m e n t w it h a v ie w to p r o v i n g its p r a c t i c a b i l i t y on th e p a ra d e g ro u n d . — N .C .F .

T h e S.J.A.A. Textbook. A .S . ( B e r m o n d s e y ) . — T h e p u b lic a tio n of y o u r a d d r e s s a t th e L . P . T . P. C e n t r e in t h e N o v e m b e r is s u e of F ir s t A in , w a s a s o u r c e of g r e a t i n te r e s t to m e , b u t 1 a m left w o n d e r i n g w h e t h e r o r n o t y o u a r e m i s - q u o t e d , o r if t h e n a m e s a n d d a te s c o n n ected w ith th e early m a n u a ls a re in co rrect. Y o u a re q u o te d as h a v in g said , “ H a p p e n in g t o m e e t a D r . M it c h e ll B r u c e ” e t c . ; a n d a g a i n , “ T e x t b o o k w h ic h D r. J C a n tlie rev ised a n d p rac tic ally re w ro te in i g o i .” A m o n g m y p o ssessio n s a t th e B e rm o n d se y M e n s ’ I n s t i t u t e , H e a d q u a r t e r s o f N o . 33 ( B e r m o n d s e y ) D i v i sio n , I h a v e th e first e d itio n w r itt e n by P e te r S h e p h e r d , 30 O c t . , 1878 , a n d m y n e x t e d i t i o n i s w r i t t e n b y R o b er t B ru c e , M ilfo rd -o n -S e a , jS g j, w ith a n in tr o d u c tio n to th e o r i g i n a l e d itio n by S h e p h e r d ( n o t a c o p y of t h e p re fa c e in t h e 1 st e d itio n ), a l t h o u g h it is of th e s a m e d a te . T h e s e p o in ts a r e of g r e a t i n t e r e s t to m e. W a s D r. R o b e r t B ru c e , th e D r. M itch ell B ru c e y o u m e n t i o n , a n d is it c o r r e c t t o s a y t h a t I h a v e b o t h 1 s t a n d 2n d e d i t i o n s of t h e T e x t b o o k ? T h e f a c ts a r e a s s t a t e d in m y a d d r e s s . T h e re w ere tw o d o c to r s of th e n a m e of B r u c e — J o h n M itc h ell a n d R o b e r t— w h o w e re n o t re la te d a n d w h o p lay ed th e ir p a rts resp ectiv ely in t h e first i s s u e a n d t h e first re v is io n of t h e T e x t b o o k . S o m e tw e n ty y e a rs a g o , D r. M itch ell B ru c e (w h o w a s a w e ll-k n o w n H a rle y S t. p h y sician ) told m e th a t, w ith th e a c tiv e c o - o p e r a tio n of D r. J a m e s C a n llie , h e un o fficially p o lish e d u p th e r o u g h n o te s p r e p a r e d by D r. P e te r S h e p h e r d b efo re th e la tte r d e p a r te d fo r S o u th A frica o n a c tiv e serv ice from w h ich h e n ev er re tu rn e d . In d u e co u rse th e m a n u s c r i p t w a s p a s s e d t o t h e A s s o c i a t i o n a n d p u b l i s h e d i n 1878 a s t h e f i r s t issu e o f t h e T e x t b o o k . L a te r D r. R o b e r t B ru c e (w h o w o u ld se e m to h a v e been a g e n e r a l p a a c t i t i o n e r a t M ilfo rd - o n -S e a ) w a s officially r e s p o n s i b l e f o r t h e f i r s t rev isio n o f t h e T e x t b o o k w h i c h w a s p u b l i s h e d i n 1885 . I n c i d e n t a l l y it is a c u r i o u s f a c t t h a t , w h e n I w a s c o m p l e t i n g m y H isto ry o j S . J A . A . , I h u n t e d i n v a in fo r a n y f u r t h e r re fe re n c e in th e r e c o r d s to D r. R o b e r t B ruce.

A I D I n 1901 , D r . J a m e s C a n t l i e ( w h o w a s a w e l l k n o w n H a r le y S t. s u r g e o n ) a fte r h is r e t u r n fr o m C h in a w h e r e h e p r a c t i s e d fo r m a n y y e a r s , officially re v is e d a n d p r a c tic a ll y r e w r o te th e T e x tb o o k , th e sty le of w h ic h h a s b e e n re ta in e d (a n d e x te n d e d ) to th is d a y . F u r th e r , h is re v isio n w a s c alled b y t h e A s s o c i a t i o n “ F ir s t E d i t i o n " ( t h i s t e r m r e p l a c i n g t h e w o r d “ is su e s ” w h ic h h a d b e e n a p p lie d to th e m a n u a l s p r o d u c e d by P e te r S h e p h e r d a n d R o b e r t B ru c e). F i n a l l y it is i n t e r e s t i n g to n o t e t h a t t h e title of t h e T e x t bo o k h a s c h a n g e d w ith each a u th o r. O r i g i n a l l y it w a s c a l l e d b y S h e p h e r d A i d s fu r C a ses of I n ju r ie s o r S u d d e n I l l n ess ( S h e p h e r d ) , i n 1885 S h e p h e r d 's F ir s t A i d to the I n ju r e d ( B r u c e ) , a n d i n 1901 F ir s t A i d to the I n ju r e d ( C a n t l i e ) . — N .C .F .

B la n k etin g Stretcher. R . T . ( M o u l t o n ) . — J u s t n o w t h e r e is m u c h d i s c u s s i o n in r e g a r d to th e m e th o d of b l a n k e t i n g a s tr e tc h e r d e sc rib e d i n t h e n e w M a n u a l o j D r i ll. T h i s is n o t w i t h o u t r e a s o n , fo r th is o n e lik e a ll th e w a y s I h a v e l e a r n e d in t h e p a s t h a s t h e d i s a d v a n t a g e t h a t t h e b l a n k e t s a r e a llo w e d to c o m e in to c o n ta c t w ith th e g r o u n d a n d e n t a n g l e th e feet d u r i n g th e p ro c e ss of lo a d in g . F o r th e p u rp o s e of th e H o m e G u a rd S tr e tc h e r B e a re rs 1 w o rk e d o u t th e fo llo w i n g m e t h o d :— T h e b l a n k e t i s o p e n e d o u t a n d t h e n o n e s i d e is fo ld ed o v e r th e w id th of a s tr e tc h e r w h e n b o th sid e s a re r o ll e d till t h e y m e e t . N e x t d o u b l e t h e b l a n k e t a n d l i e it so a s to fo rm a loop. T h e B e a r e r s N o ’s . 2 a n d 4 c a r r y o n e e a c h a f t e r t h e m a n n e r in w h i c h w e u s e d to c a r r y a ro lled g r e a t c o a t d u r i n g th e la st W a r . O n a rriv in g at t h e s i t e a n d t h e s t r e t c h e r o p e n e d , a b l a n k e t is la id o n a n d th e fo ld ed ro lled sid e s p re a d o u t le a v in g th e o th e r ro ll a t t h e s i d e , t h e o t h e r b l a n k e t is t h e n p u t o n in t h e s a m e w a y a n d s p r e a d o u t l e a v i n g t h e o t h e r ro ll a t t h e o p p o site sid e ; th is p ro v id e s fo r to u r th ic k n e s s e s b e lo w a n d tw o above. F u ll ben efit c a n b e o b ta in e d sh o u ld only o n e b la n k e t b e a v a ila b le . ~ T h e a d v a n t a g e s o f t h i s m e t h o d a r e ( 1) t h a t t h e b l a n k e t s a r e e a s ily c a r r i e d a n d in t h e p o s s e s s io n of th o s e w h o h a v e t o u s e t h e m ; a n d (2 ) t h a t B e a r e r N o . 3 is f r e e to a s s is t N o. 1 w ith th e p a tie n t. I t is a l s o a p p l i c a b l e w h e n th e re a re o n ly tw o B earers. At no tim e n eed th e b la n k e ts c o m e into c o n ta c t w ith th e g ro u n d . S h o u l d it b e n e c e s s a r y t o p l a c e a b l a n k e t u n d e r th ' e p a t i e n t b e f o r e l o a d i n g , i t s f o r m w i l l b e f o u n d c o n v e n i e n t , e q u a l l y s o if r e q u i r e d a s b o l s t e r s f o r f r a c t u r e of s p i n e in l u m b a r r e g i o n , o r u s e i n a r t i f i c i a l r e s p i r a t i o n ( S i l v e s t e r ’s m e t h o d ) . T h e D r ill H a l l is a l r i g h t fo r p r a c t i c e b u t t h e a c i d t e s t is b e s t m a d e u n d e r w e t a n d m u d d y c o n d i t i o n s w h ic h re v e al a d v a n t a g e s a n d d efects. T o m e , it s e e m s t h e p r e s e n t w a y of g o i n g in to a c t io n w i t h b l a n k e t s is a s o b s o l e t e a s w h e n t r i a n g u l a r b a n d a g e s w e re k e p t fo ld ed s q u a r e w h e n p a c k e d fo r use. W h i l s t I c o n g r a t u l a t e y o u o n y o u r k e e n n e s s in w o r k i n g o u t y o u r m e t h o d o f b l a n k e t i n g a s t r e t c h e r , 1 f e a r t h a t i t is n o t o n e w h ic h w ill p ro v e a c c e p ta b le to m e m b e r s of th e B rig ad e. T h o s e of u s w h o r e m e m b e r th e m e th o d of c a r r y in g th e ro lled o v e rc o a t o v e r th e s h o u ld e rs a n d a c ro ss th e b o d y w ill r e a l is e t h e d i s c o m f o r t in v o lv e d a n d t h e d is lik e w h ic h re su lte d . S h o u l d t h e g r o u n d b e w e t , m e m b e r s of t h e B r i g a d e w ill n a t u r a l l y t a k e i a r e t o a v o id g e t t i n g t h e b l a n k e t s s o i l e d a n d s h o u l d it b e n e c e s s a r y w ill b l a n k e t t h e s t r e t c h e r a t s o m e n e a r b y e a n d c o n v e n i e n t s p o t w h i c h is u n d e r c o v e r . — N .C .F .

44 FIR S T A ID ” QUERY and REPLIES COUPON. To be cu t out a n d en closed w ith a ll Q u er ies, Ja n .,

1946.

MANUALS

FIRST

AID

By N. CORBET FLETCHER, O.B.E., M.B., B.C., M.A.(Cantab.), M.R.C.S. AID8

T h e

FIRST-AID.

S ev en th E d itio n . 1s * 3 d * post 2 d *

P in t -A id Sim plified and Ta bu lated , w ith A ids to M e m o ry . Col. S ir Janus Cantlie contributes an introduction and we endorse his good opinion o f the book. " — L a n c e t ,

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H o m a -N u rs ln g Sim plified and Ta bu lated , w ith Alda to M e m o ry. ' This book wonderfully simplifies a complex subject and should be read by students.” — L . & N .W . R y . G a z e t t e .

EFFICIENCY F ourth E ditio n .

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3 d . post 2$d. P rob lem s In S tu d y , Tre a tm e n t and Exa m in a tio tlon n solved .’o r Sen io r Students. ‘ W ithout doubt 'oubt ,the book w ill be or grei •eat service in the training o f those /or whom it is designed . ’ — B r i t i s h M e d i c a l J o u r n a l .

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A M B UL A NC E

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TE8T8.

(S tre tch e r, In d iv id u a l an d Q u estion - S ix Folders). P r ic e 6 for 3s. post 3d.. E a c h F o ld er con tain s sp e cial a r tic le on C om etitio mppetitions :— N o . 1, T ra in in g o f C o m p etition T ea m s ; N o . 2, C o n d u c t o f T e a m in C o m p e titio n R o o m ; N o . 3, C om m on E rro rs in C o m p etitio n ; N o . 4^ F u rth er E rrors in T r e a t m e n t ; N o . 5, H is to r y o f C o m p etitio n T e s ts ; N o . 6, P re p a ra tio n o f T e sts.

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To be o btained fro m DALE, REYNOLDS & C O ., LTD , 4 6 , Cannon Street, London, E.C.4.

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46, C a n n o n S t r e e t . L o n d o n , E . C 4.

200 C o n c e r t T i c k e t s 5/6. M e m o s , R u b b e r S t a m p s , R o l l T i c k e t s , S a m p l e s - T i C E S , 11 , O a k l a n d s G r o v e , L o n d o n , W . 12 .

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e le m e n ta ry

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FIRST AID ^1)6 $ti6epen6<-nf Journal for ftie A r a b ttla n e e aiu i J ftttr e in jj ^ e n r i c h N o .

620,

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L ll.]

T H E

F E B R U A R Y ,

1946.

T R A IN IN G

O F

C O M P E T IT IO N B y

R .

S O N S

L IM IT E D ,

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A ID

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“ Gives clear and constructive advice on . selecting and training teams for first aid I S» competitions, and provides useful tips on net individual and team behaviour during . competitions............... should find a ready ( ^ 'Td*) public.” — Fire Protection. ' '' J O R D A N

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4 ^ BIOLOGICAL (M BI£) PREPARATIONS A N T I P E O L

ftZ S R tl O I N T M E N T

O n e o r o t h e r o r a l l o f t h e t h r e e r a c e s 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 l o c o c c i a n d B . p y o c y a n e u s a r e 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 antibodies ( 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 h e o i n t m e n t , a n 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 its 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 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 i t 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 r e q u i r e t o b e c h a n e e d e v e r y d a y . 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 tr e a te d w i t h A N T I P E O L O I N T M E N T .

O P H T H A L M O - A N T I P E O L is a sem i-fluid o in tm e n t, m o r e c o n v e n i e n t th a n th e o r d in a r y A n tip e o l o i n t m e n t f o r o c u la r infe c tions a n d lesions. E y e s a ff e c te d b y s m o k e a n d d u s t are so o th ed a lm o s t im m e d iate ly by the ap p licatio n o f O p h th a lm o - A n tip e o l, a n d the a n tiv iru s p r e v e n ts g e r m s f r o m dev elo p in g .

R H I N O - A N T I P E O L affords 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 o f the 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 ry n x (S tap h ly lo co cci, S trep to co 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 ill i, e n te ro c o c c i, M . c a ta rrh a lis B. P f e if fe 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 i t is t h e id e a l p rev en tiv e o f m icro b e developm ent.

C lin ic a l S am p laa o n raq u aat fr o m M E D IC 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 rg ra a n R oad

S o u th N o r w o o d , L o n d o n , S.E.2S

“SANOID” RESPIRATOR FRAME S T A

I Z

T I O

R e g is te r e d

THE advantages of standardization are well /recognised, especially in alkaline medication. ‘ BiSoDoL’ Powder, a gastric sedative and triple antacid, is particularly effective in the treat ment of digestive disorders and morning sickness. The constituents of ‘ BiSoDoL’ are standardized and, as such, can be regarded as reliable. The preparation is agreeably flavoured with peppermint and is readily miscible with milk or water. Moreover ‘ BiSoDoL’ gives prompt relief.

D e s ig n

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806838

Prices of Respirator Frames and of Filter Masks (Respirator Refills) on application.

It p o ss e s se s m a n y a d vantages o v e r o t h e r a r t i c l e s o f a s im ila r c h a r a c t e r Inasm uch a s :

It is r u s t p r o o f and s m o o t h , b e in g f l e x i b l e It r e a d i l y c o n f o r m s t o c o n t o u r o f t h e face t h u s e n s u r i n g c o r r e c t p o s i t i o n in g o f t h e M ask. It is li g h t , e a s y t o a d j u s t , and t h e l o w e r p o r t i o n fits c o m f o r t a b l y u n d e r t h e chin t h u s a n c h o r i n g b o t h f r a m e and filte r .

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BiSoDoL LTD.. 12, CHENIES STREET, LO N D O N , W .C.I

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1946

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READERS.

EDITORIAL. F I R S T A ID is published on the a o th of each m onth. A n n u al Subscription is 4 s . post free ; sin gle copies 3 d.

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Its aim and ob ject b ein g tbe advan cem en t o f A m b ulan ce W ork in a ll its branches, the E d itor in vites R eaders to send A rticle s and R eports on subjects pertaining to the M ovem en t and also w elcom es suggestions for P ractical Papers. A ll R eports, & c ., should be addressed to the E d itor at the address b elow , and should reach him before the 8 th o f each m onth, and m ust be accom panied ( not necessarily for publication) by the nam e and address o f the C orrespondent. S ubscriptions, A d vertisem en ts 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

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C annon

t d

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Street, L ondon,

THIS

...

State

registered

n u r s e s will not

a t t e n d p o o r o l d p e o p l e in i n s t i t u tions

because

they

are

only

in te re s te d in a c u t e m e d i c a l a n d s u r g i c a l c a s e s , b u t is n o t t h e r e a s o n f o r t h e s h o r t a g e o f n u r s e s in t h e s e hospitals not the nature of the w o r k , but the c o n d i t i o n s u n d e r w h i c h it h a s t o b e c a r r i e d o u t ? The f ac t , a c c o r d i n g to a c o r r e s p o n d e n t in t h e d a i l y n u r s e s w ill n ot s u b m i t to w o r k

gloom y,

ill-equipped,

overcrowded

and

unattrac

tive barrack -like b u ild in g s . “ N early a lw a y s they a r e h i d d e n a w a y in r e m o t e c o u n t r y d i s t r i c t s , a w a y

NUM BER.

B rig h te n in g th e S ta te In stitu tio n s

State

in a n i n s t i t u t i o n b e c a u s e t h e y a r e o n t h e m o s t p a r t

E d it o r ia l —

C o n so latio n

the

Institutions,

p r e s s , is t h a t s u c h

Telegraphic Address — “ Twenty-four , London . ” Telephone— City 3710 . CONTEN TS

I t h a s b e e n s a i d — a n d it i s n o t an uncommon opinion — that

B rig h ten in g

from m ain roads and ’bus routes, and m iles from the nearest ra ilw a y station, and h o w e v e r a b so r b in g their p r o f e s s io n a l d uties m a y be, n u r s e s are e ntitled

...

t o t h e s o c i a l a m e n i t i e s e n j o y e d b y o t h e r w o r k e r s in

their

S .J.A .B . H e a d q u a rte rs a n d D istric t R ep o rts

...

all

too

short

and

sanatoria

leisure -hours.

hospitals

R ailw ay A m b u lan ce N ew s

...

P o lice A m b u la n c e N e w s

...

s u c h in stitu tio n s are to c o m p e t e , as t h e y m u s t , w ith other em p lo yers of fem ale labour, conditions of

R ev iew s

...

N o s te ll C o llie ry F i r s t A id S o c ie ty

...

A L i f e is S a v e d !

...

L e tte rs to th e E d ito r

...

T y p h u s F e v e r a n d L ice Q u e r ie s

a n d

A n sw ers

...

90 90

...

C o r r e s p o n d e n t s :—

be fo rth co m in g,

for

...

staff

...

D e a t h of W e l l- k n o w n A m b u la n c e M a n

w o r k m ust be m ade m ore attractive.” T h e first d e s i d e r a t u m o f t h e p r o f e s s i o n is a t t r a c t i v e l i v i n g a c c o m m o d a t i o n a n d t h i s is s c a r c e l y to b e f o u n d within the w alls of the a v e r a g e institutions.

They

m a y be a r c h i t e c t u r a l l y v e r y a ttr a c tiv e ; n o n e the less th e y m a y suffer from g lo o m and p o n d e ro sity internally, their corridors chill and sp acio u s, and t h e l i v i n g a p a r t m e n t s f o r t h e s t a ff w a n t i n g in

A m p u ta tio n of U p p e r L i m b ...

...

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

...

hom eliness and

D efence M edal

...

a matter

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

...

N e g ativ e P re ssu re ...

...

h e a t e d a p a r t m e n t is a p t to s t r i k e a c h i l l i n t o t h e heart of the y o u n g asp iran t fresh from a c o m f o r t

B rig ad e R eg u latio n s

...

T r e a t m e n t of A s p h y x ia

...

T r e a t m e n t of N o se B le e d in g M o r e H u m o u r i n F i r s t A i d ..

...

94 94 94

\...

...

. . . (^

...

comfort.

W a r m t h is n ot e n t ir e ly

temperature, and

great

artificially-

able, not too-well ordered h o m e .

Scrupulous clean

l i n e s s is d e s i r a b l e

of all

in a

hospital

places, but

c h e e r f u l n e s s o f s u r r o u n d i n g s is o f e q u a l i m p o r t a n c e w i t h its i n f l u e n c e u p o n t h e m i n d , w h i c h is o n e o f the m a n y reason s w h y h i g h l y co lo u re d flowers are s o w e l c o m e in w h a t w o u l d o t h e r w is e be s o m e w h a t

T r e a t m e n t of H e r n i a

...

96 96

M e m b e r s h ip of B r ig a d e

...

A c tio n of I o d in e

...

v a i l i n g s h o r t a g e a n d b r i n g t h e p r o f e s s i o n u p t o its

...

full s tre n g th “ p ro vid e attractive li v i n g a e c o m m o d a -

M e m b e r of S .J.A .A .

...

S co u ts’ A m b u la n c e C up

...

austere

wards.

sum

c o r r e s p o n d e n t referred to.

in the w o r d s

the

T o coun teract the pre

F I R S T

tion, w e lf a r e a m e n i t i e s c o m p a r a b l e w ith t h o s e to be found

industry, and

transport facilities

to the

n e a re st so cial c o m m u n i t y , then, a n d o n l y th e n , will recruits

appear

to stiffen

these d an g ero u sly

thin

hospital ra n k s.” T h a t the ra n ks are thin e v e r y o n e m u s t a l lo w , b u t w e are d is p o s e d to t h i n k th a t p e r h a p s m o r e is m a d e o f t he s h o r t a g e t h a n is n e c e s s a r y . M u c h h a s been d o n e to irn p ro v e the n u r s i n g p r o fe s s io n , a n d critics m a y for a tim e rest on their oars until the

n u r s e s ’ c h a r t e r b e c o m e s o p e r a t i v e in the

sp rin g , a lth o u g h that charter only

stage

im proving

m ust be re ga rd ed as both

wages

and

conditions.

C O N S O L A T IO N . By

SCOTT.

H a v in g r e c e n tly w a tc h e d th e d e s p a i r i n g effo rts of a w o u ld b e first a i d e r to “ c o n s o l e h is p a t i e n t , ” it w o u l d s e e m t h a t a few w o rd s on th is s u b jec t w o u ld n o t co m e a m iss. The i n c i d e n t r e f e r r e d t o w a s t h a t of a n e l d e r l y w o m a n k n o c k e d d o w n by a car, w h o h a d su sta in e d ra th e r a n a sty co n tu sio n t o a n a n k l e , a c u t u p p e r lip, a n d b r o k e n d e n t u r e s . W ith h e r w a s a w o m a n frien d a n d a m a n w h o m a y h av e b een th e h u s b a n d of e ith e r. H o w th e a c c id e n t h a p p e n e d I k n o w n o t, b u t m y a r r iv a l c o in c id e d w ith t h a t of th e s a id first a id e r , s o I d id w h a t I t h o u g h t b e st, i.e., b e c a m e a sile n t b u t c o n s id e ra te o n l o o k e r , a n d r e a d y t o h e l p if r e q u i r e d . T h e p a tie n t w a s e x tre m e ly distressed , w e e p in g a n d c o n tin u a lly g a z in g w ith h y sterical sobs a t h e r b ro k e n d e n tu re s. T h e m a n w a s very ex citab le a n d a lte rn a te ly a b u s in g th e car d r iv e r a n d e v e r y th in g in c o n n e c tio n w ith h im , a n d d e m a n d i n g th e s erv ice s of e ith e r, o r b o th , th e P o lice a n d A m b u la n c e . T h e p a t i e n t ’s f r i e n d w a s p r o f o u n d i n h e r s y m p a t h y f o i t h e u n f o r t u n a t e o n e , a n d w a s m o s t d e t e r m i n e d to i n f o r m h e r of t h e “ a w f u l g a s h o n h e r m o u t h , ” a n d t h e v e r y s l i m h o p e s of h e r h a v i n g t h e d e n t u r e s r e p a i r e d e v e n if s h e w a s a b l e t o w e a r th em ag ain . T h e c a r d riv er w a s m a k in g h im self m o s t e m p h a t i c t h a t it w a s n o t h is f a u lt, t h a t “ a ll t h r e e o f th e id io ts h a d s te p p e d off r i g h t in f r o n t of h im ! ” T hese rem arks h e a d d r e s s e d to t h e c r o w d in g e n e r a l , a p p e a l i n g fo r w i t n e ss e s, of w h ic h , of c o u rs e , n o n e w e r e f o r th c o m in g . T h e first a id e r w a s n o t w e a r in g a n y b a d g e to d e n o te t h a t h e w a s q u alified , o r t h a t h e k n e w a n y t h i n g a b o u t “ th e g a m e , ” b u t s e e m e d to g iv e th e im p r e s s io n t h a t h e k n e w s o m e t h i n g a b o u t it ; fo r i n s ta n c e h e first b e n t o v e r th e p a tie n t a n d in s p e c te d h e r face, w h ic h w a s a lm o s t h id d e n w ith m u d a n d d irt, e tc ., a n d trie d to lo o k in s id e h e r m o u th , b u t p a tie n t s tr o n g ly o b je c ted to th is a c tio n ; h e th e n d e v o te d h is a t t e n t i o n to h e r a n k l e o v e r w h ic h th e s t o c k i n g w a s b a d ly torn. H e th e n , fo r t h e first t i m e s p o k e , a s k i n g s o m e o n e to c all a n a m b u la n c e , th e n h e a s k e d fo r a h a n d k e r c h i e f to s o a k u p s o m e b l o o d f r o m h e r l i p , s a y i n g , “ T h i s w o n ’t t a k e l o n g to h e a l , ” w h i c h in t h e o r d i n a r y w a y w o u ld h a v e h e l p e d to “ c o n s o l e ” th e p a tie n t, b u t for th e fa c t t h a t th e o th e r la d y l o u d l y e x c l a i m e d , “ D o n ’t b e s i l l y , t h a t w o m a n h a s g o t a te rrific g a s h , a n d it w ill t a k e a l o n g t im e to h e a l . ” F r o m th a t m o m e n t, h is b e d sid e m a n n e r d ro p p e d a n d he e n te r e d in to o n e of th e m o s t te rrific a r g u m e n t s I h a v e e v e r h e a r d , w ith th e frie n d , a s to th e p o ssib ilitie s of t h e c u t h e a l i n g o r n o t ; t h e n in to th e fr a y c a m e th e m a n , w h o in n o u n c e r t a i n m e a s u r e , g a v e h is v ie w s , w h ic h w e r e e n ti r e ly in a g r e e m e n t w ith th e friend. T h e n th e c ar d riv er c a m e for w a r d to s u p p o r t th e first a id e r. T h is w e n t o n fo r s o m e few m in u te s , a n d w o u ld still h a v e b e e n g o i n g o n , b u t fo r th e tim e ly a rriv a l of th e a m b u la n c e . T h e p a tie n t w as, I re g re t to s a y , p ic k e d u p a n d lite r a lly “ d u m p e d ” in t h e a m b u l a n c e a n d a w a y (also th e frien d ). N ex t c a m e th e p o licem an , w h o

R I D q u ie tly a n d efficien tly d e a l t w ith m a n , first a id e r , a n d car d riv er. W e l l , t h e r e is y o u r c a s e , a c a s e w h e r e s o m e k n o w l e d g e of t h e m e th o d s of a d m i n i s t e r i n g c o n s o la tio n w o u ld h av e p ro v e d v e ry u sefu l. W h a t w o u ld y o u h a v e d o n e ? I th in k m o s t certain ly I w o u ld h a v e first s e n t t h e m a n fo r a n a m b u l a n c e , r e m e m b e r i n g t h a t it w a s h e w h o w a s d e m a n d i n g o n e , so w h y n o t g iv e h im th e p le a s u re of g e t t i n g o n e , a t th e s a m e tim e p e rfo r m in g a d u ty t h a t h a d to be d o n e , a n d in c id e n ta lly , u n k n o w in g ly c o n s o lin g th e p a tie n t m e re ly by th e fa c t of h is a b s e n c e . T h e n I w o u ld h a v e a s k e d th e fr ie n d to h e lp b o th p a tie n t a n d m y s e l f , b y s e e k i n g a b o w l o f w a t e r a n d s o m e c l e a n r a g , e v e n if s h e w a s n o t a b l e t o g e t it, s h e w o u l d a t l e a s t b e o u t o f t h e w a y ! T h e n I w o u l d n ot t e l l t h e p a t i e n t t h a t h e r i n j u r i e s a m o u n t e d to n o t h i n g ; r a t h e r w o u l d I s a y t h a t s h e had g o t a n a s t y c u t o n h e r l i p , b u t also t h a t l i p s , m o u t h a n d t o n g u e a r e p a rts th a t h e al very q u ic k ly a n d seld o m leav e n a sty scars ; t h a t h e r d e n tu r e s m a y n o t b e a b le to b e r e p a ire d , b u t t h a t no d o u b t th e re w o u ld b e a w a y of g e t t i n g a n e w s e t w ith th e a s s i s t a n c e of I n s u r a n c e S c h e m e s , e tc . T h a t her an k le w as n o t so serio u sly in ju re d a s th e s to c k in g s . In fact, I w o u ld d o m y b e s t to p u t m y s e lf in t h e p la c e o f t h e p a t i e n t a n d a s k m y s e lf w h a t I w o u ld m o s t lik e to h a v e s a id to m e , a n d so s a y it. T h e a r t, h o w e v e r , lies in m a k i n g y o u r s p e e c h s o u n d c o n v in cin g . I t is of n o u s e t e l l i n g a p a t i e n t t h a t h is o r h e r w o u n d o r w o u n d s a m o u n t to a m e r e trifle. By d o in g so you a r e r e m o v in g w h a t little c o n fid e n c e th e p a tie n t m a y h a v e h a d in y o u , a n d h e t h i n k s y o u a r e a fool. ' O n t h e o t h e r h a n d , d o n o t e n l a r g e o n th e in ju r ie s in a n y w a y . I t is a g o o d p l a n to e n d e a v o u r t o d i s t r a c t h i s a t t e n t i o n else w h e re . N o t to o o b v io u sly of c o u rse, b u t to s o m e t h in g or o th e r t h a t m a y h a v e in s o m e little w a y b e e n th e c a u s e of his o r h e r c o n d itio n , o r y o u c a n re fe r to s o m e o th e r im a g in a ry in j u r y , fo r i n s t a n c e , a s s u m i n g t h a t h e h a s a n i n j u r y to h is s h o u l d e r , y o u c o u l d a s k h i m if h e f e l t p a i n , s a y , i n t h e a r m o r f o r e a r m , o r in h is b a c k , a n d so m a k e a p r e te n c e of fe e lin g fo r fu r th e r in ju ry , a n d th e n a p p e a r p le a se d t h a t y o u d is covered n o th in g fu rth er. Y o u c a n s h o w c o n c e rn a b o u t his o r h e r b e l o n g in g s , o r s u c h like. (T o “ d iscover ” a h a n d b a g in ta c t, n e v e r fails to in s p ire co n fid en ce). I t is n o t g o o d to “ f u s s , ” b y w h i c h I m e a n , d o n o t d o d g e a b o u t in a n e x c ita b le m a n n e r , a n d so flu rry y o u r p a tie n t. H e a l r e a d y is in w h a t m a y b e a t o u c h y s t a t e , a n d it is m o s t ir r ita tin g , n o t to s a y w o r r y i n g , to h a v e s o m e o n e d o d g in g a r o u n d all th e tim e a n d t r y i n g to d o m a n y t h i n g s a t once. B e r a t h e r o n t h e s lo w a n d m e th o d ic a l s id e ; n o t to o sile n t, n o t t o o m a c h i n e l i k e , a n d t h i n k a l o t o f y o u r p a t i e n t ’s p e a c e of m in d . T h e r e is, o f c o u r s e , t h e o t h e r e x t r e m e . I t is t h a t of b e in g to o s y m p a th e tic . S o m e p eo p le h a v e o n ly to s u sta in t h e s lig h te s t of in ju r ie s a n d th e y a t o n c e b e g in to t h i n k th a t it is t h e b e g i n n i n g of t h e e n d , a n d t h e y a r e t h e p e o p l e w h o a r e v e r y m u c h o n t h e l o o k o u t f o r s o m e o n e w h o is g o i n g t o t r e a t t h e m w ith all th e p o s s ib le c a r e a n d a tt e n t i o n th e y c a n m u ste r. Y o u m u s t b e v e ry firm w i t h th e s e p a tie n ts , ju s t as y o u w o u l d w i t h a n h y s t e r i c a l p a t i e n t , w h i c h is r e a l l y w h a t th e y a re , o n ly in a n o th e r form . A g r e a t d e a l c a n b e d o n e b y c o n s o l a t i o n w h e n y o u a r e in t h a t u n f o r t u n a t e p o sitio n of b e in g in a t t e n d a n c e o n o n e w h o is a b o u t t o d ie . I n m o s t c a s e s h e is a w a r e o f t h e fa c t, a n d r e a c t i o n v a r i e s , b u t g e n e r a l l y , h e w i l l h a v e a f e e l i n g of lo n e lin e ss. Y o u r to u c h w iil c o m f o r t h im a n d h e w ill a p p r e c ia te t h a t - g r a s p of th e h a n d . E v en after s ig h t and s e n s e of t o u c h h a v e g o n e , h e c a n still h e a r y o u r voice. Speak clo se to h is e a r s o m e w o r d s of c o m fo rt. If it b e in a p lace of d a r k n e s s , le t h i m s e e a lig h t, a to r c h fo r in s ta n c e , a s he g re a tly fears th e a p p ro a c h in g d a rk n e ss. D o n ’t , o f c o u r s e , d i r e c t t h e b e a m t o h is fa c e , b u t a r r a n g e it to g iv e a g e n e r a l lig h t. I f h e is a b l e to s e e y o u , w e a r a n e x p r e s s i o n o f u n c o n c e r n a n d p l e a s a n t n e s s , e v e n if i t b e t h e h a r d e s t j o b i n t h e w o rld . D o n ’t o v e r d o i t ; i t m a y g i v e h i m t h e o p p o r t u n i t y of g a i n i n g t h e w r o n g im p r e s s i o h !

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N o . 75 c ( W a n s t e a d a n d W o o d f o r d ) . — T h e m e m b e r s of th is D iv is io n h e ld a N e w Y e a r P a r ty , b y p e rm is sio n , a t t h e W o o d f o r d Y o u t h C e n t r e , o n S a t u r d a y , J a n u a r y 12 t h , a n d h a d a s th e ir g u e s ts th e m e m b e r s of th e C a d e t N u r s in g D iv isio n . A fte r a n u m b e r of p a r ty g a m e s fo llo w ed b y te a , th e c a d e ts e n g a g e d in a first a id q u iz , w ith S e r v i n g B r o t h e r C av ell a s Q u e s tio n m a s te r. T h e q u iz e n a b l e d t h e c a d e t s to s h o w a v e ry h i g h s t a n d a r d of first a id k n o w le d g e , w h ic h w a s t h e s u b je c t of v ery f a v o u ra b le c o m m e n t by th e a d ju d ic a to r s , L a d y D is tric t O fficer M iss M o o re, a n d I n s p e c to r F o u lg e r , of th e M e tro p o lita n S pecial C o n sta b u la ry . T h e N u rs in g D iv i s io n w e r e d e c la r e d th e w in n e r s b y a n a r r o w m a r g i n of h a lf a p o in t, a n d w e r e p r e s e n t e d w i t h a c h r o m i u m m o d e l of t h e e ig h t- p o in t S t. J o h n S ta r , g iv e n b y C a d e t S u p t. M r. H . T im m in s. T h e D iv . S u p t., M r. R . D . B ro w s e , in a fe w w e ll c h o s e n w o rd s , w e lc o m e d th e v isito rs, a n d C o m m a n d a n t B a rto n S m i t h of th e M e tr o p o lita n S p e c ia l C o n s ta b u la r y , e x p re s s e d t h e p l e a s u r e n o t o n ly o f h i m s e l f a n d h is w ife, b u t of a ll t h e v isito rs, a n d stre sse d th e im p o r ta n t ro le th a t su c h o r g a n is a tio n s a s S t. J o h n c o u ld , a n d d id in f a c t p la y , in y o u t h o rg a n isatio n s. D u r in g th e in te rv a l, C a d e t A lan O w e n , on b e h alf of th e D iv isio n , p re s e n te d g ifts to th e O fficers a s a m a r k of a p p r e c i a tio n of th e ir c o n tin u e d in te r e s t in th e m o v e m e n t. A film s h o w , u n d e r t h e d h e c t i o n o f M r. C a r r , o f t h e S o u th W o o d fo rd S e c o n d a ry S ch o o l, c o n c lu d e d a v ery h a p p y ev en in g .

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H il l .— A so cial e v e n in g w a s h eld by th e S ta p le H i l l A m b u l a n c e D i v i s i o n o n S a t u r d a y , J a n u a r y 12 t h , t o w h i c h m e m b e rs a n d frien d s of b o th A m b u la n c e a n d N u r s in g D iv i sio n s w e re in v ited . T h e g u e s t s n u m b e r i n g a b o u t 80, i n c lu d e d A ssista n t C o u n ty C o m m issio n e r G. J. C reech, C o u n ty O fficer M rs. C re e c h , C o rp s O fficer Jefferies, S u p t. E d b r o o k e (F is h p o n d s D iv isio n ), S u p t. L e a r ( P a r n a ll s D iv isio n ), a n d M rs. L ea r. D u r i n g th e e v e n in g a silv er c u p a n d m e d a l (g iv e n by S u p t . R o w e ) w a s ' p r e s e n t e d b y C o r p s O ffic e r Je ffe rie s to S e r g e a n t P l e a s s f o r t h e m o s t e f f i c i e n t m e m b e r f o r 1945 . A “ H is to r y of th e O r d e r ” w a s a lso p r e s e n te d to P r iv a t e W . R . D a v is fo r p e r f o r m in g th e h ig h e s t n u m b e r of p u b lic d u tie s d u rin g th e year. P r e li m in a r y first a id c e rtific a te s w e r e a lso p re s e n te d to C a d e ts R . F . R o w e , H o p e s , W ilm o t, B a n e a n d B racey. S taple

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th a t th e p u b lic ity b a n h a s b een lifted , t h e a c tiv itie s of t h e R o lls - R o y c e A m b u l a n c e a n d N u r s in g D iv isio n s d u r in g th e w a r c an be re v e aled . T h e A m b u l a n c e D i v i s i o n w a s f o r m e d i n 1938 a s a W o r k s D i v i s i o n ; m e m b e r s h i p r o s e d u r i n g t h e w a r t o 158 . D u rin g t h a t t i m e 611 w e r e e x a m i n e d i n f i r s t a i d , h o m e n u r s i n g a n d a n t i - g a s p r e c a u t i o n s ; 600 w e r e s u c c e s s f u l . T o assist w ith th e A .R .P . o rg a n isatio n , au x ilia ry v o lu n te e rs w e re called fo r fro m R o lls -R o y c e e m p lo y e e s. O ver 250 w e r e t r a i n e d , a n d o v e r 600 a w a r d s o b t a i n e d . B r i g a d e d u tie s w e re u n d e r t a k e n in t h e th e a tr e , in th e c in e m a s , a t fo o tb all m a tc h e s , a n d o th e r p u b lic fu n c tio n s. D u r i n g 1945 , 3,708 s u c h d u t i e s w e r e p e r f o r m e d , i n a d d i t i o n t o 425 a m b u l a n c e t r a n s p o r t d u t i e s , 197 g u i d e d u t i e s a c c o m

R I D p a n y i n g w o u n d e d s o l d i e r s o n r a i l w a y j o u r n e y s , a n d 16 c o n voys of w o u n d e d w e re d e alt w ith a t th e D e rb y sh ire R o y al In f irm a ry a n d D e rb y C ity H o sp ita l. A lth o u g h th e N u r s in g D iv isio n w a s n o t fo rm e d u n til 1942 , f i r s t a i d c l a s s e s h a d b e g u n i n 1939 , w h e n a n u m b e r o f la d ie s w e r e a t t a c h e d to th e A m b u l a n c e D iv is io n a s a u x ilia r y m e m b e r s ; th e s e la d ie s fo r m e d th e n u c le u s of th e N u r s i n g D iv isio n . S i n c e t h e n 75 g i r l s , i n c l u d i n g 34 a u x i l i a r i e s , h a v e b e e n tr a i n e d in first a id , h o m e n u r s i n g a n d a n t i - g a s p r e c au tio n s. In sp ite of lo n g fa c to ry h o u r s , m e m b e r s of th e N u r s i n g D i v i s i o n u n d e r t o o k 145 B r i g a d e d u t i e s , h e l p e d w i t h w o u n d e d c o n v o y s a n d e v acu ees, a c te d a s g u id e s fo r th e w o u n d e d , a n d a r e n o w o n t h e r o t a of a n e w a m b u l a n c e s e r v ic e o p e r a t e d b y t h e St. J o h n a n d R e d C r o s s J o i n t H e a d q u a r t e r s in D e r b y . I n a d d i t i o n , 1,851 -J- h o u r s h a v e b e e n w o r k e d b y 29 m e m b e r s i n l o c a l h o s p i t a l s s i n c e S e p t e m b e r 1943 . O n e m e m b e r jo in ed t h e W . A . A . F . , a n d e a r l y i n 1945 a n o t h e r u n d e r t o o k o v e r s e a s c iv ilia n relief w ith th e D e r b y s h i r e R e d C ro s s F ly i n g C o lu m n . I n 1944 t h e O f f i c e / s a n d N . C . O . ’s r a i s e d a n d t r a i n e d t h e R o lls-R o y c e C a d e t N u r s in g D iv isio n . S i x c a d e t s h a v e 274 h o s p i t a l h o u r s t o t h e i r c r e d i t s i n c e M a y 1945 . S o cial activ ities a re a r r a n g e d by a J o in t S o cial C o m m itte e , a n d th e so cia l fu n c tio n s u n d o u b te d ly c o n tr ib u te to th e te a m sp irit e x istin g w h e n d u tie s b rin g th e D iv isio n s to g e th e r.

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A m b u la n c e a n d N u rsin g D iv isio n s w e re re p re s e n te d a t a d e m o n s t r a tio n first-aid c o m p e titio n a t th e S t. J o h n A m b u la n c e H a ll, N e w t o n A b b o t, o n S u n d a y a f t e r n o o n , J a n u a r y 20th , t h e o b j e c t b e i n g to s t i m u l a t e a rev iv al of a re a , d istric t, c o u n ty , a n d n a tio n a l c o m p e titio n w o rk , w h ich w a s su sp e n d e d d u rin g th e w ar. T h e purp o se w a s e x p la in e d b y D iv . S u p t . W . U n d e r h ill. T h e d e m o n s tra tio n s w e re g iv e n by a te a m of th e N e w to n A b b o t N u r s i n g D i v i s i o n a n d a t e a m o f t h e N e w t o n m e n ’s A m b u la n c e D iv isio n . T h e n u r s e s h a d to r e n d e r first a id to a m a n i n j u r e d in a fire, w h i l e t h e m e n r e n d e r e d fir s t a i d to tw o m e n w h o h a d fa lle n fr o m a n e le c tric py lo n . D r. M o rto n P a lm e r said th e d e m o n stra tio n w a s s o m e t h i n g n e w in th e h is to r y of th e B r ig a d e a n d c o n g r a t u l a t e d t h e N e w t o n A b b o t D iv is io n in t a k i n g t h e le a d in s u c h a t h i n g . H e u r g e d t h e r e p r e s e n t a t i v e s of t h e D iv is io n s to g o b a c k to th e ir o w n u n its a n d in fu s e in th e m th e s p irit of c o m p e titio n w h ic h ex isted before th e w ar. A sst. C o u n ty C o m m is s io n e r G . W . H i n g s t o n s a id th e c o u n t y c o m p e t i t i o n w o u l d p r o b a b l y b e h e ld in J a n u a r y n e x t y e ar, w h e n th e m e n w o u ld c o m p e te for th e M a r c u s H a r e C u p a n d th e w o m e n th e M a m h e a d S h ield . T h e w in n e rs w o u ld th e n g o o n to th e N o. 9 D is tric t (C o rn w a ll, D e v o n , a n d D o rset) c o m p e titio n , for th e S lo a n e C u p (m e n ) a n d B u rn s S h ie ld (w o m e n ), th e w in n e r s of w h ic h w o u ld c o m p e te in th e fin al c o m p e titio n in L o n d o n in A p ril. D r. G re y , of E x e te r , h e said , h a d p re s e n te d c u p s fo r c o m p e titio n a m o n g s t se c o n d team s. M iss W h ite h e a d a n n o u n c e d th a t th e re w o u ld b e a b ig in sp e c tio n a t E x e te r th is y e a r w h e n th e C h ief C o m m is s io n e r w o u ld be presen t. N ew ton

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a n n u a l m e e tin g of th e a b o v e D iv isio n t o o k p l a c e a t H e a d q u a r t e r s o n W e d n e s d a y , J a n u a r y 30 t h . T h e D iv . S u r g e o n , D r . D a lg lie s h , p re s id e d , a n d w a s s u p p o rte d b y C o u n c illo r W . R . B ro o k s , E s q ., a n d th e D iv . S u p t., J. C. C h e s te rm a n . B e fo re g iv in g h is re p o rt th e D iv . S u p t. re fe rre d to th e r e s ig n a tio n of th e A s s is ta n t S e c re ta ry a n d C a d e t O fficer M r. S . C o l l i s , w h o , a f t e r 15 y e a r s , f o u n d i t n e c e s s a r y t o r e s i g n . I t w a s a s a d lo ss to th e D iv is io n a n d h e w o u ld b e m is se d . H e th e n w e lc o m e d th e d is tin g u is h e d v isito rs p re s e n t, a n d th e

m e m b e r s of th e D iv is io n w h o h a d r e t u r n e d fro m se rv ic e O verseas. T h e s t r e n g t h o f t h e D i v i s i o n w a s 36 ; t h e C a d e t D i v i s i o n 22 i n c l u d i n g O f f i c e r s . T h e r e w e re still e ig h t m e m b e r s in H .M . F o rc e s . A fin a n c ia l s ta te m e n t s h o w e d th a t th e D iv isio n w a s in a s o u n d p o sitio n . T h e D i v . S u p t . s a i d t h a t i t w a s h o p e d t h a t d u r i n g 1946 th e y w o u ld a c q u ire th e ir o w n H e a d q u a rte rs , a n d v a rio u s s c h e m e s w e r e b e i n g p u t f o r w a r d w ith t h a t e n d in view . T h e m e e t i n g c lo se d w ith a c o rd ia l v o te of t h a n k s to th e D iv . S u p t. fo r h is u n t i r i n g effo rts o n b e h a lf o f th e D iv isio n s i n c e i t s i n c e p t i o n i n 1929 .

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la n c e C a d e t D iv isio n , w h ic h to o k p lace o n W e d n e s d a y , F e b r u a r y 6 th , a t th e S t. J o h n H e a d q u a r t e r s , p ro v e d a m o s t in tere stin g cerem ony. D iv . S u p t. E. W . S m i th w a s in th e c h a ir, s u p p o r te d by A sst. C o m m is s io n e rs F. S p r a w s o n a n d D r. L eslie B e a th ; a lso p r e s e n t w e re C o u n ty O fficer F . R . S te n t a n d L a d y C o u n ty O ffice r M is s S t. L o W ilk in s o n , a n d a r e p r e s e n ta tiv e g a t h e r i n g of O ffic e rs a n d m e m b e r s of t h e B a t h C ity D iv is io n , t h e B ath N u rsin g D iv isio n a n d th e B ath Cadet N u rsin g D iv isio n . C o u n t y C a d e t O f fi c e r H a d e n - J o n e s r e c i t e d t h e C o d e of C h iv a lry to th e bo y s a n d a fte r e a c h o n e h a d a ss e n te d to th e c o d e h e w a s p r e s e n t e d w i t h a b a d g e a n d a r m l e t , A h e n , all s t a n d i n g to a tte n tio n , th e C a d e t P r a y e r w a s re a d . A sst. C o u n ty C o m m is s io n e r D r. L e slie B e a th , O .B . E . , C .S t.J ., th e n a d d re sse d th e cad ets, g iv in g th e m a n in s tru c tiv e t a l k o n th e ir d u tie s a s first a id e rs , a n d th e d u tie s th e y o w e d to th e O r d e r a n d th e ir o w n D iv isio n . C o u n ty O fficer F . R . S te n t., O .S t .J ., th e n a d d re s s e d th e m e e tin g , h e g a v e a m o st in te re stin g a d d re ss on th e H isto ry of th e O r d e r w h ic h w a s m u c h a p p re c ia te d . C a d e t S u p t. F . L eo H o lto n th e n a d d re ss e d h is c a d e ts b e s p e a k i n g th e ir h e lp in m a k i n g th e ir D iv is io n a g r e a t success. A p o lo g ies w e re received fro m th e C o u n ty C o m m issio n e r D r. H u g h P o w e ll, M .B .E ., C .S t.J ., a n d C o u n ty O fficer O . H . T h o m a s b o th of w h o m h a d in te n d e d to b e p re s e n t b u t h a d b een p re v e n te d a t th e very last m o m e n t. D iv . S u p t. M iss A p p leb y , B a th N u r s in g D iv is io n w a s a ls o p r e v e n te d f r o m a t t e n d i n g b y illness.

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o f W o rc este r. .— T h e 6 th

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a n n u a l m e e t i n g of th e N u r s in g D iv isio n w a s h e ld on T u e s d a y , J a n u a r y lo th , a t th e C h u rc h S ch o o ls, H a le s o w e n . D iv . S u p t. M iss M . E . F e a r n s id e p re sided. T h e S e c re ta ry (H o n . S g t. M rs. P rice ) in h e r re p o rt, said t h a t d u r i n g th e y e a r th e s t r e n g t h of th e D iv isio n h a d fallen o w i n g t o m e m b e r s w h o h a d jo in e d t h e m fo r t h e d u r a t i o n of th e w a r h a v in g re sig n ed . M iss N e w , V ic e -P re s id e n t, w h o h a d l e f t t h e d i s t r i c t , h a d a l s o r e s i g n e d ; 23 m e m b e r s h a d p assed th e a n n u a l re-ex am in atio n . T h e m em bers had had a useful a n d b u sy year. £ 7S 19 s . 9 d . w a s c o l l e c t e d f o r t h e R e d C r o s s a n d S t. J o h n F l a g D a y , a n d £ 7 0 fo r th e R e d C ro s s a n d S t. J o h n P e n n y - a - w e e k F u n d . M em bers h a d p er f o r m e d 62 c l i n i c a n d 14 a m b u l a n c e a t t e n d a n c e s . T he com alesow en

H a r r o g a t e .— D iv . S u p t. A. R id s d a le p re s id e d a t th e a n n u a l g e n e ra l m e e tin g of th e A m b u la n c e D iv isio n , h eld a t B r i g a d e H e a d q u a r t e r s o n S u n d a y m o r n i n g , J a n u a r y 27 t h . T h e C h a i r m a n r e p o r te d th a t a v e ry difficult y e a r h a d ju st passed. T h e w a r y e a r s h a d b e e n v e ry difficult o w in g to d e p leted n u m b e rs a n d h e h a d sev e ra l tim e s b e e n a lm o s t te m p te d to d is b a n d th e D iv isio n “ for th e d u r a t i o n ,” b u t h e a n d th e r e m a i n i n g f e w h a d c a r r i e d o n fo r t h e s a k e o t t h e old m em bers. T h r o u g h th e w a r y ears, th e D iv isio n h a d su ccessfu lly g iv e n first a id i n s tr u c tio n to t h e H o m e G u a r d , P o lice , S p e c ia l C o n s t a b u l a r y , W a r d e n s , N . F . S . , e t c . , a n d i n 1941 h a d fo rm e d th e b o y s ’ C a d e t D iv isio n , in a d d itio n to d o in g n u m e r o u s p u b lic d u tie s — a re c o rd of w h ic h th e y c o u ld be ju s tly pro u d . T h e r e w a s n o w a v ery g o o d fo u n d a tio n for th e F o rc e s m e m b e r s to r e t u r n to. T h e p o s t-w a r p r o g r a m m e in c lu d e d t h e o p e n i n g of a m e d i c a l c o m f o r t s d e p o t, first a id p o s ts , e tc ., a n d th e q u e s tio n of n e w H e a d q u a r t e r s w a s b e in g g iv e n c o n sid erab le a tte n tio n . T h e S e c r e t a r y , H o n . S g t . A . B r a d l e y , r e p o r t e d t h a t 11 m e m b e r s h a d re s ig n e d , 2 h a d r e tu r n e d to L o n d o n a n d th e re w as 1 new m em ber. T h i s l e f t t h e p r e s e n t s t r e n g t h a s 20 , p l u s o v e r 40 s t i l l i n t h e F o r c e s ; 97 a m b u l a n c e c a s e s h a d b e e n t r a n s p o r t e d a n d 98 f i r s t a i d c a s e s t r e a t e d . A fin an cial s ta te m e n t s h o w e d a satisfa c to ry b a la n ce . C a d e t S u p t . W . B i n k s r e p o r t e d t h e p r e s e n t s t r e n g t h of t h e c a d e t s a s 35 b o y s ; 17 h a d r e s i g n e d ( s o m e t r a n s f e r r i n g t o th e s e n io r D iv isio n ) a n d 8 n e w b o y s h a d q u alified b y e x a m in a tio n a n d w e re re a d y for e n ro lm e n t in th e n e a r fu tu re.

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G u i l d f o r d . — A s a le of w o r k h e ld r e c e n tly b y th e N o. 2 N u r s i n g D iv isio n , a t th e A m b u la n c e H a ll, G u ild fo rd , re a lised t h e v e r y s a t i s f a c t o r y r e s u l t o f ;£ 1 0 0 n e t . A c h e q u e for w a s h a n d e d o v e r to th e C o rp s fu n d s to w a r d s th e c o st of-a n e w a m b u la n c e a n d a s im ila r a m o u n t w a s g iv e n to th e S u rre y C o u n t) r a n d N a tio n a l F u n d fo r th e B lin d .

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p e titio n te a m w e r e r u n n e r s - u p in th e c o u n ty n u r s i n g c o m p e ti tio n , b e in g th e first w in n e r s of th e H i l l m a n C u p . 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 t h a t b o t h t h e N u r s i n g a n d C a d e t N u rs in g D iv isio n s w e re financially s o u n d . C a d e t S u p t. M iss B id m e a d in h e r r e p o r t o n th e C a d e t N u r s in g D iv isio n , said th a t th e y h a d p ro g re s s e d d u r in g th e year. O n e o f t h e c a d e t s , C p l. J . B r a s h , h a d b r o a d c a s t in t h e p r o g r a m m e “ T h e F u t u r e is H e r e . ” D iv . S u p t. M iss F e a r n s id e t h a n k e d th e O fficers a n d m e m b e r s of b o th D iv is io n s for th e ir h e lp d u r i n g th e y ear. S h e a s k e d t h e m a ll to m a k e a b i g e ffo rt d u r i n g th is y e a r to r a is e fu n d s for th e ir N e w B u ild in g F u n d .

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T r a n s p o r t - S e r g t . W illia m P u d d if o o t, of R o k e s ly A v e n u e, w h o , f o r o v e r 28 y e a r s , h a d b e e n a m e m b e r o f t h e S . J . A . B . , h a s p a sse d a w a y in H o rn s e y C e n tra l H o s p ita l a t th e a g e o f 52 . H e b e l o n g e d t o t h e 83 r d N o r t h e r n H e i g h t s D i v i s i o n , a n d h is la s t jo b w a s ta k in g a p a tie n t d o w n to W e y m o u th . A k e e n a m b u l a n c e m a n , h e g a i n e d h is first c e r tific a te in 1918 , a n d i n 1929 r e c e i v e d r o y a l r e c o g n i t i o n f o r h i s w o r k a s a s tr e tc h e r b e a r e r to th e la te K i n g G e o r g e F if th , w h o m h e to o k fro m B u c k in g h a m P a la c e to B o g n o r. H e w a s p resen ted w ith a p a ir of g o ld c u ff lin k s b y Q u e e n M a ry . I n 1942 h e w a s a w a r d e d t h e l o n g - s e r v i c e m e d a l , a n d i n 1945 , h e b e c a m e a s e r v in g b r o th e r in th e O r d e r of S t. J o h n . I n t h e film , “ T h i n g s T o C o m e ” w h i c h w a s m a d e a t D e n h a m , S erg t. P u d d ifo o t w a s seen d riv in g a n a m b u la n c e ro u n d P iccad illy C ircu s. M r . P u d d i f o o t , w h o h a d l i v e d i n H o r n s e y 10 y e a r s , w a s a p ro fessio n al m a s s e u r a n d c h iro p o d ist. H i s s u r g e r y w a s in R o k esly A venue. H is in te re s ts w e re v ario u s. H e w a s c o n n ec te d w ith th e S c o u t M o v e m e n t a ll h i s life a n d w a s a R o v e r s c o u t m a s t e r lo cally . H e w a s a m e m b e r of th e R o y a l Z o o lo g ic a l S ociety.

Railway Ambulance News.

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S t . P a n c r a s . — W i t h M r. T . H . K n i g h t in th e c h a ir, th e a n n u a l m e e tin g of th e S t. P a n c r a s G o o d s A m b u la n c e C e n t r e w a s w ell a tte n d e d . M r. E y re, h o n . s e c re ta ry , re p o rte d t h a t d u r i n g th e y e a r 1,035 c a s e s w e r e t r e a t e d a t t h e p o s t a n d 35 r e m o v e d t o h o sp ital. T w e n ty -fiv e m e m b e rs h a d e n te re d for th e y e arly e x a m in a tio n w ith o n ly o n e failu re. M r. E y r e t h a n k e d all m e m b e rs for th e ir s u p p o rt. O n th e p r o p o s itio n of M r. D ite , s e c o n d e d b y M r . B l a c k b y , h e w a s a c c o r d e d a h e a r t y v o t e of th a n k s fo r h is serv ices. T h e h o n . tr e a s u r e r , M r. A. G . B la k e , w h o d e ta ile d th e s o u n d fin a n c ia l p o sitio n , a ls o re c e iv e d a v o te of t h a n k s o n th e m o tio n of M r. R u s c o e , s e c o n d e d b y M r. E y re . A d is c u s s io n o n g e n e r a l s u b je c ts a p p e r ta in in g to th e affa irs of th e F i r s t A id P o s t fo llo w ed , a n d th e m e e tin g c lo sed w ith a v o te of t h a n k s to th e C h a i r m a n .

L .N .E .R . B o s t o n . — M r . J . E . W r i g h t , 20 , Q u e e n S t r e e t , h a s re c e iv e d n o tifica tio n t h a t H .M . th e K i n g a s P a t r o n of th e V e n e r a b le O r d e r of S t. J o h n of J e r u s a l e m in E n g l a n d , h a s a p p r o v e d h is a d m is s io n to th e O r d e r a s a S e r v in g B ro th e r. M r . W r i g h t , w h o i s a f o r e m a n i n t h e E n g i n e e r ’s D e p a r t m e n t a n d b e e n fo r m a n y y e a r s c a p t a in of th e B o s to n “ A ” t e a m w h i c h h a s w o n s o m a n y s u c c e s s e s o v e r 15 y e a r s u p t o th e w a r p erio d . H e is t h e h o l d e r of t h e L . N . E . R . g o l d m e d a l a n d 3 g o l d b a r s , r e p r e s e n t i n g 30 y e a r s ’ e f f i c i e n c y a n d i s a l s o t h e h o l d e r o f t h e S . J . A . B . l o n g s e r . v i c e m e d a l a n d b a r s f o r 30 y e a r s ’ serv ice. H e is a s e r g e a n t in t h e B o s t o n B r i g a d e . B o s t o n R a i l w a y A m b u l a n c e c l a s s h a s n o w t h e h o n o u r of h a v i n g th r e e m e m b e r s w h o h a v e b e e n a d m i t t e d to th e O r d e r as S e rv in g B ro th ers. I t is d o u b t f u l if t h i s r e c o r d c a n b e e q u a lle d by a n y o th e r c lass on th e ra ilw a y .

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i s . 2d. T h e s e q u e s tio n s a n d a n s w e r s o n first a id w e r e c o m p ile d f o r t h e L e a g u e o f T h e A m b u la n c e B u lle t in ( S e a s o n 1942 / 43 ) by M r. J. W . B ell. In so d o in g h e h a d tw o p rim a r y o b je c ts — (1) t o p r o v i d e s o m e t h i n g n e w in t h e q u e s t i o n s a n d a n s w e r s lin e , a n d (2) t o k e e p b o t h t h e q u e s t i o n a n d t h e a n s w e r a s b r i e f a s p o s s i b l e , t o w h i c h e n d h e s e t o u t h i s 360 q u e s t i o n s in s u c h a w a y th a t th e a n s w e r s n e ed n o t e x ce e d six w o rd s. T h e b o o k a c h i e v e s i t s o b j e c t s ; a n d r e a d e r s o f F i r s t A id c a n w h ile a w a y s o m e p le a s a n t a n d u s e fu l h o u r s in r e a d i n g th ro u g h th e q u e stio n s a n d c h e c k in g th e ir k n o w le d g e by r e fe re n c e to th e a n s w e r s p ro v id e d . C o p ies m a y b e o b ta in e d f r o m t h e E d i t o r o f T h e A m b u la n c e B u l le t in , W i g f o r d H o u s e , L in co ln .

H a n d b o o k of E le m e n ta r y A n a to m y a n d P h y s io lo g y .

By A. D . B elilio s, M .B ., D . K . M u lv a n y , F . R . C . S . , a n d K. F. A rm stro n g , S .R .N . L o n d o n : B ailliere, T in d a ll a n d Cox. P r i c e 4s. 6d. net.

T h is h a n d b o o k w a s o rig in a lly d e s ig n e d to p ro v id e a m a n u a l of e le m e n ta r y a n a t o m y a n d p h y s io lo g y fo r s e n io r m e m b e r s of t h e B . R . C . S . ; a n d it is c e r t a i n t h a t i t w i l l p r o v e of v a lu e to m a n y o th e r s w h o b e i n g o u ts id e th is o r g a n i s a t i o n a r e in te re s te d in th e s e s u b je c ts . T h e b o o k h a s b een co m p iled fro m tw o m a in so u rces. F irst, th e a u th o rs h a v e u tilise d a n u m b e r of c h a p te r s w h ic h h a v e a l r e a d y a p p e a r e d i n t h e i r p o p u l a r H a n d b ook o j F i r s t A i d a n d B a n d a g in g a n d w h i c h h a v e b e e n r e v i s e d a n d a m p l i f i e d w h ere necessary. S eco n d ly , th e r e m a in d e r of th e b o o k h a s b e e n d e r i v e d f r o m t h e e q u a l l y p o p u l a r A i d s to A n a to m y a n d P h y s io lo g y j o r N u r s e s b y M i s s K a t h a r i n e A r m s t r o n g , t h e c h a p t e r s b e in g s im p lifie d to c o n f o r m to th e s t a n d a r d s e t u p in t h e fir st n a m e d b o o k . In b rief th is h a n d b o o k p ro v id e s a c o m p le te o u tlin e of th e h u m a n b o d y a n d is w r i t t e n s o s i m p l y t h a t it c a n b e r e a d i l y u n d e rs to o d by th o se w h o h a v e h a d no p rev io u s in tro d u c tio n to th e s u b jec t.

C O M P E T IT IO N . N o s t e l l

T h e a n n u a l first a id c o m p e titio n of “ Y ” D iv is io n M e tro p o lita n Po lice w a s h eld a t H o rn s e y T o w n H a ll. T h e scen e d ep icted a person to jjo g a n n in g down A le x a n d r a P a r k slo p e s a n d c o llid in g h e a v ily w ith a tree, s u s ta in in g s e rio u s in ju ries. E ig h t te a m s en tered , c o n sistin g of r e g u l a r p o lice a n d M e tr o p o lita n S p e c ia l C o n s ta b u la r y . T h e j u d g e w a s D r. D . M . S h a w - S m ith , S J. A B. The com p e t i t i o n c o n s i s t e d o f a t e a m t e s t o f 15 m i n u t e s , a n d w a s w o n by W o o d G r e e n r e g u l a r police, w h o w e r e p r e s e n te d w ith th e “ W h ite ” Cup. T h e h ig h e st a g g r e g a t e w as o b ta in e d by W o o d G r e e n r e g u l a r p olice a n d s p ec ia l c o n s ta b u la r y , th u s w in n in g th e su b -d iv isio n a l cup. T h e o r g a n is e r w a s C h ie f-In sp . C la r k “ Y ” D iv isio n a ssiste d b y S u b D iv isio n a l-In sp . H . F o w le r a n d P .C . B a k e r. “ W h i t e ” C u p p lacin g s w ere 1, W o o d G r e e n ; 2 , H o r n s e y a n d M u s w e l l H i l l M . S . C . ; 3 , E n f i e l d S . C . ; 4, T o t t e n h a m ; 5, E n f i e l d ; 6 , W o o d G r e e n S . C . ; 7 , E d m o n t o n S . C . ; 8, H o r n s e y 1 S u b - d i v i s i o n a l c u p p l a c i n g s w e r e :— 1, W o o d G r e e n a n d W o o d G r e e n S . C . ; 2, E n f ie ld a n d E n f ie ld S . C . ; 3, T o t t e n h a m a n d E d m o n t o n S . C . ; 4, H o r n s e y a n d M u s w e l l H i l l S .C . S i r G e o r g e A b b is s ( a s s i s t a n t c o m m i s s i o n e r ) , a n d C ol. G. H . B . d e C h a ir (d ep u ty a ss is ta n t c o m m issio n e r) w e re a m o n g th o se p resen t.

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T h e v ie w t h a t e v e r y b o d y o u g h t to h a v e s o m e k n o w l e d g e of first a i d w a s e x p r e s s s d by M r. J . A c k le y , w h e n h e p r e s id e d a t th e first a n n u a l d i n n e r of N o ste ll C o llie ry F i r s t A id S o c ie ty a t th e W in d m ill H o te l, C ro fto n . M r. W . L. W h ittle , P re s id e n t, s a id th e S o c ie ty h a d b e e n fo rm ed m a in ly as a re su lt of a g r e a t d e al of zeal a n d e n th u s i a s m o n th e p a r t of a w illin g few . As one w ho had s p e n t m a n y y e a rs a t N o stell C o lliery a n d s e e n m a n y v e n tu re s s t a r t e d in t h e n a m e of f ir s t a i d , h e t h o u g h t it w a s u p to t h e y o u n g e r p eo p le to s tic k to g e th e r a n d m a k e th e S o c ie ty a success. M r. H . H a r tle y , m a n a g e r of th e co lliery , p r e s e n te d a w a r d s to m e m b e rs w h o h a d b e e n su c c e ssfu l a t a re c e n t ex am in atio n . A ll w h o s a t f o r t h e e x a m i n a t i o n o b t a i n e d aw ards. M r. A c k ley s a id h e h o p e d th e S o ciety w o u ld b e c o m e s o m e t h i n g of w h ic h N o stell C o llie ry c o u ld b e p ro u d . The c o llie ry h a d h a d a h a r d fig h t so f a r a s first a id w a s c o n c e rn e d , a n d h e t h o u g h t e v e r y b o d y s h o u l d h a v e s o m e k n o w l e d g e of first a id s o t h a t th e y m i g h t b e a b le to r e n d e r a s s i s t a n c e to a n y b o d y in n e ed , w h e t h e r it b e a t t h e p it o r o n th e ro a d . M r. E . F e n n w h o p ro p o se d th e to a s t of “ T h e S t J o h n A m b u la n c e A sso c ia tio n ,” said th e A sso ciatio n h a d th re e a im s

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— t o p r e s e r v e life, t o p r e v e n t a g g r a v a t i o n illn e ss, a n d to p r o m o t e re c o v ery .

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of a n y in ju r y o r

Letters to the Editor.

L a t e r in th e e v e n in g e n te r ta in m e n t w a s p ro v id ed . T h e r e w a s a n e n c o u r a g in g a tte n d a n c e a t a m e e tin g held a t th e B a t h s c a n te e n , w h e n a j u n i o r c a d e t se c tio n of th e F i r s t A i d S o c i e t y w a s f o r m e d f o r b o y s u p t o t h e a g e o f 17 e m p lo y e d a t N o stell C o lliery . T h e C h a i r m a n ( M r . M . A bbott.) w e l c o m e d t h e b o y s , a n d s a id th e c o lliery m a n a g e m e n t w e re d e sir o u s t h a t th e y sh o u ld b e e n c o u r a g e d to t a k e a n in te r e s t in first a id w o r k . M r. M a k in s o n o u tlin e d a s c h e m e of a ctiv itie s w h ic h w o u ld b e in c lu d e d in th e j u n io r c u r r ic u lu m — s ig n a llin g , s w i m m i n g , life s a v i n g f r o m w a t e r , c a m p i n g , r a m b l i n g , h a n d i c r a f t , fire f i g h t i n g , k n o w l e d g e o f t h e O r d e r o f S t. J o h n of J e ru sa le m , p h y sical ex ercises a n d o rg a n is e d g a m e s , sea a n d b o a t tra in in g , a n d h y g ien e. M r. F e n n s a id th e f u tu r e o f th e co lliery first a id o r g a n is a tio n w as d e p e n d e n t to s o m e e x te n t u p o n th e boys. It w a s d ecided th a t a ju n io r b ra n c h sh o u ld be form ed, a n d t h a t m e e t i n g s s h o u l d b e h e ld e a c h T h u r s d a y e v e n i n g in th e B ath s canteen. T h e boys w ere en ro lled as m e m b e rs.

Life is Sa ve d !

[ T h e f o l l o w i n g a c c o u n t o f t h e r e s o u r c e f u l n e s s of F i r s t A i d e r s i s r e p r i n t e d f r o m C a n a d ia n F i r s t A i d . ] t r a i n i n g o f all k e y m e n in first a id is o n e o f t h e m o s t u r g e n t n e e d s in t h e l u m b e r i n d u s t r y . A t p r e s e n t t h e r e is a g r o w i n g a p p re c ia tio n a m o n g m o s t w o r k m e n fo r th e g o o d w o r k d o n e b y t h e first a id a t t e n d a n t . (A k n o w l e d g e o f fir s t a id is o n e of t h e m o s t v a l u a b l e a s s e ts of a n y f o r e m a n a n d h a s s a v e d liv e s.) G r e a t c re d it is d u e t h e S t. J o h n A m b u l a n c e A sso ciatio n fo r th e in n u m e ra b le m e n a n d w o m e n tra in e d u n d e r its le a d e r s h ip . I n d u s t r i a l first a id in B ritis h C o lu m b ia w o u ld n e v e r h a v e p r o g r e s s e d so f a r h a d it n o t b e e n fo r th e re g u la r tra in in g m a d e av ailab le th ro u g h o u t th e P ro v in ce by th e d ifferen t c en tre s. E m p lo y ers sh o u ld e n co u rag e k ey m en a n d o t h e r r e g u l a r e m p l o y e e s to l e a r n t h e p r i n c i p l e s of first a id . O n e of th e fin est e x a m p le s of t e a m w o r k o n re c o rd h a s been rep o rted from V an co u v er. F r a n k K u c h in k a, fo rem an of th e K u c h i n k a L o g g i n g C o m p a n y , S t. V in c e n t B ay , Je rv is In le t, w a s p re s e n t o n th e job w h e n o n e of h is e m p lo y e e s w a s in v o lv e d in a n a c c id e n t w h ic h re s u lte d in th e c o m p le te a m p u t a t i o n of a le g , le a v in g a b o u t a n 8 -in c h s tu m p . The in ju r e d m a n w o u ld h a v e d ie d fro m lo ss of b lo o d w ith in a very sh o rt tim e h a d n o t F r a n k K u c h in k a realised th e d a n g e r a n d e n circ led th e lim b w ith h is tw o h a n d s a n d p re v e n te d b l e e d i n g , w h i l e t r a n s p o r t i n g t h e i n j u r e d m a n 3£ m i l e s t o t h e r e g u l a r first a id a t t e n d a n t a t th e c a m p . A n a le r t f o r e m a n h a d d o n e a g o o d jo b a n d in t u r n i n g t h e in ju r e d m a n o v e r to th e first a id a t t e n d a n t h e w a s p la c in g h im in c o m p e te n t h a n d s . T h e first a id a t t e n d a n t w a s B ill K a r a i m , h o ld e r of t h e S t. J o h n M e d a llio n , w ith a th ir d la b e l f o r J u n e 1945 . H e is n o t a m a n w h o t h i n k s h i s jo b is d o n e w h e n h e p a s s e s a n e x a m in a ti o n , b u t k e e p s o n p r e p a r i n g for ju s t s u c h a c ase a s h a p p e n e d here. H e s ta n d s a m o n g th e b e st a tte n d a n ts on th e C o ast. H e tre a te d th e in ju re d m a n fo r s h o c k a n d h a e m o rrh a g e , th e tw o w o rst d a n g e rs. A ra d io te lep h o n e b ro u g h t a p la n e b e a r i n g a d o c t o r — c lo u d s h u n g lo w b u t fires w e r e li g h t e d o n t h e b e a c h , 200 f e e t a p a r t , t o p e r m i t t h e p l a n e t o l a n d . The i n j u r e d m a n w a s l o a d e d i n t o t h e p l a n e a n d i n 45 m i n u t e s w a s in th e G e n e ra l H o s p ita l a t S e a Is la n d u n d e r tre a tm e n t. C o n g r a t u l a t i o n s a r e in o r d e r fo r t h e s p le n d i d jo b of te a m w o r k b e t w e e n t h e f o r e m a n , F r a n k K u c h i n k a a n d th e first a i d a t t e n d a n t , B ill K a r a i m , t h r o u g h w h o s e e f f o r ts a life w a s s a v e d . — S a f e t y N e w s L e t t e r N o . 11 , S a f e t y B r a n c h , D e p a r t m e n t of L a b o u r , V ic to ria , B .C . T h e

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I w a s v ery in te re ste d in th e le tte rs w h ic h w e re p u b lish e d in y o u r J a n u a r y is su e g i v i n g d e ta ils of s erv ice of m e m b e r s of th e K e tte rin g C orps a n d th e N o rth a m p to n H e a d q u a rte rs D iv isio n . I w i s h t o p o i n t o u t t h a t S t o u r b r i d g e is a D i v i s i o n a n d n o t a C o r p s , s o t h a t it is h a r d l y f a i r t o c o m p a r e t h e K e t t e r in g fig u re s w ith th o s e g iv e n fo r th e S to u r b r id g e D iv isio n . N e v e r th e le s s th e r e c o rd s g iv e n of s e rv ic e in th e K e t t e r i n g C o rp s is t r u l y a m a z i n g . T h e y e a r s of s e rv ic e p e rfo r m e d by th e m e m b e r s of th e N o r t h a m p t o n H e a d q u a r t e r s D iv is io n is e v e n m o r e r e m a r k ab le. I t a k e it, h o w e v e r , t h a t S / M G . T . H i n e s , is of C o r p s r a n k a n d th e re fo re sh o u ld n o t be in c lu d e d . E v e n so, w ith o u t M r . H i n e s r e a l l y r e m a r k a b l e s e r v i c e o f 54 y e a r s , N o r t h a m p t o n H e a d q u a r t e r s D iv is io n e a s ily e clip se th e re c o rd of S to u rb rid g e. I t h i n k t h a t in f a i r n e s s t o t h e l a t t e r D i v i s i o n it s h o u l d be s t a t e d t h a t i t w a s r e g i s t e r e d o n S e p t e m b e r 3 r d , 1914 . The f o l l o w i n g i s t h e r e c o r d o f 18 m e m b e r s o f t h e S t o u r b r i d g e D i v i s i o n u p t o t h e e n d o f 1945 : A m b . O f f i c e r F . V . S m i t h 42 y e a r s , A m b . O f f i c e r W . E . W e a v e r 41 , D i v . S u p t . C . D a v i e s 31 , S t a f f S g t . W . H . H a r p e r 30 , P t e . W . J . T i l b r o o k 22 , A m b . O f f i c e r A . E . R o d e n 20 , L / C p l . O . F . S a w t e l l , P t e s . T . A . C l a y t o n , E . A . P e r k i n s , J . T . R o b e r t s e a c h 16 , P t e . G . H . B e r r y 15 , P t e . S . F u r n e s s 14 C p l . J . H . M a r t i n , P te s . H . W . B r o o k e s , A . G r e g o r y , G . W . L a w r e n c e , G . S. M i l l e r , H . S . W a l t o n e a c h 13 . A m b . O fficers F . V. S m ith a n d W . E . W e a v e r w e re m e m b e r s of a se c tio n of D u d le y A m b u la n c e D iv isio n b e fo re th e fo r m a tio n of th e S to u r b r id g e D iv isio n . A ll t h e o t h e r s h a v e p u t i n a ll t h e i r s e r v i c e w i t h S to u rb rid g e . Is th is a reco rd for a D iv isio n fo rm e d no lo n g e r a g o t h a n 1914 ? — Y o u r s f a i t h f u l l y , J.

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d ifferen c e s in s y m p to m s a n d m o rta lity . T h e s e ty p h u s fevers a r e b e s t c la ssifie d a c c o r d i n g to t h e in s e c t w h ic h is r e s p o n s ib le for tra n s m is sio n . T h e r e is, f o r e x a m p l e , l o u s e t y p h u s , fle a t y p h u s , t i c k t y p h u s o r t i c k b ite f e v e r a s it is c o m m o n l y c a l le d in th is c o u n try , m ite ty p h u s o r J a p a n e s e R iv e r fev er a n d so on. S o m e of th e s e fev ers a r e d e a d ly , o th e r s m ild , b u t th e y all h a v e a t le a st tw o t h i n g s in c o m m o n ; th e y a r e c a u s e d by R ic k e tts ia a n d th e s e R ic k e tts ia a r e c a r r ie d b y in sec ts. I w ill o n l y d e a l w i t h t h e t y p h u s w h i c h is c a r r i e d b y lice. , L o u s e ty p h u s , a ls o c alled ‘‘ e p id e m ic ” o r “ c la s s ic a l ” ty p h u s , is a n o ld in f e c t i o n o f m a n a n d s o m e a u t h o r i t i e s b e lie v e t h a t it w a s d e s c rib e d b y H ip p o c r a te s in h is “ E p i d e m i c s ” s o m e 400 o d d y e a r s B . C . I n th e h is to ry w h ic h w e le a rn t a t sch o o l, b a ttle s w e re w o n by th e b rillian t tactics of g e n e ra ls, m a rs h a ls , a d m ira ls a n d th e sp e c ia l in te rp o s itio n of P ro v id e n c e . H isto ry , h o w e v e r , is b e i n g r e w r i t t e n a n d e p i d e m i c d i s e a s e is r e c e i v i n g t h e la u r e ls in m a n y c a s e s a n d g e n e r a l s a r e s h o w n to h a v e b e e n re lativ ely u n im p o r ta n t. A m o n g s t th e m o s t im p o r ta n t of th e s e e p id e m ic d is e a s e s is lo u s e ty p h u s , w h ic h h a s o n m a n y a n o c c a sio n d e c id e d th e c o u rs e of a b a ttle o r c a m p a ig n . I n 1632 , f o r e x a m p l e , G u s t a v u s A d o l p h u s a n d W a l l e n s te in p re p a re d th e m s e lv e s fo r b a ttle n e a r N u r e m b u r g b u t b efo re th e s la u g h te r c o u ld e v en c o m m e n c e b o th a rm ie s h a d to flee f r o m t h e r a v a g e s of t y p h u s . T h e r e d o e s n o t s e e m to be v ery m u c h d o u b t th a t N a p o leo n w a s really d e fe ated by G e n e r a l D is e a s e , w h o s e a b le s t m a r s h a l l w a s th e louse. W h e n h e p re p a re d fo r h is a d v a n c e in to R u s s ia h e m o b ilise d a b o u t h a lf a m illio n m e n . In J u n e of t h a t y e a r ty p h u s b e g a n t o a p p e a r a n d b y J u l y , a f t e r O s t r o w a , t h e r e w e r e 8 0,000 s i c k . W h e n th e r e tr e a t fro m M o sc o w b e g a n th e r e w e r e less th a n 100,000 t r o o p s f i t f o r s e r v i c e . A n o t h e r 80,000 p a t i e n t s w e r e left a t S m o l e n s k in N o v e m b e r a n d w h e n V iln a w a s r e a c h e d i n D e c e m b e r t h e a r m y h a d d w i n d l e d d o w n t o 20,000 m e n . I w ill n o t d w e ll o n t h e h o r r o r s t h e s i c k h a d to e n d u r e in

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T h is te rrib le tr a g e d y d id n o t, of c o u rs e , d e te r N a p o le o n w h o s o o n r a i s e d a n o t h e r a r m y o f 500,000 w h i c h a g a i n , la rg e ly d u e to e p id e m ic d is e a s e , w a s re d u c e d to less t h a n 200,000 w h e n h e h a d t o f a c e t h e A l l i e s a t L e i p z i g . H ere he w a s sev erely d e fe a te d a n d h a d th e v ic to rs o n ly fo llo w ed th e ir success, E u ro p e m ig h t h a v e been sav ed n e arly tw o fu rth e r y e a r s of b lo o d s h e d a n d h a r d s h ip . T h e tim e s e e m s to be c o m i n g w h e n m i l i t a r y h e r o e s of t h e p a s t f r o m M i l i t i a d e s of M a r a t h o n to W e l l i n g t o n of W a t e r lo o w ill h a v e to t a k e a b a c k seat. I t w a s ' i n 1909 t h a t N i c o l l e , C o m t e a n d C o n seil a n n o u n c e d t h a t th e y h a d p r o d u c e d ty p h u s fev er in h e a l th y m o n k e y s b y m e a n s of in fe c te d h u m a n lice. E a rlier w o rk e rs s u c h a s M u r c h i s o n i n 1876 a n d C o r t e z o i n 1903 h a d s u g g e s t e d t h a t lic e w e r e r e s p o n s i b l e b u t it r e m a i n e d f o r t h e F r e n c h w o rk e rs to m a k e th e g r e a t d isco v e ry . T h is event w as fo llo w e d b y a n a v a l a n c h e of w o r k a n d b e fo re l o n g it w a s r e v e a l e d , a s is u s u a l in i n s e c t - b o r n e d i s e a s e s , t h a t t h e n a t u r a l h is to r y of t y p h u s w a s e x p lic a b le in t e r m s of th e h a b its of th e tr a n s m itte r, n a m e ly , th e lo u se. I a m th e r e f o r e g o i n g to s p e n d a fe w m i n u t e s to te ll y o u s o m e t h i n g a b o u t lic e in g e n e r a l a n d h u m a n lice in p a r t i c u l a r . T h e C a ll ( S o u t h A frica).

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H o w to K e e p W e ll, F i r s t A id W h a t to D o in E m e r g e n c ie s In flu en z a , C o ld s, etc. M ea sles, M u m p s , C a ta r r h C o rns a n d W a rts P h y sical C u ltu re T r e a t m e n t fo r all S k in D is e a s e s T h e L u n g s , P leu risy H y g ie n e, A n ato m y , P h a rm a c y

T h e P rin c ip le s of N u r s in g T h e Eye, th e E a r T h e T h ro a t, th e N ose T h e C h est, th e H e a r t T h e S to m ac h , th e L iver T h e T e e th , th e M u scle s In fa n t W elfare H o m o ep ath y , N eu rasth en ia 375 P r e s c r i p t i o n s , e t c . , e t c .

THE Y O U N G W IF E w i l l f i n d j u s t t h e i n f o r m a t i o n s h e r e q u i r e s . M O TH ER S w h o w i s h t h e i r d a u g h t e r s t o d e v e l o p n a t u r a l l y w i l l f i n d e x a c t l y the teach in g th e y need .

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b e pre p a red f o r an em erg en cy and keep C u tic u ra B ra n d O in tm e n t in y o u r F ir s t A id K it . I t b rin g s i n stant s o o th in g re lie f to cu ts, b u rn s , s k in la ce ra tio n s - p re v e n ts spread o f in fe c tio n , q u ic k ly heals. O b ta in able at a ll C h e m ists and S to re s.

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Queries and Answers to Correspondents 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 t o p l e f t - h a n d c o r n e r o f t h e e n v e l o p e “ Q u e r y , ’’ a n d a d d r e s s e d t o F i r s t A i d , 46 , C a n n o n - s t r e e t , L o n d o n , E . C . 4 .

A I D a n d w a s s p o k e n b y s o m e o n e w h o w a s not a m e m b e r o f th e S t. J o h n A m b u la n c e B r ig a d e . . W e h a d b een g iv e n th e u s u a l le c tu re s o n p ou ltices a n d th e S is te r g iv in g th e le c tu re s a s k e d o n e of th e s t u d e n t s , “ W ith w h a t w o u ld y o u sp rea d the p o u ltic e ? ” T h e r e p l y w a s q u i c k , “ W ith a s p i t o o n l ” . I n c lo sin g , I w is h to a d d m y th a n k s to th o s e of y o u r n u m e r o u s c o rre s p o n d e n ts , for y o u r in te r e s tin g a n d in s tr u c tiv e re p lie s to Q u e r ie s in F ir s t A id .

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 i d e o f p a p e r o n l y . Good!

N ex t, p le a s e !

1— N . C . F .

3. — A l l Q u e r i e s m u s t b e a c c o m p a n i e 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 of t h e J o u r n a l , o r, in c a s e of Q u e rie s fro m a b ro a d , fro m a re c e n t issu 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 i n t h i s c o l u m n i s t h e 39 t h ( 1937 ) E d i t i o n o f t h e S . J . A . A . M a n u a l of F i r s t A id to th e I n ju r e d .

A m p u tation o f U pper L im b . F .R . (K itc h e n e r, O n t., C a n a d a ).— At a recen t B rig a d e P r a c tic e w e h a d a p r o b le m in w h i c h a p a t i e n t w a s s u p p o s e d to h a v e h is u p p e r lim b c u t off by a m a c h in e tw o in c h e s b elo w th e sh o u ld er. T h e tre a tm e n t w a s p re ssu re on s u b c la v ia n a rte ry s u b stitu te d la te r by p a d a n d a x illary bandage. T h i s w a s lo o s e n e d in t w e n t y m i n u t e s , a s w e s u p p o s e d w o u ld be c o rre c t. W e w e r e to ld , h o w e v e r , t h a t th is re la x in g w as n o t necessary , a s th e re w a s not e n o u g h lim b left to t u r n g a n g r e n o u s o r o th e r w is e to a g g r a v a t e th e in ju ry . W i l l y o u p l e a s e t e l l u s if t h i s i s c o r r e c t a n d m e a n w h ile accept o u r th a n k s from B rig a d e O v erseas ? T h e u s e o f t h e t o u r n i q u e t i n t h e c a s e q u o t e d b y y o u is n o t ju s tifie d b e c a u s e th e t r e a t m e n t fo r a n a m p u ta ti o n of lim b o r p a r t o f l i m b is t o a p p l y a t i g h t l i g a t u r e a s l o w a s p o s s i b l e a n d th e n to d re s s t h e s tu m p . G re a t c are sh o u ld , ho w ev er, b e ta k e n d u r in g tra n s p o rt to e n s u r e th a t b le e d in g d o e s n o t r e c u r . — N . C o r b e t F i. e t c h e r .

E xam in ation Howler. E .V . (S o u th b o u rn e ). — F o r y o u r collectio n of H o w le rs I t h o u g h t t h a t y o u w o u l d l i k e t h e f o l l o w i n g d e f i n i t i o n of S h o c k w h i c h w a s g i v e n in a w r i t t e n p a p e r l a s t m o n t h b y o n e o f m y m e m b e r s — “ S h o ck is a su d d en lo w er in g o / a l l the v it a l o rg a n s ! ” G ood !

N e x t , p l e a s e ! !— N . C . F .

N e g a tiv e P ressu re. C . D . ( M i n e h e a d ) . — W ill y o u p le a s e e x p l a i n w h a t is m e a n t b y th e te r m “ n e g a t iv e p r e s s u r e ” of lu n g tis s u e b y m e a n s of w h ic h r e s p ir a tio n is c a r r ie d o n ? T h e r e a r e t w o l a y e r s of l i n i n g m e m b r a n e s w h i c h e n c l o s e th e lu n g s. O n e la y e r is a t t a c h e d to t h e c h e s t w a ll a n d th e o th e r s u rro u n d s th e lu n g s. B etw e e n th e se tw o lay ers th ere is a l w a y s s o m e a i r , t h i s b e i n g a t a l o w e r p r e s s u r e t h a n t h e a i r w h i c h w e b r e a t h e a n d w h i c h is k n o w n a s “ a t m o s p h e r i c p re ssu re .” H e n c e th e te rm “ n e g ativ e p re ssu re ” w h e re b y t h e e x p a n s io n of l u n g s is f a c ilita te d .— N .C . F .

B rigad e R egu lation s. C . J . ( M a n c h e s t e r ) . — I w o u l d b e m u c h o b l i g e d if y o u w ill k in d ly c lear u p th e fo llo w in g query . A re m en w h o h av e been d em o b b ed faom H .M . F o r c e s s i n c e J u l y 1945 , a f t e r s e r v i n g i n t h e M e d i c a l B r a n c h e s of R . A . F . , R . A . M . C . , R N . o r M .N . c o m p e lle d t o s i t f o r t h e a n n u a l r e - e x a m i n a t i o n d u r i n g 1945 , i n o r d e r to q u a lify fo r e fficiency t h is y e a r ? C l a u s e 209 o f B r ig a d e G e n e r a l R e g u la tio n s l a y s i t d o w n t h a t t h e B r i g a d e y e a r i s f r o m J a n u a r y 1 t o D e c e m b e r 31 , a n d t h a t th e la te s t d a te a t w h ic h a m e m b e r m a y join to c o u n t s e r v i c e f o r t h e y e a r o f j o i n i n g i s J u l y 31 . In th ese c irc u m s t a n c e s i t w o u l d a p p e a r t h a t m e m b e r s r e j o i n i n g a f t e r J u l y 31 a r e n o t a b le to c o u n t th e y e a r of r e jo in in g a s a y e a r of efficiency ; a n d o n th is b a sis th e q u e s tio n of t a k i n g th e r e e x a m in a ti o n d o e s n o t arise. N e v e rth e le ss, y o u s h o u ld be a cc e p te d a s b e in g in H .M . S e r v i c e s d u r i n g 1945 , i n w h i c h c a s e a l l y o u h a v e t o d o i s t o p a s s a r e - e x a m in a tio n w ith in tw e lv e m o n t h s of y o u r d e m o b ilis a tio n in c o n s e q u e n c e of w h ic h y o u c a n th e n a p p ly for a w a r d s c o v e r i n g y o u r p e r i o d of s e r v i c e a s is l a id d o w n in S . J . A . A . C i r c u l a r d a t e d J a n u a r y 1940 .-— E d i t o r .

D e fe n c e M ed a l. L . J . ( B i r m i n g h a m ) . — W o u l d y o u k in d ly , tell m e w h e t h e r o r n o I a m e n title d to th e D e fe n ce M ed a l ? I have been a m e m b e r o f S . J . A . A . f o r 19 y e a r s a n d h a v e b e e n o u r W o r k s A n ti G a s I n s t r u c t o r a n d F i r s t A id I n s t r u c t o r fo r v a rio u s S u r g e o n - I n s tr u c to r s a t A m b u la n c e C lasses. T h e s e d u tie s I h a v e c a r rie d o u t t h r o u g h th e w a r p erio d a n d I a m still c a r r y i n g o n w ith p ra c tic a l in s tr u c tio n a t o u r w orks. A lso I m a d e m y h o m e a F ir s t A id P o s t fo r t h e r o a d i n w h i c h I liv e, t h e e q u i p m e n t b e i n g s u p p l i e d b y th e p e o p le liv in g in th e ro a d . W ith re g r e t I h a v e to in fo rm y o u th a t on y o u r s ta te m e n t of d u tie s a c c o m p lis h e d , y o u d o n o t q u a lify fo r th e D e fe n c e M ed al. T h i s is a w a r d e d to m e m b e r s of th o s e o r g a n i s a t i o n s w h i c h a r e - o f f ic i a lly r e c o g n i s e d viz., H . M . F o r c e s , P o lice , N a t i o n a l F i r e S e rv ic e , a n d C iv il D e f e n c e P a r t i e s of t h e lo c a l a u th o ritie s.— E

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T reatm en t o f A sp h y x ia . P .Y . (C o v e n try ).— A ch ild h a s b e e n re s c u e d fro m a c a n a l. H e is u n c o n s c i o u s ; h i s p u l s e is s l o w a n d w e a k ; h is e y e s a rf e f i x e d ; a n d t h e r e a r e n o m o v e m e n t s o f c h e s t t o d e n o t e b re a th in g . O u r q u e r y is w h e t h e r o r n o w e s h o u l d p e r f o r m a rtificial re s p ira tio n . S o m e say ' ‘yes ” w h ile o th e rs sa y “ n o .” In th e s e c irc u m s ta n c e s w e a s k y o u r ad v ice a n d t h a n k y o u in a n tic ip a tio n of y o u r k in d h elp . T h e a b s e n c e of all m o v e m e n ts of th e c h e s t c le a rly calls fo r th e p e r f o r m a n c e of a rtificia l re s p ir a tio n w ith o u t d e la y b e c a u s e th e feeb ly a c t in g h e a r t m a y c e a s e to b e a t a t a n y m o m e n t. S o t h e s o o n e r it is c o m m e n c e d , t h e g r e a t e r is t h e p o ssib ility of r e s t o r i n g th e p a tie n t to life.— N .C .F .

H um our in H om e N ursin g.

T reatm en t o f N ose B leed in g.

A .J . ( D a g e n h a m ) . — I a m f o r w a r d i n g th is “ T i t B it ” w h ic h w a s h e a r d th is e v e n in g a t o u r H o m e N u r s in g L e c tu re ,,

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F r e q u e n t l y t h e r e s u lt o f n e r v o u s te n s io n , i n a b i l i t y t o sleep w ill g e n e r a l l y y i e l d to a su itable t y p e o f sedative. ‘ A N A D I N ’ is a w e l l - b a l a n c e d c o m b i n a t i o n o f a sp irin , p b e n a c e t i n , ca ffe in e a n d q u in in e . I t is b o t h s e d a t i v e a n d a n a l g e s i c in a c t io n , q u i c k l y b r i n g i n g re l i e f t o t h e o v e r - t a x e d n e r v o u s s y s t e m . C o m p l e t e l y free f r o m u n p l e a s a n t a f t e r effe cts , 4 A N A D I N ’ m a y b e u s e d w i t h c o n fid e n c e o v e r p r o l o n g e d p eriod s.

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p lace p a tie n t before a n o pen w in d o w w ith h is h a n d s ra ised a b o v e h is h e a d . T h o u g h I h a v e a s k e d sev eral frien d s w h y t h i s is d o n e , I h a v e n e v e r b e e n g i v e n a r e a s o n w h i c h satisfies m e . I n m y d ifficu lty th e re fo re , 1 a s k a n d t h a n k y o u fo r y o u r k i n d h elp . E le v a tio n of th e u p p e r lim b s a b o v e th e h e a d c a u s e s e n l a r g e m e n t of t h e c h e s t c a v i t y a n d c o n s e q u e n t l y e x p a n s i o n of th e lu n g s. W h e n th is h ap p en s, p re ssu re on th e la rg e v enous t r u n k s a t t h e i r e n t r y to t h e r i g h t s id e of t h e h e a r t is l o w e r e d , t h e r e s u lts b e i n g (1) t h a t th e s e v e ss e ls d ila te , (2) t h a t th e r e t u r n o f v e n o u s b l o o d t o t h e h e a r t is f a c i l i t a t e d a n d ( 3 ) t h a t t h e b l e e d i n g f r o m t h e n o s e is l e s s e n e d . — N . C . F .

A I D t h e J a n u a r y i s s u e of F ir s t A id a n d w h o s e l a m e n e s s p r e ven ts h im b e c o m in g a m e m b e r of th e B rig a d e ? O n m y p a rt, I h a v e b e e n a m e m b e r fo r m o re th a n

34 y e a r s , a n d h o l d t h e C o n s p i c u o u s S e r v i c e M e d a l w i t h th re e B ars ; b u t I a m n o t allo w ed a c h an c e of c o m p e tin g f o r p r o m o t i o n o n a c c o u n t o f m y h e i g h t , o r r a t h e r l a c k of h e ig h t ! P le a se do n o t d isclo se m y id e n tity b e c a u s e I a m still t r y i n g to g e t a c h a n c e of p r o m o t io n 1 Y o u r l e t t e r is a p p r e c i a t e d ; a n d re sp e c te d . — E d it o r .

your req u est h a s been

A ction o f Iodine. M ore H um our in First A id. N .F . (S to k e N e w i n g t o n ) .— S in c e I h a v e b e lo n g e d to th e S t. J o h n A m b u l a n c e B r i g a d e I h a v e h a d t h e p l e a s u r e of r e a d i n g F ir s t A id a n d e s p e c ia lly y o u r Q u e r i e s a n d A n sw e rs C o lu m n . So I sen d a lo n g th e fo llo w in g as m y c o n tr ib u tio n to y o u r f u n n y “ b its .” O n e n ig h t a t D iv isio n al P ractice, a m e m b e r w a s a s k e d fo r h is t r e a t m e n t of a b u r s t v a ric o se v ein a n d r e p l i e d — “ P la c e a con striction as J a r a w a y Jrom the body as p o s s ib le ! ” T h is so c o n fu sed th e q u e stio n e r th a t h e i m m e d i a t e l y a s k e d f o r t h e t r e a t m e n t o f a “ r a p id a n im a l ” s u f f e r i n g f r o m “ hyd roch lop hia ! ” Good !

N e x t , p l e a s e ! !— N . C . F .

M e m b e r of S.J.A.A. L . C . ( N u n e a t o n ) . — W il l y o u k i n d l y tell m e h o w in d iv id u a ls , w h o h o l d S t. J o h n c e r t i f i c a t e s , c a n b e c o m e m e m b e r s of th e S t. J o h n A m b u la n c e A sso c ia tio n o th e r th a n by b e in g m e m b e r s of 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 ? B y v ir tu e of th e fa c t t h a t y o u h o ld a c e rtific a te of th e A sso ciatio n you a re a lre a d y a m e m b e r. Y o u sh o u ld , h o w e v e r , r e a l i s e t h a t t h e A s s o c i a t i o n is a t e a c h i n g a n d e x a m i n in g b o d y a n d t h a t it d o e s n o t p ro v id e fa c ilitie s fo r f u r th e r t r a i n i n g .— N .C . F.

J . G . ( W i l l e s d e n ) . ^ T h e T e x t b o o k t e l l s u s o n p . 173 t h a t i o d i n e is a p o i s o n a n d d e t a i l s t h e a p p r o p r i a t e t r e a t m e n t a s fo r a n irr ita n t p o iso n . R ecen tly , h o w ev er, I c a m e a c r o s s a n a d v e r t i s e m e n t q n t h e u s e s of io d in e in w h i c h , i n r e p l y t o t h e s p e c i f i c q u e s t i o n “ I s io d in e p oison ou s ? ” t h e r e p l y g i v e n w a s “ Io d in e is not a p o is o n ." A s a m e m b e r of th e B r i g a d e fo r m a n y y e a r s I s h o u ld n o t q u estio n th e T e x tb o o k on th is q u estio n ; a n d th e re fore I w o u ld w e lc o m e y o u r c o m m e n ts o n b e h a lf of o th e r first a id e r s a n d m y s e lf. Y o u sh o u ld a p p r e c ia te t h a t m a n y d r u g s — s u c h a s io d in e a n d a s p i r i n —a r e b en eficial to p a tie n ts p ro v id e d t h a t th e y a re t a k e n in m e d ic in a l d o s e s , a n d t h a t th e y m a y p r o d u c e p o is o n o u s e f f e c t s if t h i s d o s a g e i s e x c e e d e d . F u r t h e r , y o u w i l l n o t e t h a t o n p . 173 o f t h e T e x t b o o k , t r e a t m e n t fo r io d i n e p o i s o n i n g is n o t a d v o c a t e d u n l e s s t h e s ig n s a n d s y m p to m s of ir r ita n t p o is o n in g a re p r e s e n t to g e th e r w ith a n in te n siv e th ir s t w ith yello w o r b lu e v o m ite d m a tte r. I n o t h e r w o r d s , if i o d i n e h a s b e e n t a k e n a n d t h e d e v e l o p m e n t of th ese sig n s a n d sy m p to m s does n o t occur, th e n a p o iso n o u s dose h a s n o t b een ta k e n .— N .C .F .

“ FIR S T A ID ” QUERY and REPLIES COUPON. To be cu t out a n d en closed w ith a ll Q u e r ie s .

Feb.,

T reatm en t of Hernia. N . M . ( C h e p s t o w ) . — U n d e r t h e t r e a t m e n t of H e r n i a , th e T e x t b o o k i n R u l e 2 o n p . 183 t e l l s u s t o “ a p p l y i c e o r a c o ld c o m p r e s s to th e affected p a r t . ” T h is in stru c tio n h a s c a u s e d c o n s id e r a b le d is c u s s io n in o u r first a id circle ; a n d s o m e of u s a r g u e (1) t h a t t h e a p p lic a ti o n of co ld w o u ld h a v e t h e effect of c o n t r a c t i n g th e a b d o m i n a l w a ll a n d t h e r e b y of i n c r e a s i n g t h e r i s k of s t r a n g u l a t i o n of t h e p r o t r u d i n g b o w e l, a n d (2) t h a t a p p l i c a t i o n of h e a t w o u l d b e m o r e ben eficial. Y o u r k in d c o m m e n ts on th is p o in t w ill b e g r e a tly a p p r e c ia te d . T h e effects of c o ld , w h e n a p p lie d to th e a b d o m i n a l w a ll, a re s m a ll in d e e d u p o n th e s e m u s c le s a s c o m p a re d w ith th o se u p o n t h e p o r t i o n of b o w e l p r o t r u d i n g t h r o u g h th e s e m u s c l e s a n d co v ered o n ly b y th e su p erficial tis su e s } a n d th e re v e rse a c tio n a p p lie s to w a r m th . In th e se c irc u m s ta n c e s I a d v ise yo u to s ta n d b y th e in s tr u c tio n s of th e T e x tb o o k , le st b y th e a p p lic a tio n of h e a t y o u p r e c ip ita te th e o n s e t of s t r a n g u l a t i o n of th e p r o t r u d i n g

19 4 6 .

Scouts’ Ambulance Cup. At th e S cout H e a d q u a rte rs, N o ttin g h a m , on S atu rd ay , J a n u a r y 26 t h , t h e f i r s t c o m p e t i t i o n w a s h e l d f o r t h e J . A . H . G re e n a m b u la n c e tro p h y , silv er c u p p re s e n te d b y th e la te M r. J. A. H . G r e e n w h o w a s d is tr ic t c o m m i s s i o n e r of t h e N o t t i n g h a m B o y s S c o u t s ’ A s s o c i a t i o n f r o m 1912 t o 1918 . T h e c o m p e titio n , c o n s is tin g of o ra l a n d p r a c tic a l w o r k , w a s w o n b y t h e 121 s t N o t t i n g h a m ( H i g h P a v e m e n t ) T r o o p t e a m , c o n s i s t i n g of W . R . H e s l o p , R . B . H a n s o n , a n d K . C. J o n e s , w h o w ill h o ld th e c u p fo r a y e a r . D r. E . M. B ec k e tt p resen ted th e tro p h y , a n d th e e x a m in e rs w e re M essrs. D . F a r r a n d a n d R . H . W ild g o o se.

b o w el. — N .C . F.

M e m b e r s h ip o f B rigad e. A .H . (M id la n d s ).— M a y I s y m p a th ise w ith th e c o rre s p o n d e n t w h o s e q u e r y w a s a n s w e r e d u n d e r t h e a b o v e h e a d i n g in

O v erh ea rd at a recen t ex a m in a tio n o j C a d e ts . — Q u e s t i o n : W h a t is s h o c k ?

A n sw e r : A p erso n w h o th in k s th ey h av e

fa in te d a n d th ey h a v e n o t !

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i n , A //m p T a b v , a t *d> w l «h A ld * t o M e m o r y . This book wonderfully simplifies*nad complex subnet and should be read tv students. —L. & N.\V. R y. G a z b t t b .

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ERRORS

FIRST-AID.

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FIRST AID 3rt6epen6jeitt Journal for tijeAmbulance atui pursing $mrkes N o .

621,

V o l.

M A R C H ,

H I.]

T H E

T R A IN IN G

O F

C O M P E T IT IO N B y

R .

“ G i v e s clear a n d c o n s t r u c t iv e a d v i c e o n s e le c t in g a n d tra in in g team s f o r first aid c o m p e t it i o n s , and p r o v i d e s us e fu l tips o n in d iv id u a l and team behaviour du ring c o m p e t i t i o n s .................... sh o u ld find a r e a d y p u b l i c .” — Fire Protection. J O R D A N

S O N S

Entered at

P R IC E

LStot/oners' HallJ

F IR S T

TH R E E P E N C E

4 s . P e r A n n u m , P o s t F re e

A ID

T E A M S

B O Y C E -M E A R S

I s .

n e t

(

L IM IT E D ,

1946.

by p o s t\ ls . Id. /

116

M r . B o y c e - M e a r s a d vis es m o s t c o m p e t e n t l y o n the b u i l d in g o f the te a m , o n t r a i n i n g f o r c o m p e t i t i o n w o r k , w h a t t o e x p e c t in the test, d i a g n os is a n d e x a m in a t io n r o u ti n e a n d c o m p le t e s the b o o k l e t w i t h a v e r y u s e fu l a n d i n f o r m a t iv e s p e c im e n o f an a v e r a g e j u d g e ’ s m a r k sheet. C H A N C E R Y

L A N E ,

W .

C .

BIOLOGICAL M B l i PREPARATIONS A N T I P E O L

CUTAN EOUS VACCINE

O I N T M E N T

O n e o r o t h e r o r all o f th e th r e e races o f g e r m s , S tr e p t o 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 r e f o u n d in e v e r y s k in in f e c tio 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 antibodies ( 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 h e o i n t m e n t , a n 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 its 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 T I P 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 i t 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 r e q u i r e t o b e c h a n g e d e v e r y d a y . W O U N D S , B U R N S , e t c ., W I L L N O T T U R N S E P T I C i f t r e a t e d w i t h A N T I P E O L O I N T M E N T .

O P H T H A L M O - A N T I P E O L is a sem i-fluid o in t m e n t , m o r e c o n v e n i e n t th a n th e o r d in a r y A n tip e o l o i n t m e n t f o r o c u la r in fe c tio n s a n d lesio n s. E y e s a ff e c te d b y s m o k e a n d d u s t are s o o th e d a lm o s t im m e d iately b y the app lic atio n o f O p h th a lm o -A n tip e o l, a n d th e a n tiv iru s p re v e n ts g e r m s f r o m d e v elo p in g ,

R H I N O - A N T I P E O L affords 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 the a n tib o d ie s o f the g e r m s c o m m o n to infections o f th e n o s e an d p h a ry n x (Staphlylococci, Strep to co c ci, B . p y o cy an eu s, p n e u m o c o c c i, p n e u m o b a cilli, e n te ro c o cc i, M . c atarrh alis, 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 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 i t is t h e id e a l prev en tiv e o f m icro b e d evelopm ent.

C lin ica l S a m p l e * on r a q u a s t 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 I E S L T D ., Ca rgrean Road

S o u t h N o r w o o d , L o n d o n , S .E .2 5

“ SANOID” INTERLOCKING EXTENSI ON S P L I N T S

S TA N D A R D IZ A T IO N

(P a te n t N u m b er 5 3 1 6 5 o f 2 8 /7 /3 9 .) INCURVED EDGE OF SOCKET /

TRANSVERSE G R OO VE OF . SPL IN T

INCURVED EDGE OF SOCKET

TH E advantages of standardization are well ^/recognised, especially in alkaline medication. ‘ BiSoDoL’ Powder, a gastric sedative and triple antacid, is particularly effective in the treat ment of digestive disorders and morning sickness. The constituents of ‘ BiSoDoL' are standardized and, as such, can be regarded as reliable. The preparation is agreeably flavoured with peppermint and is readily miscible with milk or water. Moreover ‘ BiSoDoL’ gives prompt relief.

S. 1343 “ S A N O I D ”

IN T E R L O C K IN G

E X T E N S IO N SPL IN TS

W it h M e ta l s o c k e ts fo r jo in tin g . 2 p ie c e s : 2 5 /8 th s . In . x 3 / l 6 t h s . In. x 15 In. 2 p ie c e s : 2 5 /8 th s . In. x 3 / l 6 t h s . In . x I3£ In. I p ie c e : 2 5 /8 th s . I n . x 3 '1 6 th * . In . x 7£ In. I p ie c e : 2 5 /8 th s . In. x 3 / l 6 t h s . In . x 6 In. 2 W e b b in g S tra p s w ith m e ta l b u c k le s : 18 In. x I In. 2 W e b b in g S tra p s w ith m e ta l b u c k le s : 27 In. x 1} In. 3 s o c k e ts . By th is I n v e n tio n S p lin ts m a d e In a n y c o n v e n ie n t le n g th s m a k e ^ rig id c o n n e c tio n s by m e a n s o f I n c u rv e d o p p o s it e e d g e s o f t h e m e ta l s o c k e ts o r s le e v e s firm ly e n g a g in g w i t h t r a n s v e r s e g r o o v e s in t h e s u rfa c e s o f t h e S p lin ts w h e n p r e s s e d h o m e I n to t h « s o c k e t. U n lik e t h e o r d in a r y s o c k e t t e d S p lin t, th is ty p e Is r ig id ly c o u p le d ^ t o g e t h e r a n d h e ld a g a in s t r e l a ti v e d is p la c e m e n t b u t can be d is e n g a g e d by p u llin g a p a r t w ith s u ffic ie n t fo rc e .

★

N .B .—T o e n s u r e p e r f e c t lo c k in g s h o u ld b e c o r r e c tly I n s e r te d In C E R T A IN T H A T T H E IN C U R V E D E N G A G E S W IT H T H E TR A N S V E R SE

BiSoDoL

It Is im p e r a tiv e t h a t t h e S p lin t t h e s o c k e t, I.e ., BY M A K IN G E D G E O F M ETAL S O C K E T G R O O V E O F T H E S P L IN T .

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Its aim and object being the advancem ent o f A m b ulan ce W ork In a ll its branches, the E d ito r invites R eaders to send A rticle s and R eports on subjects pertaining to the M ovem en t and also w elcom es suggestions for Practical Papers. A ll R eports, & c ., should be addressed to the E d ito r at the address b elo w , and should reach him before the 8 th o f each m onth, and must be accom panied ( not necessarily for publication) b y the name and address o f the Correspondent. Su bscription s, A d vertisem en ts and other business Com 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

46 ,

S t r e e t , L o n d o n , E .C

C annon

THIS

recent letter to the

press,

whether

n u r s e s w e r e r e a l l y in s h o r t s u p p l y o r w a s it t h a t t h e r e w e r e n o t

e n o u g h h a n d s to run the h o s p ita ls still d o m in a t e d b y the cu sto m s and architecture of I 8 6 0 ? The s i t u a t i o n in t h i s r e s p e c t is still o p e n to d i s c u s s i o n , and

opinions

The

f o llo w i n g from the letter referred

takes

the

matter

still

differ

widely.

to ca lls for

“ N o one k n o w s w h a t duties a nurse

to train

perform or h o w

professional

nurse.

l o n g it

conse

quence, every duty not d e v o lv in g on doctor, m e d i c a l s t u d e n t , p o r t e r o r c h a r w o m a n is r e l e g a t e d

N UM BER.

...

the q u e s ti o n w a s a s k e d

m a y p r o p e r l y be a s k e d

E d it o r ia l —

P e rs o n n e l for S e rv ic e

Service.

quotation.

Telegraphic Address — “ Twenty-four, London." Telephone— City 3 f i o . CONTEN TS

P e rs o n n e l for

...

to the

nurse

skilled

care,

heaven

and

training, w hile

m aking hell

in o u r

all the

the sick,

hospitals.

the

sim ple

difference is

m ore

but

between

and

lacking

It is h a r d l y s u r p r i s i n g

that an intelligent girl or a d em obilised service w om an see k in g a career turns a w a y from n u rsin g

...

o r i f s h e c h o o s e s it q u i t s b e f o r e q u a l i f y i n g .

S .J.A .B . H e a d q u a rte rs a n d D istric t R ep o rts

...

every hundred entrants

R ailw ay A m b u lan ce N ew s

...

101

S t a t e r e g is t e r e d n u rs e s p re p a re d to p ra ctise n u r s ing. U n t i l t h a t l e a k a g e is s t o p p e d recruiting

•

101

cam paigns

...

102

th a t there will be no p r o g r e s s

...

102

training becom es

103

a n d s tep s s h o u l d be tak en i m m e d i a t e l y to r e g u la t e the co n ditio n s u n d e r w h ie h nurses live and w o rk .

C h ild C o n so la tio n

...

S t. J o h n A m b u la n c e A ss o c ia tio n

P rio ry fo r W a le s

...

T y p h u s F e v e r a n d L ice

...

G i f t f r o m A m e r i c a n A m b u l a n c e ... L e tte rs to th e E d ito r

...

F r e e M e d ic a l A id fo r F a c to r y W o r k e r s Q u e r ie s

an d

A n sw er s

...

•

...

C orrespondents

...

103

It s h o u l d

are

futile.” in

not

The

than

suggestion

is m a d e

u n t i l e v e r y n u r s e in

reality a stud en t of

be possible,

it is

O u t of

40 b e c o m e

said,

nursing

perm it

the

s t u d e n t of n u r s i n g to d e v o t e the w h o l e o f h e r tim e

:—

nursing-training,

elim inating

entirely

duties

F r a c t u r e of R ib s a n d C la v icle

...

106

E x am in atio n H o w ler

...

106

M e m b e r s h ip of B r ig a d e

...

106

P o iso n in g by D .D .T .

...

106

needs and circum stances

M ilitary H o sp ita l R e se rv e

...

106

be a d e q u a t e as a b a sic n u r s i n g t r a i n i n g q u a l i f y i n g

A c tio n of P r u s s ic A cid

...

106

. .

...

108

f o r e g o i n g , it i s i n t e r e s t i n g t o n o t e t h a t , w i t h t h e object of assisting hospitals, b enevolent ho m e s and

...

•••

108

s i m i l a r in stitu tio n s to o b ta in a n d m a in t a in s u it a b le

■■■

108

...

108

A sphyxia an d B u rn ed B ack Insect S tin g s R eview s

...

B ritis h R e d C ro ss S o ciety

...

a sso ciated w ith the m a in te n a n c e of m e n t , in w h i c h e v e n t a p r o p e r l y grated training

two

the e s t a b l i s h planned inte

y e a r s in h o s p i t a l

preceded

b y a t e c h n ic a l a n d scien tific c o u r s e a d a p t e d to the

for

State

dom estic has

set

of the

exam ination.

staffs, the up

Council

of each candidate H aving

Victorian

Consultative will

regard

State

Council.

be to a d v i s e

the

w ould to

the

Governm ent The

duties

M in iste r as

9«

F I R S T

to the most effective methods of securing adequate female personnel for service as full-time em ployees for all Government subsidised hospitals and benevolent homes, and such other hospitals, benevolent homes and institutions as the Ministers may determine. The Council will also establish and conduct an organisation to be known as the Institutional Community Service, membership of which shall be open to all females (except salaried employees) employed in full-time work at Govern ment subsidised hospitals and benevolent homes and institutions.

Child Consolation. B y J.

SCOTT.

L a st m o n th , i h a d q u ite a lo t to say , on th e in te re s tin g s u b je c t of “ C o n s o li n g y o u r p a t i e n t . ” I h o p e y o u f o u n d it in te re s tin g a n d m y r e m a r k s u sefu l to re m e m b e r. S in c e th e n h o w e v e r , I h a v e h a d m o r e t h a n o n e p e r s o n a s k m e if 1 t h o u g h t s u c h r e m a r k s a n d a c tio n s w o u ld a p p ly to ch ild c o n s o l a t i o n , a n d t h e t r e a t m e n t of t h e m . W e l l , a s a m a t t e r of f a c t, I d i d t h i n k of t h a t , w h e n 1 co m p iled th e n a rra tiv e , b u t I also th o u g h t th a t th e h a n d lin g of j u n i o r s , w h e n t h e y a r e p a t i e n t s , r e q u i r e s a s t o r y e n tir e l y to th em selv es. Y o u s e e , a lo t d e p e n d s u p o n t h e p e r s o n a l i t y of th e c h ild in q u e s tio n . A g e a lso p la y s a la rg e p a rt. In fact, I t h i n k it w o u l d b e a s w e ll if w e a r r a n g e d t h e p a t i e n t s i n t o a g e g r o u p s , s a y , G r o u p A , 4 t o 8 y e a r s ; G r o u p B , 9 t o 11 y e a r s ; a n d G r o u p C , 12 y e a r s a n d u p w a r d s . B e fo re th e a g e of 4 y e a rs, th e m a jo r ity of c h ild re n , o r p e rh a p s I s h o u ld say, b ab ies, d o re s p o n d to ad v ic e a n d c o n s o latio n fro m th e p a re n t o r a d u lt v ery read ily . If t h e y h a v e p a i n , o r s o m e in ju r y , it is n o t l o n g b e f o r e t h e c o m f o r t i n g w o r d s t h a t a r e s a i d to t h e m , d o e s a ll t h a t is r e q u i r e d t o q u ie te n o r so o th e. A f t e r t h a t a g e , t h o u g h , t h e y s e e m to c u l t i v a t e a c e r t a i n a m o u n t of s e lf s y m p a t h y , e s p e c i a l l y if t h e y a r e w h a t is k n o w n a s “ s p o ilt.” T h e u sual rem ark s such as “ N e v e r m i n d , i t w i l l s o o n b e b e t t e r , ” o r “ T h a t ’s n o t h i n g — o n ly a s c r a t c h , ” j u s t d o e s n o t d o a t h i n g to a p p e a s e , a n d in th e c a s e of s o m e c u ts o r b ru is e s — u n til s o m e fo rm of d r e s s in g is a p p l i e d , a l a r m a n d a g i t a t i o n i s g r e a t . I t is a n a w k w a r d t i m e , t h i s 4 to 8 p e r io d a n d o n e fin d s it v e r y d iff ic u lt to d o t h e r i g h t t h i n g , e v e n a t t h e r i g h t t i m e ! A lso, a s I h a v e a l r e a d y m e n tio n e d , p e r s o n a li ty e n te r s th e q u e s t i o n a lo t. O n e c a n d o little fo r t h a t t u m m y p a in , o r t h a t c u t f i n g e r , if t h e c h i l d is b a d l y s p o i l t , a n d s o w i l l n o t t a k e n o t i c e o f a n y t h i n g s a i d t o it. T h e o n ly h o p e you have, is, t h a t y o u b e i n g m o r e o r le ss a s t r a n g e r to t h e p a ti e n t, m a y a t t r a c t a c e r ta in a m o u n t of in te re s t, a n d so m a y b e ta k e th e c h i l d ’s m i n d o f f t h e t r o u b l e . I t s o m e t i m e s “ w o r k s ” if y o u a d d r e s s y o u r r e m a r k s t o t h e p a r e n t i n t h e c h i l d ’s h e a r i n g , s a y i n g s u c h t h i n g s a s “ T h i s c u t ( o r w h a t e v e r it m a y b e ) w ill b e b e tte r in a d a y ” o r “ S o m e w a r m w a t e r b a t h i n g w ill so o n cure th is.” I t is n o t a c a s e of t r y i n g to c o n v i n c e t h e c h ild d ir e c tly , r a t h e r is it a m a t t e r o f l e a d i n g i t t o b e l i e v e w h a t y o u i n t e n d it to , b y m e a n s of g e t t i n g it a c t u a l l y t h i n k i n g o n t h e s e lin es. F o r in s ta n c e , s u p p o s e th e ch ild h a s s u s ta in e d a la c e ra te d k nee- c a p a s a r e s u lt of f a llin g o n a p a tc h of g ra v e l. The w o u n d w ill of c o u rs e r e q u ir e c le a n in g . A s you a re d o in g th is, it w o u ld b e a g o o d p la n to d is c u s s th is a c tio n w ith th e p a r e n t , o r w h o e v e r m a y b e in c h a r g e of t h e c h ild . Y o u c o u ld s a y , “ D o e s n ’t l o o k n e a r s o b a d w h e n i t s c l e a n e d u p , d o e s it ? ” a n d all th e tim e y o u a r e c le a n in g th e w o u n d , th e child

A I D is s e e i n g t h e i m p r o v e d a p p e a r a n c e , a n d s t r a i g h t a w a y fe e ls b e t t e r a b o u t it. W h e n w e c o m e t o t h e B G r o u p , w e f i n d a d i f f e r e n c e , in t h a t m o s t l y , t h e c h ild is m o r e i n t e r e s t e d in t h e a c t u a l c o m p la in t o r in jury . If it b e t h e l a t t e r , w e o fte n d i s c o v e r th e p a tie n t a c tu a lly e x a m in in g th e w o u n d a n d s o m e tim e s even t o u c h i n g it. In fact, I k n e w of a g ir l w h o w a s a c tu a lly p u l lin g t h e s id e s of a c u t a p a r t b e c a u s e s h e w a n t e d a s c a r to show . ( T h is h a p p e n e d to be a “ b litz ” c a s u a lty ). If y o u r c a s u a lty b e a g irl, s h e w ill e x p e c t a n d a p p re c ia te a c e r t a i n a m o u n t of s y m p a t h y , m o r e so , if t h e i n j u r y b e in a p la c e t h a t h a s a r i s k of d i s f i g u r e m e n t . A boy, how ever, lik e s t o b e t o l d t h a t h e is “ t o u g h ” a n d t h a t h e* is e x p e c t e d to “ ta k e it.” O n e m e th o d t h a t a p p lie s to n e a r ly a ll th e g r o u p s (an d a d u l t s !) i s t o g e t t h e m t o h e l p y o u t h e m s e l v e s . L e t th e m h o ld th e s c is s o rs , o r let t h e m b a t h e th e ir w o u n d th e m s e lv e s , a n d o th e r su ch th in g s . D o n ’t t r y t o “ k i d ” p a t i e n t s i n t h i s last g ro u p . I r e m e m b e r w h e n I w a s a b o u t 11, I h a d a n a c c i d e n t a n d h a d t o h a v e five s t i t c h e s in m y h e a d . I d o n ’t r e m e m h e r if l o c a l a n a e s t h e s i a w a s i n u s e i n t h o s e d a y s , o r if th e d o c to r ju s t did n o t tro u b le, b u t I k n o w I n early ju m p e d off th e c h a i r w h e n th e first n e e d le w e n t in. M y m o th e r w as w i t h m e a t t h e t i m e , a n d w h i l e t h e d o c t o r s a i d n o t h i n g a t all, s h e s a id “ o n ly fo u r m o re , c a n y o u s tic k it ? ” B eliev e it or n o t, th o s e fo u r w e re n o t h a lf so b a d , b e c a u s e I w a s p re p a re d for th e m . 1 k n e w t h a t I w a s to h a v e fo u r a n d n o m o re , a n d I m a d e m y s e l f s t i c k it. I do re m e m b e r th e d o c to r say in g b e f o r e h e s t a r t e d , “ N o w t h i s w o n ’t h u r t m u c h . ” So you see , a f te r th e first s titc h , I lo s t all c o n fid e n c e in h im , a n d n e v er a g a in w a n te d to see h im . Y o u w ill fin d it m u c h m o r e d iffic u lt to g a i n t h e c o n fidence of a ch ild t h a n t h a t of a n a d u lt. I f y o u r p a t i e n t is w ith o th e r c h ild r e n a t th e tim e , th e n m a k e u s e of th e m . T h e y a r e v e ry m u c h m o re e a g e r to h e lp t h a n a d u lts , a n d a re fu ll o f t h e i r o w n i m p o r t a n c e w h e n t h e y feel t h e y a r e d o i n g s o m e t h i n g to h elp .

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C o u n c i l l o r J . W . C o c k c r o f t r e c e n t l y c o m p l e t e d 21 y e a r s ’ serv ice a s P r e s id e n t of th e H e b d e n B rid g e C e n tre of th e S t. J o h n A m b u l a n c e A s s o c ia tio n , a n d a t th e a n n u a l m e e tin g o n T h u r s d a y , F e b r u a r y 7t h , h e w a s p r e s e n t e d w i t h a n i n s c rib e d silv e r c ig a r e tte case, b e a r i n g h is m o n o g r a m , in a p p r e c i a tio n of h is serv ices. C o r p s S u r g e o n J . R . B. D e a r d e n presid ed . C o rp s S u p t. H . N a y lo r sa id C o u n . C o c k c ro ft h a d been a g e n e ro u s a n d h a r d -w o rk in g p resid en t. D iv . S u p t. E . S ta n sfie ld recalled th a t C o u n . C o ck cro ft w a s tra in e d fo r a m b u la n c e w o rk d u r i n g th e B o e r W a r . As p re sid en t he h a d b een fa r m o re th a n a fig u re-h ead , a n d h ad h e l d office l o n g e r t h a n a n y of h is p r e d e c e s s o r s . D iv . S u p t. M rs. M . S utcliffe, in h a n d i n g o v e r th e g ift, d escrib ed C o u n . C o ck cro ft as th e “ f a t h e r ” of th e A sso ciatio n . C o u n . C o c k c ro ft, in re p ly , s a id t h a t s in c e th e lo c a l a s s o c i a t i o n w a s f o r m e d i n 1887 t h e r e h a d b e e n f o u r C o r p s S u r g e o n s — D rs . B rad ley , C airn s, P o llard a n d D e a rd e n , an d f o u r P r e s i d e n t s — M e s s r s. D . J. C ro s sle y , E . C ro ssle y , A. R . C ro ssle y a n d him self.

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N o . SS ( S o u t h a i . l - N o r w o o d . ) — O f f i c e r s a n d m e m b e r s of t h e a b o v e D i v i s i o n s t o o d in s ile n c e fo r t w o m i n u t e s a s a trib u te to th o s e m e m b e rs w h o d id n o t r e tu r n fro m th e w a r, a t th e first p e a c e -tim e a n n u a l g e n e r a l m e e t i n g of th e D iv is io n a t th e ir h e a d q u a rte rs , H a v elo c k -ro ad , S o u th all, on F e b ru a ry 12t h . S u p t . J . E . T a y l o r w a s i n t h e c h a i r . In h is r e p o rt th e s e c re ta ry , A m b u la n c e O fficer G . E . J. C o x , s ta t e d t h a t a l t h o u g h th e s tr e n g th of th e D iv isio n h a d d r o p p e d t o 89 m e m b e r s d u e t o r e s i g n a t i o n s , t h e w o r k i n g s tr e n g th of th e D iv isio n h a d n o t d e te rio ra te d . A t p resent t h e r e w e a e s t i l l 37 m e m b e r s i n t h e F o r c e s . T h e n u m b e r of c a s u a l t i e s a t t e n d e d to a n d r e p o r t e d in c o n n e c t i o n w i t h l o c a l d u t i e s w a s 117 , w h i c h , t h e s e c r e t a r y th o u g h t, w as “ good g o in g .” H e rem in d e d m em b ers, h o w e v e r , t h a t t h e r e w a s still p le n ty of w o r k to do. I n th e a b s e n c e of M r. W . F . B illett, M r. C o llin s g a v e t h e l a t e s t n e w s o f t h e D i v i s i o n ’s b u i l d i n g f u n d . T h is now s t o o d a t £ 1 , 062 , a n d h e f e l t t h a t t h e t i m e w a s c o m i n g w h e n d iscu ssio n o n th e b u ild in g sh o u ld co m m e n ce . A lth o u g h ,£ 7 ,0 0 0 w o u ld be n eeded, h e th o u g h t th a t fu n d s w o u ld soon c o m e in o n c e th e first tw o y e a r s of p e a c e , a d ifficu lt p e rio d , w e re over. I n o th e r r e p o r ts it w a s s ta t e d t h a t th e fin a n c ia l p o sitio n of th e D iv isio n w a s v e ry h e a l th y . T h e B rig ad e am b u lan ce h a d c o v e r e d 4,919 m i l e s d u r i n g t h e y e a r , r e m o v i n g 57 c a s e s . T h e to tal a m o u n t realised by th e jo in t e n te rta in m e n t c o m m i t t e e d u r i n g t h e y e a r w a s ,£ 1 6 9 4 s . I d . A m b u la n c e C a d e t O fficer G . G re e n re p o rte d t h a t m e m b e r s h i p n o w c o m p r i s e d 36 c a d e t s a n d 10 p r o b a t i o n e r s . I n h is first re p o r t, B a n d m a s t e r J . G a lv in s ta t e d t h a t th e n ew ly fo rm e d c a d e t b a n d w h ic h c o m p rise d 20 m e m b e rs , w a s p r o g r e s s i n g s a tisfa c to rily a n d t h a t its m e m b e r s w e re a t t e n d

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in c lu d in g o n e m e m b e r w h o , a p a id r e g u la r d riv er, h a d c o n t r i b u t e d 113 h o u r s o f h i s o w n t i m e t o t h e d u t y . D iv . S u p t. G . W i l l o u g h b y g a v e a s p e c ia l w e lc o m e to a n u m b e r of m e m b e rs p re sen t, re c en tly re le a se d fro m th e F o r c e s , a n d to o n e still s e r v i n g w i t h t h e R . A . F . Som e had a lr e a d y h a s t e n e d to e x c h a n g e t h e i r b a t t l e - d r e s s fo r t h e o ld , fa m ilia r b la c k -a n d -w h ite , o th e rs w o u ld do so a s soon a s fresh u n ifo rm s w e re av ailab le. O fficers fro m n e ig h b o u r in g A m b u l a n c e D i v i s i o n s a n d t h e 63 ( T w i c k e n h a m ) N u r s i n g D i v i s i o n also received a w elco m e. T h e e v en in g con clu d ed w ith lig h t re fre sh m e n ts d isp en sed by m e m b e r s of th e N u r s in g D iv isio n .

County of Bedford. L u t o n W a r d o w n . — O v e r 80 m e m b e r s a n d f r i e n d s o f t h e N u r s i n g D i v i s i o n g a t h e r e d o n S a t u r d a y , F e b r u a r y 23 r d , a t a s u p p e r a n d so c ia l a t th e L e a g r a v e C o -o p e ra tiv e H a ll, to c e l e b r a t e t h e D i v i s i o n ’s t h i r d b i r t h d a y . I n a s h o r t ta lk , M r. W . H . W e a t h e r h e a d . C o u n ty O fficer, to ld of s o m e of th e a c h i e v e m e n ts of th e N u r s i n g D iv is io n f r o m i t s s t a r t i n 1943 w i t h 12 m e m b e r s . T h e r e w e r e n o w 23 m e m b e r s . L a s t y e a r t h e r e w e r e 27 , th e d e c re a s e b e in g d u e to th re e h a v in g ta k e n u p fu ll-tim e h o s p ita l w o r k a n d a n o t h e r h a v i n g left L u t o n . O n e of th e n u r s i n g c a d e ts a tta c h e d to th e D iv is io n h a d a lso t a k e n u p h o sp ital w o rk . I n t h e c a d e t s e c t i o n , f o r m e d i n O c t o b e r , 1943 , f i v e m e m b ers h a d b e co m e G ra n d P rio rs, a n d sev eral c a d e ts h a d g r a d u a t e d in to th e N u r s i n g D iv isio n . M r. W e a th e r h e a d m e n tio n e d t h a t th e effo rts of th e m e m b e r s h a d r a i s e d m o r e t h a n .£ 3 5 f o r D i v i s i o n f u n d s a t a h e ad q u a rters bazaar. A v o te of th a n k s to M r. W . A. S te v e n s, S u p t. of th e A m b u la n c e D iv isio n , a n d M rs. S te v e n s, S u p t. of th e N u r s i n g D iv isio n , w a s p ro p o s e d by M iss E . R o se , D iv . S e c r e ta r y , a n d s e c o n d e d b y S e rg t. C. B est. A m o n g th e g u e s t s w e r e D iv . S u r g e o n D r. T . L lo y d a n d M rs. L lo y d , C o rp s O fficer R . E lliso n a n d M rs. E lliso n . D a n c in g w a s to th e M e tro p h o n e D a n c e B a n d .

in g p ractice reg u la rly .

T h e c a d e t b a n d , u n d e r t h e d ir e c tio n of B a n d m a s t e r J. G a lv in , m a d e its first p u b lic a p p e a r a n c e in th e b o r o u g h o n W e d n e s d a y e v e n i n g , F e b r u a r y 13 t h , w h e n i t t o o k p a r t i n a v a rie ty c o n c e rt g iv e n a t th e M ay p o le In s titu te , S o u th a ll, by t h e A . E . C . D r a m a t i c a n d M u s ic a l S e c tio n in a id of th e band.

N o . 84 ( T w i c k e n h a m ) . — T h e a n n u a l m e e t i n g o f t h e a b o v e D iv isio n , h e ld a t th e H o llies, T w i c k e n h a m , o n F e b r u a r y 4t h , w a s p r e c e d e d b y a n i n s p e c t i o n o f t h e A m b u l a n c e a n d C a d e t D iv isio n s. T h e m e e tin g w h ic h follow ed, w a s p re sid ed over by C o u n cillo r C. W . B e c k e tt, J .P . , w h o w e lc o m e d M rs. E d g a r O l l i s , w i d o w o f t h e D i v i s i o n ’s l a t e p r e s i d e n t . C o m m e n d i n g t h e r e p o r t of C a d e t S u p t. A. C o o k , w h o a n n o u n c e d a h u n d r e d p e r c en t, in c re a s e in m e m b e r s h ip , A re a C a d e t O fficer E . J. G a rro d e x p re sse d h is a p p re c ia tio n a n d h o p e d fo r a n ev en g r e a te r in c re a se d u r in g th e e n s u in g year. A m b u la n c e O fficers G . E w e r a n d W . C h a n d le r re p o rte d o n t h e a c t iv itie s of t h e T w i c k e n h a m ( H . Q . ) a n d W h i t t o n S e c tio n s re sp ec tiv e ly , a n d , a l t h o u g h th e fig u r e s of d u tie s a n d c a s e s w e r e c o m m e n d a b le , e a c h officer h o p e d t h a t t h e effo rts of th e ir se c tio n s w o u ld b e in c re a se d . S e rg t. F. B lo w s, th e S e c re ta ry , s ta te d th a t th e n u m b e r o f c a s u a l t i e s t r e a t e d h a d d e c r e a s e d f r o m 804 i n t h e p r e v i o u s y e a r t o 768 . I n d iv i d u a l effo rts of s o m e of t h e m e m b e r s w e re g r e e t e d w i t h a c c la m a tio n , b u t it w a s p o in te d o u t t h a t n o t all d u tie s c o u ld b e re c k o n e d in th e to ta l. M e m b e rs h a d d ev o te d 3,391 h o u r s o f v o l u n t a r y s e r v i c e t o t h e B o r o u g h A m b u l a n c e ,

County of Berkshire. R e a d i n g C o r p s . — O n M o n d a y , F e b r u a r y 11 t h , a s o c i a l a n d d a n c e w a s h eld by th e R e a d in g C o rp s a t th e T o w n H a ll, R e a d in g . I t w a s o r g a n is e d a n d r u n b y th e C o rp s S o cial C o m m i t t e e a n d a t t e n d e d b y a b o u t 490 m e m b e r s o f t h e B r ig a d e a n d th e ir frien d s. M u sic w a s p ro v id e d b y th e P ic cad illy D a n c e O rc h e s tr a . R e fre sh m e n ts w e re p ro v id ed by th e lad ies of th e C o m m itte e . N in e p riz e s w e r e g iv e n in raffles o r g a n i s e d by M r. E . F . C. H a r v e y w h ic h r a i s e d £ 1 5 for th e fu n d s.

R e a d i n g N u r s i n g C o r p s . — O n S a t u r d a y , F e b r u a r y 2n d , m e m b e r s of D i v i s i o n s in t h e R e a d i n g N u r s i n g C o r p s v is ite d W i n d s o r in c h a r g e of C o rp s S u p t. M iss E . C . S u d u l. They v i s i t e d S t . G e o r g e ’s C h a p e l a n d t h e G a r t e r C h a p e l . The p a rty w e re a fte rw a rd s e n te rta in e d to te a b y W in d s o r N u r s in g D iv isio n a t B rig a d e H e a d q u a r te r s .

C adet N ew s. R e a d i n g C o r p s . — O n S a t u r d a y , F e b r u a r y 9t h , a t t h e A m b u la n c e H a ll, C h a t h a m S tr e e t, R e a d i n g , a first a id c o m p e titio n w a s h e ld b e tw e e n t e a m s of A m b u la n c e a n d N u r s i n g C ad ets. T h e b o y s w e r e c o m p e t i n g fo r t h e C lifford W e l l i n g s Cup. T h re e te a m s en tered , th e w in n e rs b e in g te a m N o. 7 fro m R e a d in g G re a t W e s te rn D iv isio n s ectio n “ B ” w ith 250 m a r k s o u t o f a p o s s i b l e 310 . T h e g irls e n te re d fo u r te a m s for th e R y la n d C u p , th e w i n n e r s b e :n g t e a m N o . 245 m a r k s ,

2 fro m R e a d in g W e s t D iv isio n w ith

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T h e c u p s w e re p r e s e n te d , to th e b o y s b y N u r s i n g O fficer M rs. V . M . C ro fts, a n d to th e g ir ls by C o u n ty O fficer (N ) M iss D. K . G ib b in s. T h e ju d g e w a s th e A ssistan t C o u n ty C o m m i s s i o n e r (M r . F . A. C. J a r v i s ) , a s s i s t e d b y m e m b e r s of th e C o u n ty S ta ff a n d R e a d in g C orps.

C o o k h a m . — O n W e d n e s d a y , F e b r u a r y 20 t h , a p a r t y w a s h e ld by m e m b e r s of th e N u r s i n g C a d e t D iv isio n . A b o u t 40 cad e ts a n d th e ir m o th e rs atte n d ed . T h e e v e n in g co n siste d m o s tly of g a m e s a n d d a n c i n g . A fancy d ress co m p etitio n w a s ju d g e d by M iss G ib b in s a n d M rs. P ic to n - W a r lo w for w h ic h th re e p rizes w e re a w a r d e d . R efre sh m e n ts w ere pro v id ed . M r s . K e e t i n g , m e m b e r in c h a r g e of t h e D iv is io n , w a s re s p o n sib le fo r th e v ery e n jo y a b le e v en in g .

R I D w o u l d b e in t h e f r o n t r a n k , fo r it w a s t h e i r d e s i r e to b r i n g t h e C o r p s b a c k to t h e s t a t e of e ffic ie n c y b o t h in e q u i p m e n t , d rill, d u t y a n d e v e r y t h i n g a p p e r t a i n i n g to first a i d w o r k t h a t p r e v a i l e d i n B l a c k b u r n b e f o r e S e p t e m b e r 3 r d , 1939 . W ith t h e co o p e r a tio n of all t h e ir m e m b e r s th is c o u ld b e a t ta i n e d . S g t. H . A rk w rig h t, a re tu rn e d m e m b e r from H .M . F o rc e s , r e s p o n d e d , a n d sa id h e a p p r e c ia te d all t h a t h a d b een d o n e for th e m e n w h ils t th e y h a d b e en a w a y o n S e rv ic e an d fo r th e h o m e ly w e lc o m e s h o w n to th e m t h a t e v e n in g . They w a n te d to se ttle d o w n to th e w o r k w h ic h w o u ld te n d to m a k e it fe e l l i k e h o m e . T h e r e s t of t h e e v e n i n g w a s s p e n t in a s o c ia l m a n n e r , s in g in g a n d d a n c in g until m id n ig h t. C o u n ty

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o f H a m p sh ire.

G o s p o r t a n d D i s t r i c t . — T h e M a y o r of G o s p o r t (A id. J . R . G r e g s o n ) e x p r e s s e d o n S a t u r d a y , F e b r u a r y 23 r d , h i s a d m i r a tio n of G o s p o r t a n d D is tric t C o rp s . T h e o c casio n w a s th e a n n u a l r e u n io n a n d so cia l, h e ld in C la r e n c e H a ll. C o r p s S u p t. A. T . S t a r e s s a id t h e i r p r e s e n t d ifficu lty w a s t h e s h o r t a g e of d o c to r s to l e c tu r e to c la ss e s . M r. S ta re s p re s e n te d D iv isio n a l re p o rts o n A lv ersto k e, G o sp o rt, F a re h a m , L ee-o n -S o len t, a n d S a risb u ry . S p e a k i n g o n th e N u r s i n g D iv isio n s, M r. S ta r e s s a id a h e a d q u a rte r s ’ ru lin g w a s th a t th ey sh o u ld fo rm th eir o w n C o r p s b u t it h a d n o t b e e n p o s s ib le t o d o t h i s in G o s p o r t , a n d t h e B r i g a d e w e r e h o p i n g to w o r k in c o - o p e r a tio n w it h t h e N u r s i n g a n d N u r s i n g C a d e t D iv isio n s. G o s p o r t C o r p s h a d a m e m b e r s h i p o f 198 m e n a n d 120 c a d e ts , a n d t h e N u r s i n g D iv is io n s w e r e a l m o s t of t h e s a m e stre n g th . T h e M ayor, w h o w as a cc o m p a n ie d by th e M ayoress, p r e s e n t e d a V i c e - P r e s i d e n t ’s w a r r a n t t o t h e R e v . W . J . F le tc h e r C a m p b e ll (S a r is b u r y D iv isio n ), a n d w a s t h a n k e d by C o u n ty O fficer O . J . F r a n c is .

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B l a c k b u r n .— A s u b j e c t t h a t h a s o c c u p ie d t h e m i n d s of m a n y o fficials a n d m e m b e r s o f t h e S . J . A . B . , b o th a t U n i t a n d A re a m e e tin g s, h a s been, w h a t c a n be d o n e to a s s u re th a t th e re tu rn in g B rig a d e m e m b e rs from H .M . F o rces a g a in ta k e a n a c tiv e p a r t in t h e w o r k of A m b u la n c e C o rp s a n d D iv isio n s ? B l a c k b u r n C o r p s , 80 o f w h o s e m e m b e r s h a v e b e e n s e r v i n g e i t h e r in t h e N a v y , A r m y o r A ir F o r c e , a n d o t h e r s in C iv il D e f e n c e U n i t s , a r r a n g e d a W e l c o m e H o m e to th o s e w h o h a v e a lre a d y re tu rn e d , on T h u r s d a y ev en in g , F e b ru a ry 28 t h , a t t h e A m b u l a n c e H a l l , P r i n c e s S t r e e t , B l a c k b u r n . E v e r y r e t u r n e d m e m b e r w a s in v ite d to b r i n g h is w ife o r a frien d , a n d s u p p e r w a s la id fo r 210 g u e s ts , th e ta b le s b e in g v e ry ta s te f u lly d e c o r a te d , in c lu d in g th e silv er tr o p h i e s of th e C orps. C o rp s S u r g e o n D r. D . E . A sp in , M .B ., C h .B ., m a d e th e p le a s a n t a n n o u n c e m e n t th a t A ssis ta n t C o m m is sio n e r M ajo r M a c k e n zie h a d been h o n o u re d by th e a p p o in tm e n t of C o m m a n d e r of th e O r d e r of S t. J o h n . P r o p o s in g th e to a s t of all m e m b e r s o f th e B l a c k b u r n C o r p s w h o h a d se r v e d in H .M . F o rce s, C o rp s S u p t. R . H . H a r r is o n , S .B .S t.J ., e x te n d e d a h e a rty w e lc o m e to th o se w h o h a d re tu rn e d , re m e m b e rin g also th o se w h o h a v e yet to re tu rn a n d w ith a fe e lin g of s a d n e s s , th o s e w h o w ill n e v e r r e tu r n . H e w e n t o n to lo o k in to th e f u tu r e w ith its m a n y d ifficul ties. R e o r g a n is a tio n , h e said, m ig h t see m slo w b e c a u s e th e y c o u ld o n ly d o w h a t th e y w e re a llo w e d to do, a n d n o t w h a t th e y w a n te d to do, o r w o u ld lik e to do. T h e re m ig h t b e a l t e r a t i o n s in t h e n e a r f u tu r e , b o th in u n i f o r m s a n d o t h e r e q u ip m e n t, a lso te x t b o o k s w o u ld p ro b a b ly b e rev ised . T h e y c o u ld r e s t a s s u r e d t h a t w h a te v e r c h a n g e s h a d to b e m a d e in t h e i n t e r e s t o f a m b u l a n c e w o r k , B l a c k b u r n C o r p s

o f W o rc este r.

N o r t h e r n A r e a . — T h e O f f i c e r s a n d N . C . O . ’s o f t h e N o rth e rn A re a N u rs in g C o rp s sp e n t a very en jo y a b le tim e a t a so cia l w h ic h w a s h e ld in th e A m b u la n c e H a ll, L y e, on S a t u r d a y , F e b r u a r y 9th . G a m e s w e re p la y e d a n d th e e v e n t w a s a very successful o n e , p a r tic u la r ly f r o m t h e s o c ia l p o in t of view .

H i l l a n d C ak e m o re.— T h e a n n u a l m e e tin g of th e N u r s i n g D iv is io n w a s h e ld in t h e C lin ic R o o m , L o n g L a n e , H il l a n d C a k e m o r e , o n T u e s d a y , F e b r u a r y 5th . D iv. S u p t. M iss D y e w a s in th e c h a ir. S h e stated th a t a start w as now b e i n g m a d e w i t h t h e M e d i c a l C o m f o r t s D e p o t , a n d i t is e x p e c t e d to b e of s e r v ic e to t h e r e s i d e n t s of t h e d i s t r i c t in t h e n e a r fu tu re. In o r d e r to o b ta in a d d itio n a l m e m b e r s , a H o m e N u r s in g C la ss w o u ld b e c o m m e n c e d sh o rtly . T h e S e c r e t a r y i n h e r r e p o r t s a i d t h a t 42 p r a c t i c e s h a d b e e n h e l d d u r i n g t h e y e a r w i t h a n a v e r a g e a t t e n d a n c e of 10. M e m b e r s h a d p e r f o r m e d 216 h o u r s o f h o s p i t a l d u t y a n d 54 h o u r s of clin ic w o rk . S o m e m e m b e rs h a d b e en called upo n to a c t a s b lo o d d o n o rs . A t t e n d a n c e s h a d a l s o b e e n m a d e in c o n n e c tio n w ith w e lfa re w o r k fo r a f te r-c a re of S e rv ic e m e n . 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 t h a t t h e f i n a n c e s w e r e in a s a tisfa c to ry co n ditio n. A fter C o rp s S u p t. M iss A sh to n h a d a d d re s s e d th e m e m bers, lig h t re fre s h m e n ts w e re served.

B r i e r l e y H i l l . — T h e m e m b e r s of t h e N u r s i n g D iv isio n h e ld a d in n e r a t th e A lm a H o te l, B rie rle y H ill, o n T u e s d a y , F e b r u a r y 12 t h . A m b . S i s t e r M r s . Y o r k e ( m e m b e r - i n - c h a r g e ) presid ed . A fter a n e x c e lle n t re p a st, C o rp s S u p t. M iss A sh to n said t h a t s h e w is h e d to t h a n k th e m fo r in v itin g h e r. T h e y , of t h e B r i e r l e y H i l l N u r s i n g D i v i s i o n , w e r e a t t h e e n d of o n e p e rio d a n d a t th e b e g i n n i n g of a n o t h e r in th e ir h isto ry . M rs. T o n k s , w h o h a d g iv e n th e m y e a r s of g o o d se rv ic e h a d re s ig n e d h e r p o sitio n a s D iv isio n al S u p t. a n d th e y h a d p re v a iled u p o n M rs. Y o r k e to t a k e c h a r g e . S h e h o p e d t h a t all th e m e m b e r s w o u ld g iv e M rs. Y o r k e th e ir b a c k i n g a n d help, s o t h a t t h e D iv is io n w o u l d ris e to g r e a t e r h e i g h t s in th e fu tu re. C o u n ty S u r g e o n C a m p b e ll said th a t h e w ish ed to e x p re ss a p p r e c ia tio n fo r th e y e a r s of g o o d serv ice w h ic h M rs. T o n k s h a d p erform ed. T h e y w e r e all s o rry t h a t s h e h a d r e s ig n e d f r o m th is p o s itio n b u t w e r e g l a d s h e w o u ld still r e m a i n a m em ber. H e w o u ld lik e to w e lc o m e M rs. Y o rk e a s M e m b e rin -C h arg e. S g t. M rs. B ailey th e n p re s e n te d a h a n d s o m e g o ld b a n g le to M rs, T o n k s a s a m a r k of e s te e m fro m th e m e m b e r s of th e D iv isio n . M rs. T o n k s th a n k e d th e m e m b e r s for th e ir m a g n ific e n t g ift, w h ic h s h e w o u ld d e ep ly tre a s u r e . W est

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H a r r o g a t e .— H o n o u r e d b y th e p re s e n c e of th e M a y o r a n d M ayoress, C o u n cillo r a n d M rs. J . S. T e n n a n t, th e

F I R S T a n n u a l p r e s e n t a t i o n of a w a r d s o f t h e A m b u l a n c e D i v i s i o n w a s h e l d o n F r i d a y , F e b r u a r y 15 t h , i n C h r i s t C h u r c h M i s s i o n H all. T h e M a y o r s t a t e d t h a t h e w a s p r o u d of t h e S t . J o h n o r g a n i s a t i o n w h i c h h a d t h e a s s e t o f o v e r 800 y e a r s o f t r a d i t i o n , g o i n g b a c k t o t h e K n i g h t T e m p l a r s i n 1113 A . D . , o n e of w h o s e h e a d q u a r t e r s w a s T e m p l e N e w s a m , n e a r L e e d s. H e th e n p r e s e n te d a w a r d s , i n c l u d i n g first a id a n d h o m e n u r s i n g c e r t i f i c a t e s , a n d l a y i n s t r u c t o r ’s c e r t i f i c a t e s . D r. G o d fre y th e n p re s e n te d th e H o m e G u a r d C u p to th e w in n ers, P tes. K n o w les a n d A sh to n — th e tw o y o u n g e s t m e m b e rs of th e D iv isio n . T h e M a y o r e s s p re s e n te d to S g t. L ifford, th e c u p for h a v i n g p e r f o r m e d th e h ig h e s t n u m b e r of p u b lic d u tie s d u r i n g 1945 . C p l . S t e e l e w a s u n a b l e t o a t t e n d t o r e c e i v e t h e c u p fo r h a v i n g tr e a te d th e m o s t first a id c a s e s d u r i n g th e y e ar. E ig h t boys w e re e n ro lled in to th e c ad e ts, th e c e re m o n y b e in g c o n d u c te d by C a d e t S u p t. B in k s. T h e sm artest cadet of th e y e a r h a d b e e n a d j u d g e d to b e C a d e t J o h n G o w e r , a n d C a d e ts R. B ra d le y , A rc h e r a n d M a s o n received th e tro p h y fo r th e c a d e t a n n u a l first a id c o m p e titio n . D r. L o d g e t h a n k e d th e p e o p le of H a r r o g a t e fo r th e ir s u p p o r t, a n d s ta te d t h a t G e n e r a l S ir C live L id d e ll w a s to in s p e c t th e N o r th e r n D iv is io n s of th e W .R . Y o r k s h ir e on S a t u r d a y , M a y 18 t h , p r o b a b l y i n o r n e a r t h e n e i g h b o u r h o o d of H a r r o g a t e . M r. J a ll a n d (V ice P r e s id e n t) s a id h e h o p e d t h a t w h a t e v e r liq u id w a s p u t in to t h e H o m e G u a r d C u p ( r e p u t e d to h o l d f iv e p i n t s ) i t w o u l d r e p r e s e n t f i v e p i n t s o f j o y f o r t h e p re s e n t a n d su ccessiv e h o ld ers. R e f r e s h m e n t s ( in c l u d i n g ice c r e a m fo r t h e c a d e ts ) w e r e th e n s erv ed , a n d a f te r w a r d s , d a n c i n g to th e m u s ic of th e N e w R h y th m O rc h e s tra c o n tin u e d u n til m id n ig h t.

H u D D E R S F iE L D .^T h e H u d d e rsfie ld C a d e t A m b u la n c e a n d N u r s in g D ivisions e n te rta in e d th e ir p a re n ts o n F rid ay , M a r c h 1s t a t t h e F r a t e r n i t y H a l l . T h e e n te rta in m e n t w as preceded by a n e n ro lm e n t cere m o n y , w h e n se v e n n e w c a d e ts w e re e n ro lle d b y A sst. C o m m is s io n e r H . H a r r is o n , of th e S o u th W e s t e r n A re a of th e W . R . of Y o rk s . P r e l i m i n a r y first a id c e rtific a te s w e r e p r e s e n t e d to th r e e n e w m e m b e r s a n d six first a id a n d th r e e h y g ie n e c ertific a te s to o th e r m e m b e r s b y C o u n c illo r D . J. C a r tw r ig h t, O .B . E . , w h o p resid ed . A c u p fo r th e m o s t efficient N u r s i n g C a d e t of t h e y e a r , k in d ly g iv e n b y C o u n ty N u r s in g C a d e t O fficer M rs. C u m m in g - B e ll, w a s p r e s e n te d to N u r s i n g C a d e t E . H e lla w e ll. I n h is a d d re s s C o u n c illo r C a r t w r i g h t s p o k e v e ry h ig h ly of th is p a r t i c u l a r k in d of y o u th w o r k , w h ic h n o t o n ly tr a in e d y o u t h s to b e b e t t e r c itiz e n s b u t t r a i n e d t h e m w i t h a n e n d in v ie w — to b e a b le to g iv e sk ille d a s s is ta n c e to th e in ju r e d w hen needed. T h e sp len d id e n te rta in m e n t w h ic h follow ed w a s g iv e n e n tire ly b y th e C a d e ts , a n d in c lu d e d d a n c e s , m o n o lo g u e s , p ia n o d u e t s a n d e x h ib itio n s in first aid . A n o th e r in t e r e s t i n g ite m w a s a F i r s t A id Q u iz , w ith V i c e - P r e s id e n t D . L . T o w n e n d a s q u e s ti o n m a s t e r a n d D iv . S u p t. E . W a l k e r a n d S ta f f S e r g t. A. T o n y a s a d j u d i c a t o r s . P re s id e n t H . T y a s w a s a lso p resen t. T h e a r r a n g e m e n ts w e re m a d e by C a d e t O fficers C. T o n y a n d G . R o b e rts, N u r s in g C a d e t O fficers M iss B e rry a n d M iss L e u ta s .

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S w i n d o n . — I n a n effort to re v iv e p r e - w a r e n t h u s i a s m , t h e G . W . R . S w i n d o n D i v is io n of t h e S . J . A .A . h e l d a first a i d c o m p e t i t i o n , t h e f i r s t s i n c e 1939 , o n F e b r u a r y 28 t h . T h e c o m p e t i t i o n w a s w e l l s t a g e d a n d c r e d i t is d u e t o a l l w h o to o k p art. O v e r 500 s p e c t a t o r s w a t c h e d t h e c o n t e s t a n d w e r e a g r e e a b l y im p r e s s e d a t th e h i g h s t a n d a r d of th e w o r k done. D r. R . B. H i c k a n d D r. F r o g g a r t , b o th of th e G . W . R . M e d ic a l F u n d S o ciety , w e r e t h e a d ju d ic a to r s , a n d th e c o m p etitio n w a s o rg a n is e d by th e D iv isio n a l C o m m itte e . B o y s of a lo cal s c o u t tr o o p a n d M is s K . S ty le s w e r e c o n g r a t u l a t e d fo r a fine d i s p l a y of a m a t e u r a c t i n g in t h e i r ro le a s p a tie n ts. M r. K . J. C o o k , L o c o m o tiv e W o r k s M a n a g e r , s u p p o r te d b y M r. H . C o lto n , A s s is ta n t C a r r i a g e W o r k s M a n a g e r , p r e s e n te d th e silv e r c h a l le n g e tr o p h ie s to th e first a n d s e c o n d team s. M r. C o o k c o n g r a t u l a t e d e v e r y b o d y o n a v e ry fine effort a n d e m p h a s is e d th e im p o r ta n c e of m o r e y o u n g peo p le t a k i n g u p first a id w o rk . T h e w i n n e r s , t o g e t h e r w i t h t h e p o i n t s s c o r e d , w e r e :— J . D i x o n T e a m , 207 p o i n t s ; E . M c G o v e r n , 205 ; M r s . D . J o y n e s ( a l l l a d i e s ) , 196 ; A . K i n g , 193 ; W . B e n n e l l , 181 ; F . N e w m a n , 179 £ ; A . J o n e s , 142 ; A . C o l e m a n , 137 . S O U T H E R N T h e S o u t h e r n R a i lw a y F in a l C o m p e titio n w ill b e h e ld o n F r i d a y , A p r i l 26 t h , a t t h e E d r i r h H a l l , B o r o u g h P o l y t e c h n i c , B o r o u g h R o a d , L o n d o n , S . E . 1. A d m i s s i o n is b y t i c k e t o n ly , a n d m a y b e o b t a i n e d f r o m M r. E d g a r U zzell, W e l f a r e O fficer, S o u th e rn R ailw ay , W a t e r l o o S t a t i o n , S . E . 1.

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A bergavenny. T h e C a d e t D iv isio n at A b e rg a v e n n y h a s m a d e g o o d p ro g r e s s u n d e r th e in s p ir in g le a d e r s h ip of S u p t. D e n n is E v a n s . T h e re w as a p leasin g g a th e rin g a t th e A m b u la n c e H a ll on T u e s d a y e v e n i n g , F e b r u a r y 5t h , w h e n p r e s e n t a t i o n s w e r e m a d e of c e rtific a te s a n d w a r r a n t s of a p p o in tm e n t. C adet S u p t. D e n n is E v a n s p resid ed a n d w a s s u p p o rte d by th e M a y o r ( A ld e r m a n M a x B e v e rid g e , J . P . ) , a n d m e m b e r s of th e T o w n C o u n c il, etc. C o rp s S u p t. D e n n is E v a n s , in h is a n n u a l r e p o rt, s ta t e d t h a t t h e p r e s e n t s t r e n g t h w a s 66 i n c l u d i n g officers. T h is c o m p a r e d w i t h 49 f o r 1944 a n d 27 w h e n " h e t o o k o v e r i n A u g u s t , 1944 . T h o s e b e t w e e n 16 a n d 17 h a d b e e n p l a c e d i n a ‘‘ s t u d e n t ” g r o u p w ith a v iew to th e f o r m a t io n of a S tu d e n t D iv isio n . D rills w e re h eld d u r i n g th e y e a r a n d th e a v e r a g e a t t e n d a n c e w a s 45. E x c e p t t h r e e w h o w e r e il l a l l t h e b o y s s e c u re d th e ir p ro ficien cy s t a n d a r d fo r th e y e ar. D u r in g th e y e a r tw o co m p etitio n te a m s w ere ru n , a n d th e y h a d b e en sec o n d on sev e ra l o c ca sio n s, a n d h a d p roved th a t th e y w e re u p to c o m p e titio n s ta n d a r d . H e w o u ld w el c o m e th e d o n a tio n of tw o s h ie ld s fo r c o m p e titio n w ith in th e ir o w n D iv isio n , o n e for in d iv id u a l c o m p e titio n a n d o n e for te a m w ork. T h e boys w o u ld lik e to h a v e a “ b a n d ” a n d th e y w e re a n x io u s to h e a r of a s e t of i n s t r u m e n t s w h ic h c o u ld b e o b ta in e d a t a r e a s o n a b le p rice. T h e y h a d h a d one sp len d id offer of a s s i s t a n c e a n d th e y w o u ld w e lc o m e o th e r s . H e w as g r a t e f u l t o t h e o f f i c e r s a n d n . c . o . ’s f o r t h e i r a s s i s t a n c e a n d t o t h e b o y s f o r t h e i r l o y a l t y a n d t h e p a r e n t s f o r t h e i r confidence.

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T h e M a y o r in th e c o u rs e of h is r e m a r k s s a id h e w o u ld l i k e to d o s o m e t h i n g f o r t h e m d u r i n g h i s y e a r of o ffice a n d h e w o u ld be p le a se d to p re s e n t th e m w ith a sh ield fo r c o m petitio n . I t w o u ld b e a g e s t u r e of h is in te r e s t in a w o n d e rfu l m o v em en t. C o u n c i l l o r G . H . T r a n t e r s a i d t h e C o r p s S u p t . ’s r e p o r t w a s a g r e a t t r i b u t e to th e o fficers a n d b o y s . H e w as sure th e r e w e re su fficien t b o y s in A b e r g a v e n n y to b u ild u p th e o rg a n is a tio n to 100 a n d h e lo o k e d fo rw a rd to th e tim e w h e n th e y h a d a re ally g o o d b an d . C o u n c i l l o r E . H a r v e y p r e s e n t e d t h e 1s t y e a r c e r t i f i c a t e s a n d M i s s G e t h i n D a v i e s t h e 3r d y e a r c e r t i f i c a t e s . S h e said t h a t th e A m b u la n c e C a d e ts w a s o n e of th e m o s t vital Y o u th m o v e m e n ts e x is tin g in A b e rg a v e n n y . It w as a m o v em en t w b ic h lin k e d th e w h o le w o rld . W a l l e t s w e r e p r e s e n te d to th e m e m b e r s of th e t e a m w h o w e r e r u n n e r s - u p in th e S o u t h W a l e s B o r d e r C o rp s c h a m p io n sh ip .

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years ago. - O n c e h a v i n g s e t t l e d o n m a n , t h e l o u s e h a s n e v e r left h im a n d h a s s h a r e d th e t r i u m p h s a n d v ic is situ d e s of m a n k in d th ro u g h o u t th e ag es. S o clo se a r e th e tie s t h a t th e lo u s e itse lf is k ille d by th e R ic k e tts ia g e r m , b u t, u n f o r t u n a te ly , n o t b efo re th e in fectio n h a s b e en p a ss e d o n to its h o st a n d b e n efacto r. S o d e p e n d e n t is t h i s littl e p a r a s i t e o n m a n t h a t if i t f a l l s o f f i t w i l l d i e i n a v e r y s h o r t t i m e u n l e s s a n o th e r h u m a n b e in g h a p p e n s to be n e a r a t h a n d . W hen e n t o m o l o g i s t s w i s h t o k e e p l i c e i n t h e l a b o r a t o r y , t h e y f i n d it b e s t t o e m p l o y t h e m e t h o d V a n L e e u w e n h o e k i n v e n t e d in 1673 , a n d t h a t i s t o k e e p t h e m c o n t i n u o u s l y s t r a p p e d t o t h e i r l e g s in s m a l l pill b o x e s — w e ll h i d d e n f r o m p u b l i c v ie w , of c o u r s e 1 I n t e r m i t t e n t f e e d i n g d o e s n o t a n s w e r s o w e ll, t h e lice b e c o m e la n g u id , sick ly , a n d e v e n tu a lly a h ig h m o rta lity resu lts. O n th e w a r m , m o is t b o d y of m a n c o n d itio n s a re id eal fo r th e m a n d m o s t n a tu r a l e n e m ie s a re av o id ed . S h elter, a b u n d a n c e of fo o d a n d e v e n t e m p e r a t u r e a n d h u m i d i t y m a k e fo r a t r a n q u i l e x is te n c e , a n d th e y live a n d m u ltip ly to th e ir g r e a t c o n te n tm e n t. L i c e h a v e a t t a i n e d t h e h e i g h t s of p a r a s i t i c e x i s t e n c e , e n a b l i n g th e m to d is p e n s e w ith all t h o u g h t of th e m o r r o w a n d th e d r u d g e r y of h a v i n g to w o r k fo r d a ily b re a d . They h a v e , of c o u rs e , b e e n e q u a lle d by p a r a s ite s of h u m a n o rig in , th ey h o ld th is a g a in s t th e ir im ita to rs th a t th e y do n o t prey o n th e ir o w n sp ecies.

(To be concluded.')

( C o n tin u e d Jrom p a g e 9 1 . ) T h e r e a r e m a n y k i n d s of lice, a ll of t h e m h i g h l y a d a p t e d to a p a r t i c u l a r g e n u s of a n in a l o n w h ic h th e y feed. T his a d a p t a t i o n , o r h o s t s p e c ific ity , a s it is c a l l e d , h a s g o n e s o f a r th a t e n to m o lo g is ts h a v e on o c ca sio n h a d to c o rre c t o rn ith o lo g is ts in th e c la ss ific a tio n of c e r ta in lo u s e h o s ts. T h i s , of c o u r s e , is v e r y i m p o r t a n t b e c a u s e it m e a n s t h a t lic e w ill d ie o r f a r e b a d l y in t h e a b s e n c e of t h e i r n o r m a l b e n e f a c to r . W h e n y o u r d o g , f o r e x a m p l e , b e c o m e s i ll t h e l i c e o n h i m m a y m u ltip ly e n o rm o u s ly fo r v a rio u s re aso n s. Y o u are c e rta in to n o tic e th e m , s m a ll g re y is h , slo w , flatten ed c re a tu re s a n d u n l e s s y o u k n o w a b o u t t h e s e t h i n g s t h e r e is s u r e t o b e c o n s t e r n a t i o n a n d f e a r t h a t th e y w ill b ite y o u a n d y o u r fa m ily . T h e r e is, h o w e v e r , n o n e e d to w o r r y a b o u t th is b e c a u s e th e d o g lo u s e c a n o n ly live o n d o g s . T h e s a m e a p p lie s to th e c h ic k e n , p ig , e le p h a n t a n d h u m a n louse. H u m a n lice a r e d iv id e d in to v a rie tie s a c c o r d i n g to th e site w h ic h th e y o c cu p y , n a m e ly , “ P e d ic u lu s h u m a n u s c o rp o ris ” th e b o d y lo u se a n d “ P e d ic u lu s h u m a n u s c a p itis ” th e h e a d louse. T h e r e is a t h i r d lo u s e liv in g o n m a n — th e u tte rly d u ll, in s ig n ific a n t a n d u n in te re s tin g p u b ic lo u se p o p u larly k n o w n as th e “ c ra b lo u se.” I t is a v e r y d i s t a n t re lativ e of th e m o re ex alted “ P e d ic u lu s h u m a n u s ,” b u t th e re th e lik e n e ss sto p s. O n e m a y a s w ell c o m p a r e A tilla, “ th e d r e a d o f th e w o rld , th e s c o u r g e of G o d fo r th e c h a s tis e m e n t of C h r is tia n s ,” w ith th e s n e a k th ie f w h o p in c h e s y o u r h a t w h i l e y o u a r e s e t t l i n g t h e w o r l d ’s p r o b l e m s o v e r a g l a s s o f beer. H e a d a n d b o d y lice u s u a ll y k e e p to th e i r r e s p e c tiv e “ s p h e r e s of in f lu e n c e ,” b u t o c c a s io n a lly “ p e a c e fu l p e n e t r a tio n ” t a k e s p la c e a n d in te r b r e e d in g re s u lts in fertile o ffsp rin g . T h e tw o v a rie tie s a r e th e re fo re clo sely re la te d . T h e i r life cycles a r e th e s a m e a n d th ey b o th tra n s m it ty p h u s ; th e m e th o d s of c o n tro l n a t u r a l l y d iffer v e ry w id ely . W e d o n o t k n o w w h e n th e lo u s e first b e c a m e a d e p e n d e n t of m a n , b u t it m u s t h a v e b e e n in th e d a r k a n d d i s t a n t p ast. T h e y have, h o w ev er, b een preserv ed on m u m m ie s d u g u p in E g y p t a n d A m e ric a . T h i n k of th e scen e w h e n t h e e x c i te d a rc h a e lo g is ts , a f t e r y e a r s of to il, u n lid t h e s a r c o p h a g u s of a g r e a t P h a r o a h a n d find th e r e o n h is e x a lte d b o d y o r in th e s e a m s of h is s a c r e d v e s tm e n ts th e h u m b l e p ro le ta ria n lo u se, th e c o m p a n io n of tr a m p s a n d refu g ees,

Gift from American Ambulance. T h e A m e r i c a n A m b u l a n c e in G r e a t B r i t a i n , w h i c h is b e i n g w o u n d u p a fte r a d is tin g u is h e d r e c o rd of w a r serv ice, h a s m a d e a g i f t o f £ 25,000 f r o m i t s s u r p l u s f u n d s t o t h e M i d d l e sex H o sp ital. T h e f u n d w ill b e u s e d b y t h e h o s p i t a l to e n d o w tw o s in g le -b e d w a r d s , to w h ic h m e m b e r s of th e staff of th e A m e r ic a n E m b a s s y a n d o th e r U n ite d S t a t e s ’ citizen s w ill h a v e first c la im . A t a n i n f o r m a l c e r e m o n y , in t h e b o a r d r o o m o f t h e h o s p i t a l r e c e n t l y , t h e c h e q u e f o r £ 25,000 w a s h a n d e d t o C o l o n e l J . J . A s t o r , c h a i r m a n of t h e b o a r d o f m a n a g e m e n t , b y M r. G ilb e r t H . C a r r , w h o is a c t i n g a s j o in t l i q u id a t o r (w ith M r. C. G lid d o n O s b o rn e , w h o w a s u n a v o id a b ly a b se n t), of th e A m e r ic a n A m b u la n c e . C o lo n e l A sto r, g i v i n g t h a n k s fo r t h e gift, a ls o h a n d e d to M r. C a r r a w r itt e n a c k n o w l e d g m e n t in w h ic h w e r e set o u t th e p u p o s e s to w h ic h t h e m o n e y w ill b e d e v o te d . O th e r s , C o l o n e l A s t o r s a i d , h a d a l r e a d y e x p r e s s e d t h e n a t i o n ’s t h a n k s f o r t h e m a g n i f i c e n t w o r k of t h e A m e r i c a n A m b u l a n c e . It w a s in th e h o u r of o u r g r e a t e s t n e e d , w h e n o u r c ir c u m s t a n c e s w e r e b l a c k a n d , in d e e d , d e s p e r a t e , t h a t a g r o u p of A m e r i c a n c i t i z e n s i n L o n d o n c o n c e i v e d a n d c r e a t e d it. T h a t p r a c tic a l h e l p a n d g e s t u r e of g o o d w ill a n d f a th in u s a t s u c h a tim e w a s a th in g w e could n e v er fo rg et. H e f o u n d it d i f f i c u l t , C o l o n e l A s t o r c o n t i n u e d , t o v o i c e t h e h o s p i t a l ’s g r a t i t u d e f o r t h e £ 25 , 0 00 . T h e y w e r e e sp e c ia lly g l a d to t h i n k t h a t it w o u l d p e r p e t u a t e t h e g o o d r e la tio n s w h i c h h a d a lw a y s ex isted b e tw ee n th e h o sp ital a n d th e A m e ric a n E m b a s s y a n d in d iv id u a l A m e r ic a n s in L o n d o n . T h e y w o u ld a l w a y s r e g a r d it a s a n h o n o u r to s e r v e to t h e b e s t of t h e i r a b ility a n y A m e r i c a n c itiz e n in n e e d of h o s p it a l t r e a t m e n t . S u r g e o n R e a r - A d m i r a l S i r G o r d o n G o r d o n - T a y l o r , in t h e c o u rs e of a f u r t h e r tr i b u te to th e w o r k of th e A m e r ic a n o r g a n i s a t i o n d u r i n g ' h e w a r , s a i d t h a t w h e n t h e C o l l e g e of S u rg e o n s w a s b ad ly d a m a g e d , a n d th e H u n te ria n M u se u m a lm o s t d e stro y ed , th e A m e ric a n A m b u la n c e c a m e to th e ir a id w i t h 78 a m b u l a n c e s a n d r e m o v e d 26,000 s p e c i m e n s t o v a r i o u s p a rts of th e co u n try .

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CAN HAVE M O RE MILK cattle diseases cost us 198,000,000 gallons of milk a year, war or peace— this is enough to provide every childin the country with six extra glasses of milk a week. By reducing cattle diseases we can have much more milk. Inthe fight against animal diseases many weapons are needed and one of the most important is iodine. The Iodine Educational Bureau is helping in the hattle, for it has recorded and collated all the literature accumulated over the last 138 years on the use of iodine in animal health. It is able to provide veterinary surgeons and farmers with advice and information on the uses of iodine in animal care. Yet big as this task may appear, it is only part of the Bureau’s activities. The same service is

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Letters to the Editor. “ C O N S O L A T IO N ear

T h e B u re a u is re a d y to assist a n y in s titu io n , com m er c ia l e nterprise, v e te rin a ry s u rg e o n o r f a r m e r w ith in fo r m a tio n a b o u t io d in e . T h e re is no c h arg e f o r th is service.

E d u c a t io n a l

W e a r e in n o w a y re s p o n sib le fo r th e o p in io n s e x p re s s e d , o r th e s ta te m e n ts m a d e , b y C o rre s p o n d e n ts .— E d ito r.

provided to Medicine and Industry, the two principal users of iodine.

C R IT IC IS M .

,—

I n th e a rtic le h e a d e d “ C o n s o l a t i o n ” of F e b r u a r y issu e o f F i r s t A id , I fin d m y s e lf r e p e a t e d l y a s k i n g t h e q u e s ti o n “ T o w h o m th e co n so latio n ? ” H a d th e c o m m e n ts not been p r o lo g u e d by th e d e fin ite h is to ry of a n a c t u a l c ase , o n e c o u ld h a v e fo llo w e d th e r e m a i n d e r w i t h a c e r ta in a m o u n t of in te re s t, b u t a s it s o a p p e a r e d , w e ll, to m e it w a s d i s t a s t e f u l . A re w e n o t a ll c o n s i d e r e d t o b e o f s o m e h e l p in t h e P u b l i c S e r v i c e a n d n o t to be s o u g h t o u t in d iv id u a lly ? Y e t w e find a s e lf c o m m itte d o c c a s io n p u t in to b la c k a n d w h ite , o n e of u t t e r alo o fn ess, w h e n surely, th e re a n d th e n , w a s th e o p p o rtu n e ti m e to b r i n g in to effect th e v ir tu e s t h u s e x p o u n d e d . T o m e th e id e a s e e m s p re p o s te ro u s to be c o n fro n te d “ s i m u l t a n e o u s l y ” w ith p r e s u m a b l y a n o t h e r first a id e r, a t w h a t o n e c a n w ell i m a g i n e to b e a “ s t i c k y ” p r o b le m , a n d y e t w i t h o l d o n e ’s a b i l i t y , a n d i n d e e d , s h a l l o n e s a y , p r o w e s s in d e a l in g w ith s u c h m a tte r s . F u r th e r m o re , ev en a fter a n a d m i t t e d c all fo r h e lp f r o m t h e first a id e r , n o re s p o n s e e m a n a te d s a v e th a t of a silen t, c ru e lly critic a l a tte n tio n on every m ove m ad e, or not m ad e, by o ne w h o w a s “ up a g a in s t it.” S u re ly , to s ta n d b y th e w h o le p ro c e e d in g s w ith o u t offer i n g a n y k in d of h elp , m o r a l o r p h y sic a l, a s J. W . S c o tt s p e a k s of, s h o u l d n o t g o u n c h a l l e n g e d , s i n c e i t is t h e v e r y rev erse of o u r tea ch in g s. H e s a y s “ T h e first a id e r w o re n o b a d g e of d is tin c tio n ! ” So w h at ! H e d o e s n ’t s a y h e h a d o n e o n e i t h e r , b u t w h a t effect w o u ld t h a t h a v e h a d o n t h e is su e , I w o n d e r ? H ad he u m p e d in a l o n g w ith th e “ d e s p a ir i n g first a i d e r ” a t th e

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207 STONE HOUSE B I S H O P S G A T E L O N D O N , E . G . 2

tim e , a n d a p p lie d h is “ a r t ” in a p r a c tic a l fo r m , e v e ry o n e c o n c e r n e d m i g h t h a v e g o n e a w a y t h e b e t t e r o ff , t h e p a t i e n t s fo r th e ir tr e a t m e n t , th e h e lp e r for a s o u n d le s s o n b y J . W .S ., a n d th e la tte r for a n u n c o m f o r ta b le tim e w ell s m o o th e d o u t. A s i t w a s , a c c o r d i n g t o h i s r e p o r t , I ’m a f r a i d t h e s t a t e m e n t o f “ I c h i n k m o s t c e r t a i n l y I w o u l d , e t c . , e t c ...................... ” d o e s n o t t a l l y w i t h t h e a c t i o n , n e i t h e r is t h e r e a n y c o m p r o m i s e . H o w e v e r , it is f a i r to a s s u m e t h a t t h e d e s p a i r i n g f ir s t a i d e r , s h o u ld h e re a d “ C o n s o la tio n ,” m a y c o llect th e p a lm s for b e in g a re sp o n siv e a n d w illin g v o lu n te e r.— Y o u rs sin cerely , W.

Ashmore.

B u lw ell, N o ttm . M a r c h S t h , 1946 .

Free Medical A id for Factory W o rk e rs T h e S t . J o h n ’s A m b u l a n c e B r i g a d e o f t h e G o o d y e a r T y r e a n d R u b b e r C o m p a n y ’s f a c t o r y a t W o l v e r h a m p t o n a r e s t a r t i n g a m e d ic a l s c h e m e in th e n e a r f u tu r e to h e lp G o o d y e a r w o r k e r s l o o k a f t e r t h e i r f a m i l i e s w h e n t h e y b e c o m e il l. A ll t h a t w ill b e n e c e s s a r y in t h e n e a r f u t u r e w ill b e fo r t h e w o rk e r to a s k th e fa c to ry h o sp ita l to se n d a m e m b e r of th e S .J .A .B . to h is h o m e , a n d th e n e c e s s a r y m e d ic a l a s s i s t a n c e w ill b e g iv e n . U n d e r th e s c h e m e , t h e h o s p ita l w ill a ls o lo a n th e G o o d y e a r w o rk e r su ch m ed ical re q u isite s a s b e d p a n s , a ir rin g s , b e d re sts , fe e d in g c u p s, a n d so fo rth . T h e S .J.A .B . p e r s o n n e l u s e d in th is s c h e m e w ill b e m e n w h o , s in c e “ D ” D a y , h a v e ten d e d w o u n d e d s e rv ice m e n a t th e R o y al W o lv e r h a m p to n H o s p ita l, a n d w h o a r e n o w e n g a g e d in th e C iv ilian A m b u la n c e S erv ice of th e h o sp ita l. T h e s c h e m e is s u p p o r t e d b y b o t h t h e M a n a g e m e n t a n d t h e s h o p s t e w a r d s , a n d is u n d e r t h e p e r s o n a l s u p e r v i s i o n of th e facto ry n u rses.

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Queries and Answers to Correspondents 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 t o p l e f t - h a n d c o r n e r of t h e e n v e l o p e “ Q u e r y , ” a n d a d d r e s s e d t o F i r s t A i n , 46 , C a n n o n - s t r e e t , L o n d o n , E . C . 4 .

2.— A ll 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 of p a p e r o n ly .

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 i n t h i s c o l u m n i s t h e 39 t h ( 1937 ) E d i t i o n of t h e S . J . A . A M a n u a l of F i r s t A id to th e In ju r e d .

A I D u n t i l V E d a y , I w e n t u p t o H e a d q u a r t e r s five t i m e s a lth o u g h tw ic e n o b o d y w a s th ere, b u t m a n a g e d to g e t th re e a tte n d a n c e s for th e o th e r tim e s. I d id 5 h o u rs d u ty for V J d a y a n d tw o h o u rs d u ty on A rm istice D ay. A lso I w e n t u p a n d p a s s e d m y e x a m i n a t i o n fo r t h a t y e a r. 1 h a v e n o t d o n e a n y f u r t h e r in th e m a t t e r y e t ; b u t I s h o u ld lik e y o u r c o m m e n ts. I m y s e l f t h i n k w e s h o u ld h a v e a B o a r d o f o fficers to t h r a s h o u t c a s e s lik e th ese. O th e r w is e w e w ill be l o s i n g g o o d m e n in t h e f u t u r e . B u t if I d o h a n d i n m y u n i f o r m I s h a l l s till c a r r y o n w i t h y o u r b o o k , w h i c h in m y o p in io n h a s b e e n a f r ie n d to u s first a id e r s ; a g a i n t h a n k i n g y o u fo r y o u r ad v ice. O n y o u r s t a t e m e n t of fa c ts it w o u ld s e e m t h a t t h e d e c isio n is c o r r e c t a n d b a s e d o n B r ig a d e G e n e r a l R e g u la tio n s. If h o w e v e r y o u s till feel d i s s a t i s f i e d y o u h a v e t h e r i g h t t o a p p e a l to t h e C o u n t y C o m m i s s i o n e r . — E d it o r .

F ractu res o f B ib s an d C la v ic le . C.

K . ( E d m o n to n ) .— A t a re c e n t D iv isio n a l P ra c tic e w e h a d a c a s e in w h i c h t h e p a t i e n t h a d s u s t a i n e d f r a c t u r e s of rib s a n d f r a c tu r e d clav icle, b o th in ju r ie s o n s a m e side. H a v i n g tre a te d th e fr a c tu re d clav icle a n d fra c tu re d rib s in th e u s u a l w ay , w e d is cu s s e d th e c ase a n d decid ed th a t th e t r e a t m e n t of th e f r a c tu r e d clav icle w o u ld h a v e a g g r a v a t e d th e fr a c tu re d rib s a n d th a t w h a t w e sh o u ld h a v e d o n e w a s j u s t to lo o sen th e b r a c e o n th e in ju r e d s id e a n d to s u p p o r t th e a r m in a l a r g e a r m s lin g , th e r e b y s u p p o r t i n g th e p a tie n t on th e in ju r e d sid e. W o u ld you p lease g iv e u s y o u r ru lin g ?

I f I h a d t o t r e a t t h i s c o m b i n a t i o n of i n j u r i e s , I w o u l d c a re fu lly re m o v e th e c o a t, lo o sen th e b ra c e a n d th e n a p p ly tw o b ro a d b a n d a g e s ro u n d th e b od y to s te a d y a n d s u p p o rt th e fr a c tu re d rib s. T h i s d o n e I w o u ld s u p p o r t th e lim b in a S t. J o h n s lin g (w h ic h w o u ld n o t p re ss on th e fra c tu re d c la v icle a s w o u ld th e s m a ll a n d la r g e a r m s lin g s) a n d I w o u ld s te a d y th e e lb o w by m e a n s of a b r o a d b a n d a g e p a s s e d ro u n d elb o w a n d tru n k . I w o u ld n o t a t t e m p t to lever o u t a n d d ra w b a c k t h e s h o u l d e r a s is s u g g e s t e d fo r a n u n c o m p l i c a t e d f r a c t u r e o f c l a v i c l e i n R u l e 4 o n p . 81 o f t h e T e x t b o o k ; a n d I w o u ld o m it th e p a d in a r m p it. F in ally , I w o u ld w ra p p a tie n t in h is c o a t, a d o p t th e a p p ro p ria te m e a s u r e s fo r th e tr e a t m e n t of s h o c k a n d a r r a n g e fo r sp e e d v tra n s p o rt to h o sp ita l. — N. C o rb e t F le tc h e r.

E xa m in atio n H ow ler. M .B . (C a m b rid g e ).— In a re c e n t H o m e N u rs in g E x a m in a tio n th e d o c to r a s k e d o n e c a n d i d a te w h y th e c lin ical t h e r m o m e t e r i s p l a c e d i n t h e p a t i e n t ’s m o u t h . H e w as m u c h a m u s e d w h e n in a ll i n n o c e n c e s h e r e p lie d — “ To

stop the p a tie n t ta lk in g ! ” Good!

N e x t , p l e a s e ! !— N . C . F .

P o iso n in g b y D.D.T. C . D . ( M i n e h e a d ) . — A c a s e h a s b e e n r e p o r t e d o f a 19 m o n t h s o ld ch ild b e in g fa ta lly p o is o n e d by d r i n k i n g fr o m a b o ttle of 5 p e r c e n t. D . D . T . a n d c ru d e p a ra ffin , th e a m o u n t t a k e n b e i n g a b o u t o n e fluid o u n c e . T e sts proved th a t it w a s t h e D D . T . n o w u s e d a s a h o u s e h o l d i n s e c t i c i d e , a n d n o t th e p araffin , w h ic h c a u se d d e a th . W ill y o u p le a s e tell m e w h a t t r e a t m e n t a first a i d e r s h o u ld h a v e re n d e re d h a d h e b e en called to th e c ase ? M y i n f o r m a t i o n is t h a t t h e p r e c i s e f o r m u l a of D i c h l o r D ip h e n o l T r ic h lo r e th a n e h a s n o t b e en p u b lis h e d ; th a t o n ly 5 p e r c e n t, s o lu ti o n s a r e o n s a le a t t h e c h e m i s t s ; a n d t h a t it a c ts a s a n ir r ita n t p o iso n . F u r t h e r , in its u s e a s a n in s e c ti c id e it is f r e e ly d i l u t e d b y t h e a d d i t i o n of p a r a f f in . I n t h e s e c i r c u m s t a n c e s it w o u l d s e e m t o m e t h a t t h e v ic tim in th e c a s e w h ic h y o u q u o te w a s m o s t u n lu c k y ; a n d t h a t in t h e o r d i n a r y c o u r s e of e v e n t s t h e s m a l l q u a n t i t y of D .D .T . w h ic h c o u ld be s w a llo w e d w o u ld be u n lik e ly to p ro d u c e p o is o n o u s effects, b e c a u s e of t h e d ilu tio n w i t h p a ra ffin w h ich w o u ld cau se v o m itin g . S h o u ld , h o w ev er, p o iso n in g o c c u r , t h e n t r e a t m e n t is a s f o r a n i r r i t a n t p o i s o n . — N . C . F .

M ilita ry H ospital R ese rv e. C .S . ( M a n c h e s te r ) .— I jo in e d th e M ilita ry H o s p i ta l R e s e rv e ( S . J . A . B . ) i n 1934 , a n d d i d m y a n n u a l t r a i n i n g a t t h e R o y a l H e r b e r t H o s p i t a l e a c h y e a r t o 1939 i n c l u s i v e . I n 1939 , a t t h e o u t b r e a k o f h o s t i l i t i e s , I w a s c a l l e d u p a n d s e rv e d in th e R .A . M .C . , b o th h o m e a n d o v e r s e a s (E x P . O .W .) u n til I w a s d e m o b ilis e d in S e p te m b e r 1945 , a n d r e j o i n e d m y D i v i s i o n t h e s a m e w e e k . I u n d e r s t a n d t h a t t h e r e is a s e r v i c e a w a r d fo r M . H . R . p e r s o n e l a s t h e r e is fo r R . N . A. S. B. R . p e r s o n e l. If so, c a n y o u let m e k n o w th e q u a lific a tio n s a n d n e c e s s a r y p r o c e d u r e to b e a d o p t e d in a p p l y i n g fo r sam e ?

M e m b e r s h ip of B rigad e. P .P . ( H o m e C o u n tie s). — W ill y o u p le a se p a ss y o u r c o m m e n ts o n th e fo llo w in g fa c ts fo r m e ? I h a v e s e r v e d 13 y e a r s in th e S t. J o h n A m b u la n c e B r i g a d e a n d I h o ld 2 L .C .C . c ertific a te s also . R ec e n tly I h a d a letter fro m m y S u p e r i n t e n d e n t te llin g m e to h a n d in m y u n if o r m a s I w a s i n e f f i c i e n t f o r t w o y e a r s , 1944 - 1945 . W e l l , i n 1944 I w a s o n d u t y e v e r y d a y o r n i g h t w h e n I w a s a t h o m e , a n d if t h e r e w a s a n y i n c i d e n t i n o u r n e ig h b o u rh o o d I a lw a y s w e n t to see w h a t a s s is ta n c e 1 c o u l d g i v e ; a n d , a s y o u k n o w , w e h a d p l e n t y of in c id e n ts in o u r d istric t w h e n th e fly in g b o m b s w e re c o m in g over. T h a t s a m e y e a r I w e n t u p to o u r H e a d q u a r t e r s , a d i s t a n c e o f 12 m i l e s , a n d p a s s e d m y e x a m in a tio n for th a t year. A g a i n , i n 1945 , I w a s o n d u t y

W e a r e n o t a w a r e o f a n y s p e c i a l a w a r d f o r m e m b e r s of B r i g a d e R e s e rv e s ; b u t y o u a r e e n title d to th e W a r S e rv ic e M ed al, a p p lic a tio n for w h ic h c an b e m a d e th r o u g h y o u r u n it o r to th e R .A .M .C . R e c o r d O ffice.— E d it o r .

A ction of P ru ssic A cid . N .M . ( H u ll) .— R e c e n tly I w a s ta k e n to ta s k for s a y in g th a t p r u s s i c a c i d is a c o r r o s i v e p o is o n . F o r th is re a so n I s h a l l b e g r a t e f u l if y o u w i l l t e l l m e w h a t t y p e o f p o i s o n it is a n d h o w it a c t s . T h e T e x t b o o k ( p . 170 ) t e l l s u s t h a t p r u s s i c a c i d i s a c o n v u ls a n t (o r p o te n t n e rv e ) p o iso n a n d t h a t it “ a c ts o p th e

F I R S T

ASTHMA, BRONCHITIS CATARRH, HAY FEVER

R I D

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and o th er R espiratory Sufferers should com m unicate w ith British M edica Laboratories, Ltd., fo r particulars of “ Sanolen ” the most efficacious Hom e R em edy known to Medical Science : N o w being used w ith rem arkable success e v e ry w h e re : Endorsed by the M edical Profession.

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io 8

F I R S T

nervous system through the blood circulatin g in the brain.” It is so called because it w as first obtained from prussian blue ; and it is peculiar in that it produces its effects whether inhaled, swallowed or applied to broken skin or mucous membrane. As a powerful nerve poison it may rapidly cause paralysis of nerves of brain cells (including the centres which control respiration and circulation, and of heart m uscle).— N .C .F . A sp h y x ia and B urn ed B ack . P .R . (Cardiff).— Several of us recently had a difference of opinion as to the correct method of artificial respiration which should be adopted if such were indicated for a patient who was also suffering from severe burns on the back. As w e could not arrive at a decision, we decided to submit the problem for your kind ruling. T h e restoration of breathing being much more important than the danger of a g g ra v a tin g the burns, it follows that in all such cases you should at once commence Schafer’s method of artificial respiration ; and that as far as is practicable you should protect the burned parts so that a minimum of aggravation may resu lt.— N .C .F .

In s e c t Stings. N. P. (Y o rk ).— Please tell me w hat is the nature of the poison associated with insect stings and accept my thanks in advance. T h e poison injected by the ant is known to be formic acid. In all other cases the nature of the poison injected is not know n ; but on the analogy of ant venom it has been presumed that insects produce their ill effects with acid poisons. Consequently treatment by the application of alkalies has alw ays been advocated. In these later days the venom injected by the wasp has been shown by experiment usually to be alkaline in reaction. T h is justifies the old time custom of farmers who are said to apply slices of onions (which are acid) as treatment for wasp stings ; and it therefore su ggests the advisability to apply acid solutions to counteract wasp venom. Nevertheless experience proves that alkaline solution may give relief even with wasp stings as they m ay with any form of skin irrita tion.— N .C . F.

QUERY

A I D

B ritis h Red C ro s s S o c ie ty. H u d d e r s f i e l d . — The Huddersfield 141 (M en’s) and Boy Cadet Detachm ents have just secured there own H ead quarters after having to share with another Detachm ent for almost 2 years. T h e new rooms, which are situated on the top floor of K irkgate Cham bers are in the centre of the town. There is a lot of w ork to be done however. Electric light has to be put in and the place cleaned and decorated. T his will be done by the members. T h e place has been empty for 6 years and so has collected a great deal of dirt. Furnishing is the chief worry, even second-hand chairs being very expensive. It is hoped however, that some kind friend of the Detachm ent will help them out. At a recent exam ination, they had a 100 per cent. pass. T he Hon. Medical Officer, Dr. W. L. Ingham , had been the lecturer and the exam ination was taken by Dr. McIntosh. There was also a 100 per cent, pass in an exam ination held at Headquarters under the rules of the Royal Life Saving Society Respiration Service. These, and the first aid aw ards which include proficiency medals, will be presented at the annual inspection, which it is hoped will coincide with the opening of the new H ead quarters. T h e cadets are also en gaged upon intensive training for a competition they are about to enter. T h e cadet strength is approxim ately 30 boys whose ages average from 10-13 years.

“ FIRST AID ” and REPLIES COUPON.

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These questions and answers on first aid have been compiled by the Senior Sister-Tutor of Middlesex Hospital. T h ey first appeared in the N u rsin g Mirror in 1944 , and are now published at the request of many readers who approved them in their original form and desired to have them within the covers of a sm all and compact book. T h e series covers the whole range of first aid and pro vides an adm irable means of testing and also of extending the know ledge of all who study it. Further, their value is enhanced by a comprehensive index which will facilitate reference to special items. T h e one error noticed in the body of the book is the m isspelling of “ Silvester.”

M o d ern Su rgical practice fa vo u rs an undisturbed dressing and fo r this purpose ‘ E lastoplast ’ is used extensively in hospitals. It stays in place, protecting the w ou n d w h ile perm ittin g u n in terru p ted healing. ‘ E lasto p last ’ is elastic, adhesive, anti septic. U se it w ith confidence fo r all m inor injuries.

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j d . p e r w o r d , m in im u m 4/ 6 .

Try Germolene y o u rself— and you will be convinced IN FLA M M A TIO N o f its power to soothe and RASHES, SPO TS relieve skin complaints. U nder the healing hand BURNS, CUTS o f Germolene many skin afflictions vanish in a few days — or even hours. But G erm olene’s most wonderful victories are recorded in letters like the follow ing: ‘ R ESU LTS H AVE B EEN

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W ONDERFUL’

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St. John Ambulance Brigade

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F IR S T A I D jln ta p e n b im f J o u r n a l J o r flje A m b u l a n c e N o . 622, Vol. L l l j

T H E

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O F

C O M P E T IT IO N By

“ G ive s clear and constructive advice on selecting and training team s fo r first aid com petitions, and provides - useful tips on individual and team b ehaviou r during c o m p e t it io n s .................. should find a ready p u b lic.” — Fire Protection.

JO R D A N

SONS

F IR S T

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1946.

T R A IN IN G

^ eruk esr

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M r. B oyce-M ears advises m ost com peten tly on the b u ild in g o f the team , on train ing fo r c o m p etition w o r k , w h at to expect in the test, d iag nosis and exam ination routine and com pletes the b o o k let w ith a ve ry useful and in form ative specim en o f an average ju d g e ’s m ark sheet.

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18th Edition. Fully Revised 232 nd Thousand. 313 Illus. Some coloured.

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M A D E UNDER THE SUPERVISION O F PRO FESSO R C . F . V. SMOUT, BIR M IN G H A M UNIVERSITY.

FIRST

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E D I T O R I A L . F IR S T A ID is published on the ao th of each m onth. 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 8th of each month, and must be accompanied ( not necessarily for publication) by the name and address of the Correspondent. Subscriptions, Advertisements and other business Communications connected with F IR S T A ID should be forwarded to the Publishers. D A LE, REYN O LDS & 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 Address— " Twenty-four, London." Telephone— City 3710.

CON TEN TS

THIS

NUMBER.

d it o r ia l—

T h e National Health Bill

...

109

...

110

...

Ill

...

Ill

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

...

Ill

R ailw ay Am bulance News

...

114

Letters to the Editor

...

114

Review s

...

Side L ig h ts on First Aid St. John Am bulance Association T h e Casualties Union ...

...

115

Typhus Fever and Lice

...

115

Nostell First Aid Society

...

116

Fractures of H um erus and Forearm ... Exam ination H ow ler ... ...

... ...

Bitum en Burns

...

118 118 118 118 118 118 120 120 120 120 120

u er ie s

...

and

nsw ers

orrespondents

...

Artificial Respiration

...

B rigade Competitions

...

V arieties of Compound Fractures

...

:—

Medal of G reek Red Cross ...

...

Petrol in E ar

...

Paint in Eyes

...

Multiple Injuries ...

...

C auses of Asphyxia

...

T h ere

The National Health Bill.

is lit t le th a t c a n b e s a id

a t th is j u n c t u r e r e l a t in g to th e m e d ic a l a n d a llie d

p r o f e s s io n s .

F ree h ealth aid for all is a very fine s lo g a n and a ; £ l 5 2 ,0 0 0 , 0 0 0 plan is a v er y fine plan, but h o w it w ill w ork o u t is, for the present, b e y o n d the w it of m an to d ecid e. F r e e m ed ica l, sp e c ia list, h o sp ita l and dental treatm ent are to be provided for e v e r y m an, w o m a n and ch ild , irrespec tive of m e a n s, and h o sp ita ls, w ith few e x c e p tio n s, are to be n a tio n a lise d . H e a lth centres in e v ery tow n are to form the base for m edical treatm ent either at the centre, at d o c to r s’ su r g e r ie s , or in p a tie n ts ’ h o m e s . P a tie n ts are to be free to c h o o s e their o w n doctors, and d octo rs their p a tients. S a le of practices w ill be prohibited, and ^ 6 6 , 000,000 will be paid in c o m p e n s a t io n to d octors on death or retirement. S u p p le m e n t a r y se r v ic e s w ill include m aternity and child w elfare, h o m e n u r s in g , d o m e stic h elp and after care. C o u n ty and b o r o u g h c o u n c ils will pro vide th e se . C o m p u ls o r y v a c c in a tion w ill be a b o lish e d . S p e c t a c le s , d e n tu r e s, and other a p p lia n c e s, w ith d r u g s and m e d ic in e s, will be provided at h o s p ita ls , h e alth c en tres, c lin ic s and ch em ists’ shops. A d m in istr a tio n of all h o sp ita ls, other than te a c h in g h o sp ita ls , is to be e n trusted to R e g i o n a l H o s p ita l B o ard s. M edical and dental s c h o o ls w ill retain their p r e se n t a d m in istr a tio n . E n d o w m e n t s of v o lu n ta r y t e a c h in g h o s p ita ls will pass to boards of g o v e r n e r s, w h o w ill be free to u se the m o n e y as th ey w is h , but m u st bear in m in d the p u r p o se s for w h ich it w as o r ig in a lly in te n d e d . A n y doctor w i s h i n g to enter the se r v ic e after an a p p o in ted d ay w ill h a v e to g e t p e r m is sio n , w h ic h m ay be refused o n l y if there are alrea dy e n o u g h d octors in the area co n c e r n e d . T h e s e are the m ain p o in ts of the s u g g e s t e d s c h e m e , and it will be r e c o g n ise d w h a t a v o lu m e o f le g is la t iv e w ork it will enta il. D e c is io n s are still in the scale. T h e doc tors are f i g h t in g hard to keep their end u p p e r m o st, and a lto g e th e r th e situ a tio n is rather c o m o lic a t e d .

F I R S T

S id e

L ig h ts o n

F ir st A id .

B y S I R H E N R Y L. M A R T Y N , K .C .V .O ., F .R .C .S .

I w o n d e r how m any students ever consider w hat an extrem ely difficult task the lecturer has before him when he comm ences a course in First Aid. I am compelled also to wonder how many lecturers ever pause to think w hat an ex trem ely difficult subject First Aid is to learn. Unless, how ever, both these facts are fully appreciated, it is quite impossible to produce an efficient practitioner in the art of F irst A id — be it noted that the operative word is “ efficient.” Let us consider for a moment w hat are these difficulties which beset both lecturer and student, in the hope that perhaps the learner may be helped to learn and the teacher to teach. W hen a child goes to school the first thin g that he is taugh t, quite unconsciously, is how to learn, and, unless we continue to learn in college or some form of training after we leave school, it is one of the easiest things to forget. H ow often have we not all of us heard the rem ark “ I am too old to learn .” In as much as the m ajority of students in any First Aid class is composed of adults who have left school or even college for some years, this is the first difficulty which both student and lecturer have to face. T he child, in learning how to learn, is assisted in many w ays, particularly by the training of his visual memory, which associates pictures with facts. T hus an actual pic ture of a mountain or a lake is used to impress upon the child’s mind the m eaning of the word itself. As the student becomes older, the use of pictures becomes less and less possible as a means of teaching, since the subjects neces sary to impress upon his mind become more and more com plicated and diversified, but this difficulty is offset by the progressive im provement in his ability to visualise objects described to him verbally. Needless to say, the lecturer must him self have both sufficient im agination and command of lan gu age to draw so vivid a picture of what he is describing that that picture becomes forever fixed in the student’s mind and can be re evoked at a second’s notice. It is quite extraordinary the degree to w hich visual memory can be developed, often without any special effort on the part of the student. I have know n the most com plex diagram s reproduced faultlessly and pages of a book repeated by a student, who found no difficulty in doing so since he visualised the printed lines before his eyes. A lecturer on First Aid has alw ays before his mind the alm ost insuperable difficulty that the student has no chance of seeing the real thin g before he finds himself called upon to deal with it. T h e medical student sees m any hundreds of cases upon which he has been very fully instructed before he is allowed to take charge of one himself. T h e unfortu nate student of First Aid, however, may be faced five minutes after receiving his certificate with a motor smash, including three or four different injuries, none of which he has ever seen before, few of which look like w hat he thought they were go in g to look like, and all of which he can hardly be blamed for being far too frightened to deal with. If, however, his teacher has been gifted with a vivid im agination, he should have been able to draw such a clear picture in his student’s mind of what, for exam ple, a bad case of shock actually looks like, or a compound fracture, that im m ediately the tyro sees such a case he feels himself in the presence of som ething fam iliar and therefore within his power to treat.

A I D

No trouble can be too great if it can fix for ever in a student’s mind the mental pictures of various injuries. The infinite patience which was taken by training officers during the war to fake casualties by means of plasticene, grease paints, etc., is ample evidence of the importance which the authorities attached to the development of visual memory. I would go further, were I once again responsible for the training of large numbers of casualty personnel. I would urge that no certificate be issued until the candidate had attended in the reception room of any large hospital fo ra few hours, if only for the purpose of seeing w hat an injured man looks like. W e must, however, accept the undoubted fact that some people are completely incapable of visualising anything, and are forced to rely entirely upon learning the necessary facts by heart, either straight off, as though learnt in a column, or, with the assistance of mnemonics. There is much in the arrangem ent of the St. John’s T extbook which encourages the student to the misuse of both these methods of learning. The book covers an enormous subject and has consequently been compressed to an extreme extent, so much so that it has alm ost become a list of facts — meat through and through. Unfortunately, also, the exam inations for certificates tend to demand an ability on behalf of the candidate to recapitulate lists rather than reasons, although it must be admitted that it is difficult to see how this is to be avoided unless the standard demanded of all candidates is to be considerably raised. There is, however, a method of m em orising lists of facts, such for instance as the signs and symptoms of a simple fracture, which avoids the parrot like repetition which so often covers complete ignorance of causes. If the candidate were asked for such a list let him think at once of a piece of bone broken in two and ask himself what will have been the result to the owner. Obviously, first of all it will have hurt, the first answer is therefore pain ; the broken bone and torn muscles will have bled and, since it is a simple fracture, the blood cannot escape, and will thererefore have caused swelling. Since the bone is broken and the limb hurts, there m ust be loss of pow er; and since a broken bone can no longer be per-, fectly straight there will be deformity and irregularity ; and, lastly, since the broken ends are, so to speak, loose and blow ing about in the wind, there will be unnatural mobility, and crepitus if the ends come in contact with one another. The reader may am use himself by constructing similar exam ples, using alw ays the cause, which is almost invari ably obvious, to provide the sign or symptom. Certain people find that the use of mnemonics is essen tial where lists have to be learned in which the individual items bear no relationship to each other or to anything else, such, for example, as the various causes of unconsciousness. Although these aids may be of some value, they should be discarded as soon as possible. T h e picture of a terrified first aider firmly clutching an obviously broken leg the while he mutters “ Please let Susan dry my clothes ” is am using, but hardly dignified. T he habits and customs of lecturers are varied in the extrem e ; certainly the best teachers are born and not made, and appear, from the moment they begin to speak, to attain a mental contact with each and every student in the class. N othing can break the spirit of a class more rapidly than being forced to listen to the lecturer who does no more than read the lecture word for word, pausing only now and again to clarify some point. T h e best training officers are to be found am ong the ranks of those who have made the Association their hobby over many years. T o listen to such a man lecturing to a class is a joy, speaking quite extempore and without a glance at book or notes, he will keep nevertheless to the main lines of his sub ject. He will avoid the stilted phraseology of the text and

F I R S T

clothe the dry bones of his facts so that they become living entities. W hile he will never allow himself to be diverted from his subject into the bypaths of anecdote he will nevertheless, in an apparently entirely unpremeditated manner, introduce from time to time, some experience or story which will re main in his students minds as a mental peg upon which the memory of some fact can hang. It has been suggested that subsequent articles in a short series, should be devoted each to one or more of the standard lectures on First Aid in the hope that, viewed, as the subject may be, from a slightly different angle, they may serve to assist the student to memorise his by no means easy work.

St. John Ambulance Association. B o ro u g h o f W i s b e c h C e n t r e . — T he co-operation and efficiency of a well-trained team of the S.J. A. A. in administer ing first aid in an em ergency, was demonstrated by teams from various branches of the Association com peting in the first aid competitions on W ednesday, March 20 th. The competitions which were for the Mrs. de Rothschild and the Elgood Challenge cups for ladies and men respectively were held in the W .M .C . and Institute H all and the guest of the evening was Mrs. E. A. H. L egge-B ou rke, who presented the prizes at the close. T h e chair was taken by Mr. W . S. Elgood. T h e ladies had to treat a woman who had fallen jrom a pair of steps, hitting her head and breaking her arm, while her husband who had been sitting in front of the fire had knocked a pan of boiling potatoes off the fire, scalding his leg and sending hot ashes into his face and eyes. The problem the men had to tackle was one in which two men were supposed to have fallen from a lorry that was passing over an embankm ent, into a field below, while the lorry driver, unaw are of the accident, drives on. One of the men was knocked unconscious and the other, although able to w alk, sustained injuries to one arm. Mr. Elgood announced the prizewinners as follows :— Rothschild cup.— 1 , Christchurch 79 m arks ; 2 , W isbech N ursing Division 57 ; O utw ell and Upwell 56 . Elgood cup.— 1 , W isbech B rigade 70 ; 2 , O utw ell and Upwell 65 ; 3 , W isbech St. M ary 55 . After the presentation of awards, the judge, Dr. R. E. Crockatt, M .B ., C h .B ., of Sutton Bridge, gave a brief sum m ary of his criticism. T he ladies, he said, were inclined to handle a broken arm too much when they should have left it completely alone till they started to dress it, but he was pleased with the w ay they had made the burn lotion for the scald. The men m ight have used their im agination a little more and should have thought to try to stop the lorry. On the whole, however, there had been some good w ork done in both sections. D urin g the interval a collection was taken which amounted to ;£8 12s. 4 d. for the Association.

A I D

St. John Ambulance Brigade HEADQUARTERS

AND

D IST R IC T

REPORTS.

N o . I (Prince o f W ales’s) District No. 54 ( H a m p s t e a d ) . — O n Satu rd ay. March 9 th, first aid incidents were staged at the Odeon Cinem a, Sw iss C ot tage, N .W . 3 , by 7 N ursing Cadets of the above Division. Injuries were : 1 , fractured leg sustained from a collision with a bicycle ; 2, the cyclist losing control, fallin g and injuring her forehead. Northern Area Cadet Officer Mrs. O. Dove, spoke to the audience after the sta g in g of these incidents, and a running com m entary was given by Cadet Supt. Miss G . D. Hyman. Divisional Supt. of the adult Division, Miss Finch and officers were present. As a result new recruits enlisted the follow ing week.

County of Berkshire. T h e result of the exam ination taken at the conclusion of the course given by the Casualties Union in January, was as follows Seven members gained Instructor’s Certificates ; eight members gained Member’s Certificates (having failed in one subject), and six qualified for membership only. R e a d i n g . — On Monday evening, March 11 th, at the Am bulance H all, Chatham Street, the members of R eadin g T ow n “ A ” Am bulance Division held their annual presenta tion of aw ards and social. T h e awards, which included vouchers, medallions and labels, were presented by the Chief Constable of R eading, Mr. S. Law rence, M .B .E ., who was accompanied by Mrs. Lawrence. Before the presentation, Div. Supt. W . J. Field said that the Division was formed during the South African W ar. He also stated that 1,002 public duties had been carried out by the Division during 1945 . T h e program m e for the evening included an entertain ment and dancing. Refreshm ents were provided and the whole evening arranged by the Divisional Social Committee.

a d e t

e w s

R ead in g. — On Monday evening, March 18th, at the Am bulance H all, Chatham Street, a first aid quiz was held between teams of Am bulance and N ursing Cadets. The boys’ team was from R eading Tow n “ A ” and the g irls’ team from R eading W est. T he contest was very keen and at the end of the official questions the result w as a draw, each team havin g gained 27 m arks. A further four questions produced the same result until finally, after still more ques tions, the boys’ team won by three m arks ga in in g a total of 36 .

County of Lancashire. T h e

C asu alties

U n ion .

T he Hon. O rganiser of the above sends us particulars of the Union together with a leaflet explaining its objects and constitution, and a copy of the W inter issue of “ Casualties Union Journal.” V ery briefly the objects of the Society are to provide realistic training in first aid. Injuries are faked ; signs, sufferings, symptoms and reactions are acted. W e su g gest that anyone interested should get into touch with the Hon. O rganiser, 64 , Chiltern Road, Sutton, Surrey.

L i v e r p o o l (E ).— T h e Liverpool N ursing Corps have sustained a heavy loss by the sudden death on March 3 rd of Corps Officer Mrs. Minna Ralli. Mrs. Ralli joined the Sefton N ursing Division in 1915 , and served in the St. John B rigade M yrtle A uxiliary Hospital until it closed, later giv in g valuable service in the David L ew is Northern Hospital, Liverpool. She was a keen member of the Brigade, serving as Corps Sscretary from the formation of the N ursing Corps till her transfer to the Reserve ow ing to indifferent health, and continuing her active interest in the Corps until her death. Mrs. R alli will be greatly missed by all ranks of the Corps, but specially by her fellow-officers.

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T h e Corps Supt., accom panied by Officers and members and by Corps Supt. Pender representing the Am bulance Corps, attended the Service at the G iee k Church, and later at the cemetery on March 7 th, and floral tributes were sent by the N ursing Corps, Sefton N ursing Division, Officers and members of the Am bulance Corps, and the Association.

County o f N o ttin g h a m . C a r r i n g t o n . — On March 19 th, Corps Officer J. E. Potts officiated at an enrolment ceremony of the C arrington Am bu lance Cadets, and presented 18 new members with pre lim inary first aid certificates, also service stripes to A cting Sgt. B. Sum ner and A ctin g Cpl. John E. Stones. Miss Gibson, County Supt., spoke to parents and cadets. Div. Supt. E. Stones w as in the chair. Three boys who gained the highest exam ination marks, received prizes. T hey were : 1st, Richard J. A. V aughan, 2 nd, John F. Smith, and junior award, Kenneth Gadd. Am bulance Officer T . W . Maltby paid tribute to Private R. G. H. Cornick who had trained the boys and re-organised the Division during the past tw elve months.

County o f Sussex. F i s i i b o u r n e . — On Tuesday, April 2 nd, the enrolment ceremony of the new Fishbourne Cadet Division was held in the Parish H all, Fishbourne. The Vice-President, M ajor H. Spencer Johnson, C .B .E ., opened the proceedings and congratulated the new cadets on their keenness and high standard of efficiency. H e hoped that others would follow the boys exam ple and join the cadets. Fourteen boys were enrolled by County Officer C. W . L. Gile. The evening was terminated by a short display by the cadets, and Pte. W . Barrett, member-in-charge, thanked all those who had come, for their support.

County o f Surrey. N e w d ig a t e a n d D o r k i n g . — A very interesting evening was spent on a recent Friday, in the V illa ge Club, when the N ursing Divisions of D orkin g and N ew digate held afriendly competition. Mr. Gibbs of K ingston arranged the incident, which was realistically acted by Mr. C. W allis of the Casualty Union. Th e competition was very keen. Four team s competed and the results were : N ew digate, D orkin g, N ew digate, D orkin g. Div. Supt. Miss D arbyshire and her nurses also w el comed their President Mrs. Trouncer, D iv. Surgeon Dr. Gordon Fear, M .R .C .S ., L .R .C .P ., N ursing Officer Miss W illm ot of D orkin g N u isin g Division and members of the Casualty Union. In sum m ing up, Mr. Gibbs gave some useful suggestions for future competitions. T h e evening was a great success, and a return visit is in prospect at a later date.

County o f Worcester. Mr. T . C. Lench of South Bank, Blackheath, has been appointed Assistant Commissioner of the S .J .A .B . in the Northern Area of the County of W orcester. Mr. Lench, who is w orks m anager of T. W . Lench Ltd., B lackheath, joined that Division in July, 1922 , and has alw ays shown a deep interest in am bulance work. He has presented three silver cups for annual competition in connec tion with the Brigade. N e t h e r t o n . — T he Officers and members of the Netherton Cadet Am bulance Division held a party in their head quarters, the People’s Mission H all, on Friday, M arch 8th.

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Am ong a very good attendance was a large number of girls who intend to join a N ursing Cadet Division which it is hoped to form in Netherton. At the commencement of the proceedings, Div. Surgeon Miss Howell presented the W illetts Shield to Cadet S. Ash more and the runner-up prize to Cadet C. Dunn (who is now in H .M . Forces). T he Squad Shield was handed to No. 1 Squad, Leader Cadet Trom ans. In addition, Dr. Howell presented the re-exam ination certificates for 1945 . After the presentations, refreshments were served, and a very happy evening ended with the sin gin g of “ Auld L an g Syn e.” A whist drive, the proceeds of which were tor the funds of the Brierley Hill N ursing Division, w as held in the First Aid Post, C ottage Street, Brierley Hill, on Saturday, March 23 rd. There were 60 players. Refreshments were served by members of the N ursing Division. N o rth

W o r c e s te r s h ir e

an d

D u d le y

D is t r ic t .—

A m eeting of Officers and N .C .O .’s of the above Corps was held on Sunday, March 17th, in the Canteen of Messrs. T . W . Lench Ltd., Blackheath. Dr. Newton congratulated Mr. Lench on his appoint ment as Assistant Commissioner. H e also referred to the recent death of Corps Sergeant Major D. Jones. Arrangem ents were made for the county inspection which is being held at Madresfield Court, Malvern, by kind per mission of Earl Beaucham p, on May 5 th. R e d d i t c h . — Members of this Division attended their first dinner since the Division was formed 13 years ago, when they assembled at the Talbot Hotel, Redditch, on Monday, March 18 th. Div. Supt. Jakem an thanked the members for w hat they had done during the war years. On the previous Saturday, at W orcester, their team had won a cup for the fourth year in succession. T h ey had won the same cup in 1938 , and they were encouraged in the effort for the D ew ar Shield, the B rigad e’s chief national award. Replying to the C hairm an’s welcom e, Corps Surgeon N. C. Burns said that, but for one other, they belonged to the youngest Division in the area, but in strength they were the strongest and had won the most cups. H e stressed the importance of the social side of the organisation. Entertainm ent w as provided by the “ Pot Pourri Concert P arty .”

T he death occurred on March 10th, of Mr. Daniel Jones at the age of 59 years. Mr. Jones had been a member of the S .J .A .B . for 40 years, and at the time of his death held the rank of Corps Sergeant M ajor of the Dudley and District Corps. He joined Dudley Am bulance Division in June 1907 . H e was for 10 years Secretary of the Division, later being promoted to the rank of Staff Sergeant. H e held the L ong Service Medal of the Brigade with 4 bars and was a Serving Brother of the Order. There were many Officers and members present at the funeral, which took place on Thursday, March 14 th. There were a large number of floral tributes. S t o u r b r i d g e . — T h e members of the above Ambulance Division held an informal dinner at the Cottage T ea Rooms, H igh t Street, Stourbridge on Saturday, March 30 th. The object was a re-union and “ welcome home ” to the members who had been serving in H .M . Forces and had been demobilised. Div. Supt. C. Davies presided. L/Cpl. O. F. Saw tell speaking on behalf of the “ de mobbed ” members said that all the time they had been aw ay they had never forgotten the S .J .A .B . and the Stourbridge

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Division in particular. H e wished on his own and his com rade’s behalf to thank them all, and especially D iv. Supt. Davies and Amb. Officer Roden for their interest in their welfare and for the m agnificent welcom e they had given them on their return. A musical program m e then followed, after which Corps Supt. J. A. H arris presented service medals and service chevrons to members. L y e . — T he annual m eeting of Central (Lye) N ursing Division was held on Monday, March 25 th, and was pre sided over by Miss K . Jackson, Div. Supt. Amb. Officer Mrs. M. Lucas (Div. Secretary), in her report, stated that 44 drills had been held during the year ; 15 members had passed the annual re-examination ; 16 first aid cases had been attended to during the year. A financial statem ent was considered very satisfactory.

The North W orcestershire Corps held their elim inating round of the County Am bulance Shield in Stew arts & Lloyds, Halesowen canteen on Saturday, March 30 th. T he trophy at stake was the Somers Cup. The com peting teams were Halesowen, T . W . Lench, Rowley R egis, and Stewarts & Lloyds. In the team test they had to treat two men who had been injured in an explo sion in an electric workshop, one was unconscious, the other was quite conscious. T h e results were as follows :— Stew arts & Lloyds, 273 m arks ; T . W. Lench’s, 255 ; Halesowen, 252 ; Row ley R egis, 213 . The ju d ges were Corps Surgeon W . Shilvock (team test), Corps Surgeon L. Bold (individual tests), Amb. Officer A. E. Roden (uniform). Mrs. Shilvock presented the Somers Cup to the winners and heartily congratulated them upon their success.

East R id in g o f Yorkshire. N o rth F e r r i b y . — On Saturday afternoon, March 16 th, Miss Leppington, County Officer for N ursing Cadets in the East R iding of Yorkshire, conducted the enrolment ceremony of the newly registered Cadet Division at North Ferriby, and in her inaugural address of welcome expressed her pleasure at officiating at this, the first enrolment in the Hum berside Corps area. E ight members were enrolled and thetr obligations and duties were pointed out to them. T h ey were asked ever to remember that they were now associated with the oldest Order of Chivalry in the world and were pledged to do their duty to God, K in g and all m ankind and to carry out the mottoes of the Order, “ For the Faith ” and “ For the Ser vice of M ankind.” It is hoped in the near future to have a sim ilar function at Gilberdyke, also in the H um berside Corps area.

W est R id in g o f Yorkshire. C l e c k h e a t o n . — T h e first annual competition for the “ Davies Cup ” was held at the St. John Am bulance Rooms, Bradford Road, on Saturday, March 16 th. T h e results were : 1st, Cadet Raym ond Jackson 38 points ; 2 nd, Cadet Brian W right 37 ; and 3 rd, Cadet Arthur ones 36£. F ollow ing tea in the Savoy Cafe, the cup w as officially presented by Mr. P. D. Davies of G range Road, Cleckheaton, to the Cleckheaton Ambulance Cadets. It w ill be competed for each year in order to stim ulate interest in am bulance w ork am ongst the youth of the town. T h e ju d ge was Div. Supt. B. Bamford of Gom ersal, who gave the cadets some instructive information. Mr. S. R. Ellis (Chairman of the Spenborough Council) in a short address to the young people, drew a comparison between the R. '.F . Pathfinders and the cadets. H is sincere words created a fine impression.

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Assistant Com m issioner H arrison of the South Western Area, W .R . of Yorkshire, presented the cup and medals to the winners. Appreciation was extended to Cadet Officer F. Lonsdale for the efficient organisation of the proceedings and the pro ficiency of the cadets in his charge. T h e evening" was concluded in social activity in the Am bulance Rooms. A lle r t o n B y w a t e r . — T h e fifth annual individual first aid competition of the above N ursing Division was held on Saturday, April 6th, at the W elfare H all, Allerton By water. Mr. H. B arker and Mr. R. Schofield judged the elim inating round and County Surgeon Dr. C. C. H argreaves set the tests and judged the final. T here were 24 nurses com peting and Am bulance Officer Miss A. Smith of Y o rk City N ursing Division was adjudged the winner of the silver cup and first prize. T he event was proclaimed a success, due m ainly to the efforts of the Allerton By water N ursing Division, and to the patronage of N ursing Divisions over a wide area.

S k i p t o n . — T h e 49 th annual report of the Skipton D ivi sion was presented at the annual m eeting of members of the Division, held in the Congregational School, Skipton, on W ednesday, March 27 th, and recorded a year of marked activity and good work. T han ks were exetnded to tho Am bulance D arts L eague, who handed over during the year to the Medical Comforts Fund the sum of .£ 150 , and in addition had given £ 3 0 to the B rigade account. T h e Medical Com forts Fund now stands at ^£7620 1 0s. 6d. T h e results of the home nursing and first aid exam ina tions were : Ladies, 5 Labels and Pendants ; men, 2 M edal lions, 18 Labels and 3 Pendants. Corporal W . C ow gill had qualified for another bar to his Service medal, and Private H. Pickles had qualified for the Service medal. Cases attended by members of the two Divisions during the year were : 598 cases in workshop and town ; 79 re movals to Skipton and other hospitals, involving a m ileage of 2,598 miles ; 9 road accidents, involving a m ileage of 133 miles. Mrs. Stockport for the second year won the J. Mallison cup for the nursing competition at Skipton G ala, and the report tenders heartiest congratulations. Also at the Skip ton G ala the Division won the J. Mallison shield for the best decorated car. T h e report extended a cordial welcom e to a great num ber of men back from the Forces, and invited them once again to share the D ivision’s activities. T hey hoped to be able to use the Am bulance H all, which had been the tow n’s First Aid Post during the war, next winter. T h an ks were extended to all who in any way, by service or contributions, have helped the B rigade during the year.

N O R T H E R N I R E L A N D D ISTR IC T. S o u th B e l f a s t ( W i n d s o r ) . — T he members of the above Division were entertained to dinner in the Horse Shoe Cafe, D onegall Square W est, Belfast, on Friday evening, March 8th, by the Divisional President (Mr. W m . D ow ling) and Vice-President (Alderman Thom as Henderson, M .P .), in honour of their w inning three trophies in first aid competi tions— the Lord M ayor’s Cup, the Com m issioner’s Cup and the Presidents’ Cup. T h e second named trophy w as for individuals and was awarded to Private F. Mallon. Alderm an Henderson presided in the absence of Mr. D ow lin g who w as indisposed. H e said the citizens deeply appreciated the services the S .J .A .B . had given voluntarily.

”

F I R S T

It was praiseworthy for its members to give of their time in the interests of the com m unity. W indsor Division had s e ta splendid exam ple and he hoped it would continue its good work. Belfast Medical Superintendent Officer of Health (Dr. S. Barron) said it w as a great credit for the Division to win three cups. He thought that as well as dealing with first aid, the Association as a whole, should devote attention to public health. A musical program m e was provided under the direction of Mr. H. B. Gradm an. Since the formation of the Division in August 1939 , alm ost 500 cases have received attention from the members w hilst performing Public Duty. In team competitions open to Divisions from all Ireland they were placed 6th in 1940 , no competitions were held in 1941 ; 1942 they were placed 5 th, in 1943 they were placed 1st in elim inating competitions and unplaced in the final, 1944 1st in elim inating and un placed in final, and in 1945 they were 1st again in the elim inating and 1st in the final. T he Presidents’ Cup is for the winners of the elim inating competition, and the Lord M ayor’s Cup for the winners of the final. In the near future the Division hopes to send a team to the London competitions.

Railway Ambulance News.

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

C O N S O L A T IO N . D

e a r

,'—

Mr. W . L. Ashm ore’s letter in your March issue, being freely translated means that the fact that I did not step for ward and m ake yet one more being to the fray, and harass still more the patient, he finds distasteful, and should not go unchallenged. If W .L .A . would read my article again, he will agree that the m eaning was solely in connection with “ Consoling Your P atient,” and in no w ay did I attempt to criticise the first aider’s methods of treating patient’s injury or injuries. Naturally, had I any reason to think that patient was experiencing any additional suffering, as a result of what was at most a battle of words, I would most certainly have stepped forward and tried to help. I quoted the case history in such detail, to give readers a clear idea of the situation. However, I thank W .L .A . for reading my article and for his criticism, although I would have welcomed more, his rem arks on my com m ents.— Yours faithfully, J W. S c o t t . 142 , London Road, Mitcham, Surrey. March 22 nd, 1946 .

SO UTH ERN L o n d o n . — On Thursday, March 14 th, the members of the Southern R ailw ay Am bulance Classes in the London district held a very successful social at the B ridge House Restaurant, London B ridge. Their wives and friends were invited and the program m e included dancing to “ Victor Sm ith’s ” Dance Band ; Fred L esley’s Artistes, and gam es, and a real jolly evening was enjoyed by the party, which numbered nearly 350 . T h e guest of the evening was the Traffic M anager, Mr. R. M. T. Richards, who was supported by the W elfare Officer, Mr. E. Uzzell and Mrs. Uzzell, Miss W . Grindley, Mr. H. Greenfield, Station Master, W aterloo, Mr. Card, Station M aster, London Bridge, and Mr. Turpin, Station M aster, Cannon Street. In a short but very interesting speech, Mr. Richards referred to the very strenuous days of the past years, and said it w as high time we should relax and enjoy ourselves now and again. H e urged the importance of first aid w ork and the value of social functions in the members and their friends ge ttin g together. T im e went all too quickly, and at 11 o’clock to the sin g in g of “ Auld L a n g S y n e ” the party broke up, everyone feeling very happy with an evening thoroughly enjoyed, and looking forward to the next occasion. Mr. F. A. Trott and Mr. A. H ayw ard were efficient M .C .’s.

M IL IT A R Y D

e a r

— W ith increasing traffic on the roads at night, the pre-war dazzle difficulty is returning. T h e R oyal Society for the Prevention of Accidents asks all motor drivers te ensure that their headlights are properly focused, and set, and that they dip their lights whenever necessary. Such courtesy is appreciated by all other road users, and is also an important safety factor. Retaliation, in the form of turning all lights on a driver who fails to dip is, however, a dangerous and anti-social action. Y o u r

H e a d lig h ts .

R E S E R V IS T S .

B eing one of many M .H .R . men now demobilised from H .M . Forces, I should like to know the opinions of other ex-members. In 1939 w'e received very poor support from this organi sation. T he S .J .A .B . puts first and foremost that the very best should be given by its members, and rightly, too. W hy not, then, that they in turn show their m ark of appre ciation for services rendered ? T h e M .H .R . are the same as the T .A . in service, and in being “ em bodied,” yet the W ar Service in the latter counts double for the L on g Service and Efficiency Medal. This could be done for M .H .R . personnel. Rules and regulations are made to be amended. T h e man would have the satisfaction of know in g that the part he played in W orld W ar II had been noticed by the organisation to which he gives his time and support, purely voluntary, and the dependants of those killed would know that their loved one had not been forgotten. Surely the cost would not be too great for the Jreedom they helped to obtain.— Yours, & c., A. W. (Name and address supplied)

F I R S T A ID D ip

H O S P IT A L

,—

e a r

IN S T R U C T O R ’S C O U R S E S .

,—

I have read with very great pleasure that the Ambulance Com m ittee of the Order of St. John have decided that a “ life ” of 5 years is to be placed on the certificate, and that a supplement to the B lack book has been issued with some revolutionary changes. These decisions are welcomed by all the first-aiders in this district, realising that we cannot stand still wfith our training. I w'ould like to see further changes introduced ; firstly, a course of Advanced First Aid to enable those persons who

F I R S T

have to use an am bulance room in the absence of a nurse. If courses could be introduced during the w ar to enable people to w ork side by side in an em ergency, surely the powers that be could arran ge for this to be done in peace time. Secondly, I would welcom e an Instructor’s Course. I hold a L ay Instructor’s Certificate under the St. John A m bulance Brigade, but this had to be reviewed at the end of 12 months, and I expect by now that it w ill be redundant. I am a First Aid Instructor at one one of the largest steel works in the North of E ngland, but the only exam ina tion I take each year for efficiency is the same as the one which the first and second year men whom I train take. Surely someone will have realised by now that som ething is lack in g here. There should be a course which - includes a lecturing test, to prove whether a so-called instructor is really an instructor. If such a course was introduced, conducted and e x amined in each branch by about three or four different doctors, and a medal or badge issued, then a big gap would he filled and a step in the right direction would have been taken. These certified instructors could be put to good use at other works, youth organisations, schools and young people in industry. W e realised the value of trained personnel during the war, and with the numbers of accidents in the works and on the roads increasing we should be prepared to meet the emergencies which are arising. I am sure a lot of first aiders w ill agree with these view s.— Yours faithfully, C y r i l T. G r e g o r y . Hon. Sec., Rotherham and District W orks First Aid League. 387 , Canklow Road, Rotherham.

Reviews. A rtificial Respiration Explained. By Frank C. Eve, M .D ., F. R .C. P. E d in bu rgh : E. & S. Livingstone Ltd. Price y/- ; by post j / j . Dr. Eve, who is the well-known advocate of the rocking method for artificial respiration, has included in this book an outline of the physiology of respiration and a brief outline of most of the methods in use for the restoration of breathing. There is no attem pt unduly to u rge the claim s of any one form ; but in each method the advantages and disad vantages are explained. Further, realising the difficulty which would be experienced in ensuring the availability of any special piece of apparatus, such as the rocking stretcher, at the scene of a mishap, the author has shown how improvisationing can be adopted. T o all who are interested in first aid, and particularly those who are called on to teach resuscitation, this book will be a welcom e addition to the existing textbooks.

C a n te rb u ry an d B a n k s to w n ( A u s t r a l i a ) . — D uring a recent dance held by the Canterbury and Bankstow n Am bu lance Division and theCam psie N ursing Division at Lakem ba, Lieut. J. W . M aguire, A .M .C ., 2 A .I .F ., the Am bulance S u p t., presented copies of the Cadet M anual to Cadets Corry, Silburn, Spankie and Hill. All were congratulated on their zeal and efficiency during the first three years.

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Typhus Fever and Lice. D R . B O T H A D E M E IL L O N , B .S c. (W .R an d), F .R .E .S . (E n g.), celebrated South African Entom ologist of the S .A .I.M .R .

( Concluded Jrom page 102. J T h e adult louse is a nimble little fellow, fond of wander ing about on his host. Robert Burns, who was a keen ob server of the phenomena of N ature, has given a vivid picture of this characteristic in a well-known ode, of which I will only quote one verse :— “ H a ! W here ye gaun , ye crow lin’ ferlie Y ou r impudence protects you sairly ; I canna say but we strunt rarely, O w re gauze and lace ; T h ou gh, faith, I fear ye dine but sparely On sic a place.” T he fertilised mother louse lays about five or six e g g s a day. T h e e g g s, com m only known as nits, are securely cemented to the fibres of vests, trunks and shirts or, in the case of the head louse, to the hair. After a time, according to temperature conditions, the youn g lice hatch. T h ey are an exact replica of the adult except that their sexual func tions are not developed. T h ey moult three times and then become the fully m ature adult. T h e whole process takes place on the body of man. T he adult lives a matter of about 30 days and then dies. A short but full-blooded life, an adolescence free from the pangs, yearnings and social dangers of a daw ning sex and an adult life in which nothing is lacking. It is not generally know n that lice occur on all races of man, from the Esquim aux in the Arctic Circle to the Natives in the Tropics. T h e extent of the lousiness depends on the headdress and type of headgear, and also on the am ount of clothing worn. Naked savages are usually only troubled by head lice, but they' soon acquire the other variety when, am ong the other doubtful blessings of civilisation, they learn to dress themselves. In many modern com m unities lice have alm ost com pletely disappeared, and it is often difficult to obtain stocks for research purposes. It is not so long ago, however, that Mr. Pepys wrote in his diary— “ when all come to all she finds that I am lousy, having found in my head and body about twenty lice, little and great, which I wonder at, being more than I have had I believe these tw enty y ea rs.” Needless to say, this w as written before the V ictorian era at a time when lice could be talked about w ithout a titter and a blush. T h e habits of the louse explain much of the natural history of typhus. It is obvious in the first place that they will multiply during times of fam ine and stress when soap and cleanliness are at a premium. Secondly, during wars and great national calam ities, when people flee from their homes and are huddled together under the inevitable in sanitary conditions that follow, lice not only m ultiply but spread very rapidly from one person to another. In this w ay typhus runs ram pant, and it is usually during w ars and sieges that the disease attains its peak. T o illustrate this I can do no better than refer to R ussia from 1917 to 1923 . D u rin g this period, when the population suffered the most terrible privations, typhus claim ed no less than 30 , 000,000 victim s, of which 3 , 000,000 died in European Russia alone. In South Africa, typhus occurs in the colder parts, such as the Transkei, Basutoland, parts of the D rak en sberg and T ran svaal H ighveld. T his distribution is partly explained by the fact that the natives in these parts tend to gather to-

F I R S T

gether in the cold w inter months and probably wash and clean themselves less often. W e, of course, have not witnessed the devastating epi dem ics of Europe, but it would surprise most people, I am sure, to know that between 1927 and 1936 there were over 25,000 cases of typhus w ith more than 3,000 deaths am ongst natives in the Union. T his, I may add, only represents a fraction of the real figures, as many cases escape the notice of the authorities. In the individual it is a relatively simple m atter to con trol lice, but in the masses it is a difficult, tiresom e and tim e-consum ing business. Clothes, blankets and personal belongings have to be sterilised by heat and bodies washed and disinfected. In head lice it means shaving the head and applying an insecticide.

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IG L O D IN E -F IR S T -A ID “ It doesn ’t hu rt in th e least ” — Iglodine can be applied to an open w ound w ith o u t pain. This safe, but pow erful antiseptic cleanses and heals cuts, w ounds, bruises, scalds and burns.

The PAINLESSAntiseptic

U s e d b y F a c to r ie s , H o s p ita ls , and A m b u la n c e A u t h o r it ie s t h r o u g h o u t G r e a t B r ita in . PROFESSIONAL SAMPLE SE N T O N REQU EST

N o stell

F irst

A id

From B oots’ and all other Chem ists —

S ociety.

//-, I/I0h 2/11. T h e I g lo d in e C o . L td ., N e w c a s t le u p o n T y n e .

A good number of junior (Cadet) members of Nostell Colliery First Aid Society attended a lantern lecture at the pit head baths canteen on Thursday, March 28 th. Various methods of applying the trian gular bandage in the treatment of wounds and fractures, together with a wide selection of slides on “ W hat not to d o,” were enjoyed by the boys who were very appreciative of the efforts of Mr. E. H. Fenton (lecturer) and Mr. M. Abbott (projectionist). After the lecture the follow ing team was successful in a first aid quiz, obtaining the verdict by 24 points to 22 £ :— Cadets N. Hartshorne, H. Rothwell, F. Abbott, R . Martin, R. Pease, A. Askey, R. Wood and L. Martin. Mr. D. M akinson was question master, assisted by Messrs. E. H. Fenn, J. Abbott and A. Murphy. Arrangem ents are well in hand for the cadets’ trip to Belle Vue, Manchester, in the near future.

F IR S T A ID H A N D B O O K S A N A T O M I C A L DIAGRAMS A N D C H A R T S FOR LEC TURE S H.

L E W IS

C o.

Ltd.,

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Queries and Answers to Correspondents Queries w ill be dealt w ith 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 .

4. — T h e Textbook to w hich reference m ay be made in this column is the 39th ( 1937 ) Edition of the S .J.A .A . Manual of First Aid to the Injured. F ra c tu re s o f H um erus and F orearm . G .C . (Som ewhere).— W ill you please answer for us the follow in g question which after a brief discussion we agreed to subm it to you ? A man has sustained a fracture in the middle of the shaft of the humerus and also a fracture in the middle of the forearm (same limb). A member of my team treated this combination of injuries with two right angled splints. I disagreed and said that if I had to treat such a case I would treat each fracture separately, my idea being that when the doctor took charge he would be able to exam ine and treat each fracture separ ately. Y o u r suggested treatm ent of this combination of injuries is correct ; and you are putting into practice principles which I have been teaching for m any years, nam ely that, when there are multiple injuries, each should be treated separately whenever possible, whereby exam ination and treatment at hospital are facilitated.— N. C o r b e t F l e t c h e r . E xam in ation H ow ler. R .E . (Abergavenny).— H avin g recently issued each member . of my class of would-be Cadets with a copy of P re liminary First A id , I decided to hold an exam ination to find out if the boys were studying the textbook. So I asked who could tell me the principles of first aid. M any eager hands were raised ; and I selected a boy who rapidly and confidently replied :— “ To preserve life, to promote aggravation of condition or injury, and to pre vent recovery of the p atien t! ” T he laugh which followed was well w orth w h ile; and now all the boys know this page of the prelim inary text book. G ood! Next, please ! !•— N .C .F . B itu m en B u m s. G .C . (Somewhere).-— My second query is as follows :— A man carryin g two buckets of bitumen (which is a pitch compound used for electric or cable joints) falls with the result that the compound smothered both hands completely. A first aider, whom I know, go t the patient to plunge his hands into cold water, and then proceeded to crack the bitumen off the hands. W hen this problem was put to me, I said that I would not attem pt to remove the compound (which had the advantage that air could not get at and irritate the burned parts) but that I would w rap the hands in cotton wool, apply bandages and support both forearms in large arm slings. T his done I would at once arran ge quick transport of patient to hospital. A gain I thank you for your prompt and welcome comments.

R I D

On this problem also I agree with you. Any attempt to remove hardened pitch would result in aggravation of the original injury by rem oving parts of the skin and also, as you rightly emphasise, -by exposing raw surfaces which is con trary to the treatment of burns as laid down in the Textbook. Further, the sooner such a patient is transferred to hospital the better for him and his injuries. — N .C .F . A rtificia l R espiration. P .R . (Beccles).— At Divisional Practice this evening we exam ined and discussed the recently issued Supplement to the 39 th Edition of the T extb ook. D urin g the practical work we experienced difficulty as to the method to be employed with the rocking stretcher method of artificial respiration as set out on p. 32 of the Supplement. In short our difficulty was how we could execute Rule (2 ) which tells us— “ On arrival of the rocking stretcher, lift the patient on to the stretcher without breaking the con tinuity or rhythm of the Schafer method. . . . ” W e shall be most grateful if you will be so kind as to tell us how this can and should be done, especially as there are no instructions in the Supplement with reference to this lifting of patient on to stretcher. W e aw ait you reply and thank you for the invaluable help which we all derive from your answers to queries. As Schafer’s method is dependent on the patient’s body being compressed upon a firm surface, it is clear that this cannot be done and that respiration cannot be imitated while the patient is in mid air during the process of loading patient on stretcher. T h e break, however, should be made as short as is possible ; and the patient having been loaded on the stretcher, Schafer’s method should be continued until the patient’s feet and wrists have been lashed on the stretcher and the rocking method started. I would remind you, how ever, that the rocking stretcher may not alw ays be available and that methods of improvisation should be practised.— N .C .F . B rig ad e C om petition s. J .D . (T redegar).— W e understand that the B rigade Com petitions are being revived this year and that several of the old rules have been amended. One rule in regard to Cadet Superintendents and Cadet Officers is not very clear ; and we would like to have your opinion on this matter. W hat is the new position regardin g these officers with no rank in the adult D ivision? Can they compete in B rigade Competi tions in a team which already contains an Officer or N .C .O . of the adult Division. Meanwhile we are grate ful for the innumerable instances in which the advice and instruction given in the Query Column of F i r s t A i d have been most useful. By recent B rigade Regulations a Cadet Officer is nominally attached to the adult Division supernum erary to establishm ent ; and in the Conditions for Competitions, as St present drafted, it is laid down that an Officer cannot take part as a member of the competition team which consists of four Privates and of which one may be replaced by a N .C . O. It has been ruled that Brigade Final Competitions shall not be held this year ; and there is a rumour that shortly an Officer or N .C .O . may be allowed to replace one of the four Privates in the team. — E d i t o r . V arieties of C om pou n d F ra ctu res. C. N. (Southam pton).— As a regular reader of F i r s t A i d and one who appreciates the value of the information con tained in your Query Column, may I ask for your ruling on the follow ing q u ery?: — T h e Southampton Police Division of which I am an Am bulance Officer and Honorary Secretary, were recently represented in a First Aid " Q u i z ” when a

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competitor was asked : “ W hen would you apply exten sion in treating a compound fracture of the tibia with shortening of the limb ? ” After some hesitation the competitor replied “ I would not apply any extension whatever. ” For this answ er the competitor received full m arks. At the conclusion of the “ Q u iz ” I informed the Question-M aster that had I been asked that question I should have given the follow ing reply : “ I would apply extension provided the bone did not protrude.” In reply to this the Question-M aster informed me that with a compound fracture of the tibia the bone would alw ays protrude. I am not satisfied with this ruling. It may be that in most cases of a compound fracture involving the tibia with shortening of the limb that the bone would protrude, but surely not in all cases, for instance a com pound fracture of the tibia caused by a bullet. Truth to tell the shortening would probably be accompanied by (and due to) some protrusion of the lower fragm ent of the tibia. Nevertheless you are right when you say that there are two varieties of compound fractures— (1) with fractured ends protruding through the skin and (2) with wound leading down to fracture. If anyone queries this answer, then refer him/her to the definition of compound fracture as set out on p. 62 of the T extb ook .— N .C .F . M e d a l o f G re e k R ed C ro ss. W .S . (R ead in g).— A friend of mine has been awarded the Bronze Medal of the Greek Red Cross Society, for ser vices rendered while serving in Greece with U .N .R . R .A .; and she has written to me to know which is the correct position for the ribbon to be worn. Is it on the right or left breast ? As I am not sure myself, I beg to appeal for your kind assistance in solving this question. Foreign decorations may be worn on the left breast after all other decorations in the order of receipt. Thus, if the G reek one is the first, then that is placed first.— E d i t o r . P etro l in E ar. H .D . (Colchester).— W ould you kindly state the first aid treatment for petrol in ear ? Q uite recently a friend of mine had the above to deal with at our works, and I am informed the patient was nearly “ crack ers.” T he treatm ent adopted was to wash the ear out with warm w ater and afterwards a drop or two of peroxide was dropped in— and apparently gave relief. W as the treatment given correct, please ? Personally, I cannot im agine that, consequent on its rapid evaporation, petrol in the ear is accompanied by any' risk to the patient. Consequently, I consider that it should suffice to tilt the patient’s head towards the shoulder of the affected side and to wipe aw ay any escaping petrol with cotton wool. If, however, the patient should still complain of discomfort, you could, if you saw fit, wash out the ear with w arm water. I see no advantage in using hydrogen peroxide solution. — N .C .F . P ain t in E y e s. H .D . (Colchester).— W ill you kindly state the first aid treatm ent for paint in eyes ? It would possibly happen more when using the paint sprayer out in a w orkshop yard. M eanwhile, I thank you in anticipation for your replies to my two queries and for all your kindly advice alw ays so freely given and most helpful. Paint is composed of colouring m atter and non-corro sive oil ; and whilst a drop of paint on the surface of the eye m ight cause irritation, no special first aid treatm ent is indicated other than w ash in g the eye with water. Should,

A I D

however, the patient still complain of discomfort, you could apply a pad of cotton wool and secure it by a bandage tied sufficiently firmly to keep the eyeball steady (as laid down on p. 184 of the Textbook) and remove patient forthwith to medical aid. — N .C. F. M u ltip le Injuxies. J.C. (D ouglas, Isle of M an).— At a recent competition the follow ing team test was set :— A lorry laden with timber and a motor car collided, the car driver being thrown through the windscreen and sustaining the follow ing injuries :— Fracture of the lower dorsal spine ; dislocation backw ards of the left elbow ; compound fracture with bones protruding of the left forearm ; and arterial bleed in g from lower part of left arm. The patient was unconscious when found, but re gains consciousness before the treatment is completed. W ith these multiple injuries the question arose as to the correct method of transporting the patient on the stretcher. Four teams competed, one only of which transported in the face-downwards position. T he winning team of which I was a member took the view that ow ing to the injuries to the left upper limb (which was splinted with an angular splint to con trol both the dislocated elbow and the fractured forearm) it would have been askin g for further trouble to carry the patient in the prone position because the upper limb could not have been placed to the side ow ing to fixity of the elbow joint. Now sir, in such circum stances, which method in your opinion was correct ? Y o u r valued opinion will be very much appreciated. In view of the injuries named, I consider that your argum ent and decision are sound. Further, I direct atten tion to p. 11 of the Supplement to the Textbook, where it tells you that in all cases of fractured spine the patient must be transported on his b a c k .— N .C .F . C a u s e s o f A sp h yx ia . H .D . (Bolton).— D uring a recent Divisional I’ractice there arose a great discussion on the tragic disaster at Burnden Park, and the question arose as to how many forms of suffocation there are. One of the party said that she had heard that one or two in the disaster died before they fell, due to suffocation. W e would like to know if a man or woman, out in the fresh air so to speak, with nose and mouth free, but with undue pressure on the diaphragm caused by crushing against a harrier as at Burnden Park, can be suffocated ? One of the party voiced the opinion that the pressure on the diaphragm caused the suffocation ; others dis agreed. So we would like your expert opinion on this point. If you refer to Chapter X III, Section A of the Textbook (p. 156 ), you will find the answer to your first query, namely, that there are four main causes of asphyxia— I, ob struction ; II, inhalation of poisonous gases ; III, pressure on chest ; and IV , nervous affections. In answ er to your second query, T extbook tells us on p. 156 that asphyxia m ay arise as the result of pressure on chest when crushed by sand debris or by a crowd. The reason for this is that pressure on the chest prevents move ments of the ribs, and that pressure on the abdomen prevents movements of the d iaphragm .— N .C .F .

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F IR S T A I D T O p 3 n 6 ep en 6 < -n t J o u r n a l / o r tljc A m b u l a n c e

atufr p u r s i n g MAY,

N o . 623, Vol. Lll.]

Entered at 1 Hall

1946.

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CON TEN TS

d it o r ia l

THIS

NUMBER.

—

Holidays and First Aid

...

Side L ig h ts on First Aid O bituary

...

121

...

122

...

123

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

...

123

R ailw ay Am bulance News

...

126

Letters to the Editor

...

■ ■ ■

127

Iodine

■ ■ ■

Casualties Union Q

u e r ie s

...

a n d

...

n s w e r s

W aterglass

t o

... C

...

Exam ination H ow ler

...

o r r e s p o n d e n t s

... ...

Internal Haemorrhage

■ ■ ■

...

127

:—

■ ■ ■

...

127

130 ...

130

...

130

Treatm ent of Epilepsy

...

130

Ethics of First A id ...

...

■ ■ ■

130

Fractured Base of S ku ll

...

130

...

130

■ ■ ■

132

...

132

...

132

Treatm ent of G reenstick Fracture A Drill Problem

...

Fractured Forearm and Crushed Hand Police Am bulance News

...

T h e h o lid a y se a so n

Holidays and First Aid.

is w it h u s ,

a n d th e r e is e v e r y p r o s p e c t o f it b e in g o f

abn orm al

n a tu r e .

T h e s t a g g e r i n g of d a te s w ill be re sp o n sib le for a se a so n m ore le n g t h y than c u s t o mary, and w ill, it is to be h o p e d , relieve pressure on the o v e r -b u r d e n e d resorts. In a n y e v e n t, landladies are p r e p a r in g for a s tr e n u o u s tim e, and ba th r o o m s are b e in g fitted up as b e d r o o m s and s e m i- b a s e m e n t a p a rtm en ts as “ l o u n g e s . ” L u c k ily , the h o lid a y spirit is of that u n c o n q u e r a b le nature w h ich c h e e r fu lly puts up w ith h ar d sh ip and d isco m fort, and folk w h o are a c c u sto m e d the year round to a feather bed w i l lin g ly c o n s i g n t h e m s e lv e s to the e m b r a c e s of a “ k n o b b y s o f a ” ( e u p h e m istic a lly k n o w n as a sette e ). A s is too often the ca se , h o w e v e r , tr a g e d y lurks beneath the surface of the h o lid a y spirit, and a lm o s t e v e r y resort is ab le to record a ch ap ter of a c cid en ts d u r in g the c ou rse o f its s e a s o n . It is at s u c h tim e s that the first aider c o m e s into his o w n . H e is in u niversal request, and it is to be noted that his s e r v ic e s call for neither fee nor reward, but are rendered freely and s p o n t a n e o u s l y to all. W h e t h e r the treatm ent called for is m erely a cut finger, a bad bruise, a sp ra in ed an k le , or s o m e su c h m in o r “ t r a g e d y ,” or w h e th e r the rem edial m ea su r e s called for em b race artificial respiration, b a n d a g in g , the app licatio n of to u r n iq u e ts, or w h a t not, it is u p on the k n o w le d g e of the first aider that reliance has to be placed, and m a n y c a se s w h ic h p resent a la r m in g s y m p t o m s y ield th e m s e lv e s readily to the skill and m a n ip u la tio n of the first aider, w h o , s e e k i n g n o t h in g in the w a y of fee or reward, relieves the distre ss of his f e llo w - b e in g s at that critical m o m e n t w h e n d e la y m ig h t m ean so m u ch . T h e first aider d o e s not pose as a p h ila n th r o p ist, but he d o e s b elie v e that his a c q u isitio n of sk ill and resource s h o u ld not lie hidden b eneath a b u sh el w h ile there are sufferers c a ll in g for his aid and p la c in g their reliance upon him .

122

S id e

F I R S T

L ig h ts o n

F ir st A i d .

B y S I R H E N R Y L. M A R T Y N , K .C .V .O ., F .R .C .S .

T h e syllabus of instruction of the adult course in F irst Aid divides the subject into s ix lectures, each of one hour duration, followed by one hour of practical work. There is no rig id rule, however, upon the matter, and, if the surgeon instructor can be persuaded to do so, it is infinitely better to increase the number of lectures since the syllabus as set out for each of six lectures is far too long to be dealt w ith effectively. In any case, the student must be prepared to devote considerable time at home to the study of the textbook between lectures. The exact purpose and lim itation of the art of First Aid should, in the first place, be very carefully appreciated by the student. W hether or not the scope of the subject should be extended by ta k in g the senior student further upon the road of medicine and surgery cannot be discussed at length in this series of articles. In these days of very total w ar, the certainty of finding a doctor invariably available in civilian life su ggests a pathetic belief in the ability of U .N .O . to ensure that civilian life never again finds itself in the front line. If it does, the more the fellow can he tau gh t the better, and the readers’ opinions upon the chances are as good as mine. T h e necessary qualifications of a First Aider provide one of the most interesting parts of the lecture, and are well worth while considering very carefully, instead of— as is, I fear, custom ary— tak in g them as read. Undoubtedly, the three most im portant necessities are to be Observant, Sym pathetic and Resourceful. Upon the subject of observation, it would be easy to write a book. Fortunately, it is a qualification which can be developed to an am azing extent by practice. Everyone remembers the feats ascribed by Conan Doyle to the legend ary Sherlock H olm es— feats of observation which were, in fact, sim ple— provided you knew how to observe. Practice it at first with a number of different articles placed on a tray and covered with a cloth. Let the cloth be removed for a m inute w hile the student observes and memorises each article, and, after they are again covered up, write down all that he can remember. Follow this by observation of an individual who allow s you to observe him carefully w hile he stands in front of you for one or two minutes. At the end of that time write down everything that you have noticed about him (personalities will be forgiven)— hair, eyes, nose, mouth, teeth, complexion, ears, hands, clothes, etc., all will count. If two students can be got to do this sim ultaneously on one subject, it is surprising the number of points which w ill be noted by one and missed by the less observant individual. T h is is not a gam e, remember ; observation means an infinity to all of us— doctors, nurses and first aiders. Picture yourself faced suddenly with a bad motor smash and a badly injured man lying in the road. W hat a tremendous lot can be learned without even touching the case by one trained to observe. Is lie obviously conscious or unconscious, w hat is his colour, is his breathing normal in rate and character, is blood tricklin g from ears, nose or mouth ? Is there any obvious wound from which blood is com ing or does torn and stained clothing su g gest subjacent in ju ry? Do distorted positions of limbs or body hint at in juries to bony structures, and, lastly, does anythin g su ggest further danger to the injured man, oncom ing traffic, petrol from the dam aged car, etc. ? All these things and more the trained eye will take in at a glance, and yet the beginner will often fail to observe the most obvious injuries simply from lack of training. It is up

R I D

to you, my readers, get down to it and em ulate the great Sherlock Holmes. Upon the subject of sym pathy there will be more to be said when we come to consider shock, but I would recommend the reader to look up once more two most excellent articles by J. W . Scott in .the February and March numbers of this Journal entitled “ Consolation ” It is not nearly such an easy m atter to train an indi vidual to be Resourceful. Only too often is the student apt to think that he will alw ays find himself surrounded by full first aid equipment when it comes to the real thing. He is in fact quite as likely to face a motor smash with half a dozen bad casualties when he is on holiday in the depths of the country with nothing but his own common sense to help him. A short time during each practical hour should be devoted to m aking the student handle ca’ses of every pos sible sort with no equipment whatever other than such as can be improvised. T h e rem arks upon the m eaning of the words Signs, Symptom s and H istory sometimes occasion difficulty. It is really quite simple if the student will remember that signs are what you can see or feel for yourself, symptoms are what the patient complains of, and history is w hat you are told by the patient or others of the circum stances attending the commencement of the trouble. All of us have friends who will m ake a tremendous fuss of the most trivial ailment and others whose stoicism is rem arkable. It can be equally dangerous, therefore, tC ignore symptoms on the ground that the patient is an hysteric as it is to exagerate them on the theory that he is a stoic. U se signs, history and experience to help you in your judgm ent, but alw ays play for safety. Chapter II on the principles of First Aid is one of the most valuable in the book, and is worth alm ost learning by heart. T h e point is this : When first the reader first finds himself faced with a had case, his immediate reaction will be “ W hat do I do first ?” Y ou can im agine that put as strongly as ever you like, but it will be nothing like as forcible as the real thing when first you realise w hat you are up against. Unless you are som ething quite exceptional, you will be alm ost para lysed w ith — shall we say “ ex c ite m e n t? ” I should not like to su ggest “ f e a r ” — but the result will be much the same. If on the other hand, you really have bothered to learn Chapter II, and to learn it so thoroughly that you can visualise it paragraph by paragraph, you will find yourself with som ething to cling to, som ething which will not only tell you w hat to do but the order in which each thing should he done. T h e tendency of most novices is to tackle the particular injury or the particular patient which they feel themselves most competent to deal with, leaving the more difficult things in the hope that some colleague will arrive in time to cope with them before the patient departs this life. T he subject of Anatom y and Physiology is one upon which the lecturer is advised not to w aste too much time, since it is not these subjects but First Aid that is being taught. As it is very certain that without a competent know ledge of at least the bony structure of the body and the nature and position of the chief organs no efficient first aid is even pos sible, it is up to you, my reader, to get down at any rate to this very limited idea of the subject. If you are lucky enough to have a skeleton to play with so much the better, if not you must learn from full size coloured pictures. Pay particular attention to the spinal column, which is never easy to understand, but which pro vides the bony protection of the vital spinal cord. Note carefully the skull and try to understand what we mean by the Base, since fractures in this position are fairly common

F I R I T

and most people have a very vague idea of what it is or where it is. Exam ine the pelvis in detail, noting how the sacrum , which is the lower end of the spinal column, forms the back wall of the bony basin and how the front is constituted by the junction of the big haunch bones. It is close behind this slender arch that the bladder lies, and, since a fracture here is very common, injury to the latter must alw ays be thought of as a possible complication. W hen you have absorbed all you can about the bony structure of the body, set to and get a very definite idea as to the situation of the chief organs upon which the ign or ance of even experienced first aiders is often am azing. If, for instance, you have an accurate idea of where the kidneys live, and you find a man on the football field who has been kicked hard just below the tip of his 12th rib and is showing all the signs of intense shock and also of in ternal haemorrhage, you will not be far w rong if, at least, you suspect he has a ruptured kidney. Also it looks better for the first aider to know that the liver lies behind the lower ribs on the right side of the body and not on the left, and that the heart is not in the left armpit where the tenor in opera alw ays places it, but, curiously enough, mostly in the mid line of the body behind the breast bone. T h e best w ay of all to learn these things is to bribe an unsuspecting friend to lie stripped for you on a bed. W ith a skin pencil outline on his body first the arch of the ribs, the breast bone and clavicles, and then draw upon the skin the exact positions of all the principle organs. It is what we call surface m arkings, and, by the time you have finished with him, he will be beautiful to behold— also probably som ewhat chilly— but you will never again forget where the spleen is or on which side of the body the liver is to be found.

Obituary. A s a d loss to the Am bulance Movement at March has been caused by the death of Div. Supt. J. R. Croft, who passed aw ay on May 1st, 1946 . Supt. Croft had been associated with the First Aid Movement for over 35 years, having been awarded the L .N .E .R . Certificate for Gold Bar for that length of service last year. A member of the S .J .A .B . at March since its inception, in 1912 , Supt. Croft served with H .M . Forces throughout the Great W ar 1914 - 1918 , and on his return, resumed his activities with the Division, being promoted Sergeant in 1921 and to Am bulance Officer in 1932 , and Div. Supt. in 1933 . A keen first aider, he was responsible for the training of the March L .N .E .R . Am bulance teams throughout their many successful competitions, being elected first officer and instruc tor of the railw ay class in 1933 , a position he held to the time of his death. As a reward for his untiring efforts in connection with the B rigade and railw ay class, Supt. Croft was admitted to the Order of St. John as Serving Brother in 1937 being invested at Buckingham Palace. Supt. Croft was held in high esteem by all the members of the Movement with whom he cam e in contact, and endeared himself by the unassum ing and kindly manner he showed on all occasions. Th e interment took place at the New Cemetery, March, on Saturday, March 4 th, the coffin being borne by four Sergeants of the March Division and draped with the B rigade flag. T h e Am bulance and N ursing Adult and Cadet Divisions formed a Guard of Honour.

123

A I D

St. John Ambulance Brigade HEADQUARTERS

AND

D IST R IC T R E P O R T S .

N o . I (Prince o f W ales’s) District W e s te rn A r e a . — Most realistic fa k in g of injuries gave one the impression of w itnessing actual accident cases, on the occasion of the Finals of the W estern Area on Saturday, April 27 th, at W im bledon. An attendance of some 200 Am bulance workers witnessed some very fine work Prelim inary competitions have been held in all sectors and no less than nine competitions were held. After an interesting afternoon, D istrict Officer F. E. Stratton announced the results as follows :— • Am bulance taam test— T w ickenham Am bulance D ivi sion. N ursing team test— H arrow N ursing Division. Am bulance individual— Teddington Am bulance Division. N ursing individual— H arrow N ursing Division. Drill test (Am bulance)— Ruislip Am bulance Division. D rill test (N ursing)— H arrow N ursing Division. Cadets am bulance test— Teddington Cadet Division. Cadets nursing test— H arrow Cadet Division. B ed m akin g— Acton N ursing D ivi sion. T he Com m issioner, Captain Goodley, presented the trophies and prizes, and expressed his satisfaction at the sm art appearance of the members. H e mentioned that no less than 3,000 members would be needed for V ictory D ay, June 8th. Dr. G. R. H. W ran gham , Asst. Com m issioner, expressed his pleasure and satisfaction at the large attendance, and at the w ork of the competitors. He hoped that this Area would m ake a good show in the D istrict Finals next year. Lt. Col. Selby, County Surgeon, arranged the various judges and D istrict Officer F. E. Stratton was Competition Secretary.

No. 56 ( C r i c k l e v v o o d ) . — A re-union dinner and dance w as held in St. M ichael’s H all, Cricklewood), recently, by this Division. There were over 100 members and friends present, under the chairm anship of Dr. H. A. Faulkner (Divisional Surgeon). Dr. Bridges proposed the toast of No. 1 Prince of W ales District, Northern Area. T hey had passed through hard times, he said, but in time they would be able to look back and receive the praise they so richly deserved. Replying, Assistant Com m issioner H art said thirty-three years ago that day he joined the C ricklew ood Division, and those years had been most happy. T h e D ivision cam e to the fore with attendances at such functions as the great Hendon Air Pageants. T hey had suffered from the war, but still had w ork to do. Divisional Officer S. H. Collins submitted the toast of the Division and said they welcom ed a good representation of members returned from the Forces. Div. Supt. Capt. Journet replied and referred to the w ork of Major L eakey, who founded the Division in 1910 , but had been in touch with the Am bulance B rigade since 1904 . On his retirement after thirty-five years of service a presentation w as to be made to him. Dr. Faulkner then presented the M ajor with a silver tureen. Major L eakey thanked the Division. Sayin g goodbye after so many years was a sad thing. He wanted to thank everyone, especially the men’s wives, who put up with a lot of inconvenience. T h e toast of the guests was proposed by Dr. Faulkner and responded to by Mr. W . H. Crossm an, M .B .E . T h e company then adjourned for dancing to the music of L. L o ck wood and his band, the M .C. being Sergt. E. C. Penfold.

124

F I R S T

W e s te rn A r e a . — T he finals of the Massey M ainw aring Trophy were held by the Western Area of No. 1 D istrict at St. G eorges Hall, Wimbledon, on Saturday, April 27 th. A prelim inary explanation was made to the audience, who witnessed two lorries which having followed head and tail, cam e into collision when the front vehicle w as compelled to brake suddenly. A small boy, seated on the tailboard of the first lorry, d an glin g his legs over the back, was pinned against the bonnet of the follow ing vehicle. T ho results showed that first place had been gained by No. 84 (Tw ickenham ) Division with 172 points out of 225 . The w inn ing team comprised : S gt. A. Hipsey (Leader), Ptes. A. Kem pson, R. Fletcher, R. Spoor, B. K aye. T h e test was under the able direction of Asst. County Com m issioner F. A. T rott, of Sussex, who, by his answers to questions maintained the atmosphere of realism through out the contest. He commented on the excellent approach of the Tw ickenham Division.

County of Bedford. L u to n T o w n . — T h e annual competition for the Florence Cup between members of the Luton Tow n No. 1 and No. 2 N ursing Divisions, was held recently at B rigade H ead quarters, 17 , B arber’s Lane, Luton. T h e test was first aid for electric burns. T h e challenge cup and a sm aller one which the winner keeps, were finally awarded to Amb. Sister Mrs. B. M. Brooker, who retained it for No. 2 Division with Amb. Sister M iss VV. H olyoak (No. 2 Division) and Cadet Officer Miss K. Pearce (No. 1 Division) closely behind. Dr. E. A. Butterworth, Corps Surgeon of the V auxhall Corps, judged the competition. In announcing the results, Corps Officer Miss H. M. Brown said that the object of the competition, for which the cup had been presented in 1937 , was to create interest in practical tests. Am ong the members and friends present who were much interested in the test, were County Officer W . H. W eather head, Corps Officer G. H ucklesby, N ursing Sister Miss Tooth, N ursing Officer Miss Northam and the Superintendent of No. 2 Division, Miss D. Horton.

T h e Luton Tow n No. 2 N ursing Division celebrated their third anniversary with a birthday trip to London. T h e members and their friends travelled by coach to town. On arrival they separated into three parties to see “ Merrie E n glan d ,” “ Fine F e a th e rs” and “ Under the C ounter,” all very popular shows, which everyone thoroughly enjoyed. T hey rejoined th tir coach in Hanover Square and re turned home, everyone feeling very delighted with the outing, which had been arranged with perfection by the Social Secretary, Amb. Sister Mrs. B. Alexander.

County of Berkshire. R e a d i n g . — T h e annual report of the Corps Transport Service for the year ending Decem ber 31 st, 1945 , states that durin g the year 406 calls were answered and a distance of 14,256 miles covered. In addition, sixteen public duties were covered by the Mobile First Aid U nit during the sum m er months. In September the Service was officially taken over by R eadin g Corps.

On Monday evening, April 1st, at the Am bulance Hall, Chatham Street, R eading, a series of five films were shown to members of the R eading Corps by the Ministry of In formation. The films, which were very interesting, showed the care of children’s teeth, ears, eyes and nerves and one dealt with blood transfusion. A most enjoyable evening.

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On Monday evening, April 8lh, a t Greyfriars Schools, Reading E ast N ursing Division together with other mem bers of Reading Corps, met to hear a talk given by Miss A. E. W eeks who has been serving with the Joint W ar O rganisation as W elfare Officer. Miss W eeks, who is a member of Reading East N ursing Division, left Tilbury in November 1944 , and worked in Brussels with the B . L.A. until August 1945 . From September 1945 to February of this year she w as in Colaba, Bombay, w orkin g with the R .A .P .W .I. (Returned Allied Prisoners of W ar and In ternees) where she looked after the officers while they were w aiting to be sent home.

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Sunday, April 7 1h, at B rigade H ead quarters, an enrolment ceremony and presentation of awards w-as held by the Am bulance and N ursing Cadet Divisions. T w o am bulance cadets were enrolled by the County Com missioner (Mr. C. A. Poole) and three nursing cadets by the County Cadet Officer (N) (Mrs. A. A. Poole). P re lim inary first aid and home nursing certificates were pre sented to the cadets by the County President (the M arch ioness of Milford Haven). After the ceremony, the County Commissioner held a promotion examination. About a hundred members and friends were afterwards entertained to tea by the W indsor Ambulance and Nursing Divisions. W in d s o r .— O n

County o f D u rh a m . G a te s h e a d F e l l . — The Gateshead Fell Ambulance Division held a Jubilee Church Parade on April 28 th, at St. John’s Church, Sheriff Hill, Gateshead, to mark the 50 th anniversary of the foundation of the Division in 1894 . T h e parade, headed by the D .L . 1. Cadet Band, w'as attended by over 250 members of Am bulance and N ursing Divisions, including many cadets from Northumberland, Tyneside, and Durham , and was in charge of Corps Supt. T! W . Pearson, North Durham Corps. Am ongst those present were Mr. S. Embleton (County Commissioner) and members of the County Staff, and many ex members and retired officials of the Division.

County of Surrey. B o ro u g h o f G u i l d f o r d . — T h e annual m eeting of the Borough of Guildford Corps took place on Tuesday, April 9 th, at the Guildhall. T h e M ayor (Councillor A. W . Graham Brown) presided. T h e proceedings were opened by Div. Supt. J. E. Cheshire. In the 55 th report, County Staff Officer C. E. Chaplian gave a full account of the activities of the Corps throughout the year. T he hon. treasurer (Mr. A. C. Stoughton) presented a statement on the financial situation. T h e Mayor said that the Div. Supt’s. report was one in which members of the Corps m ight take pride. H e said he wished to pay grateful testimony on behalf of the Corporation, to the efficiency and loyalty of all who had played an active part in the splendid, noble and voluntary service during the past year. An address was given by A/Commissioner J. P. Flavin (W . Surrey), who appealed for volunteers to join the Brigade.

County of Sussex. L a v a n t . — On Thursday, May 2 nd, the enrolment ceremony of the new Lavant Cadet Division, was held in the Parish Hall, Lavant. E ight boys were enrolled by County Officer C. W . L.

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File, who presented each of them with their prelim inary first aid certificate. The evening was terminated with a short display by the cadets, and a short speech by Divisional Supt. Bridle, S .B .S t.J ., who congratulated the new cadets on their keen ness, and high standard of efficiency. H e hoped that other boys would follow their example, and join the cadets. In conclusion, Pte. R. Masters, member-in-charge, thanked all those who had come, for their support.

County of Lancashire. L i v e r p o o l . — T o extend the usefulness and the scope of the Invalid Transport Service of the S .J .A .B . in Liverpool, a special Transport Committee has been formed. The Committee is composed of a Corps Supt. from each of the five Corps, viz. W. E. Searl, O .S t.J. (D istrict Officer and Corps Supt. “ B ” ), D. Pender, “ D ” Corps, T . W . James, O .S t.J ., F. VV. W illiam s, S .B .S t.J ., Miss E. A. Craig, O .S t.J ., from Corps “ C ,” “ A ” and N ursing Corps “ E ” respectively. W . J. Lewis (Public D uty Officer all Corps). Supt. J. Anthony (of the Transport Division) who has been in charge of the Invalid Transport Service for some years was enrolled on the Com m ittee— with Corps rank— and elected Secretary. Mr. Anthony would like to hear from Corps or Divisions who run a like service with a view to interconnecting the Motor Transport Service.

County of Leicester. L e i c e s t e r . — A very enjoyable supper and concert was given by the Gipsy Lane Am bulance and Cadet Divisions to all the old aged pensioners of the Gipsy Lane W .M . Club, Leicester, on April 17th. Mr. L. Miller, Am bulance Pre sident, welcomed Ihe Guests and Mr. E. Morton said the Grace, 90 sittin g down to supper. Afterwards they were entertained by Billy and K itty Travers, and Mr. M. Goode, with Percy GloveT at the piano. Supt. T. Ham es said how pleased they were to have such a good company and wished all a very enjoyable even ing, this being the first time such an effort had been made and it was intended that it should not be the last. Mr. E. Morton, on behalf of the old folks, proposed a vote of thanks to the organisers.

County of Worcester. M a l v e r n . — T h ean n u al general m eeting of the N ursing Division was held at Rose Bank, W ells Road, Malvern. Th e Divisional Secretary’s report showed that the D ivi sion had had a busy year. T h e total strength at the end of 1945 was 36 ; 33 practices had been held with an average attendance of 17 . T h e follow ing duties were performed during the year :— Public 35 , am bulance 57 , hospital 60 , medical comforts 56 , w elfare clinic 50 , guide 10 , and 82 sundry duties. T w o courses of Home N ursing were given, Amb. Officer Mrs. Newson (Officer-in-Charge) gave a short report on the w ork of the Guarlford Section. Amb. Officer Mrs. D rew said that the Cadet Nursing Division had made steady progress during the year. A satisfactory financial statem ent was presented.

D u d le y a n d D i s t r i c t . — T he elim inating round of the County Ambulance Shield am ong Divisions of the Dudley and D istrict Corps was held in V alley Road Schools, Lye. Four team s competed : Brierley Hill (holders), Lye, Netherton, and Stourbridge. T h e Judge for the team test was Corps Surgeon F. G. Lew is, and for the indivinual tests, Corps Surgeon L. Bold. Corps Supt. J. A. Harris announced the results as

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fo llo w s: 1 , Brierley Hill 209 m a rk s; 2 , Stourbridge 1 8 0 ; 3 , Lye 179 ; 4 , Netherton 137L Corps Surgeon L. Bold presented the 11 Ollis Shield to the leader of the w inning team , S gt. Philpott. T ea was served in the Am bulance Hall, Lye, by mem bers of the Lye N ursing Division. H i l l an d C a k e m o r e . — An inspection of the above N ursing Division by the Corps Officers of the Northern Area N ursing Corps was held on Monday, April 15 th. After the inspection the members of the Division gave a demonstration of hand seat drill and also of home nursing w ork. The model of the comforts depot from B rigade H ead quarters was on view. Satisfaction was expressed with the w ork of the m em bers and also the uniforms. D iv. Supt. Miss D ye expressed thanks to the Inspecting Officers, after which light refreshments were served.

O l d b u r y . — A concert for the funds of the O ldbury Cadet N ursing Division was held in the headquarters of the D ivi sion, Bethel Schoolroom, L an gley, on Thursday, April 11th. T he concert was organised by Mrs. F. Branksom e and was well received by a large audience. A film was displayed of the N ursing Cadets undergoing the rehearsal at W orces ter for the annual inspection. In her rem arks, Area Cadet Officer Mrs. Lam b invited all girls interested in N ursing from the age of 11 to 17 years to become cadets and 17 years or over to become Student Nurses. She made special mention of the smartness of the O ldbury N ursing Cadets.

An old tim e dance for the benefit of the same funds was held in the Rood End Schools, L an gley, on Saturday, April 13th. T h e event was very successful.

“ L e n c h ” C u p . — T he annual competition for this cup was held in the canteen of Messrs. T. W . Lench Ltd., B lackheath, on Friday, April 26 th. T h e com peting team s were Brierley Hill (holders) and Stew arts & Lloyds. Dr. T . A. Cooper (Birm ingham ) judged the team test, and Dr. T . W . Kem p (Coseley) the individual tests. Assistant Com m issioner T. C. Lench announced the result as follows : Brierley Hill, 193 m arks ; Stew arts & Lloyds, 191 marks. B rierley H ill will now represent the North of the county in the county final competition which is being held in the Christopher W hitehead Schools, W orcester, on M ay 25 th. T heir opponents will be Redditch, winners of the South of the county prelim inary competition.

C o u n ty I n s p e c t i o n . — T h e first county inspection in the county of W orcester, to take place since the outbreak of was was held on Sunday, M ay Sth, at Madresfield Court, Malvern, by kind permission of Earl and Countess Beaucham p Countess Beaucham p is County President of the B rigade in Worcestershire. T he Chief Com m issioner, General Sir Clive Liddell, K .C .B ., C .M .G ., C .B .E ., K n igh t of the Order of St. John took the inspection accom panied by the D eputy Supt.-inChief, Lady D unbar-N asm ith, O .B .E ., Officer of the Order of St. John. T h e parade w as under the command of County C om missioner D. F. L. Newton, Com m ander of the Order of St. John. There were 1,150 members on parade. After the inspection, all Divisions m arched past the Chief Com missioner, who said he wished to compliment them upon their turn out which was very good and upon the march past which had been excellent.

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After the parade had been dismissed, tea was taken in large marquees, and afterw ards guests, members and visitors were allowed to visit the grounds of Madresfield Court.

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W est R id in g o f Yorkshire. W e t h e r b y . — 'T alks by local people have been given at recent m eetings of the above N ursing Division. These were : ( 1 ) Structure of the blood, with demonstrations of blood cultures on slides with a microscope ; by Mr. J. Khaptor, pathologist at Leeds General Infirmary. (2 ) T h e Blood Transfusion Service ; by Cadet Officer Miss Baines. (3 ) W ork in France with Civilian Relief Team ; by Miss E. M. Johnson, former Superintendent of the Division. (4 ) N urs ing Experiences in France, Africa and Italy ; by Senior Sister M. H ardy, of the T . A. N. S. (S) Newspapers and Newspaper Men ; by Mr. W . Finnerty, form erly N ews Editor of the Yorkshire Post. After Miss Johnson’s talk, a filled first aid haversack was presented to her from members of the Division, on her retirement from the B rigade. Miss Johnson and Mrs. Lodge, now D istrict Officer, formed the Division 19 years ago, and Miss Johnson had been Secretary, Am bulance Officer, and Div. Supt. during those years. Th e new Supt. is Miss M. Strother, form erly Secretary and Am bulance Officer, who during the last 15 years has done a very great deal of hard w ork for the good of the Division. A medical comforts depot, run by the Division, has an increasing number of calls made on it, and is gettin g more equipment. Am bulance Officer Miss Roberts and Am bulance Sister Mrs. Cirbetson m anage the depot most efficiently. Tn ey are grateful for the help given by Supt. F. Ridsdale, of the Am bulance Division, and Mrs. Ridsdale.

S h e ffie ld C o r p s . — T h e annual team competition for the John Smith Shield (open to all Divisions of the Sheffield Corps) was held on Saturday, April 27 th, at the Bailey Street Schoolroom. Nine team s competed, the winners being Shiregreen Division, who hold the shield for the year. In the absence through illness of Dr. G rin ling, the adjudication was carried out by Dr. F. A. W rench, (Div. Surgeon) assisted by Dr. L. C. D. Herm itte (Div. Surgeon, Sharrow Division) and other Officers of the Corps. H. C. Else. Esq., Hon. President of the Sheffield Corps, Corps Supt. W m . A. Browne, and many other Brigade Officers and friends were present. An individual competition was also held for a trophy know n as the Harrop Cup, in which about 50 B rigade men took part, the winner being S gt. R. W . T arry of the Sharrow Division. Mrs. W . A. Browne presented the prizes.

B ra d fo r d C o r p s . — T he annual competition for the “ G adic Cup ” for the above Corps took place at Carlton St., School, Bradford, on Saturday, May 4 th, 1946 . Five team s from the different Divisions took part, nam ely, C ity 2 team s, Eccleshill 2 teams, L. M. & S. Rly. 1 team. Th e judges for the competition were Dr. J. V . Reuben and Dr. F. G. Crawford, when C ity “ A ” team were adjudged winners with the L. M. & S. R ly. team 2 nd ; the winners hold the “ G adic C u p ” for 1 year. Cup and prizes were presented to the winners by County Officer S. Firth.

P r o m o t i o n . — After nearly 4 0 years of St. John Am bu lance w ork in Aston and W aleswood Districts, Mr. W illiam Grayson of 35 , Rotherham -road, Sw allow nest, Nr. Sheffield, has been honoured by H. M. the K in g by promotion to Officer Brother of the Order of St. John.

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T h e final am bulance competition for teams in England and W ales was held in the K in gs Hall, Belle V ue Gardens, Manchester, on Friday, April 26 th. T he nine team s which had qualified to take part in competition were judged by Dr. F. H. Edwards of Shrewsbury, Dr. P. L. R egan of Liver pool, and Dr. R. Scott-Reid of Bath. There was a large gathering of Officers of the Company including Mr. G. R. Sm ith (Secretary) together with mem bers of the medical profession, and of the L .M .S . Ambulance Centre. T h e result was as follows : 1, U ttoxeter with 336 out of a possible 405 m arks, 2 , Bolton Loco, 3 , Crewe Machine Shop, 4 , Camden, 5 , Agecroft Loco, 6, W arrington, 7 , W yre Dock, 8, Peterborough, 9 , Bristol. The Shields, Cup, prizes and gifts to D istrict Secretaries were presented by Sir Robert Burrows, Chairm an of the L .M .S . R ailw ay, and the proceedings were presided overby Mr. H. J. Comber, Chief Officer for Labour and Establish ment. Votes of T hanks to Sir Robert Burrows, Mr. Comber, the judges and medical profession generally, and the Belle V ue authorities were proposed by Mr. J. Shearm an, Road Motor Engineer, Col. H. R udgard, Superintendent of Motive Power and Mr. R. O. Banister, Divisional Superintendent of Operation, Manchester, respectively, and responded to by Sir Robert, Dr. Edwards and Mr. F. Grant on behalf of Belle Vue. T h e undermentioned members of the L .M .S . Staff and Dr. Hollis, who lectures to the Leeds Am bulance Class have recently received recognition of the Order of St. John in respect of their services to the L .M .S . Am bulance Centre. Promotion from Serving Brother to Officer Brother.— Mr. S. Farm er, S. &. T . dept. Tyldesley. Admission to the Order in the grade of Serving Brother. — Mr. H. H. Oldham , Fitter, E recting Shop. Crewe. Admission to Order in the Grade of Officer Brother.— Dr. H. F. Hollis, Leeds.

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This event was staged at the Borough Polytechnic, Borough Road, London, S .E ., on April 26 th. Tw elve teams took part from all over the line, and ju d g in g by the en thusiasm shown by the competitors, the am bulance spirit is as strong as ever on the Southern R ailw ay. T he excellence of the arrangem ents was a notable feature. T h e day’s proceedings started at 8.30 a.m . and by 3.50 p m. the last group had finished the team test. By this time about 400 spectators were present. T he ju d ge for the team test was Dr. G. E. D. T u llis, of Hereford, while Dr. M. M. Scott of London judged the individual tests, and Dr. J. Clayre of Southampton, condncted viva voce examination. T he Centre Secretary (Mr. E. Uzzell) announced the results as follows :— 1, Horsham 440 m arks ; 2 , Exm outh Junction No. 1 400 £ ; 3 , W aterloo No. 1 377 £ ; 4 , E astleigh C .M .E . 3 4 8 ; 5, B asingstoke “ A ” 318 ; 6, Yeovil Motive Power 314 ; 7 , Redhill Motive Power No. 1 313 £ ; 8, New Cross Gate 311 ; 9 , Southampton D ocks “ E ” 307 ; 10 , Ashford W orks “ A ” 303 ; 11 , Addiscombe 246 £ ; 12 , Ashford Motive Power 245 . Great applause greeted the name of Horsham , deserving winners and undoubtedly the best team of the day. Mrs.

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Elliott w ife of the Deputy General M anager, presented the awards. Dr. Tullis said the routine w ork was very good, and concluded his rem arks by su g gestin g that the teams should look at their m arking sheets to see where they had gone wrong. Mr. E dgar Uzzell, who organised the final competition, thanked his assistants and numerous helpers for the part they had played in m aking the day’s proceedings such a success. T his year each member of the teams ran kin g 1st, 2 nd and 3 rd was given a prize. T he Horsham men received an English Pewter three piece tea set on black plastic salver. Exm outh Junction No. 1 each had an oak table lamp com plete with fancy shade, while W aterloo No. 1 received cases containing silver plate spoons.

Letters to the Editor. W e are in no w ay responsible for the opinions expressed, or the statements made, b y Correspondents.— E d i t o r . A R T IF IC IA L D

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stretcher, with the patient on it, in three stages to the trestle. W hile this is being done No. 1 has to get up to his feet. Each movement takes place during an inspiration as follows :— First inspiration, No. 1 rises up on one knee, w hile the stretcher is raised just one foot off the ground. Second inspiration, No. 1 rises up to his feet, while the stretcher is raised waist high. Third inspiration, No. 1 steps sidew ays, w hile the stretcher is placed on the trestle, and is adjusted there by No. 2 , who during this time has been superintending the w ork, and if necessary g iv in g the orders. A practised team will be able to time their w ork without any orders. The patient is now in place, and No. 2 takes over with rocking, the first movement of which ought to be head downwards. All this takes much longer to describe than to carry out, and if any Divisions are interested enough, I shall be pleased to lend them an 8 mm. K od ak film show in g the whole opera tion, including also the drill for undressing a patient during the continuation of ro ck in g .— Yours faithfully, W a lt e r R a d c lif f e , M .B. (County Surgeon, Essex, S .J .A .B .) 7 , H igh Srreet, W ivenhoe, Essex.

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May 1 be allowed to add to Dr. Corbet Fletcher’s reply to the query from P .R . of Beccles in the April issue of F i r s t A i d , regardin g the change over from Schafer’s method of artificial respiration to the R ockin g Method ? Corporal Mayes, of W ivenhoe, and some of his colleagues demonstrated a drill they had worked out for this at the Essex County Officers’ Course last year ; and I think that it is worth passing on. Briefly this is as follows : No. 1 immediately starts Schafer’s method of artificial respiration, m eanwhile Nos. 2 , 3 and 4 obtain a blanket or rug, and the necessary stretcher and trestle. The trestle is arranged alongside the patient, and the stretcher in line but close to the foot of the patient, as for the custom ary “ load stretcher.” T h e necessary bandages to tie the patient’s wrists and ankles to the stretcher are placed in position. T a k in g the blanket, this is rolled up along one edge for about two-thirds of it’s width, and placed alongside of the patient on the opposite side to the operator, w ho should not be astride. T a k in g time from No. 1 , as he leans back takin g pressure off his patient, Nos. 3 and 4 roll the patient towards him while No. 2 pushes the rolled edge of the blanket as far under as possible. All this must be dene during the b ack wards movement of No. 1 , so there is no time to lose. No. 1 then carries on for a few breaths, and changes over with No. 2 , who kneels on the opposite side. Then the patient is rolled in the same w ay towards No. 2 between breaths, while No. 1 pulls out the roll of blanket. T h e patient is now on a blanket without interrupting respiration. T h e edges of the blanket are rolled up close to the patient to form hand grips. Th e next step is to get the stretcher under the patient. T o do this No. 2 , who is doing Schafer’s method, should get up on one knee. Nos. 3 and 4 take the rolled edges of blanket, standing with legs wide apart one each side ; and at a given word, as No. 2 leans backw ards, they lift the patient far enough off the floor— about IS to 18 inches, for No. 1 to push the stretcher underneath. T his cannot be done all in the short time that No. 2 is ta k in g off pressure between breaths, and if Nos. 3 and 4 are firm enough it will be found that No. 2 can perform one expiration while the patient is in mid air on the blanket, although not as efficiently as on the floor. It is important that the rhythm should not be lost. Th e patient should now be tied on to the stretcher, and this is a good moment to change operators again, No. 1 tak in g over from No. 2. T h e trestle being placed as close as possible to the patient on the side opposite to No. 1 , the next step is to lift the

IODINE. “ I o d i n e F a c t s ” are published from time to time in response to a widespread demand for iodine information in a con venient perm anent reference form. T h e many uses which are made of iodine in medicine, agriculture and industry are based on one hundred and thirty-four years of scientific research and practical experi ence. New facts about the element are constantly being discovered and formulated. T his information usually finds its w ay into print for the first time through channels not easily accessible to the general public or, indeed, to all scientific w orkers— in the proceedings of learned societies and in many technical journals published in various countries. T h e Iodine Educational Bureau makes such know ledge readily available through “ Iodine F a c ts ” but can publish only a sm all selection from a large mass of data. If there is any particular inform ation you require, write to the b u r e a u (address will be found in our pages), they will welcome your enquiry and render all possible assistance.

Casualties Union. fourth Annual Reunion of the above, will be held this year at Eton on Sunday, June 23 rd. Several First Aid Societies will be tak in g part in the First Aid and D iagnosis Competitions. Admission is by invitation only, which will be sent w illin gly by the Hon. Secretary, “ T h e B end,” Send, Nr. Ripley, Surrey. Readers desiring a ticket should enclose a stamped envelope for return postage.

T h e

C a t a l o g u e . — W e have just received from Messrs. E. and S. Livingstone L td., 16 - 17 , T eviot Place, E dinburgh, 1 , a copy of their new catalogue of Medical, S u rgical, N ursing, Dental and Scientific books. T h e publications of this firm cover a very wide ran ge and many will be found of extrem e interest to the first aider. Readers desiring a copy of this catalogue should w rite to the publishers at the address given above.

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EMERGENCY TREATMENT O F S K IN IN JU R IE S Be prepared for an emergency and keep Cuticura Brand Ointment in your First Aid Kit. It brings in stant soothing relief to cuts, burns, skin lacerations —prevents spread of infection, quickly heals. Obtain able at all Chemists and Stores.

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5 (1 T H E

S M A E IN S T IT U T E

L E A T H E R H E A D

S U R R E Y

130

F I R S T

Queries and Answers to Correspondents. Queries w ill 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 , 4 6 , Cannon-street, London, E . C . 4 .

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R I D

epileptic fit should not be given stim ulants such as tea and coffee? According to the Textbook, the face being pale, the administration of stim ulants would be in order ; I should be grateful if you would confirm that in epilepsy this is an exception where a stimulant m ight precepitate a second fit. I shall be grateful for your ruling on this point and tender very many thanks for past help. Personally I see no reason for w ithholding hot tea and coffee for a patient who, having recovered from an epileptic attack, is fully conscious and able to sw allow . Truth to tell the patient m ay be exhausted after the fit and further, hot drinks will not precepitate a further seizure.— N .C .F .

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 M anual of First Aid to the Injured.

the S .J.A .A .

W a tergla ss. A .B . (Pontypool).— Please can you tell me w hat is w aterglass which is used for preserving eg gs, and also w hat is your treatment if a patient’s face and eyes should be splashed with the sam e? M eanwhile I thank you for (and patiently await) your answer. W aterglass, which is used for preserving eggs, is roughly a 7 per cent, solution of sodium silicate. W hen dry it forms a film which is very hard. It is a non-corrosive alkali ; and if face and eyes are splashed with a solution of it, then the correct first aid treatment is to wash the affected parts freely with warm water. If this does not give relief, medical aid must be sought forthw ith. — N . C o r b e t F l e t c h e r . E xam in ation H ow ler. M .R . (Cannon Street).-— At a recent exam ination the doctor asked one candidate where he would apply pressure in the case of a patient whose forearm had been accident ally am putated just below the elbow. He was much amused when the candidate in all seriousness replied : ‘ 1 Below the wound ! ” Good 1 Next, please ! !— N .C .F . In tern al H aem orrhage. F .R . (W im bledon).— In a recent test, m arks were given for rubbing the limbs towards the heart of a patient who w as nearly unconscious and suffering from internal haem orrhage. As it seems that this would have the un desirable effect of encouraging the circulation I feel that such an action should in fact have been penalised. I should be very grateful for your ru lin g on the matter. Y o u r query gives no hint as to the cause and probable site of the haem orrhage. On broad lines, however, I do not consider that stim ulation by means of friction would have an adverse effect on the patient. On the contrary, there is the possibility that, the patient being “ nearly unconscious,” there m ight be an increased supply of blood to brain and that this m ight prove beneficial. Further, the inclusion of this item in the m arkin g sheet is justified by Clause 7 on p. 6 of the Supplement to the Textbook. T h e im portant point however, is that the trans fer of patient to hospital must not be delayed.— N .C .F . T rea tm en t o f E p ilep sy . F. R. (W im bledon).— Also am I right in asserting that a patient who has just recovered consciousness from an

E th ics o f F irst Aid. L .R . (Charlton P ark).— Recently I treated a boy for simple fracture of clavicle with improvised material, using his cap as pad in the axilla and two handkerchieves to fix elbow to body. A few minutes later I found that the boy had removed his cap and placed it on his head. I said nothing and left the boy to his own devices. Please tell me w hat you would advise me to do if this occurs again. Patients are at liberty to accept or reject the advice and assistance of doctors and first aiders. So I su ggest that if on some future occasion you should meet with the same experience and especially if the patient be an adult, you should act precisely as you did recently.— N .C .F .

F ra ctu red B ase o f Skull. A. P. (F inchley).— Recently I read in a newspsper that a man walked into hospital where he was found to be suffering from fractured base of skull. T his story puzzled me because I alw ays thought that with such an injury the patient would be totally unconscious. So I venture to ask your counsel, for which I thank you. T h e Textbook names only one condition in which in sensibility is invariably present ; and this is Epilepsy. In all the other conditions the insensibility may be complete (and immediate), m ay be partial (possibly passing to complete), may be delayed, and may be absent. W ith fractured base of skull all these four variations m a yb e present ; and I remem ber a case sim ilar to the one which you quote. Some hours after an injury to the head he also w alked into hospital where two or three days later insensibility developed and quickly passed to com a consequent on a blood clot which gradually formed in the brain and ultim ately caused death by compression of brain.— N .C. F.

T reatm en t of G re e n stic k F ractu re. D .Y . (Bristol).— In the treatment of a greenstick fracture (with which I take it that there is a risk of the tissues being caught between the partly broken fragm ents of the bone) would not the attempt to place the limb in “ as natural a position as possible ” cause additional pain ? If so, would it not be good treatment for the splints (by means of adequate padding suitably applied) to be adapted to any unnatural position of the bone. Y our kind comments will be appreciated. W ith a greenstick fracture the bone is partly bent and partly broken. Consequently there could be very little risk of the tissues being caught in the broken portion of the bone. W ith all fractures the Textbook (p. 66) tells you to place the limb in as natural a position (1) with great care, (2) without using force and (3 ) without letting go until the limb is secured in position by splints. In other words, if any pain

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is caused during your m anipulations, you must at once desist, because the onset (or aggravation ) of pain indicates that you are, in fact, usin g force.— N .C .F .

Police Ambulance News. M e tr o p o lita n

A D rill P rob lem . H .B . (Sheffield).— On behalf of several interested N .C .O .’s 1 am seekin g “ Counsel’s Opinion ” re the following :— A ccording to detailed instructions on page 54 of the revised M anual oj D r ill, to move a squad to the right flank, the movement is: “ Squad R igh t T u rn ” — “ Quick M a rch ” (to the desired distance) “ Squad H a lt ” — “ About T u r n ” — “ Squad R ig h t T u rn .” T o move to the left Hank the sequence is : “ Squad R igh t Turn ” — “ About T u r n ” — “ Q u ick March ” (to the desired dis tance) “ Squad H alt ” — “ R igh t T u rn .” If the above is correct, it seems an enormous waste of energy, particularly for Bearers Nos. 2 and 4 who are carrying the stretcher. W e than k you in anticipation of your kind reply. The instructions on p. 54 of the M anual of D r ill describe the various movements which should be practised by a squad with closed stretcher. Y ou err, however, in the assumption that all or most of these are necessary for a simple movement to a flan k .— E .T .M .

F ra c tu red F o rea rm and C ru sh ed Hand. G .R . (B irm ingham ).— T he members of our Division would be grateful for your expert opinion as to w hy the thumb should be left out in the treatment of fractured forearm, but not in crushed hand. Y o u r reply will settle quite a few friendly argum ents upon this question. By experim ent on yourself you will find that the hand feels more comfortable when the thum b is not held down by bandage. For this reason the thumb is left outside the bandage in the treatment of fractured forearm. W ith a crushed hand, however, there is grave risk that, either directly or indirectly, the thumb m ay be involved ; and so it must be immobilised by the b an d age.— N .C .F .

— No. 1

D is tr ic t

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T he No. 1 D istrict Police first aid competition was held at Ravenscourt House, Ham m ersm ith, on April 29 th. Six teams from “ A ,” “ B ,” “ C ,” “ F ,” “ T ” and “ V ” D ivi sions of the Metropolitan Police competed for the No. 1 D istrict First Aid Cup. T h e team test was judged by Dr. G. H. R. W rangham , S .J .A .B ., and was set in the greenhouse of a garden, where the team was called to deal with a patient suffering from prussic acid poisoning, burst varicose vein, wound at back of head, with arterial haem orrhage, and fractured patella. T he individual tests and questions were judged by D is trict Officer F. E. Stratton, S .J .A .B . T he Com missioner of Police of the Metropolis, Sir Harold Scott, Deputy Commissioner Col. the Hon. Sir M aurice Drum m ond, Assistant Commissioners, Sir George Abbiss and R. M. Howe and D istrict Commanders, Major P. R. M argetson and Col. G. H. B. de Chair, were am ong the Officers present. Medals for the winning team were provided by Sir G eorge Abbiss. T he competition was won by “ B ” or Chelsea Division, with a total of 268 ^ m arks. Runners-up “ F ” or Ham m er smith Division, with 264 ^ marks. T he cup and medals with prizes were presented to the winning team and runners-up, at the conclusion of the com petition by the Commissioner, Sir Harold Scott.

e n t

o u n t y

o n s t a b u l a r y

On Saturday, April 27 th, the K ent County Constabulary first aid competition was held at Force Headquarters, Sutton Road, Maidstone, and the results were as follows :— M edway Division 262 m arks, Canterbury Division 245 £, W ingham Division 195 , Sw ale Division 191 , Folkestone Division 158£, Tunbridge W ells Division, 148 , and Sevenoaks Division 107 . T he First Aid Shield was presented to the w inning team by Mr. R. C. M. Jenkins, Assistant Chief Constable of Kent.

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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 8th of each month, and must be accompanied ( not necessarily for publication) by the name and address of the Correspondent. Subscriptions, Advertisements and other business Communications connected with F IR S T A ID should be forwarded to the Publishers. D A LE, REYNOLDS & 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 Address— “ Twenty-four, London." Telephone— City 3710.

CO N TEN TS

d it o r ia l

THIS

NUMBER.

...

133

...

134

—

Voluntary Effort

...

Side L ig h ts on First Aid

...

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

...

135

Nostell Colliery First Aid Society

...

137

R ailw ay Am bulance News

...

137

S .J .A .A . Overseas

...

137

Letters to the Editor

...

138

“ Collect Wounded ”

...

138

...

139

Reviews Q

u e r ie s

... a n d

... n s w e r s

t o

o r r e s p o n d e n t s

:—

Hypnotic Poisoning

...

Exam ination H ow ler

...

Admission to T he Order

...

D rill ... ... ... Aw ards of T he Order of St. John Strong or W esk T ea ...

... ... ...

Perforated Duodenal U lcer...

...

Torn Fem oral Artery Figure-of-E ight B andage

... ...

142 142 142 142 142 142 142 144 144 144 144

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144

Service Medal of T h e Order Efficiency of W ar Service

New Mobile U nit

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... ... ...

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C o n s i d e r a b l e interest attaches to the a c c o u n t written by priso n e r s of war of their e x p erien ces d u r in g the y ea r s of c a p tiv ity . “ N o r iron bars a c a g e ” is the title of on e of these, and a n o th er e x p r e s s e s in g l o w i n g term s his a p preciation o f the parcels for p r iso n e r s’ serv ice, w h ic h form ed s u c h a feature of the work s o c o n s is t e n t ly carried on by the R e d C ross. S a y s the a u th o r — “ M a n y tributes h a v e a lready been paid to the R e d C ross food parcels. It is im p o s s ib le to sp e a k too h i g h l y of all the R e d C ross has d o n e in e v e r y w a y for the prisoners. It s e e m e d a m a z in g that w e three prisoners of war, tucked a w a y in ho sp ita l in P aris and off the beaten track of the c a m p s, s h o u ld h a ve been re g u la r ly su p p lie d w ith parcels and never o v e r lo o k e d . T o b egin w ith, w e received the invalid co m fo r ts parcels w h ic h w ere s p e c ia lly m ade up for the sic k and w o u n d e d , and con ta in ed not o n ly m edical requi sites but a lso various fo o d s for b u ild in g up s tr e n g th . Later on w e a lso g o t the o rdinary food parcels w h ic h were b e in g se n t to the prisoners in G e r m a n y . T h e s e were le ss elaborate, but e v e r y t h in g in them was e x c e lle n t. O n top of th ese c a m e the parcels of cig a r e ttes and tob acco, as w ell as th o se c o n t a i n in g m edical s u p p lie s and d r e s s i n g s . ” T h i s P .O .V V . T r ib u te is q u oted in the M ay iss u e of the Summary of Work of the R e d C ross and S t. John W a r O r g a n is a tio n , and a m o n g other in te r e stin g and in stru ctive features is a re port of the v isit of F ie ld -M a r sh a l V i s c o u n t M o n t g o m e r y , C o m m a n d e r in C hief o f B . A . O . R . , w h o w a s present at a m e e t in g of civilian relief workers, w h ic h included the team leaders from all parts of the B ritish zo n e , and, in a d d r e s s in g th e m , he said “ I w an ted to visit the headquarters of the B ritish R e d C ross C ivilian R e lie f s o that I could th an k y o u all for the help y o u h a v e g iv e n me d u r in g the c a m p a ig n in N o rth W e s t E u r o p e , and later d u r in g the o c c u p a tio n of G e r m a n y . Yours h as not been an e a s y task. Y o u r w ork has been in v a lu a b le to the A r m y , and I w a n t y o u all to k n o w h o w m u ch I appreciate w h a t y o u h a v e d o n e . T h is headquarters is n o w the centre o f a la rg e

V o lu n ta ry E ffort.

F I R I T

o r g a n is a t io n ; I b e lie v e y o u h ave nearly 6 0 team s at w ork in G e r m a n y . L ike the A r m y itself, y o u h a v e g r e a tly e x p a n d e d s in c e the d a y s w h e n y ou landed on the b e a c h e s at A r r o m a n c h e s to help us to deal w ith the F r e n c h civ ilia n s, and later w ith the c iv ilia n s o f B e lg iu m and H o lla n d . I often th in k that s o m e of y o u r finest w ork w a s d o n e in H o ll a n d last year. T h e c o n d itio n s there, as y o u k n o w from e x p e r ie n c e , were e x tr e m ely bad. T h e r e w a s a g r e a t d a n g e r of our troops b e c o m in g in fected w ith d ise a se s c a u g h t from the c iv ilia n s. \ ou did a fine jo b in c o m b a t in g e v e r y ty p e of in fe c tio n , and y o u g a v e Britain a very h ig h nam e in the m in d s of m a n y of th o se p e o p l e .” A s he e x p r e s se d it, the grea t v o lu m e of v o lu n ta r y effort w h ic h w a s m ade d u r in g the W a r w as the factor, m ore than a n y other, w h ic h carried us th r o u g h this W a r , “ and w e se e it carried to its h ig h e s t d e g r e e in the B ritish R e d C ross and the other v o lu n ta r y s o c ie tie s asso ciated w ith i t . ”

S id e B y

L ig h ts o n

F ir st A i d .

S I R H E N R Y L. M A R T Y N , K .C .V .O ., F .R .C .S .

subject of shock is far too important to be dealt with towards the end of the already overcrowded first lecture. It is, in fact, worthy of a lecture all to itself, not only for the importance of the condition but also for the difficulty which all students find in understanding it. For all practical purposes there are only three things which cause death after an injury— haem orrhage, asphyxia and shock. Every student has seen sligh t haem orrhage, most can im agine asphyxia, but shock is one of those in tangible things which, unless actually seen, is very difficult to visualise. It may be defined as a state of profound depression of the vital activities of the body which occurs to a greater or less extent after every case of injury, lt is, in fact, the illness which results from an injury and, like every other illness, it has own signs and symptoms. T h e majority of my readers will by this time have read the Supplement to the 39 th edition of “ First Aid to the Injured.” T hat this supplement has at last made its appearance is a m atter of the utmost im portance to everyone interested in the science and practice of First Aid. T hrough out the w ar tlVe Ministry of Home Security and the M inistry of Health did their utmost to provide the personnel of the Casualty Services by means of their hand books with the most up to date know ledge possible. U nfortunately as much could not be said for the authorities of the St. John Am bulance Association. Y e a r after year throughout the w ar teaching continued, exam inations were conducted, and certificates issued on the basis of the authorised T e x t book last revised in September, 1937 ! How real was the need for the revision is clearly shown by the fact that it has been found necessary for the new supplement to extend to 33 pages, 30 of which are devoted either to re-w riting com pletely large sections or even entire chapters of the old T e x t book or to providing supplem entary information. I propose in subsequent articles in this series to embody the modernised teaching of the new supplement as it comes into the picture. Chapter IV on Shock in the old Textbook has been entirely re-written and considerably extended. For the first time the difference between prim ary and secondary shock T h e

R ID is clearly explained, and crush injuries and their treatment receive their first mention. T he easiest w ay of m em orising the essential points in the treatment of shock is to learn the four things which tend to accentuate it, nam ely— ( 1) Haemorrhrge ; (2 ) Pain ; (3 ) Cold ; (4 ) Fear. Obviously, therefore, deal first with any severe haemorrhage, next take steps to deal with the injury itself by temporary measures designed to relieve pain and m ake the patient com fortable without exposing him, next do everything possible to promote warm th and, finally, to relieve fear. T he latter is very genuinely im portant and only too frequently forgotten. T h e patient who has just survived a bad accident at the cost of a severe injury is terrified, no m atter how bravely he may conceal it, not only as the result of w hat he has been through but of the death or dis ablement which he feels may be in front of him. As long as this state of mind persists there is little chance of over com ing his shock, and a quiet word of confident re assurance will go a long w ay towards im proving his physical condition. Transport is a matter of very great importance when dealing with a case of severe shock. Providing that no condition exists which demands urgent operation, such as abdominal injury, internal haemorrhage, or compression of the brain, as a general rule it is better to delay m oving a badly shocked patient until some improvement in the con dition as the result of treatment on the spot has taken place. It is quite possible that it may be thought advisable to transfuse the patient with blood or plasma before m oving him at all, and even to continue the transfusion while trans porting him in the ambulance. T he shock of a chest injury will be greatly increased if roughly transported, and the driver of an ambulance carryin g such a case should be warned not to drive at more than 10 m .p.h. and to choose the smoothest roads available. T ransport by air in preference to road has saved many lives in this type of case. In burns, shock is extrem ely early and severe, and is the commonest cause of death in the first few hours. Not a moment’s delay should be allowed to occur in trans porting bad cases to hospital improvement is unlikely from any treatment other than immediate tranfusion in order to replace the rapid loss of fluid which occurs from the burnt areas. In the first great w ar many lives of men suffering from fracture of the femur were lost from shock alone through splinting them only on the long wooden splint from armpit to foot, and then subjecting them to long carries down communication trenches on stretchers and then by ambulance over shell torn roads to the C .C .S . T his method of splinting was found to be ineffectual in controlling movement of the fractured bone ends and conse quent shock during rough journeys, and the use of the Thom as splint was made compulsory, even in the front line, with the result that the m ortality from shock was greatly reduced. W ith regard to the causes and varieties of fractures one or two comments may act as pegs upon which to hang the m emory of facts. It is not alw ays clear to the student how m uscular action can cause a fracture. T a k e the standard example of a fractured kneecap. T h e lower edge of the patella is fixed to the upper end of the shin by a powerful and quite inelastic ligam ent. T o the upper edge is fastened the im mensely powerful group of muscles on the front of the thigh. Im agine a man to be running fast and to be just at the point when the thigh muscles are contracting hard in the effort to straighten the bent knee and throw the whole leg forward. At this moment let the movement of the leg be suddenly arrested by catching the toe on a projecting stone. T he patella is balanced across the front of the bent knee and is snapped across it like a dry stick.

F I R

> T

The upper arm bone is occasionally broken in much tbe same way in tbe act of throw ing, for exam ple, a stone or cricket ball. One of tbe most curious exam ples of tbe immense force which m usular contraction can exert which has ever come my w ay was that of a man who, with one hand on the ball of a cistern and the other upon the faulty lead of a wander lamp, took a shock of 300 volts A .C. directly from one hand to the other through both arm s and shoulders. T h e result was so tremendously violent a con traction of all the arm and shoulder muscles that both arm bones were fractured just below' the shoulder joints, the upper ends of the broken shafts of each hum erus were forced into the heads, i.e., impacted, and finally the heads of the bones themselves were dislocated from each shoulder joint. Note carefully the definition of a compound fracture. Students are apt to have the impression that this term applies only when the fractured bone projects through the skin, as pictured in some of the standard illustrations. It is to this type of compound fracture that the instruction par ticularly applies, w arning the first aider to m ake no effort to straighten or extend the broken limb in order not to risk d ra g g in g back into the interior of the part the dirty and contaminated bone. Remember, however, that a compound fracture is equally one in which the wound extends down to the site of the bony injury, as would be the case in most w ar wounds. In such a case, of course, no further harm can be done by dressing, straightening and splinting the limb. The Greenstick fracture of children, generally seen in an arm, is far more common than is realised, probably many are missed altogether under the impression that the case is one of a simple sprain. A lw ays think of it w'henever a child, after a fall, complains of more pain and loss of power in the limb than the accident would appear to have warranted. Several points may be worth noting with regard to the treatment of fractures. Remember that in the process of straightening a broken limb and, in the leg, of correcting shortening by extension you are go in g to cause the victim considerable pain. Unless the first aider is prepared for this he may readily loosen his hold upon the fracture. If you are go in g to give a patient pain hold the limb firmly and do what you have to do steadily and strongly. Do not jerk or use force, and, above all, do not hesitate, or you will certainly cause unnecessary pain in an effort to avoid givin g any at all. W henever you are in doubt as to w hat sort or length of splint to employ, remember the one standard rule, namely, that it must be long enough to control not only the fracture but the joints above and below the injury. Y o u have only to ask yourself does the splint which I have just put on conform to these requirements or not, if it does, a ll’s well, but if the joint above or below can be moved, then it certainly does not. In the case of a simple fracture of one or more ribs without injury to an internal organ, you are instructed to apply either two overlapping bandages or a folded towel firmly enough to afford support. T h e difficulty is how to do it. If such a bandage is to relieve pain, it must be tight enough to prevent a deep breath or the agon ising stab of pain resulting from a cough or sneeze. This degree of tightness can only be obtained if the bandage is drawn tight and knotted while the patient has expelled as much air as possible from his chest. Stand with the knot ready to tie and instruct the patient to exhale as fully as possible. W hen the chest has reached its mini mum size, m ake fast your knot and repeat the process for the second bandage. T h e result will be an effectively firm and com forting support for the broken rib instead of two quite useless bandages which will be fallin g around the patient’s feet by the time he rekches home

R I D

x 35

St. John Ambulance Brigade D IS T R IC T

REPO RTS.

N o . I (Prince o f W ales’s) District No. 147 ( E a s t B a r n e t ) . — This sm all but virile Division are fortunate indeed to have an active Social Com mittee. Several successful dances have been arranged during the W inter Season, which has just been wound up by a “ Grand V ariety C o n cert” at their H eadquarters. T h is was the first attem pt in this direction, and the support given to it by the record attendance of an audience of nearly 300 , speaks for itself. T he show consisted of 12 really good numbers, and ended appropriately with a humorous first aid sketch entitled “ T h e Patient’s D ilem m a,” performed by men of the Division. T h e large attendance included the President, Councillor F. L. Snow. No. 1S 1 ( M o l e s e y ) . — At the annual general m eettng of the above Division on Saturday, May 11 th, the Chairm an stated that the acute lack of hospital accommodation had resulted in an increase in home nursing and the establishment of medical comforts depots as envisaged by the S .J .A .B . would fulfil a very real need. T he D iv. Supt. had earlier explained that during 1945 , a drive had been made to implement the funds so that a comforts depot could be installed. T hey now had the funds and were in a position to staff a depot, but the great im pedi ment was the fam iliar one of lack of accomm odation. T h e Secretary reported that of the 292 public duties per formed during the year, many were attended in London. Fifty-six cases of accident or sudden illness had received assistance at the hands of members of the Division. T h e Chairm an complimented the Division on the keen ness of the active members and reminded them that with the return of peace-time functions, duties would become more interesting. T h e Chairm an was Dr. P. A. R odger (Div. Surgeon).

58/5 ( W e s t e r n 115 ( S t . J o h n s

P o s ta l

S t.

M a r y le b o n e )

D iv is io n

T he above Divisions held their first post w ar annual dinner and dance at M acks Restaurant, Oxford Street, W .l, recently. His W orship the M ayor of St. M arylebone, Aid. C. Steel accompanied by the Mayoress were am ong those present. T h e chair was taken by the Division President, Mr. H earn, Postmaster, W estern D istrict assisted by Mr. C. A. Forsdick, Assistant Postm aster, V ice President. H is W orship the M ayor in replying to the Visitors toast expressed his great pleasure in being present at this ga th er ing, and said that he had the interest and well being of the Divisions of the S .J .A .B . greatly to heart and would do all he could to foster them. Mr. C. A. Forsdick said that he w as very happy to announce that the problem of the D ivision’s H eadquarters accom m odation was, he thought, practically solved. Suit able premises had been alm ost agreed upon. D ancing to the band of Ernie Hill took up the latter part of the evening and a happy and enjoyable time was experienced by all. an d

W o o d )

N u r s in g

D iv is io n .—

County o f Bedford. L u to n C o r p s . — W ardow n Am bulance Division carried of the “ John Burgoyne ” trophy, in the annual team test competition, held at Dunstable Road Junior Mixed School on Saturday, May 25 th. T here was keen competition between the eight Luton

F I R S T

Divisions, and the winners had only a tw o-m ark lead over S kefko Division, the runners-up. T h e M ayor and Mayoress, Councillor and Mrs. W . G. Roberts, were am ong those present. T h e ju d ge, D r. J. K elsall Thom as, of Dunstable, set the team s an unusual test of circum stances like those which resulted at the Bolton football disaster, using three “ patients.” Alderm an Burgoyne presented the prizes to the w inning team.

County o f Berkshire. M a id e n h e a d .— A competition in first aid was held recently between the Maidenhead Am bulance and N ursing D ivisions for a silver cup presented by Dr. W . Brodie Moore, Div. Surgeon and Medical Officer of Health for Maidenhead. Three team s from the Am bulance Divisions and two from the N ursing Divisions entered, the winners being the N urs ing Division team captained by Am bulance Officer M. Richards. T he trophy, which will be competed for annually, is to be know n as “ T he W illiam Brodie Moore C up.”

R e a d in g C o r p s . — On Saturday afternoon, May 4 th, at the Am bulance H all, Chatham Street, R eading, a com peti tion in first aid and home nursing for the Dr. H ow itt Cup was held between team s from the N ursing Divisions of R ead in g N ursing Corps. Four teams entered, the winners being Team No. 4 from R eading South N ursing Division captained by S gt. Mrs. M. Essex with 271 m arks out of 388 . T h e Cup, which will be held for twelve months, was presented to the w inning team by the County Comm issioner (Mr. C. A. Poole). T ea was provided.

R e a d i n g S o u t h e r n . — On Thursdayevening, M a y 2 nd, at the Am bulance H all, Chatham Street, a presentation of aw ards was held by the Am bulance Division. T he County Com m issioner presented lon g service medal ribbons to Amb. Officer W . Barton and Cpl. P. Meads ; two long service bars to D iv. Supt. A. M. Pope and a long service bar to Amb. Officer F. M arshall.

A I D

County o f Lancashire. P a d g a t e . — The pupils of the Bailie School of D ancing and Mimi (principal, Miss D. Bailie), supported by the Green ing L ight Orchestra, gave a dancing display in the Bell Hall for the funds of the above Division. Special features of the display were the national dances of Russia, France, Denm ark, N orway, Sweden, Switzerland, the Rum anian w edding dance, Double Irish, Irish Jig and H ighland F ling. T h an ks were accorded to Miss Bailie, company and orchestra, conducted by Mr. H. A. Roberts, by Corporal Cream er, of P adgate Division and by Corps Officer Massey, of W arrington. D uring the course of the evening it was announced that Mr. C. N. Geldard had been promoted to Div. Supt. of P ad gate Division, and Mr. J. W alton to Cadet Supt. It is most gratifyin g for Div. Supt. Geldard to receive his promotion, as he has been almost blind for a long time, due to an accident, and has studied for his exam ination only since his eyesight in one eye has been restored. H e has now been admitted to hospital for an operation on his other eye.

County o f Northam pton. L ast month, the Northampton H .Q . Division revived one of its pre-war competitions, the “ W ilkinson C u p .” This is an individual competition consisting of a series of questions on first aid to be answered on paper, the five best are then given a practical test case to deal with. The questions and test were set and judged by Div. Surgeon Dr. T . M. Murphy. At the w eekly drill on June 3 rd, the cup was presented to the winner, Corpl. F. Gibbs, by Mr. H. W ilkinson, a former Superintendent of the Division and son of the donor. Div. Supt. H. I. Edwards said it was hoped to revive the Corps competition very shortly.

County o f Surrey. C h e a m .— A new St. John Cadet Am bulance Division has been formed at Cheam, Surrey, and has been registered as the C 89 (Cheam) District. There are at present II cadets and 12 probationer cadets.

O b i t u a r y . — W e regret to announce the death of Amb. Sister Miss E. K . Batten of Reading Post Office N ursing Division. By her death the Division has lost one of its original members, as Miss Batten joined on its formation in M ay 1939. In 1940 she volunteered for special duties attached to the W .A .A .F . for w hich her Post Office training gave her exceptional qualifications. She returned to civilian duties in September 1945 , but was unable to resume effective B rigade membership through illness, which was keenly reg retted. T h e funeral service, which took place at St. Peter’s Church, E arley, on M ay 3 rd, was attended by Officers and members of R eadin g Post Office N ursing Division.

S w i n d o n . — Members of the Swindon Division are to build their own headquarters as soon as plans are approved by the Swindon Tow n Council. T h e scheme is estimated to cost between ,£ 2,000 and £ 3 , 000 , and will take about 18 months to complete. The members hope to augm ent their present funds by the pro motion of various events. T he new building will have two storeys, and is intended to be the headquarters of the men’s and three nursing D ivi sions and the three cadet Divisions of the S .J .A .B . in Swindon.

County o f E s s e x .

County of Worcester.

— A fully laden lorry travelling from the Tham es Board Mills, Purfleet, to Grays, ran up an incline and over turned. Cpl. J. S tirk and Pte. J. Gam e of the Grays D ivi sion were quickly on the scene, and whilst Cpl. Stirk was m akin g arrangem ents for the use of a nearby house, Pte. G am e returned to the Mill on his motor cycle to collect the firm’s am bulance. In the meantime, am bulances belonging to the T hurrock Council and G rays Division, with Amb. Sister Mrs. Mepstead as attendant, had arrived. In all, 19 cases were treated, 3 of them being detained in T ilbury Hospital, whilst some were attended to at the Mill Surgery. W eather conditions were unfavourable and these three B rigade members are to be congratulated on w ork m ethodically and sensibly done with hastily improvised first aid material.

L y e . — T h e Officers and Cadets of the Lye Cadet N ursing Division gave a party on Friday, M ay 24 th, at the Am bu lance H all, Lye, in celebration of the second anniversary of their enrolment. T h e combined cadets were inspected by Area Cadet Officer Mrs. Lam b who congratulated them upon their smartness. Mrs. Lam b presented Corporal’s stripes to Cadet Meriel Rhodes. T h e program m e included anatomical medley (Quiz), ban daging competition and gam es. Refresh ments were served by members of the Lye N ursing Division. Cadets from neighbouring Divisions were also present.

G ra y s .

County of Wiltshire.

T h e county final competition of the S .J .A .B . in the county of W orcester was held in the Christopher W hitehead

F I R S T

School, W orcester, on Saturday, May 25 th. T he teams com peting for the County Am bulance Shield and the Com m issioner’s Cup were Brierley Hill (North) and Redditch (South). There being no team to represent the North of the County, Brom sgrove N ursing Division who had won the Southern Area elim inating competition were awarded the County N ursing Shield. Am ong the large audience present was the County President The Countess Beaucham p, M .B .E . (Officer of the Order of St. John). T h e ju d ges were : team test, County Surgeon Dr. Nicol (Birm ingham ) ; individual tests, Div. Surgeon Dr. G. J. Meikle (Malvern). Assistant Commissioner Dr. C. Porter announced the results as follows :— Redditch 254 m arks, Brierley Hill 233 . Countess Beaucham p presented the trophies, and con gratulated the winners. She said that competitions certainly kept up keenness and efficiency and the lessons they taught were well worth learning. P o v v i c k . — T he annual m eeting of the N ursing Division was held recently. Div. Supt. Mrs. H. M. H iscock in her report stated that the strength of the Division was now 22 . Thirteen members had passed the annual re-examination, 5 members became eligible for their first Service Chevron and 2 members for the 2 nd. One member gained her 6th W ar Service Bar for full time C .N .R . Duty, whilst another member gained her 4 th W ar Service Bar for voluntary work in connection with Hospital Library and Hospital Service escort work Thirty-nine practices in first aid and home nursing had been held during the year and attendances had been very satisfactory. A medical comforts depot has now commenced to function.

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1 3 7

Railway Ambulance News. SOUTHERN H o v e . — A most successful first aid quiz competition was held at the Ralli Hall, Hove, on Saturday, May 18 th, when the Horsham team beat Redhill in the final by 37 £ points to 36 £. Other team s com peting were Brighton Engrs. Dept., Brighton C .M .E . W orks, L an cin g C .M .E . W orks. Three points were allowed for a correct answ er with m axim um for contest of 45 . An audience of over 150 witnessed the event. T h e Mayoress, Mrs. H. C Andrews, presented each member of tbe w inning team with a case of teaspoons, silver butter dishes being given lo the runners up. T he proceedings were brought to a close by an enjoy able concert.

R e d b r i d g e . — T he resumption of the competition for the Redbridge C hallenge Cup, after a lapse of seven years, was a most pleasing event. There were 16 teams com peting for the above Cup and the “ Robert G illingham ” Cup. T he prizes were presented by the wife of the founder of the competition, Mrs. R. G illingham . T he ju d ges were Dr. A. Ayres of Bognor R egis, and Dr. K. Mawson of Horsham . T h e winners were B asingstoke No. 1 with 238 m arks ; second, Southampton D ks. “ E ” 229 ; third, Salisbury Loco 220 ; and fourth, B asingstoke No. 3 214 . Mr. E. Uzzell (W elfare Officer and Centre Secretary) presided.

West R id in g o f Yorkshire. B r a d f o r d . — On Saturday, May 11th, the above Corps held the annual competition for the N ursing Division, when three teams competed, City, M anningham , and Bolling, the winners being M anningham , with City second. M anning ham hold the “ Busby Cup ” for one year and also received Saving Certificates. Judges for the competition were Dr. Chester and Dr. Todd. Cup and prizes were presented to the w inning team by Dr. F. G. Crawford. There was a good attendance of spectators.

Nostell Colliery First Aid Society. T w o instructive and interesting visits were made by the members of the above Society recently, one to the Mines Rescue Station, W akefield, and the other to Leeds General Infirmary. D uring the first visit, useful hints on first aid treatment for burns was given by Supt. W . Riley, who conducted the party round. A rocking stretcher was displayed, also a new type of resuscitator. Fully equipped motor transport, which stood ready to deal with any em ergency call, was inspected. Am ong the sections visited at the Leeds General Infirm ary were the new private patient’s department, a new kitchen and a special diet kitchen, also the new X-ray diagnostic department, which occupies 6,700 sq. ft. on the second floor of the Infirm ary extension. Members were invited to stand behind the teleorthoscope, an instrument used for internal exam inations. A tour of the laundry was made, the visit concluding with a tour of the Princess Mary ward. Follow ing tea, the whole contingent attended the Empire Theatre. T h e next outing will probably be to the Sheepbridge Coal Com pany’s first aid station. A field day, sports and am bulance competition is being contemplated for members of the senior and junior sections, and it is hoped to include a novices’ competition for a trophy and medals.

S.J.A.A. Overseas. WlTWATERSRAND AND SOUTHERN TRANSVAAL (S. A.) CENTRE.

W e acknow ledge receipt of a copy of the Third Annual Report and Accounts for the year ended Decem ber 31 st, 1945 . In an accom panying note the Secretary (Lt. Col. F. W . Sm yth, O .B .E ., S .B .S t.J .) states that when w ar broke out in 1939 , it was realised that St. John had a tradition to live up to, and the Com m ittee of the Association were ready to meet whatever demands m ight be made upon it. T h e V .A . D .’s made a m agnificent response to the call of the Association when, in face of considerable opposition, the Committee successfully established the first A uxiliary M ilitary H ospital in South Africa, which resulted in the founding of tw enty others all over the Union. T h is spirit of loyalty and devoted service w as very evident throughout the w ar jea rs. N ow that the war is over, St. John has turned its atten tion to the alleviation of suffering am ongst the less privileged sections of this country. It has been decided to establish near Johannesburg an O phthalm ic Hospital sim ilar to the one in Jerusalem. It was only after the Report had been published that the announcement was made that T heir Majesties, the K in g and Queen, accompanied by the Royal Princesses, would visit this country, and it is the ardent wish of all St. John m em bers that they may be given the opportunity of w elcom ing T h eir Majesties.

Members of the London D istrict of the S .J .A .B . manned

59 first aid stations including 15 dressing stations along the route of the V ictory Parade in Central London. D uring the aquatic display 18 stations were manned from Savoy Hill to V au xhall Cross,

F I R I T

Letters to the Editor.

“ C ollect W o u n d e d .”

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

“ R E F IN E D ” D

e a r

FOODS.

,—

By “ r e fin in g ” our foods over much, incidentally with great w aste of ingenuity and labour, are we not needlessly injuring health ? T he fam iliar story of the w heat berry is now underlined by experience in the United States with domestic salt. Shortly, it has been found in the United States that refining salt and tak in g out the iodine which N ature provided resulted in widespread ill health manifest in sim ple goitre. W hen, through the co-operation of public health authorities, doctors, the salt m anufacturers and grocers, iodine was added to the salt and iodized salt was popularized, goitre was proportionately reduced. Now the Am erican Medical Association is recommend in g that a sufficient amount of iodine be added to all the domestic salt used in the United States. A sim ilar recom mendation for this country w as made more than two years’ a g o by the Medical Research Council Sub-committee which studied the subject. Iodine is already added to half the domestic salt con sumed in the United States. In this country the proportion is n egligible. Apparently nothing has been done about the Medical Research Council recommendation, although the health of hundreds of thousands of women and young people particularly, continues to be needlessly im paired.— Y o u rs faithfully, A.

L a n c a s te r

S m it h .

Arcot Orchards, Sidmouth, Devon.

S E R V IC E . D

e a r

,—

Much has been stated in your Journal from time to time about service records. I wonder if you know of any to com pete with mine ? Passed first aid Jan. 1931 , home nursing March 1933 , medallion A ug. 1933 , sanitation and hygiene July 1942 . Received public anti g a s certificate and Royal Life Saving Society’s B ad ge for Artificial Respiration in 1939 . Appointments held in the B rigad e : Div. Secretary from Feb. 1938 , promoted to Sergean t March 1939 , and Amb. Officer in Dec. 1945 . I was elected to the Com m ittee of the St. John Am bu lance Association in Jan. 1935 and appointed Secretary in M ay 1940 . This latter position was held until April 1946 , when I had to resign ow ing to my appointment as Councillor on the U rban D istrict Council. I have been a member of the Salvation Arm y for 35 years and have just been presented with the long service badge and bar for 25 years service. My w ar service includes four years with the B .E . F., 1914 - 1919 . In this w ar I have served as Sergeant in charge of stretcher bearers.— Yours, etc., J.

N u tt a ll.

Barnoldsw ick, Colne, Lancs. April 30 th, 1946 . [Congratulations Mr. Nuftall on a fine record. anybody beat it ?— E d i t o r , j

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Can

B v J. W . S C O T T . U n d e r the above heading, you will no doubt agree that there is still much to be thought about, in spite of the fact that we no longer have to deal with Air Raid Casualties. Not to be forgotten, however, is the ever increasing number of cars and motor cycles now on the road, also the additional bus services on many routes (but not the one that goes to and from my office !) Unfortunately, there will alw ays be street accidents, no matter how much the ‘ Safety First ’ is pumped into the public, and the need for stretchers and the know ledge of the handling of stretchers and stretcher cases is still of para mount importance. Furtherm ore, the need for research and study to endeavour to discover new means of more effective and com fortable transport of the injured is still as great as ever. The new supplement to the textbook has made some great strides in this direction, and one very important alteration applies to the loading of spinal injuries. No longer do we have to ju g g le about with various types of these spinal troubles— no more turning and tw isting on to tummies, etc. For all spinal injuries, the supine position, please. T h a t’s a bit of good news, isn’t it ? T im e and time again have I wondered w hy a class is informed by the D octor of the extrem e danger that is attached to any move ment of a fractured spine, of the very delicate nature of the spinal cord, and the direful results if the cord be pinched at all between the two vertibrae. Then the class is shown the various methods of loading, turning and tw isting patients on to a stretcher. Often have I winced as I have watched the efforts of some when they have been at practice on this subject ; and I know quite well that my classes have winced when I have been dem onstrating ! Now that I am on the subject of loading, I would like to talk about the “ word of com m and.” B rigade drill, I find is pleasing to witness at all and any time, and naturally, to a great extent, the smartness of movement does depend on the manner in w hich the command is given. But I do think, and I think you w ill agree, that from the time that the order “ Collect P a tie n t” is given, the guardsm an-like manner should be dropped, and a bedside, or I should say stretcher-side, manner be adopted. From the time that the patient is approached, all movements should be done in a smooth like movement, never a sharp movement or a jerk. “ Lift stretch er” should not be “ snapped o u t” for fear that stretcher be “ snapped u p ” and the patient does a two or three inch bump on the stretcher ! Instead of that crisp manner, the command should be drawn out. “ Li-i-ift Stretcher,” so that it is conveyed to the team that the move ment is slow steady and smooth, avoiding any risk of a jerk during the lift. As the stretcher is lifted, be sure that it is not tilted at all ; an even lift must be maintained. W hen stretcher drill is being rehearsed, it it wise that each member of the team has a turn of being the “ patient” and to feel for him self the various sensations while being lifted by four, five, six or seven bearers ; he will feel, if he allow s himself to go limp, just as a real patient would be, w hat it is like to have his head h an gin g backw ards, un supported, as he is hauled on to the three or more knobly knees ; how, if he is allowed to sag in the middle portion, he has to have an extra heave in that part to be d ragged on to the middle m an’s knees, and he can easily im agine the additional discomfort an injury would be. W hen No. 1 returns with the stretcher, will he please take care of how he places it. I and m any others have had some fearful cracks on our ankles and shins when the stretcher is hurriedly and carelessly placed.

F I R S T

Now to transport. T he sam e smooth manner applies in this section equally as much. Important is the broken step, else the patient will be taken for a most sickening ride because of the “ w h ip ” of the stretcher, especially the allmetal type. It is surprising, too, how difficult this is to check once the rock has go t going. Traction— gentle traction on the head and feet by two bearers is also mentioned in the new supplement.. You will note that it says gentle traction, and in no w ay must it border on the “ r a c k ” principle, as practiced in days of old. W hen perform ing a blanket lift for a spinal fracture, care must be taken that the head and feet are carefully turned in uniform with the body, as it is turned on to the roll of the blanket, otherwise you will be faced with further trouble, a kink in the cord, for instance, or a twist in the vertibrae. An alternative method of blanketing a stretcher is also referred to in the supplement, and this method allow s for adjustment to be made, according to the length of patient, by pulling the 3 -fold blanket nearer or further aw ay from the crossbar of the stretcher. And last but by no means least, don’t at any time step over your patient.

Reviews. Illustrated. Handbook op Instruction oj the Royal L ije Saving Society. London : 14 , Devonshire-place, W .l. Price 3I - b y post 2/4.. This handbook of instruction was first published in 1891 when the Royal Life Saving Society was founded. It has had a popular and successful career down the years ; and it has recently been completely revised and re illustrated, the result being that it is a most comprehensive and valuable guide to life savin g and that it should be in the hands of all swimmers. T h e book is attractively presented and gives instruc tions both for those who wish to learn sw im m ing and also for those who are interested in more advanced sw im m ing strokes. Another pleasing and useful feature is that it con tains sound physiological information relative to the Schafer method of artificial respiration. Tw o members of the S .J .A .B . from M alta (an Am bu lance Sister and an Am bulance Sergeant) marched in the V ictory Parade in London. Th e official Textbook of the S .J .A .A . is being translated into Greek, Turkish and German, the latter for the training of Germ an police in first aid. Colonel Sir Alfred Webb-Johnson, B t.,K .C . V .O .,C . B. E ., D .S .O ., T .D ., F .R .C .S . (President of the R oyal C ollege of Surgeons) has been appointed Hospitaller of the Order of St. John. H a m p s t e a d . — The N ursing Division spent an enjoyable social evening on W ednesday, May 15 th, when they celebra ted the Golden W edding of their senior member, Corporal Mrs. Bowen. Lady D istrict Supt. (Reserve) Miss W alker presented to Mr. and Mrs. Bowen a cut glass vase and flowers on behalf of past and present members of the Division. Mr. Bowen thanked those who had given the vase, and spoke of the happiness that Mrs. Bow en’s membership of the Division had been to her and to himself. After the presentation, past and present members spent the evening talkin g of “ old tim es ” and happy experiences during their service with the Division.

R I D

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F I R I V

Queries and Answers to Correspondents. 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 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 m 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 .

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S e rv ic e M e d a l of the O rder. E .T . (W illenhall).— Also 1 would like to ask if you think that there is any likelihood of w ar service in a first aid or medical capacity counting double towards the Service Medal of T he Order of St. John in the same w ay that w ar service counts in the various Services with reference to their appropriate long service medals. There has been no official suggestion that service during the w ar years should count double towards any award of T h e Order, and it is not likely that such a decision will he m ade.— E d i t o r .

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 i d 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 f r 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 lu m n is t h e 3 9 t h ( 1 9 3 7 ) E d i t 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 .

H yp notic P o iso n in g . A .C . (Selby).— T h e T extbook gives as the cardinal sign of Hypnotic Poisoning as the contraction of the pupils to a pin-point. Given the following signs and symptoms in case of Hypnotic Poisoning— patient, unconscious ; breath ing, stertorous ; face, livid ; pulse, slow and w eak ; skin, cold and clam m y ; eyes, fixed and equal— is it possible for the pupils to be normal ? Y o u r kind reply will be a great help to a number of first aiders in this area. Y o u have mis-read the instruction in the Textbook, which, on p. 169 , gives as the cardinal sign of Hypnotic Poisoning— ■ “ a tendency to go to sleep, developing into stupor and later stupor.” It then adds the statem ent that pin-point pupils are peculiar to (and only found in) cases of poisoning by opium and its preparations. W ith the combination of signs and symptoms which you quote the pupils would not be normal. Probably they would be dilated, except]when opium or a preparation of opium has been tak en .— N . C o r b e t F l e t c h e r .

E xam in ation H ow ler. M .B. (C am bridge).— In a recent exam ination a candidate was asked how would she treat a patient who had pushed a foreign body into her ear channel. T h e doctor looked surprised when she replied — “ / would blow down the other ear, and so g et rid o f the foreign body." Good !

Next, please ! !— N .C .F .

A d m issio n to The O rder. E .T . (W illenhall).— Could you let me know where I can obtain information regardin g membership of the Order of S t. John and the statutes and regulations as they stand to-day ? I should like to know all details regardin g the various grades, etc., and what they entail. I have read the various books on the Order, but none m ake any mention as regards modern times apart from mention in g a new Charter. For the inform ation which you require you can apply to the Secretary-G eneral, T h e Order of St. John, St. John’s Gate, E .C .I . . . W e would remind you, however, that admission to The Order is granted only in recognition of w ork of exceptional merit in advancing the objects of T h e Order. E d i t o r .

E ffic ie n c y for W ar S ervice. H. M.C. (H etton-Le-H ole).— Before joining the R .A .F . in 1940 I was a member of the S .J .A .B ., having my first aid certificate and voucher. D uring my service career I served as a nursing orderly for five years, during the last three years of which I was a Corporal in charge of Station S ick Quarters. Since my release and return to the B rigade I have passed my efficiency examination, and have been informed that it qualifies for my m edal lion. Surely my service exam inations should be taken into consideration for aw ards of medallion and label. Many of my colleagues in the Medical Branch of the Services will be in the same position. Y ou have fallen into the error of regardin g work in Sick Bays of H .M . Forces, where there is full equipment, as equivalent to the training which the B rigade gives its members, namely, the treatm ent of cases for which use can only be made of the m aterial which is at hand. Y o u r exam ination after release was for the purpose of dem onstrating that you had not forgotten your first aid ; and, having passed your exam ination, you were entitled to the awards which you missed while on active service.— N .C .F . D rill. J. F. (Loudwater). — Please tell me if trained personnel should fall in and remain at attention until they receive the order to “ Stand-at-E ase.” I can find no reference to personnel being “ At E a s e ” except under “ Recruit D rill ” in the new D rill Manual. On the instruction to “ F all-in ,” personnel should take up their positions and stand at ease until they are called to attention. T h e reason for this instruction being in the Section for Recruits is that the training for these positions is taken in the recruit stage. — E .T .M . A w a rd s of T h e O rd e r o f St. John. L. R. (Bircotes).— One or two members of our Ambulance Class have 25 continuous and active service in St. John Am bulance w ork, as instructors and captains of com petition teams. W e wonder if we qualify for the Honorary Serving Medal ; and having read with inter est the Q uery Column in F i r s t A i d for a number of years, w e thought that you may be able to enlighten us on the subject. Y our question is not easily answered, as it is not clear whether it relates to the Service Medal or to the grad e of Honorary Servin g Brother of the Order of St. John. T h e conditions regardin g the Service Medal can be explained by any Officer of the B rigade. On the other hand, the distinction of being appointed an Honorary Serving Brother arises from exceptional w ork in furthering the objects of T h e Order and the cause of first aid over a number of years. It is not awarded for competition team w ork nor for passing annual re-examinations !— E d ito r .

F I R S T

WHAT I ODI NE

143

R I D

THE

EDUCATIONAL

BUREAU?

★ H o w

h e lp s

th e

m e d ic a l p r o fe s s io n

I t h a s a ll b e e n c o l la t e d b y t h e I o d i n e

io d i n e

E d u c a tio n a l B u r e a u . T h e s e re fe r e n c e s

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p r e v e n tio n ,

e le m e n t w h ic h h a s a c c u m u la t e d d u r in g

r a d i o l o g y a n d n o n - s p e c i f ic t r e a t m e n t o f

th e p a st 1 3 4 y e a rs.

v a r i o u s d is e a s e g r o u p s . N e w

Io d in e

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E d u c a tio n a l by

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S T O N E

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“ A s a w o rk of referen ce, th e book w ill be extrem ely useful and should be in th e library o f all ambulance w o rk e rs .” — First Aid.

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Strong or W eak T ea. R .E . (M onm outh).— In the Supplement to the Textbook we are told that in the treatm ent of shock w e must administer “ stron g tea or coffee with plenty of s u g a r.” In the treatm ent of burns and scalds, however, we are told to ‘ ‘ give large quantities of warm , w eak, sweet te a .” Please be good enough to explain this difference in treatment, and accept m any thanks for the valuable inform ation gained continuously from the Query Colum ns in F i r s t A i d . T h e treatment of shock calls for the adm inistration of fluids combined with a moderate and indirect stim ulant, such as tea or coffee ; and in most cases of shock a drink of hot tea or coffee w ill do all that is necessary. W hen, however, the shock is due to burns and scalds a different condition calls for treatment, because the body fluids are driven from the veins of the victim into his tissues. Conse quently, one good drink of hot sweet tea or coffee cannot do what is necessary ; and better results are obtained if fluids are administered freely- over a period, which fact necessitates w eakening of the stim ulant tea. Hence, in cases of burns and scalds, the instructions are to “ give large quantities of warm , w eak and sweet te a.” — N .C .F . P erfo ra ted D u od en al U lcer. W .M . (B arking). — Could you please enlighten me on the signs and symptoms of a perforated duodenal ulcer, and also tell me w hat first aid treatment should, or rather could, be rendered ? As I am deeply interested in such matters, I shall be grateful for your reply. Am ong the causes of shock named in the T extbook are abdom inal injuries. W hen a duodenal ulcer perforates, then injury is done to the sm all bowel. Consequently, if you should be called to such a case you would probably find a condition of severe shock which had come on more or less suddenly, was heralded perhaps by an acute spasm of pain, and w as associated probably with a history of old-standing indigestion. Treatm ent is to be as laid down for severe shock in the Supplem ent to T ex tb o o k .— N .C .F . T orn F e m o r a l A rtery . W .B . (B ostock).— Please tell me w hat happens when, as the result of a wound in the thigh, the femoral artery is torn and com pletely severed. Does the artery resume its function after treatm ent ? If the femoral artery be com pletely severed, the only possible treatment is to ligatu re the torn ends, which means that its function is ended. Fortunately, however, the vessel has a collateral (or “ b ack d o o r” ) circulation through certain vessels which grad u ally enlarge and take over the w ork of the destroyed main artery. This re-establishm ent of circula tion takes months for its com pletion.— N .C .F . F igu re-of-E igh t B an d age. E. D. (Chesterfield).— Many of our Division follow closely your answers to queries in F i r s t A i d each month. W e shall be very grateful for your ruling on the follow ing point :— At a recent competition held in the Midlands, our team was penalised for applying a figure-of-eight band a g e round the ankles and feet in the treatm ent of a compound fracture of leg, with bone protruding. The opposing team tied the bandage round ankles only and w as awarded full m arks for this. T h e Judge con sidered that the figure-of-eight bandage would cause an extension, w hile our version is that, if put on properly, a figure-of-eight need not cause an extension, while at

A I D

the same time it does secure the foot and prevents any likelihood of the foot falling outwards again. W e thank you in anticipation of your kind reply. From your statem ent of facts, it would appear that the members of your team were penalised by the unrealities of the competition room. W holeheartedly I approve their choice of bandage ; and, as I have several times stated in this column, first aiders treating an actual case in the street would see if the protruding fragm ent was being pulled back into the wound and would act accordingly. So please convey to members of your team my sympathy and best wishes for future com petitions.— N .C .F .

“ FIRST AID ” QUERY and REPLIES COUPON. 7 o be cut out and enclosed with all Queries. J u n e , 1946 .

New Mobile Unit. T h e Divisional Superintendent of No. 75 Borough of South

end Division, S .J .A .B ., sends us particulars of a new mobile first aid unit that has been built for the Division. It is a self contained unit with hot and cold water on supply, two large dressings cabinets which form their own table for w orking. T here are two beds which can be instantly converted into stretcher trays or folded up out of the w ay if more room is required. T h e equipment comprises two extra stretchers, four folding chairs, extra blankets, pillows, enamel ju g s and bowls, kidney dishes, complete utensils for refreshments for the staff, towels and numerous other useful articles, all of which are stowed in lockers over the drivers cabin. Portable steps m ake easy access to the interior and it is alw ays ready for immediate call in case of a serious accident.

Classified Advertisements. A d v e rtis e m e n ts w ith re m itta n c e should be se n t to Lo n d o n , E.C .4 . R a te 3d. p er w o rd , m in im u m 4s. 6d . m in im u m 6s. B o x n u m b ers Is . e x tra .

First Aid, 46, C an n o n S tr e e t, T r a d e ad vts. 4d . p er w o rd ,

T ickets 7 /6 . Posters, H ats, Novelties, Rubber Stamps. “ A ” T i c e s , 11 , O aklands Grove, London, W . 12 . O M P L E T E Leathercraft Outfit for Beginners, 30 /-. S ix-W ay Rotary Punch, Leather Pieces, Press Studs, Press Stud Tools, T h on gin g, ‘ D ’ R ings, Leather Paste, H andle Loops, Turnfastener. Clayton Leathercrafts, F .A ., (Dept. 146 ), Sutton-in-Ash, Notts. S .A .E . for Enq.

O N IS T H O R P E C H A L L E N G E C U P S . Open Am bu lance Competitions for Seniors and Cadets, Donisthorpe Church H all, Saturday, A ugust 31 st, 1946 . Entry forms, S gt. J. Finch, D ay-B ell, Moira, Burton-on-Trent.

O R E C A M B E A N D H E Y S H A M C O R P O R A T IO N A M B U L A N C E C H A L L E N G E C U P . A First Aid Competition week sponsored bythe Morecambe and Heysham Corporation in conjunction with the St. John Amhulance B rigade Morecambe and Heysham Corps, will be held during the week com m encing September 16 th, 1946 . Enteries are invited from the follow ing Areas, Lancashire, W est R iding of Yorkshire, Cum berland and W estm orland, Northern Ire land, and Ladies from the above Areas. T h e number of enteries are limited from each Area to ten and should local enteries exceed ten, elim inating tests should be arranged locally ; further particulars m ay be had from the Corps Sec., Am bulance H all, Alice Street, Morecambe.

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Tunstall Bandage W in d er each 6/6 Splinter Forceps, pair 3/6 S t.Jo h n ’s Pattern T ou rn iqu et 1/9 each Solid Steel Scalpels 4/6 each N.P. Scissors from 7/6 pair A rte r y Forceps, N .P. 6/- pair Fitted Pouches and Haversacks always in stock. Let us q u ote for you r First Aid requirem en ts. 45, 'G r a m s

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ASEPTIC

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T he G ear illustrated (A .B .C .D .) carries tw o stretch ers on one side o f A m bulance, leaving o th er side d e a r for sitting patients. UP A N D D O W N action Is quick easy fo r loading o r unloading. A.

S h o w s th e tw o stretch ers in position.

S how s th e top stretch er low ered rea d y for loadin g.

Illu stra tes th e sam e G e a r w ith the top stretch er fram e hinged down for use w hen o n ly one stretch er case is carried.

D . S h o w s the sam e position as in “ C ” o n ly w ith cushions an d b ack rest fitted for con valescen t cases.

W h e re Am bulances are required to carry fou r beds two Gears are fitted, one on EITHER SIDE, and th e same advantages apply as d escribed above. Full catalogue o f Ambulance Equipment N o . 7A will be sent on request.

G R E A T P O R T L A N D S T ., LONDON, W.1 Telegraphic Address:—

Phone :

KAR VALID. W ESD O, L O N D O N

Langham 1049.

Handbook of First Aid and Bandaging.

F 0R DIVISIONS OF THE

St. John Ambulance Brigade

A. D. Belilios, M .B.

can be OBTAINED from

D. K . Mulvany, F .R .C .S . K . F. Arm strong, S .R .N .

An e le m e n ta r y c o u r se P r ic e

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Printed and Published

LONDON BRIDGE, S.E.i. 'Phone 3 Hop *476 (4 linei)

’G ftm i 3 MHobson, Boroh, London.”

by D ale , R eynolds & Co , L t d . , 46, Cannon-street, London, E.C.4, to whom all communications should be addnsssd Telegrams— “ Twenty-four, London''

T elep h o n e-C ity f f i o .

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