First Aid to the Injured 6th edition 1904 by Museum of the Order of St John

FIRsrr AID TO THE INJURED

IIfl/lI1",11'!I A., .. o tJ.c Or.7 r 0)'/. Jul.". II o"o"(l"!I Life Jltlltuu nj; (Ill! L, chlj'u (lilt! EUfIlnl,,' to, tlta ASiO"ia iOIl.

With a CIHPTT:l: all "Strct( IHF Tr,lll,-p.\rt," rt.·i e.l froU1lh:ttorigiMlly written by ::,lr FurnF.Y. Kit of J,'siice of the a.a,,· of John. ill aceol'(laJl<'c ",itll thr .\.nllv AI,,> a (beiu,g' the Fi,th Lecture, fllr Fetn tIt, Oldy). hy F. :u ,I('Du\\EL COSGR l VE, .• l',R.C.P.I., K.t:g'.t aft/tV til,: I). I,,' .• I. .J. h.I, IIrJllO"ui'Y Lie Me".r er (I); (uI,l L;.;tUfCf an,l E ulI,iIIC' fv, tie ASIXTH EDITION, 180,00:> t:> SJ:::,OOO. Price 1::;. net; b)' po. t, Is. :.:: 1. '1'0 BE OBT.U:: ED .\T 1:)1'. JOH.1 '.' nA.TE, CLERKESY'-ELI., L E.Q, W , H . c· L C. 50,000 1:/0+

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ARR ANGED ACCOR DI"G TO TIlE RE 'J"I£D !-:YLI,,\BC'S OF THE .UD C(J(,R'E OF TIlE ST . JOH

-6ran'tl l@riotl! of tb e ®rlJer of tbe of cSt. .moun of ]eru%aLem in <!Cnglnn'O.

unb' :;;Jatr.olt .of 1l!.c

lfis Most Gracious Majesty King Edward VII.

(6nllTb'

His Royal Highness the Prir·ce of Wales, K.G.

VACANT . @lliTitf .of

His Royal Highness the Duke of Connaught, ILG.

<!rH.Cl\tiil.c @ffiuXlS.

Prelale-Hi., Gr;:ce the Archbishop of YORK.

Clutllcellor-The Right B on EGERTON OF TATTON.

Secl'etar),-Ceneral-Colonel Sir IlETWr:RT JEKYI I., K.C . l\LG., R .E .

Receh'er-Cenerat-ED\\"I" FRESllIIELD, Esq., LL.D.

A1?lI(>IIcr-Thc R ev Canon DUCklYOJnH, C.V.O.: D.D.

Reglstl'ar-

CC/ll'al,?g-lst-The He-\·. \ V. K. R. nEDF'ORll, M.A.

Directl'r 0./ tlz ,: Amoll/awe Departllleltt-The ;\lost Hon. the Marquess of K.G.

I.i!r .z1·ia n-Li<!ut.-Coloncl RICHARD HOLBECHE.

Secretary-Colo:1el Sir HERIlERT C. PERROTT, Bart., c.n.

CizairlJl(1.1l 0./ tlu British OJ>!ttlzalJllic fros/,ital, jerusn.;em-The Right H on. Enrl EGERTON or TATTOX.

Chie/ Sccn:ta, J (1./ Ihe A mOlilance Department-Colonel Sir HERtlERT C. PERRO"!"T. Uart., C. B.

Assislant Director (1./ tlte A mOlllall(/! DejarIJIICllt-Lieut.·Colonel Sir RICHARD C TEW'l.E, Bart., C.I E. Assista1tt Receiver-EDwIN HAl'iSON FRESIlF'IEI.D, Esq., 1\[ .\. Assislfwt Liorarr'a,t-CYRII. DAVEl\l'ollT, E"q.

Assislattl Secrelaly-LoCKllART S10CI':I\£I.L, Esq.

ACcolmtflltt-V,lILLlAM R. EDWARDS, Esq., A.C.A.

/Jillt. Sure/ar" n/ tlze Brihsh Ophthalmic Hosjital, jerllsalemMaior J. T. \\' OOLR\'Cl! .. Asslst(wt H01tOrary SNre/ary (./01' Scotland) 0/ tilt: British O,lJ/zlizalJllic Hospital, jerusalem-A. A. GORllO:-', E q.

(!ZUC Q1;OltllciT.

Tbe Council of the Sub·Prior, as President ex·o.!Jicio, the Executive Officers, aml the following ftlcmbrrs:

Sir JOlll'l [o'l-RIEY, C.n.

Colonel J. C. DALTON, R.A.

The Right Hon. Viscount Kr-;UTSFORD, G.C.l\T.G.

The Right lIon. Lord 1\[OSTVN.

Sir JUlES N. DICK, K.C.n., R. T.

Colonel C. \\'. nO\\'flI.ER, C. B.

Sir D\'CE DUCKIYORTH, 1\I.D. COLLINGRID<"E, Esq., M.D.

Major-General Sir 0\\,[·::-. T. BuRNt·, G.C. I.E. , K.C.. r.

Sir GFORCE HAYTER CHUBB, Bart. l\lajor-General The Right Hon. Lort!

The Chapter consist, of the Knights of JIl',ti ce and SlIh-Prebte, de jure; the E"ccuti"e Officers; the seledeu of Council; the following ®fficia!ing )jflapTt1iltJ,

The SlIh-D<!:lll of the CIlAI'I.I.S I The Re\". Sir BORR.\[L\ILE S.\\,ORY ROY/I!., C.V.O., D.D., Bar!., 1\l.A., Ai'\)

Hrprcsrntrrti\)c Hninuts oE QIinm,

I.F ,Rcr T. BlDDUI I'll, r->q .,[ ajor·(;eneral ASTI EY

Colonel Sir h. T. TII\CKI· I< IY, K.C.U .. I T.(I!;., R E. Tn'p.-Cen. B. TI"'NIS, l\[ D., R.;';.

Colonel C. 1\[. 'N ATSO"', CU., C.i\I.G., R.E.

Sir AI/lIlUR J. R. Tl<E:<::'ELL, C 1\[.(;.

Sir RICIlAIW DOLl.l.AS POWFl.L, Bart., K.C.V.O., 1\1.ll. Colonel C. 1\1. ROYlls, H., LP. J. IDIUNO OWE,", Esq., F.R.C Licllt.-Col Sir RICHARD C.TUII'U. , Bart., C. 1. F. F. FREsHFIFln,EsQ,l\LA. (,,:neral Sir F. \\'. E. FORFSTlLRWALKER, G.C B., G.C 1 G. 1:: '2

trr:te foHolntng ate t t c 1!tltigtts of ]usticc:

H .R.H . Prince CHRISTIAN OF Colonel The Right Hon. Loro S CIiLESWIG-HoLSTEIN, K.C., 'VILLlA"! Cl!;ClL, 1\I.V.O. C.C.R. EDW!:--1 Esq., LL.D

H .R. H. Prince CHARLES OF DEN- (I{,)JIoraJ:V ("OJJllllflfid,r.)

MARK , G . C.B., C.C.V.O. His Grace the Duke of FII'E, K.T. ,

H. H . Prince AL/jERT OF SCHU';S- C.C.V.O. W!G-HOLSTEIN, C.C.D., The Right lIon . Lon, HII-\SSLY, C . C.V .O. KoC.H.

H .S. H .TheDukeofTEcK,C.c.V O . The Right Hon . Yiscount 1""\lI'LEH.S H. Prince FRAXClS tW TECK , K.C.V.O., D 0 . The Hon. Earl

Captain H. S .H Prince LouIs OF The Right HOll. Ii-count B FO!W, C.C . \Le. (JI.JIlJrtvy R. N. Bfli/ijJl.

Captain H.S.H. Prince R. E'q. uF TECK, R.C.V.O., J).S.O. .\RTIILR \"CIS (;:U'SII."1 LF\ EThe Right Hon. Lord Lr·:lt,lI. [, ''I. Lieut.-Col. TRl::vE.'Ex ] UIES Hor.- Colonel F. ,I. II"YI,\TE C D Col. CII ES \\""UII.\;I! ::'>II..I"('-\\',

CH ..\ RLES PE:Y!UERTON CARTER, Esq . C. II., ;'I [ P. 'ir J . FURLEY, C . B . (Han . Bailiff). The Right Hon. the Earl of R,,:-:· The Right Hon . Lord ST\,';lIORE, I'UI'I \', G .c.?lI.G. The Right Hon. Lord S,\XDllv!'S .. FRA:>!CIS RODERT D,\\!Es, I::sq. G.c..."1, (;.C.I.E.

Sir B!wOK KAY, Bart. Sir ,I I1LAI,r-:, C.C.:--LG.

Sir T . NORTH Ibrl. Caplain N \ Til \, 'IFI. (;EO. PHI!.!I". ::\lajor Sir ARCIIIBALD Ban. The [011. lhl' hn! of,:\\ E'\ Til.

Col. 'ir HERBERT C. PI'. <lW'I-r, A FRASEI{. ,E"l' Bart., C.B. The Right 1I01l. L"rd 'I

The Right HOll. Earl FER!lERS, CoIOI1,,!CIL\RI.ES 11101,111 -llt.'TlT.

Colonel Sir JAS Grr 01:: \, C.V.O., The ::'>lost Hlm lhe of C .B . rREAO,\l.ll.-\!':!', K.(;.

HENRY JOliN LOFTuS, EsC], His Grace the Duke of Colonel BETHEL MARTIN DAWES. Kl;., l;.C.V.O .

The Rig!1t Hon. Lord OF Field-;\brshal the Right Han. Ea, I ROBEf1TS, K.C., 'K.P, Gen. ..ir CHARLES WARREX, ROBERT Ilr<Ulll' , I-l,LCAI{T1 /{, ]i.Sq., C.C M.C., K C.B., R.E. F.R C.S. ColoneIJ HIESCEC!I DALTON, R.:\.. If..\\' FOR!\E", FS<J., Lieut.-Colonel AYUlER GOULD F.R.C.S. (Edill.) ,R E. Colonel JO!l:--1 ,\1 U'; \,I'!'R :\1.\'1

The Right Han. Earl ELERTO:--1 OF TUAK!, C.1l., C.;\! (;, TAT'-();'; . Colond C . IV. Bo"'U! l'!<, C.B .

rr be fo Holn inlI Em tf) e

T he Lord Bishop of El.Y I The Dishop in .h IS.\I.I·,·!.

T he Lord Bishop "r S,\L!SllURY. The Bishop of t;II:R,\LTAR . The Bishop of BRIT!SII '5.

TH E A;\IB UL A"OE DEP AItT?LEXT OF Qlirnn'b- .@riotI! of ibe ®rber of tbe 1i'1of5pitat

of .st. JJobn of ]rr mml em itt (!CngTl1l t1r.

HIS MOST GRA CIOU5 MAJESTY KING EDWARD (SO\'EREIV\' liE \IJ ! ATRO!': OF TilE ORDER.) va. tJ rrsiLJrn t.

HIS ROYAL HIGHNESS THE PRINCE OF WALES , K.G. (LR,\NTl ! RIOR O!' TilE ORDER.)

I""rntraf Exrr utu e liommittrc.

Con,i,ring exd:.t l\'ely of :.I]embers and Associate, of the Or,:er.

Il:e A m!>"luJl({' II,j>flrtlJlt'Jlt and CllairJl'flll 0/ COlJllJlitLt:/!he ;'I[o,t Ihn. lht! ::'>[arqll<:ss (,f HI<["-\!)AI.!1\,T, K l,.

Anislant Dir,'ctt>p aJl ( fJ l' I CI . . I' lel1 \111) C TF.:YII'L1I', B.:rt:: t.I.l-:: llJ ·/I/alt - Lleutenant·Colonel Sil'

De/,lf!J'.CI,.rr.irlJl(l:l.Sir .11)11"1 FURLEY. Committee (lulluri,- C.UI"I).

"tell/I,"",s.

c:.,!onel J. C. n \! r<)x, R. \. ,,'Ionel C. \\'. B()\\ r,u 1<, C Il. I 'It! Rev. r. \\'. \\'Oll]).

:'I1,ajor,General ,\STY!'\' TE!lR\".

C. B, (Life ::'>lcmoer of the \:. F"h \1.1).

Colon'" Sir J. \\ . OTT I E\, K.,C T. F. l nspector-0 cncr.1.1 \1.1)., R.N.

Ir F!ll.:nEllICK NORl1UR\ I" C n 'I D

K H P R N (01 tel I' ' ,'- .'.,. .• . ,rec or- ,ellcra, 1\ edlcal Ikpaltm(;llt, }(o),.L1

S C. \ VA!!!lE!.l., F-'<l.

c.n., M.D.

SIIr"leon.;\l aJor.Ccncral Ir JOII:-: n\, CO!.E RE.\DE

C. S. ELLISTON, E"q., ;'It. R.C S. K.C.B .

£1.

QrentTlIl Q[ommittre-{OntirlUCd.

CHRISTOPHER CHILDS, Esq., M.D

. urgeon-Gener:tl Sir JOSEPH FAVlu:n, Barl., K.C.S.I., M.D.

CHARLES J. TRnIBLE, Esq., C.l'II.G., L.R.C.P.

Surgeon-General Sir R. HOOPER, K.C.S.I.

Colonel CLEMENT MOl YNEUX RoYl)<;, C. B., ;\1. P.

Captain J. \V. NOTT BOWER.

Surgeon-General Sir K.c.n., ilI.D., K.II.P.

{Director-General Army Medical Serv ice) .

EmlUXD OWE:-1, Esq, F.R.C.S.

The Right H.on. Lord CLAUD HA\IlLTON.

The :Mo,:;t H on. th e l\Ltrt\uess of 1'0".

Lieut.-Colonel A. C. YATE.

Sir BEtlNETT. K.C.V.O., F.R.C.S.

REGIXALD Esq., F.R.C.S.

Lieut.-Colonel E. 1\1. WILS·)N, C.B., C.M.G .. D.S.O ., R .•\.2\I.C.

'urgeon-Genera\ A. KEO(,H. C. B., vI. D.

Lieut.-Colonel W. BABTIE, c.:\I.t;., R ..\.:'1.C.

Colonel GEORGE H. 0'1\[,\1.1 EY, R.A.

Sir EDWARD L. O·l\L\LLE't.

Deputy,Inspector.General 1\[, COATES, ;\1.D., R.N.

JOHN ASTLEY Eq., F.R.C.S.

Ex.OjJicicJ IIIL'lilbers 0/ COlillllith'e.

Colon,=l Sir HERBERT JEK'tLL, K.C.M.G, R.E. (Secretary.General of the Order).

EDWIN FRESHFIEI.D, Esq., LL.D. (Receiver-Gener:tl of the Order).

The Right Hon. Earl ELERTON OF TATTON (Ch:tirman, OphttL'l.lmic Hospit:tl).

<£f)irf ccrrtu'C!! .

Colonel Sir HERBERT C. PERROTT, B:trt., C.B. (Screlary of the Order).

fm'll $!orr!'mper.

WILLIA:'1 R. EDWARDS, Esq., A.C.A. (ACCOltltiallt 0/ the Order).

men'll @fficrz.

ST. GATE, CLERKENWELL, E.C .

Tdt!graphic Addrcss-" Firstaicl, Lontlon." Tcl..-pholle -llolborn, 861.

LONDON AND \\'ESTi\1INSTER LIMITED, (Lothbury, E.C,)

REVISED 1901.

FIRST AID TO THE INJURED

SYLLABUS OF INSTRUCTION.

rIR'T LE()TG!lE.

A. Objects of InsL'l1cLioll, &c.

J A 1m f descnpllOll of the Human l')kelctOll }' a])(1 the :'I1n scu1a1' Nysten'. ' ")OlYS, C:' :Slgml, ami treatment of Fl"l"f'lrC!'i C(,tLlOl1&' , n,nd Ntr,lir;.s. ... , ., D, Thc Tl'ianglllal' Dunrlage an<l its application.

SEGO:\D LECTURE.

Di,,1o·

Heart anll Blood The Circulation of the

tI B. directi on of the Art,eries imlic 'lLill" lC POIIl S W lere the circulation mC1.y be by di. , i t-;I PI' ,ssurc, or by the application of Lhe tournicillet or by ' L

differcnce .4.rtcrial, Venons, and Capillary iLee mg, anc the "anous c",Lcmporary mean of arresting

D. Thc Triangubr Bandag aT d iLS rpplicalion.

58 REFERENCElOC,1

THTIlD V CTl'RE.

A. A brie f uvs.::ription of the reryOUS Nr;;tell1.

B. First Aid Lo per. om; sutfe ring from shock or collapRe a.ftor injury , injury to the brain, collapse from dl 'ink, epilepsy, hint.ing, hysteria,'iUllstl'okc, clecLrie shock, drocLs of lig htmn g, amI conv ulsions in ehihlrcn.

O. FirRt Aid ill caRes of frost-hite, burn" or scaltlR, illjury by yitriol thrnWlllg. \YOU 11,1', hiles of H.nilll:.lls, R(, Igs of in sects.

D. "\Vll1 t to do \I hen the' .11'''s-; c1tcilCS fire.

K The Cri(),llgu!'l,r Baudnge and its a.pplie l,tion.

FOl'RTH LECTURE.

A. A lI1't f of tho Organs amI Meehani·1ll of Re;piration.

D. The Immeuiat treatmellt of th e apIJ:1rcntly drO\I'l1Cd or othcl'wil'lc 'll. Hes;liratio: I, Tl"l'[tttllcnL for Ohol in g.

O. First A ill to tlto,e l))i":otlc:l.

D. The llnme(ii:1.t,· hl'')t 'i(l trcattllPllt of illj to the Tnterna.l OrWlll'-l, :ltl'l to those s11fcr;It3 ftO,ll Interna l

E. Foreign Bod .cs in the E) C; E :1', and K os ..

FrFTH LECT{JItE (fur :Males only) .

A. Improvl'ieu il,ethod::l of lifting l1ml c:1.rrying the s ick or itljur ed.

13. Methods of tifting an(1 carrying sick or i nj urc d on stretchers.

C. The eo nvcyan.::e of sueh by rail or in country carts . 9

FIFTH LECTURE (for Females only).

A. Prep'lraLion fOl' receplion of Accident Case I), of Lifting and Carrying.

C. Prcpara.tion of Be(l. 1 >. He1tlo\'ing tho 'lotheH. E. }>rcparati()Jls for. 'urgcoll.

K01'E 1.-1he !'ul.jed of p')i>;olh; "houltll,e lrea.ced in a !,(·Itera.l manner. The comt1lon poi::;on and only Lhe1l' and elrects taught.

To get rid of tho ])OiHOn is the only t.reatment \I hich can h(' sutely practi, eel hy nOIl.prufe,.; ional p r on'; tiLe administration of antidotes is the medical man's duty.

l\Ol'E n .-The last half bour of 011<.:h lec-tul'e should Le de\ oted t,) practical W()t k, snch He.; the application of il'Hl "plints. lifting (wcl carrying wounded on

K OTE ] n.-Therc should be an inlon-al of a w'ck between (',lch lecture. . \ C'all(liclate for exail1inatioll mn t attend at IC'1.8{ four (Jut of tho Ii\' , locllll'(';;.

rOTE n-.-::'Ilale <-h"scs must pa."s in that system of ,tl'etchel' cxerci3e Il1ost 'uitahle for the locality.

'OTE "\ . - ",\ s little time as pos8i hlo is to he sp nt on il1struC'(ion in anatol1liea.l and physiological tletai!:::;, 'mel Ex:allliners are particlllarly rcquested to remcmherthut it is " Firat Aiel" flat ha:, t.o be t1wght anel tested, and not a.natolllY a.nd pby .:iobgy.

SUMMARY OF CONTENT&

CHAPTER 1.

EJS pla natory --tF--

l he Human Skeleton. ,-pine, s kull, ribR, breastbone, upper extremitie, , pelvis ancllower extrem iand joint':! ...

Muscles. Volllntary and involuntary

Fra ctures. Camles, varieties, signs and symptoms

General Treatment of Fractures. Apparatu s , splints ancl bam1age. . (ieneral rules for treatment

Treatment of Special Fractures. Rpine, cranium lower jJ,w, rihs, hreast·lJ(me, collar -uone, a.rm, forearm, mda,earpu"1, finger, pelvis, tl1lgh, knee.cap, leg, foot ... ... '" ...

Dislocations, Spr ains, and Strains

CII APTER II. /

Circulation ' of the BlooJ. Organs; general, lun g , and liver circula,ti0ns; the heal t, art eries, veins, c,lpilhries, blood, cour"1e of circulation .. , ...

Hremorrhage (" r Bleeding, Arterial, venous, capilla.ry

of Hremorrhage . Pres'llre, elir ct and in11irect; in strumenta.l (by tourniquet) , and digital' fle xion, posi tion of pa.tient, elevation of limb '

Course of the Main Arteries and Arrest of Arterial Hremorrhage. The aorta, arterie, of the h ea.t1 and nQ{;k, of the upper extA.'emities, within the chest and abl1omen, of the lower extremities . ..

Venous Hremorrhage. Varico. e yeins

Capillary Hremorrh a ge ...

'IIAPTER III.

The Nervous System. Cerebro-spin 'll, RympatheLic

Insensibility. Ciener,II treatment, examination of patient, !';hock, and (;ompre.'sion of the hrain, apoplexy, collapsc fro111 drink, epilepsy, faintmg, hystelical fits, snn.-troke, electl'i ..· .hock, of lightning, convulsion:' ill children

CII.\PTER IV.

Wounds and Injuries to the Skin. Brnie:;, \\oullfls, fl'Ost.hitc, lnu'Jl!'l anil peal,]", what to do \\'111.;11 the dr'ss catches lire, yitl'iol thro \\'ing, lJites of animalo.:, sn:lkc l,iies, f'ting,,> of il: 'cds, &c.

CIIAl'TEH. V.

111e

System

Artificial R espiration. ,,'yhe t 1"8, Howanl's :111(1 Labon1e'::; mclho 1

Drowning Strangulation , Ch okir.g, Ha nging, Su ffl"cat ' on

('ilIA I'TER VI.

Poisons Glnd Poisoning. f'irnplc c1irectiong for trC'1.tment. 1)oi-on8 a.lltl their treatmcnt tiell: Na.rcotie"1, illebriant , delirients , corro-;ivl'':; (neilis and a lk alif'), i r ritant ...

20 30 31 33 43 04 G9 ,2

P age 'i8 99 101 le2 l O'!' l-!G

CHAPTER VII.

In j uries of Speci al Or g ans . For ·ign hotlicq in Lho eye, car-pa:-;sage and nORC, T\1" chest (Lhnrllx) and organR contn.inecl in It (hent antI lung;;), \\'oullds of the Th'" abdomen an!1 til(' orgalls contained it (hYcr, ,pIe 11, intt'stineR, kich1 ',\'s, hladder), with re;1tmen f injury tn them, Rupture ,.

fIA PTEll 'V I II,

Bandaging, Application of >he l'iil,ll;;U\,ll' halHlage to the scalp, forehectcl, &c" "hou\tiPr, hip, ha,l1(l, foot, chc t, hack, kn 'P, e[l)Ow

CHAPTER IX.

Carrying Patients. Four, two, an!1 three-ha,1l(lUlI seats, fireman'" telllpOrttl'y stretchers, lo crOS3 a ditch or wall, to an'} nnload. a wagon

CHAPTER

Stretcher T rans por t. llltr!),l'l' tOI \-, ,'tI'ctclt '\''l, stretcher eXf'l'ci".''l. Tit, Ar-;\ f'H'll'littel'

CilAPTEU XL

The Fifth L e ct u r e ( for Female s on ly), Pre paration for reception f)f l1ccHIC'nt Ci1>;e'{, Choice [111<1 p reparatil)ll of a room . Liftllu; anll carr ying, Preparation of heel. R. 'lll n-il,g thL' clothes, P repat atll)ll fot ,urgPf)Tl

20)

,'kelcton, showin" p(),illGl1 (If main ill torio;:: /ronti"j)/"'rc

Vertehra ..

,'kull and verteln·.d 'oIl 1ll!1

HOlles uf the kft UP]J(:f' l'_ tlL!!1Iit,\

Bone,' of the l·i!.!ht IO\\'l'l p. ll'lll1it\,

Tll hip joint,

Ilj,lgJaI11 sho\\'illci n" l,l11 ... d,' III ,hintL ,,-itll Hl'tu y, \ cill and III I \ I "

:-lil11plc fracturl' Ilf

('()IIl}Joul1el £nll:tl1rt: of It'!! "

Tri :lliguln' "pll,.td

'l'l'i,tllgular han(lage . oflce fold!' d ..

Triangular lHllHlalfl ', folded H" II) ."tll II,llIOI,Ii!l' .. ,

'l'I'j,tllgubl' ll<tllllag<', foltll'd ,1'-' III r ,\' ]',lIHlag()

Hod kl10t

. \llothcl' llleLlI<1 I oj "l' '\11 "pliJlt .. .., .. ,

Third l11'.'tltcl'l (If "eCUll11!! "illillt, willi kJlot

'I It ' "allH', "ill! kll<Jt cUIIIl'lelc<l

L.u'ge arlll-sling

:-;111all ann-sling

('lIat tail tUl'Jlell up to j'll"l11 :-ling

:-Illllg f0l'l1le(1 from f.lLcl'l.: slit u}I ..

Huullgc fot' fmdurc of ImH'/' j.ll\"

Ibndagc for fmd un' o. rib"

'l'l'l"ltl11(' lltnffl'"l't:11' 11ft' ,Il.n'-ill 'I ,,\')!_, 1.I',(,ht"ltla

,,\ltem !lin: llIl'tlro'l ,,! ditto ...

']'rentnwnt of fraduH' (,f er,ll.ll'-l'ol\{' II illl lIlJl' 1 alul.lgc

Treat1l1l'lIt of fntclul"!! (If ani

Angular splint

Treatmcnt of fl';,,;luJ"(' flf fOJ'" I'lll

IGl lou

]3 .'. ',' J>u'je

:2.> "27 2!1

Treatlllent of fracture of metarcarpu3

Treatment of fracture of thigh (man)

Treatment of fracture of thigh (woman)

Fracture of knee-cap of fracture of knee-ca!J

Treatment of fracturc of leg

Ditto singl e handed

One form of eu located houlder ...

Principal hlood ycsseLs and organs of re 'piralion

DiU.gram of circulatioll of the blooil

Field tourniquet

!-)crcw tonrni(lllct ... ... . ..

Digital compression of carotid art ry

Arrest of from temporal art r,)'

Arrest of h::cmorrhage from forehead ...

Arrest of h<t!lIlonhage from palmar arches

Digital compression of ra.dial and ulnar arteries

Flexion of eloO\o\-

Di gi.tal ccmprc.c;::;ion of bra chial artery from below

The smlle from alJOYc

Compression of axillary artery ...

Digital compression of subcla\'i:lll artery

Flexion of knee- joint

Digital pressure on femoral arter,)' ...

Application of tourniquet tu femoral a1'tl'ry

Brain antl . pinal oonl, 3011(1 nen'os proceedi ng from it ...

The lungs and bronchial tubes

ArLificiall'espiration: inspiraLioll

Artificial rcspiration: expiration

'rho organ of th e chest and abdomen

Handage for head

Bandage for shoultll l'

Tbn(hge for hip

Bal1(lage for hand

B :ndl-1ge for foot

T3anc1age fOT ehe'L (front)

Ganc1age for chest (ba.ck)

Bn,nciae'e for knee ..

{1'onr-hanc1ed seal, .. ,

T\\o-hanclecl s at ... ... . ..

Alternative grip for Lwo ·ha.[1(le!l .s at

Another alternative grip for sa.!l)D

Three-handed sca.t ... ... ...

lifL (carryin e,) .. .

fIreman ",lift (lowering)... ...

• 'en.L impt'oyiRe!l with pol ',; an(l con.

• trelcher improvised with poles anrl co,ltR

•'tretcbcr imprnyi->cd "illl al1<l SIck

Fllrky orc1iI1'lr,V RL.reLcher (clos (1)

"(I'l1l'ley telescopi c·ha.1HllC(1 fi tretcher (open)

c?,el'ci,;e '{o. 1., preparing to [Old

DILto, placmg on str lchor ... ..

D!llo, placing on i'Lrcicllct'

DItto, carrying Rlr lcher

•'Lrelcher cxol'ci<;e No. IL, prdnrio u to lO;lll

DilLn, pr<'pal'ing to 10;1(1 ... L b...

• ' lrctchcl' exercisc J. o. Ill., placing patient Oil slretcher

f.,trctchcr cXf'l'cise No. IV., nl"t positiuJl

f-lccoll(l position

Ashford litter ...

HCll reRt., tllre" fOl'ills

Page 56 5!l 60 (jl (j2 6:2 6;j (jt) 70 7'2 7(j 7(j ,0 Hl ,2

Pnrle 1;j.I. lG-l W.") 166 W7 16R ]6 170 172 1 17:) 17,) 17.) 1 17n 1.:2 1 3 1 -! I '(j 1 '.' 1,'!J I n:1 Hl(j un HI8 2DG

PREFACE.

--t.:---

AT the rC(1uext of the Central Exccntiye 1 haye 'vl'itten nHtlHlal ct ' the official lti1l1clbook of the, t. Job 11 Am llll1<1.1H.:0 Associtttion.

The i>tridc:-, lllade in the tenching" of "Fil'.t .Aid, " and the of the ,'t..John . \ml>ulance Brigade, ha\'o necessitatec1 an enlnrf!,'clllcnt of preyiOllS ,rol'k:-, on tbe pullli"hecl lly the .\u·;.·o<.:iatioll.

I hiWO ollde:l.yourocl to include on]y al':) llllll"il anatomical anc1 detail ,u.; ix al):-,() 1\ltdy ]leces.'nr,)' to enal)]c I':)tllc1ellts to gra 'P intdlit(cnily the principles of treatmcnt.

The greater p i1.l't of the (lil'cdiollS for the applicat.i oll of the trii1.Dgllbr emel for lifting alld clll'ryill g pati ents, is adaptc(l alllloL yerbatilll frolH tllc \\ 01'1, of the b ,te Surgeoll-:Jlnjor Sh epherd, <1,' re-written h,\ Dr. Hobert Bruce.

I 'rish to cxprc. ·1':) my th,1,llks to Colollel C. Bo\\"(llel", Drs . .J. Browo, U. Chilel .·, 1. Coatel':), ,V. Collingric.lgc, .J. R Crea.. ·e, O. H. D.1.l'will, and H, A. Latimcr, " ' 11 ) ha,ye, as a SUh-C Dllllllittec of tho .\..sl':)ociatioll, a:-,,'istel i me ill my work.

JAlIIES CANTLIE.

June, 1901.

IX'l'HODUCTLON TO THE ,IXTH

TlLE ,'t. J 0hn Iltbulance A, '.Dciation }1<1' (;Olliplctccl the twellty-,'ixLh y'ar of it, existence. DllrillO" the period :::.ince the A,'')oeiation hCCfall work 11 undreds of tholl " lllCl-; of mell and !let ve at the Chl .'C' of tile A... oeiation how to hoh tlll';r illjurccl l1l'lgltll llll';-;. In cYcry country li\ iliz,tLion ha' cloc ' uf th e> As.'ociation find n read.\' audicncc. All l;nk ' of :-iOCil'ty te -tify to tlte of the instruction gi,·on. followers of no rcligiou:-J or political creed CetYll at Its aiuls and ieleal::;. .Tew and Cltri tiiU.l and J\In.holllcdan, Brahnlin and Bndclhi t: <tt'(;l'pt It::; LCIlCt,.;, anel appreciate the bOlll'tit ' it

1 nell'r tit" ilu 'pil' c'x of the .fohn A11l1mluncc l\'>s()cia.tioll, "Fin.,t Aiel» dcn."!lope < l illto a c1i·t branch of ,'lll'gcry, a sl)ccial tmiultlg. Jeither in our 8choo1<; nor in Ollr IWKpitnbi "Fin;L Aiel" Hpccially tnlwht, anel it is to the initiatiye of the, 't. John Alllbut'lllCe tion .that 10th the pub.lie amI the medical prof" 'ion :It'l' mclebtecl for }HLVlllg c1e\-cIopccl aud tUlwht thiJ 11 lporbn t elepartLllcn t, of gOlleral .'urgery.

A'd"

rrl 0 1'11 truction begini:) <1,nd cuds ;"it.h \.1 " 1, . 1 ' "1 1 'mel C1.ill\.Ut,,- lcl tho subject Ii:) tn,ught t lOHYll A 1 Y < • c1 ' 1 Tl duty of the <llulmlance pupIl en H tl \'C \' , Ie d 1 ()'ht to he WhCI:C the doctor'::) comment".., 0 . 1 ,1' y of (lut\' or mtclcK s . Ino o\'orlal)I)lll(f 01' (; H, Img J 1 o 'f . l"u:3 eycr lcon more libcntl or i< 'the • 't .John o'iven to the puhhc, and thl.! \\0: 0 '. :.,' t"l " A contm lC wllll t . 1 ,tIl' for:, liferi ll(r hllllUlll'ty remam. to n . , and I':lJ lllpd : i:' endure...

F'J],'T' AID

TO rl lIE I N,J UHED. ('HAPTEH J, Y.

By .. First Aid " III 'HIlt tlla fur /II of ski1led :ihH1Htauce \\ llich tmillccl jJl amLI dance "ork \ ;111 .!lfonl to tllLH:k or illjnl"cd. " Fin.,t ..:\ id to the Illjmul " 1:-- a. IJJ:mch el'rl'actit'cll demamlillg" :-;pccinl trailJillg ami Cdll('uti 1], '11Je priJl<:ipal aim and ohjc<.:t oj' th e Jollll 1\ IldlldallCC .A:-:'I'ocintiull to tUlc,h ill !allgl:nge Ilow to lleJp n .' ick 01' illjured Pl'}".O]J IIJJti] ti le l:L1 "in,' (II d dlldo1' arc obtuillLCl.

A U[JU-'.;f, 1904·

A flirOle!' cllHl illl}Jori.ant l)};:ncL of HlllIlllL.U (c 1\('l'k ih the' cillTiclge of .id: or il1jlll"ul 1 UH.. ll' Ly 'il(.!tdwl", l)yallJlntlHlJ" \\ago] ); 1')'Je1il, OJ by impo\ J:-'l,d mealJ::> of tmu:-;p0J't.

Beron' proceccliug to g"iyc ill detail tll( \ Ul':Ul1 .. tl V 1( Lt takeD ill the e\'l'llt of Hcc'ident Ol' ::;l1(lu ' 11 il1l1u-H it IN to know I"Olllcthillg of the stnlcture of the Il(Jcly (elelllcntal'Y HlUttOlll."), alJ{l the fUllCt:Ol1t:! of :-;(I},Jf of the more important (,rgam; alit! I:ly::;t l1li3 ( 'IItmy phy.-iology) _\ :-.llOl't uu;cripti 11 of ll( ('c:-;:-;ary anatolllical and phYHiulogic a] loillts of impol1:),IlGl i,' thcrefore giycn H:-; the " \,CIU.1 subj ct.' :/I} dH;ClI, ':-';ccl ill detail. It i ' e:-.::,euil.lI to relllcmbel' WJH'll "t.nuying anatomy that tlll' hi man l- dy is

20 ,uppo.'3ed to stH,ll(ling er<.'ct, WiLh the directed forward", [tncl the thumb,:) ollt",ucl::;, 01 aw,t)' from the body: 'l'ho "Illiddle linc)) of the is a linc dra W11 YCl'LlCall), [rom the top of thc head to a point between thc feet.

THE SKELETOl-

T •

The human 1YK1y if; rnnulde'l upon n. l) on), fmme\york which soncs: (1) To give .'hape [tnd to th e 10:1y ; (2) to athml ctLtflchmcllt to ,the lllnsc]c.' ; a.nd (:1) to th e 11101'0 vita.l organs III tbe skull, in the chest, and III tho [tbdomen.

, THE B.lCK BOXE , SrlXE. OR YERTEBRAL COJ mIK.

Thc Vertebral Column. -E'wh sOg'mcllt of which th e spine j tel'ltH.!ll a Yortebra, A Vel't elmt (1) of n or m.as'-\; (:2) of pro ce'so"" two of whie h JOlll h2,hlll rl to 101'111 a ci1.11al for th o spi na1 Canal; hony proj ectio ns-th e l:>PlLlC' of tbe Yortehr,;:) -ca.n 'be felt b enoath thc "kin ro1' tho whole lcngth of the h l,ck (Fig, 1), " The YertchrcC, :B ill all, :trc gl'ollp:;llllt ,l'egLOll. ' :1. The Neck or Cer vical vQL'tebL't-C arc 7 III lltlluber ; the firdt 01' atlas fonw:! a joiut with the O,tSC of the sK ull, at which the nodding m.ovement of, h ea-i t:1kel:> place; the seconrl or an.'l, h,Y the between it and the atl a:,; , al1ow:3 of the HIde to SIde

movements of the head. II, The Back or CorsaI vel'tebnc, 12, in ha\'e lhe 12 pai n; of 1 ibs n,ttached on e1th er Jele, 111. The Loin 01' L urn bar

!lPINOUS PROCESS

SURFACES suppor: riNO HEADS OF Rles

J,'I(;, 1.

ycrtc1m.e, 5 in lll1111hl'J', al'lo) the lal'gc:-;L of all tho vertelme, IV, The HllllJp none or Sacrum COI1 of yerteln'cc, ullited in <Ullllt::; a...., a.olicl 11la':!s, \\ hieh "i t h the t\\ 0 ha11llCh bOUCH, fOllllC:; the pc1vi, ', V. Th e Tail BOl1e or Coccyx cOll,'ists of vertebnc which are joinc(l together to fOl'1ll a sJIlgle group, Th e v{'l'tclmc in each 1egioll nrc 1< 110\\ 11 hy llllm 1>01':-;, cOlll1ti I'g clo\\'ll\\'nnb-l",t-, :?lld, 31'(1, te,

,Between th? o[ i he YCl'tobrm thick pieces of or c,al'tlbge (u,deI'lJertdJ,'({l rlt'sc.-<) ar intel'po:-(cd, wInch, wlllbt th e,v 11l11U the Lone.' toget her, allow of frce movement to the column <1:::; a whole, and s 1'\'e to brcak the sheck of any '1H1c1cll force appli d to the

spinc, Thc whule I 'llgtl' uf thc spinc str[\,ppcd together by ligAmrnb; re,tchillg from cncl to CII l of the CUIUllll\.

THE. 'KLI,L

'rhe 1)011eS of tit£' ,,!til '\ arc <1rr<ll1g c1 Jl) t w , groups, those of th' lll'<lin caRC, or Cl'aniullI. anc1 010,'(' of the f

The lJOllnc1: ri c:-w r U if' Cr a n i u m arc t \t c' \'tl,lIlt, or d(J]ne, the rounded portion f()1'lllilll1,' he tOjl of the hend; tlll' front O!'

hl'o\y: tIte h,t( k or L11 .· head, " 'llen' tItc gre.1 t.l' .... I, extcnt of hrain ('xisb" ,\11(1 where, thf't'l'l' f ll',

Fw.2 . .' ,;:UJ.L Al\D V"RTEnRA L

ShClrillfl 1(ft ,·ifi" [J,f/(l}IO),' lion nf brea8/·hone. Thp ?'i[!Jd Tibs aTe removed ,

thc cmnium is "i lk..,t and deepest; UIC or temple:-;, where lh,' openings into the cal' 'S an' seen, and to which the car is attached. The j"ve of the Cl'<lni1lll1 is hidden from "iew lrr the hOlles of the fil('{' ,mel the ycrtehr ,Ll colnlllll; it arc 1111111 'rOllS perforatIOn. ' tor tile pn:-',nl!c of the hlooc1 goillg to nn(l from the Il1"lill : through the large:t opening the hrain and Hpillal corel :t1" continuous.

The hUlle: 01' till' Face, \\ iLh tile l'\J,;c p t. ioll of t h ' 11)\\ er jn,\\", nrc firllll,\- joilltc(l togethcr, ,' 0 that 1110YelIlent hcl\\ Cl'1l lh c lll is illl}lO, il)le.

The C<tyilic' or th e ll():-;C anel of the eyc sOl:keL (flrln't) nre formed l,y th" b011cs of the l:ra;!illlll ancl face conj()intly, Tltc llHmth ca :ity i..; f(Jl'1Ill'(l llct\\ l'l' ll the upper and lower jnw"i, the Pettltl' l,l,illg the hony r()of of lbc 1l1l'Hlh, \\ 11i('11 "i 'Flrat '..., iL from th' c<lyity a!J()\"e,

TIm Hrn.".

'1'11/' R ib s con,i..;t of t \\('he uf clll'\'ccl 1,011es exten(liug from tlt <... Ycrt '"Imll l:Olllllll1 Lehincl to the front of the borl r, and arc ],no\\'l1 hI' llllluher;-;, l .. t, 2li.d, 3rd, COl from They form joints ',',ith t ll " dor,,;)l Ycrtehrtc, and Owir IUOYClllent l'l'semhlc , th It of the handle of a lHllkct. TIll' rib ' arc not, ho\\ '\C1', lJtHl,Y throughout their Cl1tiH' length. .l\t ;t, short r1istcl.l1cc from the breast-hone the bony material ell [-;, 'lltl1 grii:ltle (c((1·fila.r;e) take ' its

place. The npper Beven pn,il':-l, named the trlle rihs, are H,ttctched l)y th8i l' c:l.rtilc1.Q'()H Lo the hone: the lowe r five pclirs a.re terllled the /ctlse rihs, eli-> their (,;1.l'tila. ')·Cf; fan sl10rt of the miudle lin '. Of thc fnJsll rills 11th and 12th pn.i1'i-> are termecl the floating or ,vingod ribs, m; their ends al\; frce in frollt. The rih-' enclusp the chest, and :.;erve to protect thc lung.', JH';Lrt, Ii vcr, ote. (sec Thorax allt1 Ahdomen).

TllG: RHEA.

The Breast -b o ne (stenlltltl) a dagger-shaped bone with the point bolow, jll,'t over the pit of the :-;tol1u1.ch; it i->upporb:! the inner clld:.; of the collarhone and the Heven lrue l'ihs are l'ulll1cdcd with it 011 eithcr .-ide.

THJl: UrrE[l,

The Should er honoi-> are the c()lhr-bolle (r-lGI'ic7e) nlJd the sholllcler-bl<1(lc (,'c 'pull(), :lIlcl they together (,,)Ivtitnte an impcrfect gircHe-tlle "l1onlder gn·dlc.

The Collar-bon e can be f,.)lt bClH.'ath the I')kin at ih<=: lower and front part of the )Jeck ;LI') a llnnow C\1l'\'u ,l 1'0'1 of bone, ",bont the thickl1e,',' of a finger. It., inncr e!lcl rel')ts on the upper pan 01 the hrca:-;thone; thc onte1' ])(1 joil1i-> with 1110 :l:' thc top of the sholl1Jc:' ; '1.t eiLher cwl a joint cxist:-;. The collar-bone is cndowed" ith extm ehll')ticii'i', Owing to its being pos. c.'sed of a c10uhle Cl1rve,

PART OF COLLAR

l'O\;ES 0:,' 1'.lE LEli'l' t \'f-ER EXTRHlITY.

jnner t\\"o-thirrl:-; of the 1)011e he i)lJ-( ('\11'\ eel 1'01 a lHl the unter third lYl.ck\\<lnl. ' Thi::) i:-; llel'C . 'cLry ill order to l' ,.j ·t v tlle Btrain thrown on the OOIIC' llY fall,' on the hanel, elbow, 01' bholllder.

The S hou ld e rbla d e 1ili-> at the \la,ek of the chc, ·t, mHl f01'1111') jnil1tl') wiLh the l'ullar-bollt' and t}l<J llOlW ur Ute ann.

Til' bone of t h e arm (klllIlCI"'lU') l' aehet-l from the fo<boulde1' to the enlOW.

1u the Fo r e a rm nre t\\ 0 bOliCH, the Radius on tLc out l' 01' thnmG l:>ide. , . .

[tJ1cl the U lna 011 the inner, or lltLle 1ll1gCl Both bone::; leach from the elbow to LLe

J3o:m 3.

2J wris"G, .and they ch:tnge their rc[;tti po ition with every turn of the hand.

Tne Hand is compo eel of: (1) the bones of the wrist or eight in number, arranged in two rows 01 fou r ; (2) the (the ..k t..ile palm) . pre enting bones, which form the cond snpport the bones of the fingers' (3) phalan7c. or finger bones, three in eaell finger, <1.11 (1 two in tbe thumb.

'fnE PET;ns A.:\D Lowln. EXTflDTITIE .

ThA Pe lv is .-The large 1m 'in-like mas of bone attached to the lower l,(.. Ol the -;pine COlllPO::;OO of three bones, the two haunch hone') anrT the sacrum (or l'llmp hone). 'rhe hn,nllch lllCl't (at the pu(; e. ') in the middle line in front. onl.V <1 small pi 'ce of gri::;tle intervening, but, hehind, "wrnm pla('c' l het\\'een thern. The pelvis to support tho abdomen anel it :, conteuts, to protcct the organs within pchic cu·:ity, to give att.whment on its outer surface to the mU:-3cles of the hip and thigh, md prc.:iellL:i the deep ::locket for thc hc:tcl of the thigh bone -the hip joint.

The Thigh bon e (femU?') readlC'-) from the hip to th e knee joint. The shaft ot the bone it> stont, nmnclec1, and arched

The upper end prej n, ronndecl heael, supported on a lleck " 'hich projects at :111 !.1 ngl u :P)nl the shaft of t he

Trrl(: 1I BO:S-E (FEbHm).

FIG. 4.

130\(RS OF 'TIlE RWIIT LOWER E)..TREi\llTY.

K\EG CA P (PATE!.!.'.

Dlwocrr Hr "E (yIUl C A). f-:1iJ'1 TIOl'o E (TIIlfA).

PFAI A"l;E',

PELns.

2 bone to fit into the Bocket of the hip jOillt. The lower end expanch; to form t\\'o projcctioll:-; tho knee joint.

The Knee Cap (patella) is [\, t h ick tl'iangnlnl' piece of bone with iL:-; npwt\.,rd.' lying in front of the knce jOillt and the lo\\'cr end of the thigh bonc. It (;a11 l)e felt itnmecliaLcly henen.th the f:ikin.

The bo n e s o f t h e leg (1,1'C the 'hin bone (tiDia) and the Brooch bOlle (jilJlila> The Sh i n bo n e (tilll'a) i' trianglll,u' ill hbapc. It from tho knec to the ::tnIele, into hoth of which joint:-; it and phy. · an iInpol'tnnt part. The :-; hm'p edgo Of ."hin Gall ho felt itllmoc1i(l,tely bcncath the f:lkin of tho fj:Ollt of the lc o.; at the inller Hido d tbo anIde a, stout pieGc (If hme proj ,Gt:-; frOtH tho tibia. The B rooch b on e (filmla) lie: parallcl to, and on t.he outer Hicle of, the tihia. Thi:-; hone doo::; not enter into tho formation of the knee joint, but it.. lower end form:-; the outer bouncbry of the ankle joint.

The Foo t .-(l) The group of irregular at the in. ·tep the tarsus. There are f:lcyetl bono':) in the tar:mH, of which the hrgest is the heel bone, a.nd the nppenno.. t (the ankle bono) fOl'tU:-3 the lowcr part of the a11kle joint. The fiye long boncH in front of tIl tar:-;u:-; cOIlf>titute the metatw sUP, amI o:.Lch hone supports n, toc. (:3) Each toe, except the bif( toe, po...·c::;.'cs thrce b011C:-;, namcd the ] 't, 2nd, and 3rd The big toc h;1,8 two uh:.Llangcs only. :2G

A Joint i.. fOltned nt thc jltU ·ti,Jll of two or 1110re honc.'. III joitlts 1'llch It.' the bip, kllcc', dlu)\\, cte., the surfaccs of thc l)()tle:-; are coYcl'ec1 1))' t!-ristlt' or (,(Ll't/la[I(!, a harcl den.c, f:lCll1i-ll'llll.lucCllt ('oYcrillt( "hithle ·scIl." fridiOllnncl the yiolcllcc awl ."hock of a full. Lubricatiuu the j(iitlt i" a tleal', 8tickyorsyrnpy fluid, tbe "joint oil," or ",l/l/oria, enclu:->L'c1 \\ithitl ill' f})8U7e • Tyill!.! the ])Utll' firmly together, 1mt yet allowing of 1!1m'Cllll'll(, nre a 1Hlml)Cl' (If 1 a.'Hh (r lil/aJ3 1m::;) cartilage, ..ytluyia, cnp nIl', and li!.!;l.BH:ut, are ther fere the cCllllponent pal' " of

FIG. 5.-THE IIII' JOI:\T.

Section ('j a Ball (lnd ,'ocJ.ct Joint. the Iillll) joinb.

To explain the formation of lil1lb joilllf'l, the fullo\\iug exnmple' [\.rc given ;-

1 The Sh o uld er, a joint! COtlRi::;Ls of a .. ludlow H<mcer-like .'urfacl' on the outer angle of thc f;houlclel'-hlaclr (.'wlfJulll), and of the r ounded head of t h e arm-bone (ll7llllP/'U,'} 0\\ ing to

TENDON

NERYE

ARTERY

VEIN :MUSCULAR TISSUE

tho ,'hnlluwllc,' uf the l:'>ilolllc1er-ulack tho rouJJd clld of the . ann-bollo I'l'}'\, prolle t{'11*. to escape from I, 2. Tile Elbow, a , hinge joim, is COlllj)(I,'ul , of tho ann-llOlll' and of Lhe t\\O fOl'e-nrl1l honos below (the nulim; ,mel Ullln.). Th e UP PC1' end of the ullla fUl'lllS n, "tout projectioll behind-t.he tip of thl' eluow--whit:h ,e1 \ es til clllLracc the antl-llollc and maintain thc hUiles of the eluow jOillt III po:::ition.

THE Mt -SC LES

P AT ELLA

The muscles of tlll' body are eJu,s 'incc1 into

FIG. 6.-DIAGRAM SITOWINn 'RECTUS 1Jtr3CLE OF THIGH, WITH ARTERY, AND

two grollp,', the I fJlwdw!1 alld t1ll: 1'1l!'fJluniaJ'!J Jilllsr/r:.o{

The Volunta ry muscles COll1)tjtute the 1ll<l'111ll1Ik of mll, 'dl't:l met \\ Ith III Lhe JimlJN, the hencl and nrck, nud thc surfat.:l' of t],e tnmk. These lllll:-:<:les arc a,ttnc:hcel to the L(jlJ(':-. al!(l <tK Lhoy P<1., frolll onc hOlll' to alluther th·y l'J'(I, H joint, all(l heiug l'lldo\\ l'c1 with the po\" er of l'0l1L1fl('Lioll alld reb atiulI, C<lll:-,e the mOYelllen t:::; {If t he body. A:-; it lllUsc1e l'nl se,' <l joint, it h},e .. it. red, Hl,..,by appclLl'cuH.:e alJd 1>ecol11e ' a Lenclon (leador). Dlu(I(l 'd' tra\'c r 'C and . npply the 111l1sclcs, alJd tllL uerve' clltel'iug thc h'ing them under the dircct of the brain alld ,pilla l COl'( 1.

The In voluntary muscles llrC llll't witlt in the \\ all .. of the :-;tolllHcL and in the ltil' pn, al1d ill lllUo..;t of the illtenlill 01'g11l1:-! aJl(l 1>l0()c1 ycstieb, al. () 11 il ,pccial forlll ill the heart. They arc not ulldl'r tlle iuHnew:e of the will, 111lt ecmtiulle their \\Ul'k (h,rillg thc lWlln; or they ar' Kuppli e(1 hy 1\ l'parall' :-;l't of lll'rVl'.· (·cc X Cl'\'Oll"i Sy'tcm).

\ J 0 TlJ EIR THK.\.'l\\lEXT.

By a Fractur e Jlllaut «(. lJrokl'Jl hllle.

l'.\t;::';E,' 0 [" FRACTl!HE.

A oone l11<1 y lJl hJ'(lkcll hy :1. Direct Vio lence. WhclJ fnUll a LImY,

illlpa,ct of a bullet, or crn 'h of a wheel, etc., a bone ll1'eak8 at the spot where the force i.' applied, the fr1:tcture is termed direct.

2. Indirect Vio l en ce. "\Vhen the bono 1l1'e<11: at distance from the tjeat of inj the fradnrc iK termed indirect . Alighting on the feet and fl'acLlll'ing Lhe thigh-bone or the bone' of the leg, or all the hand and the or the collal'-lJonc, arc fttmili'U' exam pIes.

3. M usc ul a r A ction. The knee cap ancl the arm llone arc oeca 'ionally llroken by tt yiolent conLrttctioll of the muscles attached to them.

YAlllETIE:-\ OF FUACTUREH.

1. S i mp le . The hunc itj broken in two, with but fillght injury to part.'.

Co m pli cated . bone i. In'okcll and other i.llpOl'tant adjacent trnctlll'C' injured either lJY Lhe \' whiGh cawed thc' fmcturc, or by Lhe t->harp cl1cltj of the bone a hlood y(\ 'tjel, nen'l" or ,my of tho orgn,llK \vithin the skull, chest) or <.1,' dOltlen.

3. C omp ound . The 1>ono i:-; broken and the skin aid puncturcrl or torn) allowing the air to cOllllllunicate with the scat of the fnwtnre. 1'11e fnl.'::tnrod ends rna,)' protrude through the Hkil1, or tIl" , vonud may l ead do\vLl to the fracture. The yiolcn ·c tit \t brOKe the bone, or the of the hone

e.pvl-ially elm·jug (' lrcle,,; lUO\'emCllt

c I·;ea.lradtll'c tu hecollll' compound. ,mny

1 reference llW.Y Dbo 1><.' nmcte to titree lLore

FIG. 7.

DIAGRAM OF SUfl'LE FRACTrRE UI LEt.,

Fro. DIAl.RA;\I OF CU:UI'JU.:\D 1<'R.\.C1 HE UF LEIl , \\"T-r nO:"E lTRUDI:\O. D

yariet ic.. Comminut e d :-The hone i::; 'heel into seye r a l p ieces. Green-stick :--In children, o\\ing' to t h e softer 'tate of the l)on'y tis 'ue', n. l)one may hend and crack without hreaking completel,r a<.:ro::; '.

Impacted :-' Yhcn, iu,'tcad of oyerric1illg, thc brokcn • ends of a bone are driycn the one into the other, the fracture i aid to be impac.;tec1 . Scycml of the n.-ual and symptoms of fnl.dure mentioned below are absent in green-,'tick ancl impactecl fracture.

.\SD ,'y)lPTmlS OF FRACTUilE.

1. Loss of Po wer in thc limb.

2. Pain at or ncar the ,'cat of fracturc.

3. Defomrity. The injured lilllb Jies in an UlllHl.tural pO'ition, and is at the .'cnt of the injury.

-1. Shortening. Owing to the contraction of the mll,'cle.', the end::; of the bone OYCrrilk, cau .'hortening of the injurecl liml).

5. Swelling. The oyclTic1ing ends of the In'uken bone, the contraction of the muscles and effusion of blood, will c:allse the parts around the cat vf the frn.cture to increase in hulk .

6. Irregularity. If the fra.ctured bon' is clo.'e heneath the "kin as in the ca.se of the jaw, collar-Lonc, hin-bone, etc., the gap in the Lone or the cnd' of thc fra<J'lnenti:; may bc fclt by the fingcr.

7 . Unnatural Mobiiity. ) I OYCl1lcnt may hc

lllade ont at the ,'cat llf the brcak in the l)Ol1C n' \yell at a joint.

N. Crepitus UI' l)OllY grating l1lay be felt or heard \\ hell the brokcn l'llclH lllO\'e onc upon thc other.

The lct.'t two ,'honld un1\' be 'olwht 1,,- a ,·Ul'O·COll. C"

.ApPARATUS FOR OF Fn.\'Cl URES.

a nd Bandag e s arc thc apparatu, l,y \\ .h!ch brokcn 11()l1eS are to l)c trcntec1. In hospita):.." and 1Jt1.lH1agcs appropriate to eyery Yarid} (If Iractl Crc <1.1' at halld, Imt for "Fil"t .Aid" treatmcnt. t h ey frcquently ha yc tob illlproYi.'cc1.

Splints lllay l)c illlprO\'j,'ed from ,,<llking' :-;tick.. , lllltlm:l1n:-;, billinrd cnes Lroulll or h;ll1c1ks, 11 POliC:ClllClll'S tnm<.:ileoll, a ll1ll.kct, a h,lYOllct, or <l ,\\01'<1 it,' 'al)hanl, a folcled coat, (1.1;y pic<.:e uf ,rood, firlllly folded .11e\\'sparlr or any other papLl', it rulkcl-llp map 01', III fa ·t, an!Jtltill!J that is firlll clJul IUlif/ lnollglt to l.:eejJ the joint ...:. ill1))/((7iutdy abuce aJ1tl Ue/OIl' the bone c:t re;::t . " 'hetbcr allY of the aboyc arc HY1ubblc or not, the l.1ppl'l' lillll> Illny 11e tlCd to the trunk or thc 1u \\ c1' limb to it,' fellow.

Bandages may he illlp],()\·j:-;ed from h,lllclkcrc:llids, l)elt:-;, 8traps, 1n'<1.<':(,,', tll'c:kties, or allY piccc of linen or <.:otton that COI11C8 to haucl.

Triangular Bandages (Fig, 9) nrc

mar1e hy cuttll1g a lJic<.:c of lincn or calico about fort v D 2 "

LOWER. 110"RDER.

FIG. 11. BROAD RI.NDAGE.

LOWER B RDER.

FIG. 12. NAn ROw BANDAGE.

inc h es :-.(jlmre mtn 1,\\'0 piecel-) CI'O. way". Th hc 1l.ecll'ithel ill-! a broad or nmT()\\' hlllldage.

The broa d i::; wave by t:,pl'cading the bru)(lagc

FIG. 13. FH'.l<J.

thl'll lhl' p,illt dowll to the 1o\\' '1' 1)01'(1('1' (Fig 10), and tlH·j) foldil1g' into h\l) (Fi!.!.. 11).

The narrow i., irillcl ' 1)), folding the hrondlJnllc1aL'e in t\\·o (FIg. 1 '2).

\\ -hCll not ill 1l!)C', tilC tl'inngulnl' handage l-illOllld 11 folded ;u" a llano\\" hambgc, the two (,1H1:-< be turllcd to the centre, nll( 1 the i1cl.mlagc then folded into folll', rcc1lH.:iIl/..:· it 1() .L packet ahout Gi illChcl-) hy illclll'.·. Wh cn the handage i folded in tbi::; manner it i.' only lle<.:e.'sary to exte n d it lellgthwu,c to forlll a lIarru\\ to unfold tl;c narrow bn.lldage and .'0 donl )le it::; \\ leli h to m ake a broad ba,ndn,ge.

The bandage 'houl d alwaYd be fastened either by a pin or by ty ing the end::; with a r eef knot (Fig . 1:3).

FIG. 15B.

FIG. 13A.

, Yhen for ,'eem'jug the l)nnc1ag'e be fulded narro\\", and lllny he applied either (1) lly Int.'Hing it on 'c, t\\' i(:o, or ltlOl'e round the lim l l l.1mI splint and tying wi th a reef knot; or (2) hy doubling it, paHsing it round the limh anrI splint, in.'erting one enc1

through tile loop f0l'1ll'(1 hy (loIl1)1ing lhe l)(l11c1age and tying it to the free curl with a rcef kllot (:-;ee Fig. U-) ; or (:3) ]ll'o<,; Icrliug aH in No. P), lmt 1.H. :-;ing uoth CUdH throng-It the Joop ill oppo ite (liredioll.· (:-;cc Fi!.!. ] 0 .\), and t,Yiug' them "itlt i, red kllot (f'ec Fig. l:)Jl).

KnotH .. honld aI\Y<ly", "here po.. il)le, he tied oyer a :-ipJint so that they way uot P1'C .H UP()U -tl'ndnre,' to do thelll injnry.

L arge ar msling (Fig. 16).,'pruHI out 11 l>;lIlclage, put Olle end O\er the .houlrlcr on the HOlLnd :-;iclc, let the othcr hang du\\ n in

FlU. 16. front of the <.;he. t ; C;1.lTY the poiut behind the dhow of the injurec1 arm nnd l)cnc1 thc an11 fo1'\\ (11'<1 oyer t.he middle of the banc1ctg'e: thel1

Celrl'Y the 'c(:0 11r1 'l1<l on1' the of tlH' :side, a.mI tic tv L1l2 other eml; urin!!"

tIlt' IJ0int fvl'\Y,"tnl, r\,llcl pin to the front of the

Sm a ll armsli ng (Fig. 17).

- Fuld the 11H1Hlnge into th' 1lH>a<1 then plate I),l'

l'lJ(l ()\ l'l' t h(· t-lholll<kr oil the t-lmm<l ero'.,>

tllC fOl"eanl1 on (" the Itli<ldle or th·, lund<ll.!,·c down the l:h,·... t: then 111'ing: 1 111; other clld O\'l!' thc 11 the illjurec1 . jIlL', Hnd tie nt :-idc ()f the lleGk.

Slmg, · way lIe l!xtclllporit:)cll by tlll'lling np he tail of the coal Hncl piUllillg it on the ( 11'ig. ,1('), or if til, t:>calll of the :-;leen' h;lS RJit Ill', hy )'c-;t ,illg tIlC arlll 11l the 'l'i p of dl)tl1 fOl'med, ,1Iid pillllillg :\,' :.,;110\\'11 in Fjg. 19.

( : ENEUAL HULEf) TU BE OB 'Efi\'F.D 1. ' ] I n; TUEA'nfE);T

O!i' FrU.(TUREt:.

Thc ul1jed of tin.;t aid Lrentmcl lt. of fradllrc:-; j:-; to gll,ITd :It!'ailll' flll'LlJer Irli,'I,; llid, ;1]1,1 ('''pI'l'ially to preFw. 18.

VCllt p in,plc fr:1(; 11 1'0 from i'l'(;UlIlill!! t'oillpliented or l'0Il1j)Oll11rl. To aLl;> ill thi:-; (11(1 :1. A tt e n d t o the Fr ac t u r e on 1he spot w h e re the acciden t o c c urred. ,I IlI,lUr!' hm

c r owded the or how. hOl't the di:-;tnnec to cl. more conyenient at' cO!llfOl'ah.le plaee, .llO must he mn,c1e to mo\"c the patient nllLd. t h e l )m)c 11 <1.' ueen rendered. n' illlmny·thle n:-; hy .tt or other re.. tr lining' ,\ Ith grent principle t.he treatmL'nt of fracture.' i.. a que 'tlOll of detaIl. .. .

2. Steady and support the lnJured 11mb onee, .0 that itt! furth l' 011 the pnrt or either the patient or the hy:-;tamlen; Itl .

'3 When a bone of the lower extremlty lS gently pull npon the foot until 1iml) regain a more no1'n1<1.1 tlhnp. ,rhen the of the limb it; improyec1, on no aeconnt.lct go of th.e lUlll) until it i . ecured ill P)' iLion 11,'- ,·pllllt.', othel'\\-It:;e the lllu-'cles will he nll ' )\H,.l to cUlltmci , and the 'Cnc1.' of the hroken hlll' lll,ly pcnetr<lte the. Sbll, pierce a l>looc1-Yes.'cl, or (.10 flll:ther 1 ,1.H:t well to attempt extcllslIlll (I.e, .'t.rete h.lI1g) III C,Hie of a fracture of thc lIPl' '1' limb . TIll' .'honl(l he left to the lll'geon.

4. When the fracture is compound amI further cOlllplic,ltecl hy ::;c\'crc hCClllOlT1Htge, arrest the hcemorrhage bcfon' fmther nr c trl.kCll. In all ca. cs of cOlHponnd appl y c1en,n ings to the W 01.111d .

f5. Apply splin s and bandages to .'e :lrI::l the tunb in position, to prevent moycment wIllI t the

patient i' being ca rried to hi s h ome, to a he-spital, or to tempora r y .·h elter. The be long enough to k0l'l) the joint .. imlllediately <l1)oYc helow the fracLured lone at re .. t.

G. III eye )'Y C.'a"e of fractnl'e, it i.. to keep the patien : warm .. 0 a' to ]cH.. ell t.he of the 'JIOCK of thc accident: t.hi.. is donc 1 y a d('ak, \\ 1, or coat oYer the raticnt nutil he reache.. hdtcl'.

:-';PEl'L-\L FRAC'l'URF .

Fracture of the Spine. -The yeltchral column lllUy be Lrokell citht'l' by direct yiolcllCC or by indirc(;t yiolcll(;e. Ii';Il1ill!.; frOlll a height (11 the 1 ack a l)nr, or npon an UIIC\,Ol1 i.. an l'x<U1lple of direct yiolencc. Falling (HI tllC h ead or a Cl'll:-;hillg force nppliccl to tht' hcad, <lIC nall1ple .. of illdirect ,i(llclJce, cal1::iing' u;:;ually a 111'okll1 1lcck. 'Yhat U 1],)11( nlv l'l'!';itnlccl a,' a hroh'll Iltlck com.,i of a fladure (;r tlte proce cOl1l1ediul!, t.he LOlJe,' ,rith c1i .. placUllcnt of the Ycrtehrrc, thl'l'ch) endangering the spil\al cord <1m1 the ncnl':-; i,-;.'uillg' fl'Olll it, lending t.C) e l111p]etc or partial phrnly')is of the put, below the f injury.

Treatm en f.-Pl' f'YC llt all 1ll0Y('mcnt 011 the 1 al t of the patient. If it dodor i' within cnll, keep thu patient quiet until h c nrl'iye.. If the l'>cnice,' of 11. doctor cannot be obtained within reasoJ]al;]e time ,

a. blanket, sheet, 'tout plaid, piece of sn,il or l"l11vas, otc., bcnellth the p'ltient. Do not roll the pl.tient ovor in doing but p,v,' the l)lnnket or t-;hecl, (' te., carefully b eneath the hon,el, then under th2 body and lo\\"er extremities as he lie,' on hi,' hack.

Poles al'e then to be ro11ed in the blanket one on oach , i<1e . The IHtient 1nn)' no\\" h:: lift ,1 1'0111' pcr::iOll " 1. \\"0 011 either side, gt\l,sping tIl:: (e,u..:h per,'on hJth h;111(1.'), laid on a stree hel' OJ' shutler, an(1 e,1.l'riecl to ShOltol . Yo flll'ther troiltlllCllt is called for nntil the (lc)"tor arri\'ei', e\.(;ept to gi\'e th' \ mtcl', t e:l, ctli, if he i '

Fracture of the Skul1. -Frudmos of the (',"l11:Ulll m" h in plOpol'tion to the L''\.tCllt of the illjmy to the IJmill cO '1Lline1 \yithin it., hound,tries.

U.-u .llly th'2l'c arc SYlllptom,' of illjlll'y to the l)]'ain (se e ('ompreio1l ,1.11,1 ('oll ell,siull, pages 10,' and 109).

Fr.1dnrC3 of the ",wIt are k.;;' c1angenHl.' than fl'it f'tnre3 or the has2 of t!!l' ··n1lJilllll. 'Y hell any p eut of the vault i.' and a sca1p WOU1lel reyeal.' the inj nre 1 hono, h,tdme may he or felt; VIi' llnv or may not n:--,>ociatcd with eyidence or hi'i1.in iujnr\',

hase of the eranimn ii':l fradnrecl, 1100(1 or dear fini(1 Jl)ay ib,nc frOID the ear; or the l)loc:d 111'1.y esc,lpc from the or may (lowll to the' :-;t,)l1Nch whence it lI1n.y h WI11)itc(1. The fmet ,re III ty in \'ol'\'c the orl)it, ,dWl1 1,1<10(1 wi ll into

tlte ,U0tet.- of OJ' built ('yc:-.. ' rileD tIle fradure 11-i far back, there lll:l \' be iWlieLtLiollb of a at the bn,c k of the head ..

l :tll,\" II "lllfJ),J'hng-(' frO}l) a })luu(l . YC '.'cl III the (:>ee p.l"'C Pl ace the pnticnt F/(;. 20. III 1111 ('il,"} po. i tion to In'('<lLiI,'; llll(lo nIl clothillg': carry

tit!' P;ltil'll! illrloor, or 11111]('1' llt·IIN; apply (I. f']C';lll hillldkr·n·llicf, a pi,.',.'· of lillt or Jill 11 dippcd ;'1 c:,)1(1 UI', if 11 \'1Iil;.1,\l" all ieehilg, to tIll JI!';I( 1. I}o not S!,in] by the mouth if tltl' i.- in en, illlo, tt:et '\, doctor . pecclil)'.

Fracture of the Lower Jaw. - There arc the usual )f fmcLnrc, \\ ith ill'nl)ility to or lHI\(' ttl" '. i l \\ freely, irregularity of mc teeth ,.11-1 bkcdill ' " inllll the l ' t 1)1 h' . . 1'ea lI1('nt. :teethe p,tlllt of tilt !l'lllll he]o\\ the lllJured bone, pre::)::) it gl'llLly IIp\\:l rds agnill'i. thfJ

UpP21' ja\r, and ll1,1'ntrtin it in that po.·itim1 hv a lHl.lTO\\' bandage. To H,pply the bc.tndage pla<.:e 'the tD onc 1)idc of the c;liin, carry the elld1) np the 1)lde of the head, cros 'ing thCI]) jlvt ahove Olle ea.r, ,md paB the end 101lUd the head tyin a them on the side of the he,:d to the dro; ill; (Fig. -\nother method l' to tIC the end, 011 the top of tbe hearl and pas a. e<.:ond bandage in front of the chill, f;t.'ten the enels at the lJ.·tt.:k of thc neck and tic all fom ends on the crown of the head.

Fractured Ribs. -Tbe rills usually fmdurccl are tho'e occupying a ccntral po:ition in the <.:hc:.,t, namely, the 7th, th, and 9th. The llighcr ;1lH1 the ]o\\'e r pall'B are seldolll fra 'tul'ed. A rill 1I1H\' 1)(.' In'okcll 1): a direct blow 01' 11Y (I, "j111'1'2e or (;l'u.h.' Jt may l)c lJroken in any part of its C011r.'e, but it is 11 'l1ally fracturcd halfway hetween the hrea. t-llonc al:d the bade-LOllC. The clanger of a broken rill nlrie.' wlth the of injury to the lung. Practically, wherever a nL l ' to be felt there i luna beneath, 1 b (, tnel'efore any force whIch tCl1(ls to d l'i\Te the enels of the broken bone inward . may teetr the 1111)0',

Signs and S.z;mptoms." Then a ril) i.. In'ol{Cl1 the patient complains n f a severe pain, on attempting to take a deep breath; the breathing i.. ..hort alld shallow, crepitus may be felt on pla<.:ing the 11nn(1 Oyc r the mJured part. hould the rilJ penetrate the lung b l ood may be coughed up a n d exp ectorated.

Blood coming from a torn ]Ullg i, coughed up; it i,' of a lJrigbt red colour, and a frothy <lppearancc.

J'Teatment . - TVhen tJo e lun!! is 11(./ i1Jjlll'ed app]:T byo

In'o,L(l IJHndaue ' firmly lOUllcI the <.:hct, with tIle ccntre of one lJ<Uldagc illlll1edintely ahoyc, cillel the ceutn.! of thl' !-ill'on d illlllledi;(telv Lc]o\\ the of fracture. The arc to 1)e placed '0 that the lowcr 0\ th e upper to half it extent.

Thl'Y arc to l) e tied 0 11 tlJe't1pp0f-,ite :-;ic1e of the both \\ ith th e kn ots to the fnmt of the' l)oclY, and tight cllough '0 (yiYe :he paticnt llupport and cVll:,brl

Fw. 2 1. 1U breathing (Fin·. :?l) . \Yhell no an'

}Jrocurnblc, tighiellillg the \\alt:>t<.:O,lt hy pilluing the hu.:k or 'ccuring it othel'wi 'e i . good plan. n ' 71f71 the n'v;; ar e lJi'oh-ellJ raw:dnu hu'urij to, and it may be hcenw1Tha(Je from i71e lung, do not place it Lanclngc

l'onud the bOl y, bnt lay tIt patient do\\ 11, illclill"cl

a little to\Y<.\l'(h the injured :side, in order to more play to thc t-3ound 1lIug; loo:sen the doth ing, give icc to suck, and place all ice-lmg Oll the che:-;t oyer the hrokcll rib. A lmlldage rOUll(} the cheHt might tend to c1riye the oroken hone further into the IUllg. A largo , ling to support the :ll"tll of the il1jllrcd is adyisai;lc in either caf{e.

Fracture of the \\'hell this accidcnt l' w:lpectccl, lit \\ IICII II.\' pasHlllg till' fino'or over tho hrea ·t-hone the frad lIn: call hc Hf'ttml1y felt, tho trojlJ/rnt to he folhl\\cU j:-;, to ulldo aU tight clothing, to pIner the patient ill n,' e;tsy :1 pO'ition f1:; pos.'illle until il do ctor inTi \"(. , allrl to l\'oid rough handline: (Jl' ,',:ddcll 1IlOV('tll Ollt.

FHAcrURE OF HiE BOXES OF 'I [IE U prEI1 EXTRE;lrITY

Fracture of the C ollar-bone (c1ari,.zp).-Tho nnn on tho illJlll'<.' 1 f$idc if, palti,tll,Y 11< ]pL,,.;, m d tlto pa,tient usually npp0l'tr-; it. (It the dV",· \\ ith llili h'md, and i.nclincr-; hif:l llCad towul'd:-; th' inj Ill'c(l :-;ic[('. ,rhen the finger ir:; passed along the illj lll'ccl hOllC thc fra ct llred end' can gellcndly be felt to o\'erbp, Uw 01lter fra,gmcnt haying dropped J>ClO\\ the lcyd of the illller one. 'rhe other HignH 111lcl fiylllptuHl' of fr'1ctlll'u arc mostly pl'cr-;ent.

Trealment.-Helllove 111(' ("Ht \\ i It l"1.1l', l' eg inning with t]IC f;(Jlllld i-iidc :JtIc1 ""upp'H'. ing tllU

injllred lillll, 1,he ]'ellloval of the .' leeve therefrom: al. 'u take off' m.; lIlllUh more of the clothillg n: i.. cxpedicllt. Pla.c a pad ahout the , iz' of II Bath hun in t lJe armpit of tJle injured :::idc. (;ently l )ellc1 t lJ(, r01'eprJn well up, keeping

Fl<:.

the elbow far b:H.:k practIcable, and ,npport ill a. bl'ge arm ,'ling. J nr:;Lcacl of applying till' large arlll .. Jing ill the n 'Hid method, it i.. to p8-_" the end, that in the onlinary way \"ould go uyc r

the fractured bone, l)enea.th the armpit of the illjlll"l'( and tie the behiud (Fig. All [tlLerlll ti \'e forlll of -ling, preferred 1,)' 'O lllO, pul on as follows: flex the foreanu [ti':) auo,'e; place Olle cu· 1 of l!'IG. :23A. (Baad!1ge nnd body, omitted sllolV detn,ils of sling.)

the bandage Oll the SllOldclcr of the uninjured <;iri.n, keeping the point to\\,:trdH the iujurccl side; pass the b;t 'e bet\\'ccn the fkx:c·l forearm anel the hody, then under the armpit and aero' the llack, awl

till' two on .'llOulder of th£' sonnrl ,ide. Tlte point iwd part of the sidet; of the hlllc1agc are now to he folded to snpport the elbow und fixed ,vilil one or two pins (Figs. 23A 2:113) jhy eiU1I'l' of the::;e plans the broken l)ol1e not 11l'c-: 'Cll tlpOll 1)v the l),llld,1gt'.

/illttllY tip·htl\, Kel'ure 'the t,) the . iele of the hod,' hv a hro(lfl tlpplicd illlllledint ,1.)'

oyer <\l.ll IlP(lll lhe dhow uf thl' injmed lilllh, a" ,,110\\ 11 iu lltlill . (Flt!;':>. 'H (Ina L'<llTy tltl' 'ucb hOl'izol1tally round tI,L' as to lL'\ l'r OUL ;01111 at thL' . h,) tit''' joint, thl' pad f.1I111lllg' the [ll.l'll! II. l'ij. \Yhl'll oue

ouh' i [t\',lilabk place:1 p:1d in thl' 'Ilmpit} fit,; the forcllnn as ill tliagl':llll (Fit!,'. apply lUtlTO\\' hilldage illlllll'di.l.te1y !1110\'(' tllL' clhl)\\, l>rilll!; Olle cud acrosH tlll' fnmt of the chl' t ; en.l"!'\' the ot Iter cud 1)l,hillU the arm, u,ucl then bring it ell' 1

between the limb and the hody; }la,,' it so :1-.; to embrace the portion of the ha.lldage on the front of the chcst, and £111<l11y C:,llTY it round the lJcH.:k .; light and tie off as in diagram (F'ig. 24).

Fracture of the Sho u lder - b l ad e (.f;fitmla) i· to he treatcd, aftcr the elothiug i.. J'ell1o\'cc1, h.\' applying a uroad triallgular hallc1,ll,!c {innly 1'0111](1 the hody, oyer the ,'Cltt of iujury awl tltcrl'i'orc cl()s . up to the arl1lpit8' the li1l11) i. then 11y a large ann ..ling.

Fracture of the A r m (lw,ltlei'll.'»).-The 1)(1l1L' way be broken clo::;c up to the Hholllcll'J', ill the llIiclclk of its shaft, or in the illlmediatc lleigltl)olll'hoocl of tlle elbow joint. The u.'1.Htl allCl HylllptOlIJ'J 'Ire present.

Treatment.- When the Humei'us i.' l)'((('tll1'crl at it ...; end close to t he .ioint Apply a 1n'oacl handage with it· centre aboyc the middle of thc ann, and carry the end::; rounel the ann and 11ody, tying them on the oppo.. ite side; l:>upport thc furcarm 11.\' <l nnall arm sling. When the shaft of the IbllJlet'us i.' lwoken :-Bend the forcarm at right angles to the ann; apply four splints of wood or folc1ed ncwspapcr.', covers of book', etc., to reach from 'llOulc1cr to ell)u\\, to the front, back, outer, and i1lneridcl:i of the arm (rig. 25). 1'he splint in frollt (oyer thc 11icep.., mu. cl e) must on no acconnt l) '0 long a .. to pres' upon the fold of the elbow joint, othen\ i,.c the l)lood-

5:l

arc ill (LtIlg-er of hcillO' c:ompressecl. The tm \\' coyer of H wine hottle cut to a proper lcngth fC)l'Jl1::> an cxcellenr, for the front of the anll. rll C:<l.'C of c1itlindt.\, ill procuring ,plinto', it will he .. ntticicnt to place them 011 the entcr and inncr only. 'ecUl'e the f'pl in to' 1>y t \\ 0 l>andnge " 011 e nhoye and the othcr helow the ,eat of fnwturc. III ca.e no o'plint;-, arc nvnilahle, sccure the arm ,.... itil hro hrond bnndag-e' to the ide. Support the forcarm l)y n smull arm H] iug. P(al'tW'es tlip elbo/l' johd arc nttCll(lcd lrr '0 much

FIG. 25. swclling,' and it i ' '0 c1iftiCll]t to ·l.l'crtain the CX:lct naturc of the injury, that wh 11 the accidcnt occur.. indoor ' thc limb 'houlcl 11C laid on t pillow 111 the most comforta111c pO'.'ible; ice or cold water dre iug::;

::;bon1tl be apphcd tu tbe injured part, but no flll'thl' j' treatment ,hould he atLelll ptml peneling the arrival \If n. doctor. ' Vhcn the n,cl5ident occnn; out of 000]':-;, it is to be trea.ted hy the lLpplicn,tion of all angular Hplillt (Fig. :36) made follow!:) :-TnJce two of thin tin wood one Ion!..!; enougb to reach from tll \ nl'lllpit to ju:t hd o w the elbow, the other long to 1'c:1ch frOll} above the dhow to tb finger tip': tie , , I I , 1 FIG . 26.

rldollnit.y "ill lj{' lOl1' ld 8. t the scat of frHctl1r, [<1 1 ;'C\10 -pam ,,,hell lllOH'IIIt llL )!-; attempted.

f r a ctu r e of the Ulna alone 1l .·\U1.1Iy oeel.!., nt. the upper clI(l of til e bflIlC, in the IIciubllollrlHlf HI oi th e elbow. Th L' tip or 1h e ell)(, 1\" i:-; lol'l1v d hy the uln.t, and it fall UpO:l th8.t pruce. ', oflJOl1e j . :lIlt to 1)]'o<1.k it oW

T he R adi.us i,' frC'I111 Iltl y fractured iUl111ccliat c1\' (1 ), ,\ c the "'I'LL, tIle l't' n it (r a f;1.11 on be hnllll.

-'ecHre l)y narrow bancla!..!;c· ahoye an 1 below '· the scat (If fradul'c, nond Huppllrt by no lm'ge arm S1illg. On arrival at hOlll<', as if the illj my hacl

l'mn lye t he and treat oc cllrred indoorH. thcm together n' to form fL right angle, and apply the anuular splin t , 0 formed on either the onter or inner iele of the flexed limh.

Fracture of the Forearm.-Si,q71s and , ·'fll ilp /oms.- 1T7u:> n both bones (the Radius and Cll/a) (U'(I uroken, the u ,' ual sign,' and symptoms of fracture nrc lJl'cf:>cnt; when on(' of the. tl[,O 7Jone<; on7!! is lirokm th e are modified, lmt th( limb ,vill 10'e power, a

FIll. '27.

fmctul'e i' i 111)a otCtL ,1.11<1 tLl' ::,igns of ilddl1l'e [lrc con eqllcnt1y mocliHecl h11t the deformity t t· u) : aeu e pam un ,m.m l mont, and the p '" ?I the IW.ll 'l are ,'UffiCIL'ntlyt 1'01lg l11'oof tha the lHll j(J 1. 1n·oken..

Treatment.- The tl'catlJll lIt i,: the 'ame whether

fractnr e i of ono 01 hoth of t llG bone. B end til forearm at right angle1; to t h e ann, k ee ping the thumh npwards a nd the palm of t h c hand the hody: apply two broad ::>p l illt· ,,-hil e the forearlll i.. m aintained ill the bent p01:lition, 0110

a long t h e iUllcr, the othe r th ' outc r '-.iicl' of till'

limb . Tile innCl' 'plint shou ld he. 'l OlH.!; enough to r ench from the elh ow to the anel Lhe outer from the elbow to the hack or tbe IHl11d.

the }'y l)Hltdage', one ahoyc, an(l anot h er hclc)\\ the ( f fracture, and a third to n, t h e IIHml in pu:::;itiOll (Fig. 27).

F ig.

Finally, s l1ppo r L til, limo l;y a large ann :::;lin g'.

Metacarpus .- Onc or mo r e of t h metacarpi)l bones may be brokcn lJY direct or indirect

1Vh ell a metacarpal oon' i::> fractured, place a ronnd pad, .'llch a a lyall, in the palm of the hand, bend the fingcr' rOllnd the ball, and the wholc 11)' a oandage and ;1.pp l,\" a large arl1llillg (Fig. 2

Fracture of a Bone of the Finger (phalanx) .

- The llatnre o[ the iujlll'y i · rcndi]y recoo'nizable a the deformi ty can he hoth seen anel felt . ' the injured fingcr gcntly into po. Itton, apply n. narrowplint along the front of the til!ger, and 'ec nre it hy a piece of linen, tape, or pIa.tel'.

\\ ben 'c yeral fingers are injured apply a 'plint large enongh to .. upporL the '\\'hol e ham1. Support the hand i1l111 l'ure;11'1n 1)), a. large a.rm .. lill 0'.

F ,racture of the 'ions and - " hen, aftcr :)cyel'e 111.] my III the lleighllOlll'hood of t l1C' hallllch bonc, there i:-; no .. igll of injury to the lower e,trcmit,'-' hut the pali nt unable to ::>tand, or walk, or e\'OI1 to moyc the 100\'er lilll1JH, \Yithont groat clitticl1lt,\' am1 pain, a fracture of the pehiH may llC a:). ulllc(l to occlllTec1. Deformity, c r cpilll::>, cte., cannot u,'llally be made out. Tl;e ·el · and Ol'gn.llH, e:.;pecittlly the bladder, wl thm the pehit-i, a re in O'l'eat dH11O'Cr of Lein,)' wonnclecl.

v 0 0

T reafmenf . --- L ,lY Lhe ptlLient ill \\'hntcyer po 'ition

i ' fOllUcl to giyc greate·t eil:-;e . Hilld a broad handa.ge r onnd the hips tight to Huppo rt the ptLrt, but not Lig h a'-.i to pre 's the Lr okell bone

furthcr iJlward . towel,I'd::; tho eayily of tho pohiH, awl thereby canso more damage to the illtcmal orgnl1 .·. FIe. or straighten t h o lower liml)s according HH the patient ,,,i.-hes, and lay him carefully on no hhl.llket, :-; hn tter, or stretcher befol'c nHwing' him to ,1, pLlI'e u[ l:>heHer.

FRACITRE OF THE BmmH or THE LOWER EXTREm'l Y.

Fracture of th e Thigh bone (jpm7l1').-Thc thigh bone may be broken at the neek (the l1pper end) ; nonywhcre in tho length of .. haft j or the lo\\'er end close to the knce. Fntctul'e of the neck of the thigh bone j,' very apt to occur in old pcople ;mel from Y(1l'y ..lio·ht illj llry. A sey c rc of tll(' hip is apt, to be for a fI'HCLlIl'l'. It.. m:1. be taken ctl:> a ,afe guide, hO\\ oycr, that.. "lIt'll, arlel' an injnry in the ncighbourhoocl of the hip joilli th(' injllred can, \\bil.'G lying' on the hnek, the heel off the grollnd, the LonL i'! not broken j hut jf th o heel cmmot be rai.' od it.. i,' KHJC to as.. Ill11e llw.L tho hone is broken. Fracture of the lower cml of Ow \ high bone i, apt to involvo tll e kne e ill th \ i ilj Ill',), with serious detrimont to the joint. Si,llTlJ and Sumpfoms.-The' u,'lml of fractur(' . 'llle foot of the injurec1lilllb \\iUlie in 80m ' pusition, lls ll a lly on it:-; outor 'idc. The on tho injureel . id m a y va,ry from onc-11n.1£ to tlll'cc jnchcK

'f',,((ltmrJd.-(l) Stead y tbe iujun.:d liEJ) by huldjug tbo foot. (2) C:clltly (haw (lown the foot of th L illjlll' 'cl sidc, and hring it lllto lille \\ itll the foot (,f the , onnd limb. 'Vb 11 two 01' three n,i,trmt. nw at hanel, it i' one PCl',:Oll ' (Illty to nttulc1 to the foot, it in pO..iti ' Hl alHl not letting go until tl. ... tl-> [mel hnnc1Hg'e ' ,d'C applicel. (3) .Apply it.. plillt u} tllc outer :-;jl1 e of the 1Iro1\.e11 liml), luDp.: l'llOl1gh to rencll fr()JJ1 Ule armpit to beyond th e foot. A In'0( )l1l lWlldk, h lJlo,:-;kct.. (butt end in anJ }-

FJG.

pit / ' a lIlttp r(Jllc d lip, ," couple of billiard /.'Ul', tied together, (II ,my picl'e of \\ ooel cnt to lIlay be n:-;ccl as n Aprl)' a, .. plint on the llI:--ide of the hnJl\.l'll tlligh, long cnough to reach frum the i11l->iclr of the top of the thigh (tllC i 1.1) the k11ot'. (t» NCClll'l' tlll' Hplints ill p .' ition 11y h,lll(hgcl->. Pas ' one I'u1.tlld Uw che .' l jut lJClow llrlllpit.; <111ot11cr roUll(l the pch'iH; .1, third and fourth I ltl1llag-C, emhracing' both liplintH, ..1l'e placcd on the thigh, one aboyc and thc othcr below the scat of

fracture; a fifth b1.ndn.5'0 round thc lee:; a "ixth i::l to to be passed behind b th anlJe, 'J the end', ed o:'er the front of the feet, embracing the sp1l1lt, amI tlClt off b 310w the feet. Finn,lly, apply a 'eyenth rounel both (Fio'. Do not appl y n. bandage over the abdomen, a' it might can'e the patient lo ,,"omit, and, would not keep the ,'plint fi!·lIl. (6) T::eat hock by kceping til? " Tar.m. lJ hell a lJ81'sf)n is sinr;le-lianr7ed,. It l' expechcnt, afte\' extension of the 1i1ll1, to tic the feet togethcr to prevent the hone' from <"I.gain oycrlnpping; an(I, t1llcL:r the::iJ circumst'ulce', ,k; well ,,,hen the pn.t1cnt h ,L woman it I::; wen to pn.::-> all the limh bandn,g'l' -' ronnd bdth limb 'J c1i:pewsing with the in::;i<1e .. plillL ( Fin' 30\. o

FH; 30 .

Fracture of the kneecap (pat ellrl) .-The kne ecap ml1y be broken oy f<tlling on the knee ((lil'ect violence) . 'More fre rluently it i, broken hy mUf)clllcn' action, an l1ceident which may a1'i 'e ,loS follows: ,

6 1

\rlle]) tne foot :]ip::; nncl an attempt i,' made to reY<.!l.lt a fall, the llln,'<.:lci'> in the fl'( 11lt of the tbigh <Lct wIth S U <.:ll ful'<':u il1 the atielll],t to maintaiu the 1><11H11(:e that the knee cap lilty 1 C :-'llappcd in two, and } !/mplmlli<.-The lillJl) "ill l)e quite helple ': a /lap JIlHy 1)e felt hctween the 111'( l,l' ll llld of tll e kneecap; th e ]ml' e joint \\'ill 'pL'cdily f)\\,cll.

Turd 11/( 1/f,- Lay tile patient 011 hi · hl<.:k; "cll and

FIG 31. FRACTURE , upport the head and .. houlders. OF K"EEC \1'. and l'<li,e the liml). ..:\pply <. plint along the hu;k of thc lim1) ll'lH:hing' fro ill the hip to l)c,Yonr1 the heel; apply a 11111l'O\\' lxtl1c1agc ,,,ith iti'> ccntro placed ilJllllccliatcly above the broken Imee<.:ap, '1'0:-;,' the clHb behind oYcr the ..plint, and tic oft' in front helow the hrokcn bone (Fig. 32 1.

To ensure til'lllllCHS a ::;c<.:oncl bancl.'to·c may be applil:c1 in n .. im11a1' Wlly to the fir't, b u t commenced below. :tnd tied ahoye the hroken bon e . The sp1 ill t i, to 1)0 fmthcr ,'eclll'cd hanclnge, rounel the thigh and leg.

Th' foot i.. thcn to he 'llpport d \yell off the ground hy n pillow, roll of clothilH!,', etc .. or if llone of the .. c call ue had, by re:-;ting tlle foot of the injured limb on the top of the foot o{ the ::;oulld limb. An ice-bag or

old-water drc:; 'ing Hhould appliL',d on the in,lit of the inj ured kneecap as soon as P08s1ble,

FL(;. 32,

Fracture of the Leg (ti6ia and ]'JllCS may be broken at timc: 01' ('Ithc'!' 1l1ly broken alone,

Signs and Symptom'S.-The W:lual sigu.') ::I.llc1 ;-'Yll1p

b" 1 tu the ,kill tOl'US are present., The ti U1 IS that the fractureu. cndH can gellclall} be readily felt. 63

A fracture of thl' fihula three 01' rlml' illcltCt) alJoyc its luwcr cnd it; fre(}ltelltiy llliKtakell for H anrlnot infrequl'ntly for a di",loc:ttiull of t.hc Hllkll'. o\\'illg to displac:cllll'ut I)f tit!' foot being thl' ltl();-,L Pl'(' llIillCllt Sigll. ,\VI101l 1)11' l)Ulll' is brokcll tl!'jl'l' will bl' nu 1ll11l'kecl

1'1·eatnzent .-(1)· ,.'tl·td . the lillil, by hd(lillg the foot of thl' illJlll'ccl liitle. (2) thE; f(lot of tIle illjured ide lL'\'el with the foot uf the ."OllUU lilllh, with

FIG. 33.

thl' toef-o up\\'ard;-i, :Iud do Hot /,'1, g'O 11Iltil the splint' hayc l)ecn fixcd. Applyplilll.' to the leg, onc on thc out 'iac, Hllotltn Oll thc ilbitle. The HplintH :-;hOlllcl ue long enongh tu l'c:wh frolll al)()yc thc knee to h 'yo nd tho foot, that the kncL' awl ·l.ukle jointl-o arc kcpt at rc.'t. If olll,\' onc ;;plint i' available. place it on the -ontoI' ,'iele. en thc ..plint by hallc1ag-e' plncrd onc ahovc "nrl anot.hcr belo,,' t.he 'cat. (If fracturc. A thin1 handage i' to hc ·applicd immec1i<1 tely aboyc thc kncc, and n. fourth and fi fth 1'On11U

Flg.34

both ank l e:::; and knees tL' in the case of the thigh. 1Vhen single-handed, ,L[[,cr extending the limh, ti' the feet together, dispense with the inr:;ide Rplint, anel c:-\'1'ry a ll bandage round both limb' (Fig. .34). ' Yhen the patient is a woman the in8ide .'pEnt lllay 1Je pell.'ed with, and all the hlndager:; may ue carri 'c1 round both limbs oyer the clothing. no splint is ayailable, tying the leg ', ankle' and knee ' together is of great sen ice.

Fractures of the Metatars al Bones and Phalanges (crushed foot).-Fmctures of the.'e l)one::; are commonly cau 'e el by the pa' 'uge of n. heeL"), weight oyor the foot. The accident is recognised 1)), pain 011 movement of the foot or toes, swelling and lo .'s of power.

Treatmen t. -The treatm nt con ..ists in the Clpplic(1,tion of a fiat splint of wood or other material, such a' a book or piece of cardboard, to the .'010 of the foot with a bandage to encl0 'e the whole foot.

DISLOCATION, .

A di.locat:on i' t h e eli pbcellleut of one or more of the bones enter ing into the formation of a joint.

T he joint frelluent ly dislocated are those of the shoulde r , the elbow, the t h umlJ, the finger8, and the l ower jaw , The joints of tbe l owe r extremity are b ut sel dom dislocated . "

IG - AND ,·nrPTmr. ' OF DrsLocATION.

(1) Unnatural position of the limb .

(2) Pai n uf ,L 'eyel'e .'i<.;kening character.

(3) De f ormity in the nei,,'hlJou1'hoocl of the injurcd joint. r

(4) Fixit y of the j oint. rlllikc n fractnre the limb canllot be 11l0H'1i at lhe joillt by ·itber the patient 01' other.'. •

(5) Sw e ll ing a nd numbn es s of the parts hcluw the 'ent of di:-.locntiol1.

Ab s e n ce of the cr ep it us <.:hnmdel'i.lic of orclll1nr,'" f!':u:ture.

Tlm .\.T)IE\T OF attempt 1)e 1.l1ac1e }),'" anyone ex 'cpt a. dodor to reduce a dISl()catlOll. 'J he £u11o\\'i11'" trcatment, hm\'eYC'r, til e ani\ al of the ShOll hI bc carricd out :-

::V h e n the Ac c id e n t o c curs o ut of d o ors. -

(1) III t.hc C,l:-;O 01: of t.hc 'hol11der, :-;uppOl't the upper cxtrcllllly ill \\ hntc\'er positioll !.!'iYes mot e.,l.'c hy H l.arge n,],1ll sling; pre\'L'llt all jult'i 11g of the lllnb.by. tymg a ronnd the limb ane! l)l'!Y l' l )r pl11111.1lg' the slJllg' tt) thL' dothing-. " -hen 110 l11C,11lS of applymg <.) "ling' '.tre at haud, fasten 01' pill th e ccat .'leoH' to, the clot h 111g'. (2) \ rhe11 thc cibo\\' is eli,,· locat.ed low 01' fa. ten the uppcr C'xtremity to the 'i,lc

66 of tl1 h )rlv in t.L., most comfortable po. iLi.on l?O, (3 ) 'Wh en v any joint of the 10we:- lR c1,1.:-;ln: cater1 ph,ce the limb in the po ltiOU pos:-;d IlL: and the patient on a ,'tretcher to honse 01' h OUle.

When the patient is indoors.

RelllOye

clothing from 1.bf' inj med joint an tI limb. (2) Phce til ' patient on a couch or bOll. (3) n st the limh on or pillow::> in tll po ·ition which a.fforc1::> most comfort.

(4:) Apply cold (icc, or towel::> wrung ont of cold water) to tIl dislocated joint. (5)

'When cold ccase. to FIG. 35. oive comfort apply ONE FORM OF DISLOCATED SrrOULDE&. (flannels or

f I T t ') (6) When the to wels wrUllO' out 0 lOt '\\ (I. or . , t

• t:> t' t T' 1 hy n,Pprol)l'Hl. P shock is severe keep the palen '\\ ell n ( remedie '. (See hock.)

07 srRAIN

'When by a. ndden wrench 01' b\' i t the ligaments :1lld the al'ollnel tlle joint are tretched and to)')), ,the joint i.' .'aid to 11 sprained. "Going oycr" tlw ankle i one of the C0l111l1011Cst example' of an accidcnt of thi kind.

• IGX. AXD •.'YMPTO)C OF.

, udden .'eycn? IJ11.in and inability to n.C the joint after a twi ,t 01' \\T011Gh mark the OCCUlT nce a. a Hpraill. Jnid:ly the part . \\ n,ncl become,' disco]oured"hlack and blue "-owing to the cfFn:ion of hl oc d into and arollnd the joint. There is, ho",e\'e1', 1)( fracture or di 'placement of the bone '.

TREAT)1E 'T OF SPTLUXED AXKLE.

When at some distance from house or home. - Do not iC'moyC the ,tocbng or 1)( ot. hut hind the foot ant1 ankle tightly round hy '\ hanc1age. The h:llldngc is to be pa eel 11010',1 tbe wai t of the boot, Cl'os.'ed on tile front oj the ankle, and tIl n carricd rounel and rOl1nd the ankle, where it i, ' firmJy tied. ,Yet the hmc1ngc aftcr application', 'it i' thereby tightened. After reachin g shelter , Jay the patient clown re1110\'(', without dragging, the boot anel tocking, cutting 110tjj if neces. ary; place the injurec1 part in as comfortalh

a. position as po sibl e, apply ice Ol: dre '::; ing-, to t h e joint as long a,' they r c h c yo pn.lt1, whcu they cease to give rciief, apply hot [omcntatlOn.' or ,1 bran poultice. , 'Vhen other joint are sprcl.inerl they re(plll'e mnch th n ScUl1e immediate treatment <1." when they nre di.. loca ted.

TRAINS,

" -hen, during seyere exertion, as liftina' nncl pn lling heayy weight::>, mu 'cle' or temlonl::) are oyor· 'trdch ed, they are said to he " .. traineu."

SIGxa Axn S¥1I[[,TO:H'.l OF •

,\Yh en a part i' ·tritinecl u. whlen 'hitrp pn,in occnr..;, rendering fmther exe rtion painfnl, clitticult, or impossible. If the .. train has occurred in tho hu.:k, til l patient may l)e lUutule to stu.ud upright or tctke a deep breath withont p:tin. 'Vheu in a limb, the strainc rl musde may s\\"e11, cu.u.. ing severe cramp-like pai.ns.

OF 'TRAn... • .

PI tee the pati ent in as comfortahl e ,1, ;1'; po ·.'ible, and apply hot-water hottles or hut fomentations \\"hen t he pain is 'i'l..!ry l::)eYere.

A so-called Btrain i.n the groin (rupture, or hernia ), i ' an injnry of a totally different llatnr0 (sec pag e lGO).

CHAPTER II,

orgn.n.' cOl1ccl'llcd ill tho Cil cnlatlOll of the lliood arc Lhc Heart , tho Arteries, the Veins, nnel the Capillaries.

The Heart i.. .'iwated ill the ehe. t hehiud the hreclst-holle and rih l.et \\lUI the 11mg'. ancl illllllccliate l.'- nllo\"o the dinpll1ilg'Ll; the heart (, 1I1i'lll01:- \\iilt ;t qllHrL c l' of it. l11.lk tu the right, and the rClllaillillg thl'ee-(lllaJ t() the left of the 1l1ic1cll' lin c of tllo boch', 'I'll ' llcat of tho heart lilay lIe felt just belu\\' to the ilJlll'r uf thc lcft Ilipple. Th e hmrt fOlll' l'clyitiL"', h\ 0 on either of n contral partition (-..;eJl/lulI), The t \\'0 llpper l',lyitic' arc lHllllecl the right and left auricles, the t\\() lo\\'cl' th e right and left ventri cles. The artcrial, red, or pllro ll]uud is chi\ Ul fl'Cllll the left \ L'nlricle of the llL'ct rt into the aorta (the llIain L'L llimi artery of tile l)ody). From tlw aOl til 1lntllchc'i (arteriet;) are gi\' (,11 oir to ill I rilrt,' or the hody. TIlL'sC arterios c1i,ide alld snlJ-cli\ jelL, "ud:-o f'l1lall du they hcc.:omc that thl',\" luiCl'o ('opie dilllCl•..;iol1:o., \\'hell th('.'- nrc tcrllleu III the cnpilhtl'ie'i an iuten.:hnngc of ga c ' 1!,lkl'!'- pbL'c, "h ercb." tl.e llouri::;hmcllt al1cl maint nallc,-' ( .1 1 the tibcne' d

tJ9

.L Larynx (voice box); T. Trache:t (wind pipe); R.L. Right Lung; L.L. Left LUllg (t,he lungs are drawn back to exp!)se the he:lrt. and blood ves!>ol-;); R.A. Right Auricle; ..Left AUrIcle: R.V. Right Ventricle; L.V. Left entnclo; Pulmonary Artery; Ao. Ao. Aorta: ,.V.C. upenor vena. cava (the Luge vein carrying hlood ft'om .the upper part, of the hoay to the heart); LV.C. InferIor vena, cava (t.ho hrge vein carryil1 CT blood from the lHrt of the body to the he3.rt) . Th; four pulmonary VClna C'l1not be sho" n in the diagram.

OJ'!.!;auti of the hodyare proYided for, and red blood a":Sllll1C' n. purple colour; 111e purpl' (ycnou .) hlood 110\\ pa 'He::; frOltl tit, (;npillaricl:) to tl10 YL,Ill', which ,,'on H'Y it tU\\ ards the heart, gctting larg rand htrg'l'.r as they proece,l, 1y l)eillg joined hy neighbouring yeill., llntil they flll<l11y a two large yc",ds re<tl'h the right :mride uf the hc;1l't. '1'he Yciu, 1\- ill the limh.;, are proYidetl with yahl''' at fn)llUl'llt il:tcrYaL-., \\ ltich preYl)J1t thl' lnlck\yarcl flow or the 1,lnol1. :-,pl'cial YbtClIl of I,luod yc.sels, callcd the i. CUll(;l'nwtl in c<llTyiug the 1J1uucl thronglt til . From the rigllt anl'ide the 1)1 00d pas.l'. to the right \l'lltricJc, aJl(l i' thence carried to the wherl' it i.., purified COllt'lct "ith air, and l)ecome, l'l'll ill c:ulo ur; it is then cun \ eyed to the kit Huric!""\ uf t hcnrt and passci-) into the left Yclltl'icie, omplcting the cirelllatioll.

The heart contnu;t" ill nt avemge Ul.te of \:leycllLy-t\\'o timc. a minute, 1mt the rate Yaric. ' , illl.:rea ing as thc po itioll is clwllOed from the lying to the .. itting or to the .'tandinJ PO.'itlOll. ...\h O\lt two onllCCS (n. winegln 's fnl) of hlood are rli"lh lrgccl into the aorta at C\'erv cOlltrudioll of the left Yell tricle, and the lJlood i::;v f:icnt into the arteries ill jet" or waYCf:i, cansing the pulse, which may be f,'1t. llong the cour e of all the main arLerie. w11 'rc\""r th' tinger (;all be phlcetl on all artery a .. it p<"l::> e.' o\,el' ;t bone. In the \'Ci'IB uo lHllsc is to bc found, ;\.::; U10

Explanation. In the lllidlUe of the diagram is the he'll't with its four chambers. Above the heart is hmvn the lung (pulmonary) circulation. The low er part represents the general (syo;temic) circulation. V essels containing impure (yenou ,) ulood are shown bbck, while tho e containing pUN (arterial) blocll are shown white. The connecting ves, els rcpre':>ent the capillaries. The arroW!4 RlJo\\r the direction of the liow of blood,

FIG, 37.

DIAGRAM OF TUE CrRccrLATIO::-l" OF TUE BLOOD.

b eart ",aye is expenu ed durin g the p[lssage of the l)lood through the capillaries and reduced to a regula r and evell flow . HJEMORRHAGE.

H remo rrhage or hleeding signifies the e cape o! blood from an injureu. or diseased blood-vesRel.

Arterial Hcemo rrhage.-Dlooc1 from an artery (1) is scarl et in <.:olon r ; e cap s in spurts 01' jets corre ' ponuillg to the pulsation of the heart· and (3) flo,," "rom the side of the "ollncl lleare::;t the heart. It i', ]w,,"eYer, chiefly\\ hen the \I'ollUded artery i· do::;e uclow the skin, (l in the 1 and, foot, temp'le, etc., that the ulooel ue :sel'n to e 'cape in jct, '\"h en the i, UL'l'P scat 'c1, a::; in the leg, t.he lJlooc1 may \\'ell up from the lJOttOlll of the wound lI.itholl t mark d . ign.' of pill 'utioll, The (luantity of l!lood lost yaries w:th tbe . izl' of the artery wouudc( 1. '\ \' bcn the aorta, or onc of the huge arteries at the root of thc neck wOllnded, d cath is instanLaneou ; whrn the mltln arteries of the thigb, armpit, neck, etc., are wounded, death ",ill occur in a few moments unk:l' the flow i ' Pre.ure applied t o medium .. izcd ml tho 'e of the Ie!! or forearm, 'within a few minut e ' of heing v,olll1ded, "ill "ayc lifc ; hc.clllorrhnge fr om 'lllnllcr arteries may cau e scrion . los. of streng th th e flow i ' ' p 'cdily nne ted. Venous Hcemorrhage. - 'Wh en it Yein i':l cnt tnc l)lood (1) i.' of a dark colonr: it flull ill a slow, continuous trcalll; (3) it i froUl the side of the wound fnrthe't from the heart. ,Y ound ' of ycins of the limbs axe 'omcwhat le. cla,ngeron. than in the <.:a 'e of arteries of ize.

Capillary Hremorrhage. - Blood flowing from capillaries, a' from a ligllt; \round of the kin: (1)

lio'ht-l'ed in colonr.; (2) flo\\'i') bri::;kl!, in a continnous (3) wells up 1'1'0111 all pomt. ' of the cut sur f:l.l' e .

GENERAL 'IPLE.' OF THE ARRE '']' OF AH1'EHIAL l-LL;'[olUUL\(;E,

The principles of treatment to be followerl in the event of bleeding from a la.rgc artcr,Y MC: ,l..t, to apply direct pressure o,n the bleedIng and if uire<.:t 1H or f-ibIG, to apply pressure on the roam trunk or the artery between the wound and the hear t as close to the wound as possible . Tbe closer to the wOI1Dd the artery i' (;omp rc ':;,ccl, the 12 'S \rill ue the da.mage to the limb.

The me::tllS employed in tho arrc t of 11 arc digital ,ml(l 111 tr,lllllcllkli c.omand flexion of th? hmb: LaYlllg down and el eyating t h e IllllO w111 the force \\ nh ",hidl the blood cscapes. , '

1. Digital compression is the appll,catlOn of the t llQmb or fino'c rs e iLh er Oll the hlecdll1g POll1t i.t 'e lf-direct tl.le trunk of th? main arte ry leading to thc compresswn.

11. Instrumental compresslOn al::;o he n pplied by the direct a.nd. indired _ (a) D ilcrt instn;,menlal cOJII]Jl'csswn may be, carned , out a.pplyin g n. handlwl'ehicf, piece of Illlt or huen

fuTdel1jnio a. fiJ)1illl, bard pad, aud pI u;c(l 011 the Llcedillg point, where it is ReClll'l'Cl l)y a hllldagc fin111y t ic(l rounel the part. '1'0 fold th e handkc1'rhiej a s a pad, proceed aB follows :-Lay the handkerchief olll ou a flat surface.; bring thc 1'0111' corner. to the (cutre of thc hanc.lken.:hicf.; :1gnin hi'jUO' the COl'll '1'-, to the cC'ntre, and continue folding the cort1ers to\\ arc1' the ('cnlre until the handkerchief lJeC()lllc' a hard pad, The 1'01111(1, smoot h snrf,lcc is placecl (11 the ;:;kin oyer the artery, nl1'1 to pl'c\'ellt thc p;Hl ullfulding, tile ]Jacker .cl f>11l'i'-t 'e l1l.Ly hc fixed 1'.)' a "lfety pin, or I'titchccl wilh a lleedle alld till'cal1, if such are at bmd. A IUll'Ll 1)\[h 'tancc such as a .tOllC, cork, llut, marhlc, etc., milY, jf llCl!e;) [uy, ue ill the centre of thc pad. • ' \lOuI (l oecfvion permit, a graduatrd com pr('ss 111:1y l)c madc ,md applied a follo\\;:; : Place a filllall folded 1'iece of linen o r liul, or cotton, up on the blec(ling point.; oyer Ull::> place <l .econd Hnd largcr piecc of the same material; a third and n. fonrth 01' more pads, eneh huger th,m it. are superimposed, until [\, regular COllC i., formed, with it::; point o r apex resting on the wound, and it un (, pre' eel down l)y n tightly applicrl 1l::ll1dage. (&) I lIdirect con ist. ill ::;topthe flow of uloocl Lhrongh the main artery h'y ' no tonrniC),llct. A tourn iq uet :, an in trulllent whereby prc!'):-;IIl'c can IJC made on the trnnk of an a,rtery so <i::; to top the flow of Llood throl1e:h it. A

tourniquet may consi't of a, pall to be placed 011 the trunk of an artery, a stmp or banda.r;e applied so ac:; to encircle the limb and pad, and cL buclJe, sr;Tew, or twistinq appa1'Gtlls (such as a tick) whereby to tighten the stmp or "bandage. The three principal tourniq uets are th3 im proYi 'ed , the field, and the

FIG. 38.

FIG. 39.

FIELD TOURXIQUET. SCREW TOURNIQUET. scr ew tourniquets. Tourniquets are seldom applied except to the brae;hial and femol'nl arterie. An improvised tourniquet i.. m<1,de and applied a .. follows :-On the trunk of the main a,rtery, say the femoral or the brachin,}, apply a firm ly folded pad, ahout

the size of a tenni.' ball cut in two for the thigh, and of a walnut for the ann; over thi' pad p1nce the centre of a narrow triallgular (or other) bandage, and ti c the en(ls 011 'tIle .. idc of the limb oppo itc to the pad. the half-knot of the bnlld:lg-e i:-, made, place <1. tick, pencil, \\'nlking- ,tick, poker, truncheon, or 01110 ,'uch ill 't rmn nt, npon it, and then complete the kllot, adding' yet llllotilcr lullf-knot for Eecnrity. Th e" tick " i ' no\\' to l)e twi:-,ted, whell Lhe lnmc1age will he tightened <lncl the pad pre "eel firmly upon the trunk of the artery ,\ith ,'l1ttit:iont force to n,l'l'Ci>t th e Ho\\' of blood, boulel a 'uitabk P,1. Ll not li e at hawl, a Imot lllay be made ill the centro of the hUldagl" :mel \\ h en ctYcli1nhle, a stOllO, cork, dt:" cnclo.'eel in it to "1"e it fiJ'llllle. 'lll(llmlk. '0-' thn.t the ulllp;illg, aml not the tlat ' iel o of tho knot i ' next the :-;kin . The" . til'k " ii> fin;t11y 'locked" in by the endN of the hambge ll,'ec1 for the to,-'rnicluct, U1' by another 1>:Ulc1nge 'cel 1'0tlU't til limh ancllllac1e to cnd()se and fix tIl e :-;tid::. The field tourni q uet 0,111,'i .. t:-; uf a p ,H l and :-;tntp. / Th e pnel i. pIn ' eel ()ll tll e COHl'.C of the arter)T am1 fixed thereby tll ' strap, \\'hi ,11 i ' pulleel tight null huclded off. 'rhe screw tou rniquet (hy t;OlllO ('011:-;iclorod oh-;olct , ) ad.' 011 the ' nlllO principle, tho h O\\,CYl'l', heing tightened hy ,1, Nnc,," npp'1.mtu "

An elastic bandage pa' 'c d rounel the limu immcdiately ahoyo the t:lC,Lt of <1,n arterial hrcmorrlw.ge and

puHell tight will, arrcHt b leedin g. Tho simpl pr F-'Ll'ed fo r m of th iH hn.ncln,ge is n, ,tri p of eh . tic wcllhing or thirty inches l ong anel two , wiele, \yith a pi ece of tape sewn at each end. An ela ' tic brace 01:' helt will, h owever, anf5\\-er the It not advisable to u . e a, (!ord or clastic h:n rlagc , unless no other apP'l.ratns can be had, n. ' the pres. ure of the cord cuts off all circulation in the limb , III. Flex i on of t he Limb .-The arteries of th e back of the knee and the front of the bend of the lll0\v may he compl cs 'erl by placing n, pad npon th e trunk of the main artery at the knee or clbo\i-, and , after f1111y ilex'ng the limh , securing the in a. flexed p osition by <.l, hll,l1unge.

D ress t h ". w01lnd . After the h£Omo Thage has been arrested hy the indire ct method, the wonnd mllst he coyered oyer hy n, dean dressing. (ee \VOUlld,)

In all cases, osp::cially when the patient has to he moyed some the iujured limb or par t sh ould be l'nif5ec1, if po 'sible, and rnaintaincd at r est by splints and bandages, if n eed be.

T HE Ccun, E OF TITB: A RT ERlES AXD TITE

A RR EST OF ( Ser Fronti ce ) ,

Aorta i,' the main artery of t h e body. Commen(;mg at the left ventricle, it fo r ms an a r ch behi n d 'i 9

be upper pa r t of the 1>rl:1. t bone. From the mch arc gi \ cn oft' the largo tru nk s \\'hic h cany the 1,1(, 0(1 . t o itll.:r of the hea d a11l1 Deck alld to the nplK1 l The aorta pal-."es c10\rIl .11 the Jdt (f l1,le, to llelow t h e nayc], \\ 11 rc it, by dJ\ lcllllf! mto t\\'o large IJranchc:-) (the iliac , ) \\ hid) 'Ol1YCY the llloocl to the organs in tile und to tlw luwer extl'emit !e.....

ARTERIE . OF 'lITE HK\D AXD XH'K,

The Commo n C ar o ti d Arteries nm l 1p t he n l'k one on eitllC'r .... id e or t h e \yl 11flpipc, anc1 on n l cye1 "lth (, \ CLl111':-; Apple, " just bel ow tho angle of th e h n\ cr .in ", rliyi(10 into the internal and extclllil.l cnroti ( s . The Int e rnal C a rotid up deeply in th e 11 ec k. ,111d enterin!i the l'l'<Ulinlll ,illst illtllllal tG the ca r .... npplics the 111':1i11 with l )lom1. The External Carotid artery gi \"0:-) oft· branches to the tOlH!,l1e, t he throat, th facl', the llO:-;C t h e temple Hnel th c ....

"N OUXD, OF THE CAROT ID ARTEmE THETR

BRAKC' H ES ,

When a Carotid artery i s wounded, a in the ca. c of cut throat, npply digital com}Jrc""ioll by placing , t h nmu on the <ll'tery h,v t h e side of the windpipe, l'ltne l' on the \\olllltl or b it and the hcart, prC'ssing hack""[lnL clg'1Liw.;t t h e backbone tnbn0' cnrc to (Hoid the Pr e,' 'li re mn t maint;incd

80 by the thumb (hy reby.' of iL if nece, ' nry), u n til tho doctor <lrriYes; no othcr method l)eing <1.pplicable in Bleeding from the Templ e readily arl'C ted by the thumh on tho ,wund, or by plating ,l firm p<.td on the "'(jl1nd, and makmg" h .Ya h1.lldage applied follows: -Apply a. lllrlll p.lrl on the hleeding point then place the cen tre of 11.

narrow bandage on the oppo ' ite .icl' of the hend to the wOl1ncl, carry the bandnl.!:e horizont:·t11y rOllllcl the bead just ahoye the leyd of tho eyebrow.', make a b\ i,'t oyer the pad, pas ' tbc end, ronnel the hcad <lQ:nin, or l"alTY onc end tho top c;f the head and the other

Fl\. . 4J. under tho chill, Hml tic firmly (Fig. 11).

1'l1<1,o'e frl)Ul the Fo re h ea d , or from allY l)art of theMScalp . CH,n be alTo·tcrl on the same'iH'ill(;iple. HcclUorrhage from the Ton g u e i. ' u 'nally (;ontrollccl by ice; . h0111tl il"C be un nccc .. or llllobtainn,hlc, iLnd the \\'ouncl tH,r fonn1.rd, the 1JIC'NIing point may h" ped bet\\'cen thC' finger and thumb .

II, 'lJ10rrIhv r frOUl the Li ps way l·,c contl'o1]c(11JY ice, or, if ycry by cOlllprc.... illl!; the lJlccding point

l'Ct\\'Cl'll the fino'('l' and tlll1llllJ. HcC'lrlOrrhage frorn "'he C heek it:) .y pas:--ing' the l\Jl' '-fiuger i1),.·de thc cheek an!1 :]IC tlmlllh ont 'i(lL', amI c()mpl'e.. finltl\' either on the \"CJUI;d or below it, 1· .e., 1letw'Cil the W01111(l and the hcart. The tnlllk of th e

Facial A rtery may 1 e cc 1l11H·l',.;scd all the ed!.!.l' of t.he 10'wer jaw, ahmt an inuh and a-h,tlf in front d' the <111 t.,l e. 'When the 1,}ccdi'nS is from 11 T onsil, P a l at e , or the inside of the T hroat, biyC' 1 '0 to suuk ; if

FlU. 4.1. hcl'lllol'l'hngc it; sever itlllay 1e llccc<.;snryt(' compl'c thl' c'll'otitl ;1. til 11 'lk.

fl'Olll the N ose i' Ll\ ' hS Iollcn\' :- cat the patlCnt on a chair \\ ith LIla IH\tcl slightly thro'\,11 back; nndo

1 t d eck' l"ti'C the , 11 t' 'ht clo thin o' ronnd the (; lCf:i an n -' ,1 19 t:> 1 d 1 ' cold icc H, cold f:ipongc, handti above the le<.1. ) app,). ) } , l ' . -1 f thc or a bunch of key' ove r the tipllle at • collar; keep the l"tticnt in a cllrrent of ftctih ,UI) ,md

FIG. 42· ARREST OF lLEi\WRRIIAGE FllOM FOREHEAD.

en no account allow him to hi .' head oyer a basin; place the feet 111 hot ,,:atcl'. Eloo

. . f n th e Ear channel, \,"}}1(;h gellcntlly l' 'Ulng rm

indi cate a fracturc of the hase of the cTanil.m, n . Llst he wiped away a:) it i::;·ue.· ; no attempt i' to Le made to pIng the cnr. ,rh ell the external part of the errr it. elf i ' \\"ou1)(1l'r1 and Lleed free1.'.', grn p the Llceuing point uet\recn the finger rrncl thlllUU .

•\ RTErrIE OF TUG t' PPEll [TIFf'

The Subclavian artery P,l:)'C ' frOlll hehind the il1Der end of the cullar-hollC acro " the fir ·t rib to gaill the armpit (u I ill(1). Tn the armpit the Ax illary artery , "hith i ' C1 cOlltinuation of the .. uu'lavian, keepH do l" to the 'houlder joillt, and can hc fclt pll bnf ing- when thc finger.· nre clL'(lply pre .., cd into thc armpit. The Brachial artery is a continuation of th e axillary, and nm ' do" 11 the HIm ou thc inner ' ielc of the biters gradually pa.' 'jng' fOl'\Hlrd ' until it gains the middle of thc front o f thc clbo\\'. The iUllcr . eam of thc cont leeye nl 10YC thc elbow ronghl:' indicate ' ii ' COUl' ·C. J11 t llclow thc l' lho,," thc brachial ,ll tl' ] y c1i\' idc f) into the radial and lllnm' <trtcrie. T he R a dial artery nUl' along thc outer side of thc fl out of (he fOrCtlllll; it., coursc mEW bc indicated by a line c1ra"'-ll from the middle of the hend of tbe in fr IlL to the root of thc ball of ih . th.umb. .1\ bout OIlC ilH:h aboyc the wri ,t, and one-h,l1f illCh from thc ou tcr (i hum b or mdial) sidc of the forc,lrm, where thc lC.l.dial artery lies upon thc ra.diu, thc pulse i to 'DC fclt . Thc

muial J, the wrist, tlll'll' h::l.Cbvards above the root df the thumb to t h e bJ,ck of the hand, and forward hetween the metacarpal bOlles of the t hnmb n.nd forefinger to the palm of the hanrl.

The Uln ar art ery rlln along the front of the forearm, to a line dra;wn from the centre of the front of tIl(' elbow to the root of the hall of the little fin2;i3T. In the hn.nd the branche. of the radial :wd n.rteries combine to form the snperfieial and doep Palnnr archo:3. The s up e rficial P al ma r ar c h i ' near the surface or the palm, n.nd corre. ponels to the line that l'lm along the inner ,ide of the ball of the thnmb. The deep Pal m ar arch is -lightly nearer the wri t, bnt lie.:! (l eeply on the hones. In the fingers, the arteries run along either &ide of the finger., to the tip, where they unite .

ARREST OF ARTERIAL H ,E:lrOnrmAGID IX THE UPPEU LDl13S.

W h e n a D i gi t al (fin ger) art e ry is w o u nde d place the thumb on the hleeding point and compress thlJ p:1.rt firmly; subsequently, appl y a small pad on the wound, and bandage with a piece of tape strip of linen, or a strip of round the finger and pad. Wh en the Palmar Arc h i s wounded , place tho; left thumb firm ly on the hlcecling point, leaying th::l r ight lund free to apply a pad and banc1age.

A.pply :1 fir"'ll pad (a folded handkerchief), or better

,till, graduated compress on the bleeding puint, make the patient gnvp the pad firmly, and apply ,L l mlldage m; follo\\' ,' :-Spread out a triLl,nguJa!' lmlldage, turn up the lower l)ordcr about four Inrbes, lui' the l/ack of the pn.tient'b hand on the eentre of U;c hUlclage, fold the point oyer the knuckleti and wri ·t, Fl the two encl.' r Ollnd the. wri::;t, make the patiellt Fw.43.

pull on the point of the bandage, the end::; oyer the fingers tWlCe and tie them a. firmly a. ·ible. the point (A) down to t h e knuckle and fn. ·tell ,yith [l pin B (. ce Fier, 4-3). helld the forearm well up :111d support with 11 large ..1.1'111 ::;ling.

The Radial and Ulnar arteries lllay b0 co111pre 'sed by pla.cing the thumb::; on the arteries one inch above the wris t (Fig. 44) . Thi ' may be l1ece'sal'Y when the wound in the palm is too large to be coyered by the thumb j in.·teacl of the thmnh', the cork of a pint or quart boUle lllay be cut in two

Fl ' . ..J4.

J ngth wise, and one hn,lf laid on t.he radial, and the other on the ulnar artery a little above the wri·t; place the rounded side of the cut cork next the skin and secure them by a tight bandage. See td:::u next paragraph . 7

Hcemorrhage from a woun d of the Radial or Ulnar artery in the front of the foreal:Ll be a.lTe ·ted 1)), n pad plnecc1 in front of the 11lldd1e of

Fw. 45.

the e1bmy th forearm being firmly flex d on the arm, and maintained ill the fle xed position by a bandage.

The p ad l1lt1Y be llln.de of <l. .lumdken:hief with a small stone or cork wntppeclllp llllt.i l mt when no p'lr} is a.va,i l tl,ble the .'lecYe rolled or gathered u p a ' far <lS t h e el bow will 'cne a. ' a pa 1. B cnd the forcarm up on t h e ann and tie ,t lHllTOW bandage r ound the wri st a.nd then r Olln ,l the upper p:ut of the a r m, e r os in o the enclt) hetwecn the forea r m and a.rm :-50 a to prcyent the klllc1age "lipping ott': tie t h e limb to the ide by a. ban dage cucmJmg the limb a.nd the t r unk.

FIG. 4 5.

Hremorrpage from t he h and , forearm , bend of elbow, or lower par t of the arm , may hc a rre 'ted by comprc:)sing the brach ial artery hy d igital or hy a, tonrni cpet . ·Wh ell applying an imp r ov ised tourniquet to the hrach in l artery, it i '. not a 1ways n ece"sttry to u::;e the tick.i t h c lICHt plan IS to tie a h alf-k not and pull the lvmdage tight; if the Ll ee dillg stop s, compl e te the r ed kn ot, but if it doe:) ' lOt s t op u e the 'tick. as de 'Crt eel on p age 77.

To apply digital compression to the Br a chial a rt ery. -Extend thc arm at right allgles to the Lody, pa l m of the hand IIp \ran.1 :·;. Stand bebind the hnll, gn1.'p the ann, the thumb 011 the olll:ide of the lilllb, Hnd pa,':) t Ile finger ,' uucler the back of the ann ulltil the f:ealll of the cont, or the gTO()\'e 011 the of the nn.l>;clc (bicep, ) i:) reached. Pre,':) the pulpf:> (uoL the tip:) of the fing 'r ' nrmly on the course of the artery (,ee Fig. 46) . 'o me prefer to

Fm. 47.

gra p the arm from abo\' the 11m 'de, hnt if this COULe adopted, great c,u'e Le taken to pre" the artery agaill,'t Lhe bone, and not again t the l) :ccp' mmicle (Fig. 47). A .'light turn of the hand outward ' it gra 'pt) the arm \\"ill bettcr en ' me ' ion of the In practi<.:e feel the pU]'e \\ ith the free hand during attempt,' ,tt compre:)sion of the brach ia l, to acel'tain if the flow of blood a long the art ery is

'-' - ,......-:: . .;'; ,

Hremorrbage from the armpit or arm rnay he "e ted by of t h e axi ll n,ry artery, . Rollllp aI I ., 1 b 11 ' tnan O'ub .r a h arJ p acl the of <1 bllllcLrc n, 111 a 0 ( -«2.: '\

9 1

hanclagc; plrwc thc pad in t;!C hl'lilpit; C](lFS t h e balHbgc on the ::;honld 'r, pull the cllcll' tif!llt, and tie oli' l1J](l c r the oJ>pm-,;ite armpit, ta1illg C' that neit h e r the pad 1101' bandage h a:-; :--'CC1Il'( tIle inj ured a r m to t h e patient's 'ide, a ill Fig. 4-.'.

-19.

Digital compression of th e Subclavian artery mil:' he mad, \yhen the WOUllC ill the main arte r y i · high up ill t h e ann or ill the <lrltlpit. Proceed fl.::; follo'\' :-Barc t h e ned: to below the colla r hmo. place the injured limb cl0 e again:-;t the sid e of the patic n t'l'3 hody .'0 as to depre. ·.· the a nd

FIC.

your st,llltl oppo:-;itc the tl,lC !la.nd for tho right <tud \'lce YCli'i<l., p,ttjP lhe neck low clown, pbcing tho fingcrs bchmc1 1 thumb immec1icttely [11)0"e the ecntre of t le ,H-

I . th lollow lJdwccn the 111U aUa.checl to lone III e t ' 1 ' , ' " lY the bone (tho l)irc1" nest) ; compres8 the thumb cleeply c1(j\\'ll\\(tnl:-; a.nd the fir·t rib, which i' helleath the CbvlC1e itt th',tj (Fig. 4:9.) III practice the pllll:)e .lll:l)' lll' felt c1t tho W.1ll0 tillle to cO Tc rtain if the flow 1:-1 :sLOPPCl1.

\Y0UXDS OF THE L.\RnE _\RTE LUE::, THE on. A13DO)1EN.

At, H ,E \JQRRTIA.G E.)

'Wound::; of the htrge arterie.' within thc trunk e,m 0 llwmorrhage llltO the ,cctyity the che'l or of ,the bd "11C1 O,'IY" 1'1:-;C to ::;1 nnd :-; \ lllptOlll of a 01110n, (l b\" b • internal hoomorrlwge . Signs and I.'!lmptoms of Intr?'nal

A rapid los. of 1> n.11.o l' the fil.te {;oldncss or the L'xtrclllltle' , Luutnc:->s, more \"hen thc Ul):'ight po::utloll n.s ,LUll cd. ; tho becon les h mneu a.nd 1t hom cd, .IS hy yawlling' and ; the pul'o 0Tuunully md 1l1,lY altogether at the \\ the patient his ell'lU'> about, tllg':--l a.t the ronnd the neck mel call' lor air. Filml1y, the pntlcut may becollio totally unconscious.

'ireatlllcnt rf II/t e rl/al II(I'JJ1oNhaf/e.-Keep th patient fiat: 1lJHlo ;11 I tight dothitlg I UllIHl Lhe neck; provide for free eirelilaLioll (If Hil'; fan tho patient; sprinkle cold on the fae : apply i::>meJling .. a1t. to the nostril ; gi\ 0 ieo to . uck or cold water to (h-inle Rai . e the fceL n. fool nr two from the ground. and handa!!c the lim1)s finJl]" frOlll thc fect to thehipf-;, and flom the hal1ch t(; the :-"ho1l1ders. A 'VOl'cl stimulant .... in nil ca.. cs of kClllol'rhng- c, nt all eyent until hI cuing hal':) bccn controlled.

THE COURE OF TilE ARTERIE ,· IX TBE LOWER EX'l'Hl;; \lITrE".

The Femoral artery, fI. cOlltilluation of iliac, enter,' tho thigh ill lll( ' tcntre of t he fold of thrgroin, \\'h 1'0 it mny be felt pnl immediately below the Nkill. 1'he com"'c of th e nrtl'ry llHly he indicated hy n line c1.'fI.\\'n fnllll the cClltn of the groin 1(1 the hfl.c;k part or the il1Jll'l' ·iell' of the knee. TilL artery occnpio' only the IIp)ll'l' 1\\"o-thinl of thi . a' at the 10\\'01' p,u t of UI(' thigh the' fCllloml urtery pas, to 1.11 ' hack or lhe lol l' 'joint 11l1(ll'1' th 11.l l1l or poplitca1.

The Popliteal artery -the anc r}, of the hamoccllpie.' the centre of th e space at th e hu'k of thE> klll'C (f1' (> ham). It l'Jal' c(l de ep]." l ll't wcen th projcdioll. of bOtll' nt Lhc low e r end {) thc femlll', amI i::; further pJ'otecte(l by the mll<;e·h ,\ n. nel tendeD")

a r ound the ham, .J II ,t o.]loIV Hurl he h illd t h e knee j oin t t he poplito:"tl artery divide' illto t h e ante r ior ( fr on t) and po tcrior (back) tih i.a l a r te r ie.',

The Post e rior Tibial artery do",n the cent r e of the of the l eg to the iuner of the an kl e, whore, h.:'t\\'lCll t h heel ancl the lower '11(1 of t h e tibia, it enter" the of the fo )t tl') the Pla nt ar arte r ies. In thc upper part of til, leg the tilJial artery i:-.; decpl,\' placed beneath the mu:-;de:-; of the cetli, bnt to\\'[trrh the anklo it COUle:-; ne<1rcr the ,'mfa,ce, and c,m 1).:' rdt pllhating ill t h e h ollo\\' on t h e in n er 'idc of the a ll kle, I n the sole of the foot t h e plantar enteric') ]'n11 forward amullg:-;t t h e llwt,ides to supply t ile foot ,mel t h e toes,

The An t erior Tibi a l artery OOI1IC:-'; fl'01l1 t h e popliteal n,nel at p,t 'S8' forward ' l)ct \\' cen the leg bOll'S. Th.) arterY l'\lll'l (lown the front of the lel.!, decply pL:tC8 cl clllH;llg-;t the 111ll:->clet:;, to the frunt the ankle, A line drctwn from the front of the npper cud (he tel) of the 61mh to thc centre of the front of t h e ankle indicate" tllC eUllr 'e of the nrten- .

The Dor s al a rt ery of the foot is tilC <.;ontinuation of the antcrio r til)ial artery: it p,vscs al,)]]g n line dr,"twll from the millclle of t h e frout uf t. h e ank l e to t h o intel'y,tl het\\ CL'll the hOll " of t h e hig an 1 the n ext, ",here it pas'et:; downward' to t h e sol e of tho iUJt, to ]o r m 8.11 arch ,,-ith the mte r ic ' o f Hol e,

A nn E, T uF A flTEH 1.\.1. I TilE LOWER Ex rTIEMITLE _

1. When the ar t e r ies in the Sole or Back of the Foo t are wounded , remoyo the buot and ,-to<.;king; apply Lho ldt thu1ll1) firmly on the l)leeding point; an(l, \\'ith the right IWllcl, pl'qal'o and place a pad on the wOllnd alld lnL1l(lngo tightly, An expcriellc d peron might l)c aul' to furthcr ,' l't:nrc the tllTl'::;t of 1 y mcnns of pad, tightly pb,corl on the ankle at the point' il1c1itated in t h e frol1ti -pict:,,-

Fw,50.

When th e a rt e ries of the Ham or of the Leg ar e wounded , or when a pad is insufficient to arr e st hremorrhage from the foot or ankle, p l ae8 a pad t h e size of an orange

l)chind the KIlee of the injured limh; flex the 1eg npon the tbigh until t h e h eel almo.'t the huttod: ; Ht:tm l'C the limh in the flexed position p a!).'ing H, l1iuTOW bandage (or H, • trap) 1'01..111(1 the l eg inUl1ediately above t h e ankl e; cr08S the end' het\\eell the leg an d thigh, and, cnrr ying th'lll round the limb clo,'e t o the top of the thigh, tie them off fi rmly . \Vhen no pad is to be h ad, roll up the trouser l eg as far n" the knee, and flex the leg on that a' n, pnt1. It is no llCCCf>S,"ll'Y to take off the clothing to comprr:. "

t.he popliteal artCly hy a pad and fic.ion. Except at he lower third of the l eg, it is sclllom pn.,il>le hy (lirect prcs,'nre on the ul eeding point to nne, t hcemol'l'h,we from t h e arteries of the leg.

:l When the femoral artery in the lo w er half of its course is wounded, and w h en a p ad and flexion fail to control hremOl rh age from the popliteal or tibial arteries , apply (ligital comprC!):-;ioll to the femoral artery at the groin, until a tonrniqnet call he appli (l.

To apply Digital Compression to the Femoral artery at the Groin. -. l1}lpo,'ing it it-; he right femoral t h at if:; to ue com pI' s8ecl, p r oceed < s follow. :-L ay t h e patien t down fl:"lt on t h e hlCk : .. tand or kneel as conyenient on the l eft .. :cle of the patien t's bod y; to n nc1 t h e g r oin, r ai e t h e foot b igh so t o fl ex th e t hi g h on the bo(l y (t h e fold in t h e clothing at the to p of t h e t h igh "'ill indicate the

g r oin); p a's th e nngcrs of t h e r igh t h and OYE r the ou te r side of th e r ig h t h ip ju 't be low the edge of

t h e f r on t p Rr t of t h e h aunc h bOlle a n d lay the

fl e h y p a rt of t h e t h um b fl a t on centre of the g r oin . P as' t h e nnge r s of t h e l eft hand to the i n nel"

s ide of the r igh t thig h cl 0 'e up to t h e fUl k, alld

l ay th e l eft t h umb on the top of t h e right thumu

F ft:. 5 1.

ahead.\" in [ osition mer t h e arte r y. Pre...:,' 1iull lv hackwarcb ,\gain, t t h e b r im of the pc h ' i.s, \\ hen the "How of !)lo()(: wlll 1.)e compl etely ane ted (Fig. 51). death i:"

111 ]Hcmo r rhage from so large an artery, it is not to wa te time r emOyillg the clot h ing;

t n c iellloml arter)' at the groin can in mell ue ccm -

p r e !:led as a t mpomry measu re oYer the clothillo·.

To apply a To ur niqu et to t he Femo ra l ar ter y.--In practice it is good plan conr, e of tho artery by c1rawmg a. Ime hom th,e centre of the grom to the 11<1c \. Wfi part of the ii1ller side of the knee; the artery call he C01l1pres 'cel by a tOl11:!liq llot al l y poiut on tll? of tll line thu.' JJ1lhcatcc1 or a httlo

An impr?Yi ,' el, <t Held, or n, tourlllqnet may he used. The pa.d of the improYi:-;c(1 tonrniq llet houlcl be a '

fLl:l half an a 11<11'1'0\\' banda.ge 1l:l to bQ p Ia 'cel ",ith ih; centre oyer tbe l pcul, and the knot tied on the of the thigh' the ,( tick" i.' to 1e placecl between the ., of the knot, , ' 0 as to ctYOl.( l illJ'uril1cr the ,kin when it IS FIG 59 b V ] ] 1 ,e t' 1," , . twi"te(l. Ii ma v, t 1e , ' lel\.

1S to hc {( the limb put in a ,pIint or tied to it, fcHow (!fig. 52). ..

4. When the artery is wound e d In the upper third of the thigh t h e he compres 'ed by the t h umbs at the m stea( of a pplyin g a tourniquet. R el a y s of as..l' t allts mus t

l)e m p Joycd t o keep up t he pre sure unt-il the doctor a J'J'i vC8, th e f1' .'h Ut'lt'li tant applying hi:::; thUlJ1b' Oll t ho,'e of t h e p r eyioll.' a.... istant, w h o carefu lly :::;liIJB h from hClleath so a. to pl'c \'ent gl1 'h e:::; of blood dlll'm g the change.'. \ \'hcn 'tanC are fcw, or a d octor not to he had, an attempt may be lllade to a rr /:it t h e })(,clllorrh.lge by p l acing a pad on the centre of th e gro in, and maintnilling p re oy an b.,tic conI pn.R cd fr om the oack of tho th igh, cro:-;.. ed ovor the \)a d , RJld t hc end .' fn.'ten cl l)ehind OYor the loil1l:i.

ILLMOHRIIAGE.

Th e UUlT cn t of Llood ill t il \ Yeill;:! i::; ill 'l dil'eetiol1 tow artlli th e h eart, there fore, ",hen a yein i.. cnt t lJC

1)100<1 wi ll i:::;l:lue from the elld of the \\'Olllldcd y(-in fUl'th cl) t J' cmoyed frolll the h eart. T he 11 "hy

th e 11(1 near cr the heart do(,,' llOt b l eod i..

p a rtl y by t h e dirediun of the flow of t h e blood, (llJ(1

p a rtl y by t h e \'al'i'e:::; ill the vein ::;, wh ich nre'9 'p 1<l .( d

<lIS to prevent a. hack ward flow. The .'llper£cial will '

a r e mor e a pt to he woundcd t ha n aro t h e deep vein .

T REA 'l'l\IEKl' OF YB,\nUH

(1) Lay the patient d o w n, the 11c<I(1 1't'. Ling Oil a Ja w s uppo rt or pillo\\'. '

(2) S h ould it be <l y('in ill uno of the cxtn lui ies

t.h a t is bl eed ing, elevate the limb.

(3) Uado the clothing alld expo. c the hlL\clting p a rt .

(4) A pply direct pressure on the wound by th e thumb, and maintain the pre::;::;lll'e sub.. eqnentl y by a Vad and bandage.

(5) houl d direct pre ·.. ure prove in -nfficient, apply a pad and b an dage on the trun k o f the vein , 011 the side of wound furthe t frum the heart.

Va r icose Veins. -The vein::; of the 1'g' arc specially apt to he come varico ·e. ,\'hen a vn.ricose veil'} is examined, it will be 'een not only to he dilated and tortnou:, but head-like (vaticose)projeotionH occur along it, oonr::;e. A VOill bccome vn.1'icose front various cau::;es, such as long standing, tight etc" etc. The fin.,t cfred i· to throw extra. work upon the "alves, and the bead-like projection arc can ed by the blood accunm1a.ting in the pocket::; hehind the v,\.lYe·, In timc, the channel of the yein hecome'o wide that the valves can no longer span the Ye, .'e1. 'Whcn one of the.'e dilated \'eins, f-my, in the leg, is wounded or hur'ts, blood flow' from the 10\\,('1' end of the cut \'ein, hut from the curl nearer the heart it flo,,'s in much In.rger amount, owing to the imperfect -tn.te of the valycs in the \Tein.'.

T1'eatment.- , Vhen lucmorrb,\.ge occur::; from a varico::;e yein in the leg, the tren.tment is to-

(1) L ay t he pat i en t fia t) the resting on n. low ::;upport or pi11o,,'.

(2) El evate t h e li m b , raising it high, at a right anv;le to the body if neees 'ary. 101

(3) Re m ove the clothin g ::;0 as to expose the hleeding part.

(4) Apply d i r ect pressure on th e w o und hy the thumb, and sul)Hc'lucnt1y hy a pad and handage.

(5) Apply b andages fil'.'t, 011 the side of tho \\ onll(1 further from the heart ; on the side 11 ar'1' the heart, llCml(l the direct .. tlr c pnwe ill.'uAicient.

OF 'APILLARY ILc:'IWRluu.\ ; E.

Nco also TrcatmonL of \YOllllds.

To al'l'e. ·t hWlllOlT!t;\ge fn nn enpill'lric-.:, a Hl igb t degrce of ' llftiCC'" Prcs:-'lll'e m ly hL' applicd illstanLallC01.vl\T 1,\- thc tlllllllO, and maintaincd q llcnLly hy a l;tcl plcdget uf lillen ur lillt.

Ill,ly a1 '0 he exercised hy applying a piecl' (If strappillg' (vIa 'tel') to the \Hl1111 ,1 oyer a pad. .AllY lll, ,dictllllCllt ",hidl <ticL in the uncsL qf h,c11lurrlutge i,' t e rmed

S ty p tic. Culd, as col(1 air or icc arre 'is lnell1ol'l'hn o 'c hy conLmdillg' thc lJlo()(1 '. ,rat ' 1' as hot can he bornc, 1)y cn,nsillg tlte l,Joucl to clnt, lllny check ·;tpillnry lUCtllOlTha6 e.

Snch as fill' 'tram]:" of w(lol, 0)' cottn". "001, com,,'e h10ttillg papcr, etc., etc., haYl ) if clean, KOlllcthillg to recol1lmcll(1 them. Colludioll applied 011 n nne web of CottOll \\'ool i.. nn etticient Ht)'ptiC ,u:d provides <'1.11 cLl'tiJicial .. kill, helping to ' _' elude ail' from the \\'olllld.

100

CrrAl'TEIl lIT.

TIlE N EH,VOC . 1'1'1£1-L

'TI\'O systems of n erve::;, the Co1'o1>1'0 spinal :1ucl Lho 2Y lllpn.t h etic, preside oyor tho 1l10Ycmcnts and flmction . of the body.

The Cerebro-Spinal system i,' made up of the Drain, Lho pinal Coro, :111d the 'fhe Brain is .. ituatod within the (;r:1uiulll, and i!) di vided in the middle line, so that, \yith the exccptioll of a few connecting hand.. , the right and left Rides n.rc ::;cpn,l'ate.

'rh e Spinal Cord i::; the l ong corel of ncrvou,' lllaLLer lying \yiOlin tl e spinal in Lh e bOll.r :11'ch formed hy the yertchnc (sec Y crtebra l Column). H. 1'::':1\'08 the brain case tbrough the ha::;o of the skull, and r each es as Iowa.' the upper inmbar ycrtclm:c.

The Nerv es proveed from the lmLin a nd ,' pin , I cord in pairs; th e fonner arc termed t h e cmn ial, and the laLte r the spina,l n erv es. A pail' of s pinal nerve eme r ges h e tw een each of the ycrtcbrw. The nerve,' cross the brain ahout iL::; base, and in the spinal cord, so that the right h a lf of the brain preside, oyer the left h alf of the body and limbs, and the left h n.lf oyor the right side of th e h dy n.nd limbs. Jn the limbs aud tl11nk th o 11 01'\'C are III ,t \\'iLh as large pearly w,bite tl'llnks, [tnd can he traced to the nIll oles and skin. , \Tbell the n Ol'\TI.!S torll throug h therc

103 p ltr a,lysl::; of motion and "Cll. 'atioll ill til, region in "llidl they are eli. trilmtcd . The Sympathetic System or llenl'S clJn i.)h of a dn,tl)le of llenc ,md ,';lllall ll l' lTO'l ' llla,,;;e':J ({unrdiu ) (011 either S1-1" of or thc ,.pilwl colullln. The chain ex end , from tIl(' In-c ot tLc . kllP to tb0 C( , c}'x. The 1I11 \'l' of thc :-;ymI ,atht·tie ,.,y tell s end lll'lUH:h to tll thl 01'0,':111.' o. tIt· cl.v,t allrl a! .c10111 c n. It \"t "lll that co.ltnls L· t:try 111ll'cl " ':> of tLe l H) ch' ; i 'reg l1nt (: s a'l lim \ itnl fllnctions :1 :.., \\ ell a ;tc1jll. h the I-iupply o· l) ,')ccl to thc secreting and QXCrctillg 01'Frl.. -3

J)rAGBAM :--HOWI.\'(; THE BR U:" i \ ND TUE CORIJ. \\ ITH TUg NE RVE::, OF TIlE LFFT :::oIDE OF THE BODY.

104

gans. The sympcLthetic '),stem diffe rs from tho cerebo-spinal system, inasmuch as it acts d ur ing sleep, and k nows no prol onged r est.

IN SEN IBIL I TY.

Unconsciousness or Insensibility 'lri.l'.' when the function' of the urain arc in cl.bcyanee, eit.her di r ectly from injur y or disea e of the urain it 'elf, or indirectly from disturbance of the adion of th ' lungs or he:1rt .

TREAT:\I E JT OF lIT Ei\ .. IBILITY.

\ VHEK A PERSON IS FOUKD A STATE OF I!\SEK 'JB1Ll'l'Y :

l. Arrest hremorrhage , if present.

2. Lay the person on the back , or in the position in which lJreathing is most eal:5y.

3. Undo all tight clothing round t.he neck, clle t, und wai:-:;t, ullfastellil1g the bra.ce and top uutton of the trou. ers in mell, and the corsets in wumen.

4. P r ovide for a 'ufticiency of fresh air uy keepina' the c rowd a\Yay if in the street, or lJY opening the and -windo\ys if the accident has occurred inc1oon;,

5. Obtain a doctor ' s help at once; as n. general rule until he arrives keep the head low if the f,tcc pale: and rai . e it if the fctee is flu hed.

G Kever leave the patient until 'you luwe placed h im in charge of a responsible persoll.

N.B. Giy(' no food or fluid' (neither stimulants, tca,

water, 110r medicine) by the momo "'}iil the patient i:-:; in en . ible.

PnOCEED TO THE PER. 0.' AS I:\DICATED BELOW, TO LEAR.' THE OF '1 HE J..::-:;EXS!BILfTY : -

1. Feel if the pul ' e beat. at the \Hi t (radial a.rtery), at t hc temple (temporal artery), or in the neck artery). The pul ' l' Illay be au ent, or it may he HUIHttllmllylow, quick, 01' f chIc: it lll<i)' n, ueat occn.:-:;ionall,'i' (intermitter (, pule); or, the pult:!e lllny fjuil:kly and altel'l1utely (irreg-u1ctl' puL'c), AU these conditioll ' indicate 'ome seriolls mi 'chid \\hen \\ith illcnil)ility. A f'ehle pulse indicate the uf . tinn;lallt:; ( 'al Yohttik, 10 drop' in \\ater, or a tea 'poonfnl rd hrandy in a of \YahI') i:-- H(hi . abll', pruvided that the patient i ' ahl ' to all cn\". \ Yith a pul'l' "ithh()1<l stimulanb-..

:.!. [f the pulse cannot 1ll' felt placl thL' hamloy l' the heart or apply the cal' t.o thL' c.:hc:-:;t., tu H-,;ccl'tain if the heart hctl.ts.

:3. Ousen" if the pcrson alld note the o(lonI' of the brcath. The ur(,llthiug lW1.Y 1JC '10\\' , 1;11>0111' c1, 11nrl accompanied hy Jowl sl)oring and ]llllling of til" checks dnrillg e. piratiull (.str'1 to mil.'> IJ}·cath£ng).

4. E'\<tminc the .·calp, Hud lliltk of the head for iujury; th cal" alld the for sigll of

105

k and the montb fot blood, frotlt, :t,l ins by acids, ete., and for foreign hodies.

5. H,ai 0 the ,wcl eX)tmiue the Htntc of the pnpil::;.

Tho pupil::> are the round Hpottl in the eentrG of the blue, brolYn, or gr0Y iris, "[ neIer oJ'{lin,u,\ condition in f:lhaded light the pupil.' dihlte; in hrighr light they oontract to :-;m'1.11 dimel1tliontl. In ,'e"crat eli'oa 'ed condition' tho pupiltl arc altered, tho)' ma,\' hJ bofh Itidely dilated, Jr uoth mimltei!l contracted, OJ', fill tho other hand, they lll:lY he unequal or irl'l'gularthat itl, may ue large and the other small, Every 0110 of such altered conditions denote::; a Borioll. state. The pllpib are, aid to lJC fi.red when in oiLher a ::;hndctl or a hright light no alteration take.,; place in their Hize,

6, Examine the body and extremitie.' fot' :igns of fracture, dislocation', woundH-the ncck for . ignH of stra.ngulation or hanging-and cornpnre the two sirletl of tho body as to limpne::;B or helples ' ness, 7. Notice the temperature of the 'kin, whether it Le natural, hot, or cold. The quickest way of doing this is to place tho lxwk of the hand on the ll<1"kecl chest of the patient.

SrrocK ( OllrETIMES LEADING TO COLLAPSE FRO ;\! INJURY),

After oyery accident of ,my 'c\'crity the patient suffers from shock. It it'> not '0 much a mrnLcLl

H.7

ditioll til" t !I:-, ollr depend ell I, 11 nOll the physical of illjw'j'. 4 S,iyns ml'l patient COIllplaillB of fccllllg cold a nc111J:IY ,1l' lIn lly .. lli ycr \\ i th cole!. Tile f.tlC is pale, the Hkin iH col 1 ;ltld dallll1lY, the pulse il"l the brcathing is HC,arecl,)' per('cptible, the tllre of tlte 1)0(1,\, If uy a thC'111l011leter, \\ ill he to lIe h.!low t.hc tHll'lual (9 '4), III vcry Heven.!

JIIJllriel-l ,'nclt L' XlCll .. in.: 111ltllS, ll\'ol;:(:1l holt '; ' , "aled "'oumb, 01' .evcr-- crti'll \\ [tIt dec-p, 'C'ltcrl i.ltjurie,.;, tlte tell1pemtlll IIl:t r fu 11 to 94- (lcOTct's or C\l!ll 10\\" r' in IHlch C<\,'CH ii> c10111)Lflll. }lnticnL, Illcantimc" m:l)' rCIHajll c1lllsciouK, hut appeal',' dazed, III :-I(llJlO c<t,eo.; of :-dwck the patient way keep quite <luid., but ill othel' c.:'lSO:-l a lll,trkctl, lIltl't.!<lsolw1>le J'utltll! SIlCSK pl'c\"aiJ:.,. 'llill pn

Inay llOc llllC' (1cliriom, owing to f'l'Yl'rc }lain, 10,':-; of '1)100<1, or tdetlL.". di:-.tllrbancl', n' way collap.e from e-xt.rClIlU Iusi') ol ))10011, or tlte f'c\'crity of thc ::;hock.

Treatment. - Pl'c\'CIH the It!lllperall1l'C fnllill<)" 1", t' )\'erillg ,(,]10 pattl'ut IIp "ith a cont, kha\\'l, or anyt.hlng at hallcl. J.\8 S,\'Hl HH }lo:-lsi))10 gcL the under covel' in a warlll rOO1ll, (:1' in and promote \\"(l.nntlt hy lwt fhnnehl, hot t.C) the feet and abdomcn, and, if the patient is uoL l111COllSCiOllH, giyc \\'iU'lll drink, ' , tea, hot milk, ctc, ,Vbell applying hot ll1lttleH hOC that they are \\ rapped up

106

]08

in a piece of flannel or doth of .ome kind to pre· vent po sible injury to the skin.

oION OF TUIl: I3H.fiIN.

'Vh en the cra.nium is ;' trnck no scvere hlow, or injnred during a. fall, th e urain may be concn sec1that i:'>, the per. on may l)c ,'tullncd. 'fhcre may be no wonnd of the sca.lp or injury to thc bOlIC, but the bmin is so shaken that for the time being it i.. flln ctionless or paraly cd.

ani -In enibility, a, f 0cl)lc the pnpils fixed, and gener;),1Iy e'1n :11 in size. History of n. fall or a se\' cro u1uw may 130 obLclined; or injury to the h ead may uo evidenced uy wound:::;, bruises. etc.

Tl ca1mon t.-S ee (page 100).

OF TIlE TInAIt'.

'Yh ell from a fall or h10w the cranium is frn<.:tnr ccl , a.11(1 a pieee of l)on o driycn inwarclt', thc lm"l.in may l) e compressed. On th othcr 111lml, the l)l'oken iJone ma} injure a ulooc1-ycssel within the craniulll, and uomprcs8ioll lilay r e.. ult from pl'Csi·;n}'e of blood on the ·ura,in. ]n tbe former c:t:so tho inscllsihilit.y will comc on immediately' ill th e latt er, after Homc minute8, pOSHil)]y 15 or 20, that iH, \\ hcn the Llood has accumulated in .'nfficieut (!u,mtity to cx )' . cise pres.-nrc on the brain.

Signs and Sfj?i1ptoms.-Jn 'en ' ibility; evidence of a

109

wound of the scn,lp; the fracture of n, cmllial hone rnu,y be felt: a Hlow, full pu1ije; ste rtorou s unequal pl1pil s, becoming fixed \"hell the pru,:-,nrc seyere. In injurics to the brain '-ymptolll::; of (;011C11:-;sion may fir.-L pn.:\"ail, Huccecded by '-YlllptOlll'- of compresijion.

'l'r eatmen l.-t-..,; cc ..:\ pople:-.y.

..:\ Plll'LEXL

\"\'hen a dit'casccl hlood-yc' 'el giYes "'n"\' withill the urctninm the brain it' cOlllpru:; 'cel and its 'tissue part]", de ·troye\l 1),\' the l)luod \\ hich e.-cilpe,. Wh cn the quantity of hlood is large the Hymptom.- c1eyclop so rapidly that. the condition is tcrlllccl an apoplectiu fit or :-;CiZlll'C

• 'i(l nS and ilJilit,\', a fllll, :-;1o,,pu1.-e, ' tcrto}'ou'l breathing. Ul1cq nal (unc largc und (llle smal1) illld n\.cd pllpilH, a flllShcd facc, a hot, kin (the tcmpemLlll'c " f thc hody is n ' uil.11y lllnrkedly raiHecl) and the limb; of oneicle of the hody limp, \\ hile, on thc other, tIle normal ri.gidity lllay ue rctained-are the indications of a .'eycre a:lJoplecti e attack. 'llhe age of the paticllt i.. a help in rec ol!,lli::-;ing the condition, it i.. n " nally clclerl.,- people \\ 110 are seized.

Treatmellt fo), ApIJ1Jl e:r?/. C01/cll.o <' ion and COlIIl'1' Ps<"io n of the Brain.-(1) Ueneral treatment for (loosen the clothing round neck, chest, and abdo-

110 men; provide for a frce draught of air). ( 2) Lay t he pati ent on t h e hn,ck ",jth the head l:llighLly rai ·cd . (3) Get a doctor at onee. (4) AppJy cold to t h e h eac1 , either by an ice-uag or by doths wr nng ont of col r1 wator. (5) K eep the feet warm by bot \\'ate r 1\1U 'tal'cl leave::;, or a ltHl 'tn.rc1 plaster. N .B.-P revent anything being given l}y the mouth. 'r ake care tha. tbe 'kin ii::l not injul' d by the hot-water hottle,' j they ought to be testec1 uy feeling thcm with t h e hack of t h e hanel, and then wrapped in f1:11111 cl, etc., before placing t h em agn.inHt the skin.

COLLiPl:lE FRO)! DR1}!\{.

P hYBical collap:e from chillk i1:; generally \Vitnot; 'erl in y ery pOOl' per::;ollH, upon whom, from want of nonri 'hment, immfficient dothing, etc., ell'ink (It may be oyen a small qwmtity) ha. an unc1ac eft'ed. It i.. seldom that c11'1ll1kanlH heccllllo physi(;ally their mentR.l powerB may he paralys (1, but the e11'cnla.tion of the b lood retain: it: power.

Signs ctncT Symptom,s.-ll1l:len,'ibi l ity 1J1:(,y he complete or partial, t h e patient being either capabl o of being 01' totally llnconsciolH:i. T h e pnhie i ' feeble or completely at the w r iHt; t h e hreathing i ' H l o\\', and perhaps slightly stc r toro u s; the hreath Hmell ::; of drink ; the pnpi lH :1.1'0 dil ated, e([llH.l, and responc1 to ligh t j the face iH pale a,n l t h e ::;nrLtce of t h e skin col el anc1 dam my.

I II

.B.-It lllll.'t not be as, Ulllccl that a per:on has colbpl-ied from c1rillk merely because the lncath Hme lb of drink j frequcntly, ,,·hen people arc feelil],!.!' ill, they take 01' arc gin'll after \; hich the y lllay become ill. elkible not fl'rm the drink hi irC)) ;) thc cn,u:e which iml11ccrl them t take it, e.g., ape pleA Y coming 011, effe ·t: of pui';(Jl1ing, ctc., etc. oJ Trwtmenf.-( 1) Ul'llL'ral trcatlJlent for y (lOO.CIl clothing, pro\ irll' free eir<:ulntioll of ail', phtce in position ill "hich hreathillg iH p( (2) Kccp the paticnt \\tUIll hy coycring him O\cr ()r taking him incloor:, and applying hot-\\"nter and f riction to tll .ul'fal'c, more c:-;pecially the limbH. (3) 'Vhcn thc pati nt can lJ J'Ol;sccl g1\ e \\·.ann t n or cotree. (4 ) W h en tho iH l'c:-;tc'l'e(1 gIve an cmctlc of a de ':-; rt -f;poollful of jJl a tlllJ1!llC'rflll of 111kc-\\ anll \\ atcr. ( Dj W hen t 1.l emetic has effected its pllrpo:-;c, ' npport the paticnt's :-;trength hy tea beef ' tea, brandy i1) :ulall III Ul.ntity, or uy any of the prepnred fo ell) 01' eN')e n ce '.

The apoplectic , ' tat a11(l from (hink arc not nnfrequently the one for thl' other. T he more prominent mean ' of distillcfui 'hing them arc as fo ll ow, :-

1. I n apoplexy the pati nt j. wmally getting on III year j colln.p >e frolll chink lllay occur ill a per Oll of a ny age.

11 2

2. The ab 'cnce of the ' mell of drink wo uld indicato apoplexy. \ .' ,.

3 . Pupil.' genen1.11y unequal. and 111 apoplexy) equal and re poneling to lIght 1ll colla.pse from drink. . II

4:. Thc pulse at the wrist in IS u ' ua y .trong H,nd full; in collap'e from clrmk It IS feehle or c1.ltocrether absent.

The features in apoplexy are u 'ually cono'csted and suffu. ed; in collapsc hom drink they arc pale cl,nd pinched. . . . '\

6. ,hould men,m; of the teml?ertl.t llle 1>8 at hand, it will be founel in conslc1erahly aboyc, and in Gollap. c from drink conl11d nthly below the normal (9 " -1).

ErTLEP':;\".

This disease j:-, frequently termcd the "fHUi ng sickne s ." It 0<.:CU1'l:; in pcrt:;ons of almot>t any age, hut most frequently it i ' secn in adultK. I t is a common form of 'fit," rmel a.' It occnrH with lmt little if any wa.rning, the ,'eizu1'e nut)' take place l)y night or. (lety, at in the at public meeting., III a pUUllC COllycynnce-lll fact, anywherc. O",ing to it · suelden dc:"elopment the pJ.tient may [I1Cn1' seriou' danger, c:-;peclally "\\'hen the attack como::; u n ncar a nre, maclnnery, n t:;tcep b1.nk or prccipir' (', or where traffic i ' great.

113

, ig{/,sandSymplom ,,,;.- Sollletil1lb with, but gellerally without, a seream the paticnt Ltlb to the gruIllHl, illl1cnsible. The lllll,cles of the body arc ill n, of Hpa, 111, ,0 thn.t the feat nrc,' arc distorted, nnd the hamb ;'\,l'C tightly clell<.:hecl \\ ith the thmnl,' in\\nn]:-:. Vcry quickly, tlH! rigid hy "\\ hi(;h all thL''i' part' have been fi.xcd i,,; lxc hallgcc1 for n. . tate of COll\ during which the facl', lilllh:i and l )ody are yinl 'JILly ('n ntorte(1. The L" lllay -;qnint, the pllpil . ttl") c1l'Ull, dilated and fiXC l1. The face at fir.. t pale, l)CCI)I,ICS 111111ky, all11 froth frllljllL'lltly appears nL tho lllOnth and occa.. ionall,v n the llostrib. The t onguc il1 H pt to be hitton, nIH1 \\ h(lll it it:; the froth frolll the lIlOl1th may be tingcd \\ i[11 Idood.

The duration of all epileptic fit is 11l1Cci'inin ; it may GOlltilluC for hut a lllillute or two, or fur five to 1iftc n minute.;. Wh Cll the tit thc patient llW) recovcr completely) fall lllto a c1ecplecp or lllay hn.vc n. snccet:;l1ion uf .!inibr tit·.

'Tr(',tlmNd.- ( 1) (: encm l tren tment for il1:::el1s1 hi li tv (loooell elothing, alle)\\ free circulation of n.ir, to pOt:;ition). (J) Pr IYc ut the patient from hurting hilll,'clf he fed} . and after he ha fallen. (3) During the fit drag him n w'ly from a wnll, llc<1,\ y piece of f1lrniturc, or other of dangcr not c;lsily [J}oycd; plvh lightcr furnitur e out of the "\yay. (:I,) Kneel down beside the patient and npport hi::; head. (G) Wrap a piece of ,\ooel or any hardmntcrial (hauclb I

of pocket knife, indiarnbber, pencil, etc.) in a handkerchief, and hold it between the teeth to prevent the tongue being bitten. N.B. The movement of the limbs must be hut not altog ther pr(lvented or completely cbecked, a' during the spasms the muscles might b e torn. GiYe nothing by the mouLh. (6) After the fit see th:tt the patient is Glued for l)y friends, 01' COll yeyed to slH'ltel', and allowed to l'C\'t an d sleep.

Callses.-A clo 'e or crowded room, tight clothing, fright, sudden bad news, fn,tignc, \y,:mt of food, los::; of blood, heart bil nrc, etc.

Si,qns and S!j?nptoms- Pallor, a feeling of gichlinesH, a feehle pul. e, ,' lmllow hreathing, blurred \'i,'ion, followed by ins ensibility more or Ie::;::; cumplete.

T1' eatm en t.-(1) li-eneral treatment of i.n 'l'llsihility (loosen clothing, provide Gircnlation of air, aLtend to position). (2) Lay the patient dO\\'ll fiat on the fio or, on a cOLlch, or on the grolmd, or, if pO ' ihle, as whell the patient is on a form, l et the head drop oycr the cdge ot the form a little belo'w the le\'cl of the body. (3) H.aise th e feet a little. Uct as much air to on the patient ct' possible by creating a draught, by fttnuing, etc. 4) Smelling salts held to the l1ostl'ilH will ai.d re co very. (5) 'Vllcn sensil)ility i,' restored remove the patient into the open air, lJl1t f>hould recovery be delayed for several minute ,' after the fiat

115

pO".itiOll has Leen 11.Fi,'nmecl the ' " \\ 1lJhlt yet in 'eJl::;ilJle to tl P,l.t.l llt mu,'t be carried 1 r - '. IV opcn aIr. ote.-It if> the call' f i' • thv }H"CIII 0lTIJ<1 ue he'fore tl'" t" 'tel 0 . the lam t, 11. . ITC ·t tl . Ill<' lC Ill::>Cll 'l ' l't I' I C }lcttll'l)L i:-i iildl"" . f b III 1 T. f ' Cllllg rom " "m t of . l' gIn.! f(Joel at fir,'t. ' noun, ' 1l11ent,

t • " IIYSTEHI CAL FIT::; (HY.'IEHr").

, 1!llh an,I ,C'1JlJ/j)(m/l -']'} t' .] . " ,. lC ]>'1 ICllt 11 , III cOllse(l uC1J GC of y it young denly lo:->es <':ollllll'md of flllelI : t 1l.1 CX<':ltCllJCnt, .'lld1 . l ,leI ec m o" 'wcl t t' 1 ,'n ),'H e, Oll a COUGh ( .', ,-. ." ,c 10 11.', 1C 1 n III :-;0111C l:OluiUl't· Ll .. nue COllllllenee' tbro\\ in cr he',' If ,1 .C 'ltlOIl, teeth clcUGbill(T hcr Ii .1 ahout, hcr 1 t 1 . b Ii 'I, ii J,t "lllO' her h ,t '1 l'.11 1111g at anything' or nIIY b, .,,11 00 'C, li:lcklllg, or lnllO'hillo" ']'] ,.0111C llC,ll b el', crymg', '- b-" IC C\ e l'llll'{ n 1 '. npward ' and the eyelid . '1 ' '. Illy )C tnrnecl tilll c' " fl'Otll • opellcc amI, hut l'al>ic11y \t '0 mil)' appc'u' . t tl I'd .' jrreglllar FiympLotl,' lC s other completcly in 'c tlHible in} It' . 1C IMbcnt 1.' llot l' I' ' 1)'::; cna. 1'f'a ment. Sp cak Jil'lll( ' t) t1 . her with n colel ",.tt l' 1 1 l I?, pn,Llcllt: thrcatcll 'C fit " , .' ].] J ( Cl. ( 011C Ie, and, If Hh ' .. in hcl' i:-; ct'o Icr wlLItl] cold Welte]'. Medical trcatmcnt .,. " Cllro I ' . t' lllilld anel 1)t)c1,' \\ J 1 C. 1M lC!lt of thc GOmlitioll of 11<.: 1 O'IYC:-> n 'C t tJ t 1 hy,'t crical attl1.·ck t- 0 1e Oll( ency to • THOKE.

Heat Stroke ar:d Heat A I pop . exy arc terms T :3

114

also applicd to thj.- condition. (( l1nstroke" i'4 n.-nally applied to that form ot the ailmellt which eOlll,)S on snddenl:r ,yhi1 ,t to great hcnt; aJH l IC heat .. troke' is the term 11 'ed when :-;)'Ill})V)ltlS appe;U' after th£:' sun hn Het, in cOl1seqnolll" of exposure to :-.evere heat dnl"ing th llay. Sign.' a.nd SymptO/H8. - \Yhih5t (,'\pu:-.ed tll gl' \It heat, cV in the Cllginc-rool'l or toke-holo on bu.ml ,teamers, eSi'.:.;cially in the tropil:s, or durin).!, ,1., mar<..:h ,,-hilst he:1.\""i1)' bl1l"clened in very hot \Yen.thor, p er .. ons so Kitun,ted may develop a ' udcl'll o..;i!'kllCo..;:-;, a feeling of hin tne,,;sJ giddi ne,', , alHl diftie lllt y j n hren.thing. The patient c.:omplains of thirt-;t, the :skin l)ec.:o111o:-:; dry and burning, the f,\.ce congo, ted, tht.: put e quick and honnding. Finally, insen.'i),ility may re 'HIt, with breathin)!, follu\\ ell»)' colhtp03c.

TJ"eatmpnt. - Dnl) all tight remo"c patient to a tool, hacly .' pot-if on boarcl .. hip, hel\n en deck ; jf in the opcn, to the t-;hn,de ; if a hOll"", c<\'1'ry him <"l:Hl uarken the 1"110111. I'tl'ip the patient to the wui::;t, pl'O(mre at:> free a cin:nbti(111 nf air as pos'ible l)y f,tuning yigoroll)-;ly hy 0POI:111g' the door and. winduwt:> if in the 11Ol1)-;C, or pbcing in a dnlughty place if on hoard ·hip. Ko ' P the patient lying down, but with the head, llc<:k and ,houlder, well rai.'ed on a plllow or foldecl coat- Pour col d wilter on the heacl, neck and body, jllgflll ;1. flcl'

1 17

,llldn1, \lntil return. ..An ice-1Klg to the head and t-;pll1C or cold \\"aLer applicatioll.' .:hould he contilluec1 for Home honrH The patient may heLVe cold \rater to drink whell cOllsciou,', but no t-;tillmlant.

*ELECTRIC SnocK.

Through contact with all elcctri<..: cal)Ie, "ire, or other electric lllellillLrl. the .. hock lllay he ,,) <1.-; to l'tlu'o in. en ·ihilily, anel th e .. nffercr "ill he lUl ctl)l c to cxt;:icatc him.'elf. ltnlllcdi·lte ,Lep lllU"t be taken remove him from contact, hut an attempt to do thi" h. (Itt '11(1 'cl wi It ri,k, as any-me touching the :sutfurer "lthout prep 1' prec:llltion i lin,ble himself to rc<..:ci \·0 :1 "h'Jck. The rik <.::tIl ho\\'e"e1' be mntcri,t.Ih- reduced if L It entirely obYiu.tecl, hy n.Yailing 011C of :-. t f '.-?: t ull'll ' ,\ h i<..:h tl rc a pparen t to ,)'one po ·sC-; "; n cr n q elementary knowll'do·e of the lam; \\hi··h go\'ern eledri<..: CUlT 'llt. ome hoc1ic', known a . .) are p,uticulnrly ,a ited for tIle tr<111<;mi:-.sioll 0 electricity an.d are in .. tantly .'eized, whell po ' ' ihle, l)} a Ctlrrenl tL· It:; path. A", uf hoLlie · mal' he mcntioned, iro11) Imt"'.', wiLter or moi ,t ure, and one'::; 0\\ 11 I)ouy. Other bodie ' , called" nOll-<':olHluctoi' , 01' ill 'ulator:-:,' the cnrrent) anel amollg.-t the ...t; ar-:! ill c1iarubher, elry Kilk, dry cloth, dry tmel dry hay or ,tn\\'. An elcetric Cl1.lTent alway' choo 'c.' til J

ThiH article has heen k indly revit;ecl l,v },II'. S. B. e llrell, Engineer and General Munaaer ofvLhe Liverpool (h"erheld R:tilwa.y. to

116

be t cononctor and the shorte::;t way to the earth, bllt it will not pa " into a body, no matt r how gooc1 n. conductor that llody mH,y be, if its ogrc ' i preve])ted by an illo'ulator through ,,,hieh ihe currcnt can])ot pa" .

No doubt the "irnple't Wtty to froe a , nfi'ercl' from contact with an electric current would he to ::;\\ itdl off the current, hut this conrse ,,"onlcl often be (l'.lite impo ,'ible, and even if po, ,' i1)le so llllleh inconl'L'nicncc a.nd pcrhaF ' danger to the lives of otber::; might arise that omo other methoel I1n" II ually to be adolJted, 'Whenliberating the su ff'crcr from cOlltactl'elUCml le1' -

Lt. Do llOt touch with nnkccl lll'.nds the, ufi'ercr or his clothing jf it is cla1l1p. 2nd. Keep your,'elf in ,' uIatecl frOln the callIe or apparatus, from the sufferer, and from the cilrth as \yell. 31'd. A1though indinrullbcl' i,' prohahly the be ,· t in ulatol' do not " 'a, 'te tilllO ill rnnnillg for illc1iarubllcr glove, or mat::;, hut use dry artic:leH of ('lothing ; an indiarnbber tobacco pouch or ponche" or cnp, wonlJ erve to protect tho 11<Lnc18 in an cmergency.

T o divert the fWTenl th e sujJel'eJ'.-Haying in 'ulatod your own hand,' and llody, get an iron rocl or any other form of conductor that mel)' bo at hanel, and connecting one end to the earth and the othcr end with the cable or whatcyer may be the medium of the current; or if the snfferer i, ' obta.ining the shock from two cables or conaudol':s neither of which

C£ earthed " IJlace the rod in connection wit!l both, and tll 'lllTcnt \\ ill th 11 he diycrted from 111m, ]I the Hu11'erer is not releascd by the above 1I1C,lllS insnlate your own per, on ll,Y foitallding on u. dry boa](l" dry dothincT a lnmdlc of dry hay or gla::-: , lmcks, t-ilu.te, an iudinl'ubhel' lllat or ,'hcctilw. fl'otcct your h<.tlld ,' 1lY placing a many thiekn ljSCH as possible of dry dotbing betwcen them and tllC ufferer, a,ml elldeayour to n).i ·c <l1)cl inn],Ltc 11im from contact \nth the carth and the concluctor. ,\'ben the sufferer i.. the en1'ro11t ccuseH to paSH tln'ough him. Tho cahlo lllay then be withdrawn, but c,tre taken in "ith'c1rawin rr tll \ callIe that tho pcrl:ion, 0 cloilltf him ,' elf .. iW1.11atec1, othenvise he "ill a foibock. ,Y]wn thenfi'erer is rcmo\' ed frelll contact :-

1. Apply the !.!:ellCl'.1l trcatm,C'llt f( :1' (loosen dothillg. procllro freo CJl'(Jllbtl II of mr ami placo in a 1'0 'lining position).

2. Dip a towel ill cold W<Lter and attempt to arouse him by sharply tho [l.uel

3. C01llll1Cnc.: artiticial pinl. tlOu 11 oiher m'ill ds fail to re:-:;toro animation. " Laho)'(lc '8" method ('co pa(fO 1-12) ha,' been found to be vcry 'ucce. i'>fnl.

4. bums, if there aro any ( " tC pug \ 1 :2H).

EFfEC''j':-3 OF

A person stl'l1C'k by lightning i ' u , .. ally more or Ie s

118

119

120

d eprived of con cion no::; 5. The treatment is the same a' t h at for e1ectric shock, ex.cept, of course, t h a,t t h i nstl'llctions for removing the patient from contact with the ele ctric medium do not apply.

CO);y(JIJ [O);S IN T cethin; or st mflch t l'ouhle3 ar2 the comm nc. t of conyul.·ioll' in infant.

S i(ln:; and Symptoln' . - 'paslll of th,] tnll'des or the limb' and trunk, liyidi ty of the f;we, insensihility, OCel. ion lIly s1.uinting, suspende rl and fregllently froth at the mouth .

T i'eatment.-Pnt the child in a w<.t rm b .1.th aho ul" th e normal temperature of the body (98 degree' Fahr. ), so that the Wetter reache as high a' the midd l e of t h e trnnk; and plac e a sp nge dipped in cold water on t h e top of the head.

12 l

CHAPTER IV. \VOeND>-'

I:sr.JURIE OF TIlE KIN. BnuI:-'E::I.

A I3LO\Y any'.dlere on tile ",urface of the body may cause hrcl1lorrhflQ,'e helo\\' the kill, " ' ithollt the skin being wOlluded. A" black eye" i ' an iuj lll',V of this nature.

i.flllS and; '!lJllp!()lI/s.-The injured part is at nr:;t l\.. ldened by the ]llow, lJllt the colour q uidd,), a a d II ky hue and then becomes purpl e, and aften\"lrds lilmost black. In a few days the colour nppears of a l ig llter tint, and after gradually F\ 's ing throuo'h purple and "iolet 'hade', it chnngc-3 to a Dolour and then to ..1. yellow ting • before the llormal colour of Lhe skin is attaillC'(l.

Tl'eatllumt.-Beyoncl the immeLliate application of icc or col(l-water dre",.' ing ', no "fin:>t aid" treatment i., required. TlJe "irine popt,larly a cribecl to raw meaL applie 1 t) n b1<'l.ck eye hflS no fOlluc1,ttlOll lJcyOtHl t lte fact that the piece of mont i:-; cold.

'\Y01::i-lD. .

A snrfaC0 woulld may Le dofined as an inj my involving n11 opening in the .kin.

THEAT'IE:\T OF IN GENEHAT..

Be sure t h a t yo u r H ands a re q uite Clea r:.

1. A rrest H cemo r rhage at once \\'hen the

Hom've can be a 'ccrtailled. WhLn internal h,011101'rhage is 'u pecteel the meaHllr .;:: to he nrc:Hest, free circulation of air, 100 enillg clothing, and free u '3 of ice to .'uck; an ice-hag may aLo he applied externally in the neiuhLolll'hood of the wOUDCl.

j. Cleanse and Dr ess the Wo und-( A. ) lnWll IIld-ofdool'3 it is but .. cldom that apprupriate mean. ol' cleaning a wound arc at hanel, (a) If llO water i !lL 11 mel, anel but one cl ean hn.ndken:hicf it.;! t had, \\ i the \\'OtU1r1 if it is dilty, with n. corner (f tIle h<1.1)(1],e1'<..:hief, then fold the hn.ndkcrchid :,nd tie it oyer the wound. If the handkerchief sodcd apply a piecc or clean (unprintecl) p :lp3l', as tilC' of all ellvelope, on the wound, and tie a hanclkerchief necktie or urace OVCl' it. (1)) If d ean water i.' 1..1)" and'tbe wound is dirty, lmt not otherwj, c, \\'<lbh tile wOllllel frcely, dip (or wa h if nece.' <11'y ) the llanclkurchi 'f ill the water and apply over thl \round.

(E. ) TVlt en in-rl()v!','i fli p (f'{Jllll,l \\' itIl watcr that hn.s been boilc rl anrl allo\Y(,d to cool. To the water might be added, in the J:.ll'opol'tion, , if at hand, a few crystals of pcnnanganate of potash to a half-tumbler of wate r; boraeic-acid (n. tea poonful of the powder to a half-tlllJl blerfnl of ",n,ter) : 01' any of the disinfectant lotion ill comlJlOl1 lli'>e. The the wound are to lIe d allsecl bv washing with soap and water. Wh en t.lw part ha:-':) h ee n dried, absolute '\ill 112 cll,;urcd Ly

123

mopping the -kin around the wounc1 with Rpi ri t. of "ille or \\ ith \\ hi -kyo })/'f 'S8 the u'(Ju1UI,-'l'be \\ OlllHI nll\\ hc c1re,'secl by 011C or thc follo\\illg llll'tho(h; : -(a) .\ pi('l't' of dry lillt, lillcn, or calico of ,c \'cntl tbit.:kllc. 'Hl'S , awl 1..nUlc1agcd . (II) 'l'lJe drcH ill" IlHlV he ,'onked III \\ alel'. boiled emu cooled or ill c;f lite Hntbeptic lotion' 0)' ill Friar, lJell':ialll. (I) 'C'u tton wool, lint, or gauze (1IIcdit.:ated) IllfLy l)e appliul wet or dry, ncxt the \\(Jllllc1, illbtead of the al,oY0 c1rC.-Sillf.!, or applied o\'er the rlrei" ing. (II) Alltiseptic powdl:l', ,lw h ,t.' horacic acid, rna,)' ue rlll:--t 'tl oyer the \\'ollnd, Clud then covered \\ ith lil1t or cottOll \\001 anel bn,mlaged. "'- T, B. -C''l. l'bolic acid, :dthollgh yalLlaulc ,'\..' an on <lcC0111lt of 111<111,tl'cic1ellt'> ha.\'iug oct.:l1J'l'ed ill r Cl'llt YUllb thruugh it.' mit),lpplicntion is not a .afe lotion to uc kept ill tll1' home (1., a c1 rC.'Hillg' for \\ oUllc1... Ve .eh carhoii<..: acicl lutionhonld not he left al)out.

The cleallline ',' of clre... i11 'Y:; of liut cottOIl \\ 001 or gn.nze cc'I.ll be guantnLectl onlv aHer they 11a H ! l ieu} 'llhjcetccl to great heat_ call he hy pla.cing the <]llalltity to be llsed in p, cloret Lil) ill a hot O"C11 for half an hom. It is ad vi -n. hIe llOt to touch clean eIre ' ' iugs with the hand, IJut \\ ilh de ..m forcep., pincers, twar tou!)'s, &<..:, \Vh el1 the hlood hn,' ern -ted mcl' a \',()\m<1 do 1l0t disturb it unless the \YOlllld is kllO\\,ll to lJo clirty.

12.,1,

3. Rest. T h e \\'ollncled part, whell eIre sed, sho nl d be kept quiet by "plint', sling', or by rest in bed.

'YOU:s' 0 AND TUElU ,'rECIAL TnEATMEi'\T.

T he treatment of WOllllCb in general applic,' to these wounds ;--

Incised Woun d s .' Yhcn the ,·kin it:) cut 111 <t knife, a piece of gllts', or other 'harp in 'll'llll1cnt, the W01ll1d i' termed illt.:i 'e d. The edges are clean cut and the wound ga.pes.

The edge. of a large inei cd wound may be held toge.ther , afte r it 11a' been c:1eltn'ecl, by narrow strips ?f adhesive p l aster laid acro 's the wounel with a sligh t 1Il terval bet ween each Rtri p.

Punctured Wounds. -rrhe wouud caused by the stab of a knife, dagger, bayonet, etc., is termed punctured. The wound i' u nally sma]l rounded or jagged, and the edges driven inwctrds b}: the weal;oll. '1'h e dR-ngeI' ari, ing from the injury depends upon the sitllfl,tiOll of the wound, or the depth to which the in 'trnrnent has pcnetrated.

wounds must not be probed. Foreign bodIeS lLl wounds, when llidden from view, are not to be sea,rclied fo r by probing, they are to be left till the doctor n.rl'iYes. ('ee a lso Inten111 H temorrhage .)

. Lacer Gl ted VV o u n ds .-'When a part of the hody IS t orn off by machinc·ry, by the bite 01' claw of an ,;"ui.m.1, hy [111 artillery shell, etc" a l acerated wound

]25

result'. The parts arc torn ullcqnaJ1y,o that the b urface of the \"io111)(l presen t:-3 a very .n(. yen and l'ap:gec.1 nppearancc.

Lacerated wounds ,cltloul bleed ml1ch, bl1i ''ill n part of a limb has been torn oft', say by machinery, a tourniquet i,' to be nppliell 100 'ely round tbe limh above the ,,'on nel, ready to be t"isted tight 'houl(1 It ·tual h,cmorrhage come OIl.

C ontused W ounds.-'Ybcll from the lJlow of a blllllt in 1.1'U111 nt, such as n. stick, tltll1t.:hcon, etc., the 1->1-.111 ia h r oke11 amI the parts around 'eve rel:r brui. 'ed, the wound i' aiel to be contuccl. The edges of thp ,,'onnd are 1ll1CVel1 and llriven il1'.\';)l'c.1'; the i.' U 'W lly insignificant, a few drol)S of bluod lIlcr 1y trickling from the wonnd.

Trent ns a wOlmd imel ( hrui. e.

G unsho t W ounds.-"' bcn a perl:;0n it:) "peppcred;J at 'OI11e di 'tance "ith small hut from a gun, 1"0 that the sho,;; has time to read, th wound..,; mn,y be wille apart. Eycry, 1. t, a bl1mll l,linf1l1 'wuul1d, fr01l1 which a little b lood ooze and Hpeedily gets hardellcu into a. scab. Cnle' the (C "hot" haH penetrated the chest or (bc1omen, 01' ,vonnd (1 the eye or a join, there i' little clanger from the injury The wouud from a rifi!:' llUllet will Hhow one or two ,Yonnch;, accorcling a:-) the bullet remains in or the body, forming the. apertures of entrance and exit.

Gun::;hot WOUtl13 are to. be covered over by lint gauze, cotton \\'0)1 (medICated), if either is to be had, or If not, hy some other clean dre,' ina, , Vhen the surfc1Ce of tl13 b Y has been "peppered" by a number of mall shot::-l, do not n,ttempt to remove them, wra,p the pa,rt · wJullded (a \\-hole limb it may be) 111 a ::;heet or towel \\Tun!!,' out of hot or cold water, whichever is the lt1!)rc comfortalJle.

Poisoned W oun ds., Yonnd may be poi oned the time of th e injury, or may become 0 aften\itrJ:-; by the natu r e of the di, 'charo·es. "C uder thi ' headin(I' be the bites °of auimnJ', the ::-;tiu"" msects, the P?lsoned wOllnd,' can cd by natiyc weapons

P?l::-;oncd l>y some drng, etc. ; these will he (;omndered 111 dcta,il later. "\ \' hen WOIlllCh; hecollle poisoned by dirt, neglect, ill.'anitalT '1llTOtllldil1(J' , etc., they ::-;a.icl to .be '. .'cptic,". 'rhe word means putnd, and antiseptIc materIals a\)(l are tl:at prevent a wound hecoming putrid or septIC: With the treatmcnt of thc c condition::-; "fir::-;t aid" has little to do, but all that i ' po t:lihle prevent a wound becoming ::-;cptic when it i::-; firt:lt .'een s h oul d be attempted.

For see BitCH, 'tings, etc.

When a }omt is wounded , Ray by a 1mllet or other body, or by a -tab, the part is to he up 111. cotton wool and the limb put in a splmt. T he lImb 5hould be maintained in the H i

pOt;ition lw...;t calc to Pl'CYCllt gapill:; of the \\'ound.

When a needle b reaks off after penetratin ,., the skin and Iii \I.ppcar , take the patient to a doctor at oncc. I' hl' \\otUl(l i" 11C<1r a joiut keep the joint at 1'e -t 011 n. plint. 'Whea \ fish - hook i ' cIll1Jcdded in th ' kin, do 110 a ttempt to withdraw it hy retractionthat i.', bY the ,1,' it went in-1Jllt cut off th e " clre:-;.. ing j. or the '0 that only the metal ic.; l eft, and then () 'ce he poiut thc skill, l.laking the hook 0 aayel Oll\yn,rd' until it ean be with(1rl\.\Yl1.

FnOf)T BITE.

During ,,,me tv "eyer cold, part of the 1H )cly, ll-';lUllly the feet, fil gel'';, or cttr , lu 'o 'e n ation, ,mel hccoUle til''''; W;) ': \\ hite, and then and of a pnrple ilppe·u·uncc. 'cn 'ation heing lo ·t in the part, it is often oll l y h\o' the by ·tanr1er::-; dr,l \\ ing it ttelltillu to the ion III colour of the Cal', no c, t<.;, that the fru hitLen made of the fact

1'reatlll{'Jif.-Do 110 hring the patient into a \\',UIll room until hy frictioll l'y the hanel, or hy ruhhing \\ ith the 'lon '<l,t ion and circulatiun in the frn.thitten part are 1'e tor d, N egled of tili., prcC:<.l,uLio1\ may lead 0 cleatll of the ti ne affcctl'd . , Yhen

Girculation i:-. reHtored the paticnt ought to be in a room :tt n tcmpr.;rature at 60 deg. Fahr.

126

BunK Ai\D SCALDS.

A burn i; ' by c1ry heat, UH {huncH, ho t m etn.ls, etc.; a i,' cauNed 'by moi .,t heat, ::;11<.: h as boili ng \Yette r ) hot o il, ta r , etc. fiUns and S!Jl1Ipt ollls.- T he eii'cct of hent ull Lhe

hotly mny b e a mere rec1deniug of the skin; if mOl e severe it mn.y canHe 1)1e1l::; or "bliNter'" to form . "W hen the lmrn is vcry .'evere, the clecper ii .'sHeH of t b e limh ' or trnnk lll,ly he c barred and. bla,ckencll.

T h e dothing mny adhere to the burned ::.kiIl , rell de ring it to .' eparate them . Immedin.Le uallg('r to life i ' 1:l110CK, cUllBcyl by tho exLcllt o f injury to the ::;kin j the mo r e remote dangerH are exhau :-; tiol1, severe reactionary inflammation, deformiLy f r om " etc.

Tl'eatment.-(l) T h e clo th i n g o ver t h e i nj ur ed p a rt m u st be carefu ll y r e m ove d. If pLm;k to th e t'kin, Lhe adh er ent c10thillg mllsL be cut aro und with oci ', 01':-; nn(l left 1,0 cume awn,y Hlll 'HC<lIlOnUy . If the foot is Heuklcd, tho 1100L he carefully reU1o\'ed, llllc10ing the 1<10e and (;lltting 01(' h a ek ::;3alll of the boot, so that the boot may fnll o tt' in stead of p ulled off; the stocking :lllu.,L be cut all a long, so that iL falls away frOlll the l)n.rt. It i::; the duty of the by:::tam1en; to pn'pill'C Lh e dro::;::.;ing 1\ hile t h e clot hi n g is being 1'omo \ eel.

( :2 ) Immediately CO 'J er up the wound fr om

129

air. (U) ''' !JCll tllO :-,klll i::; 1l1Cl'L1y l'vddcllCcl t h e ,ti l' hc l·:\f·lllrlccl 11)' dn. ·tillg it "itll' tiullr, \\llitiw' J)()\\·d c J".'d 1·!Jalk &c. The part i,' thou to 1w

11 .\ .<l th.1Ck byer of cottO]} \\001, JI1l!IClaged anel ,

1 I I III t:lllll'(l11 : the lll " .-t n e(llllfol'talJlc pO 'itioll po.-sible.

(I,) \\ hCll blt ill'C JOl'lllcc1, or \\ hell the , ' lll'face i,

cl:nrn' rl. "flak or :-Ill Cal' 1 ieee:::. of lint or liltOll . with (lltH" liu ::: cc(l,. a]llIum1, or cod-lin.. r oi1:-., (lJ'

\\ Itlt \'acllllC, lanollJlo, or cnld crcam. CalTOll

(t I l.. " rClll.ccly, j, n.mdc b,\ lJli\iug oqual

]>-11 t of llll:-.i cc(l 011 and lllue \\ ate!' . 011\'0 oi:

Ilia,' 11l' n cel instcad of the linscl'd "oil. WhOll til L ' I "llrfac c. i,' do not co"cr tll o part \\ !llt 0110 J.:J'l.!." C ::.;/Ject of lint, l'llt \\ :-itrip

IllHlllt 1n'cndth of the hand; thi. · I,' a". dlll·lll!.!· :--nl, ·c.fFll'llt (lne trip can l,\.. at :l tlllle anc1 it frl'.'h drc. :--ill..,! ;lpplicrl

IIL'IIll'(' tIll' ad.)<lecut , tl'lP i. taken oft'. TI, l' ttl the "\ .,tl.. lll Jes.' the111 \ronld 1.(' the '\ l'l'l' the whole of the burllt l"lll'faee laid lIar' tu thl' all' by rCJ)lu\'al uf all tllC clre, 'ing at OIlC time'. , rheE l'Il\'l'l'cd 11.\- the oily drc .. cllyclop ill(' part in t·(.'ttoll or if that canllot hc obtained, \\ Ith a IHcl'e oj tlaulll'l. ,r hell the faee i.- humt L'llt " "1 n \ , CI., tum, hll' thc faec Ollt of lint or lillCll, le;tying 11(:11: , tltl' e.\:e'" the no.e and the mouth. OIP the I I, U-;!\. III the. OlIoI' YHelme apply it to t h e facl" auel

II \ ". o\'er " lth cnttoll woo], l el1Ying' apcrture ' fill' t he K

eye ' , no,'e and mouth. ' Vhen the or foot i hurnt or a,nd wa,rm wn.ter-that 1.', WeLter ttt the temperature of the bo(ly (9 ' 40) at. hand, p1<wc. tho injured limb in the "ater untIl .. d.l'essmg· can be got; and if a de 'ert-. poollrul of .'(Hla (bicarbonate of .oda) be to a. of tho warm water, a 'oothin<r alkalme lotIon ls pr ']1<U,(,(1. Do not prick the blebs or bli tel'i:5; leave th,lt to the doctor to do if he think it right.

(3) Treat Shock. -The seY,ere ' hock, which accompanic' every burn of any . Ize,. l1lU be (lealt with by applying warmth to the ' .'1.ll'face ?! th? 1Jocly {}'enerally and by givil1O" war111 drmk... 'k.) Be very' °of the dangor of eycn :-;light burn::; of the neck.

When a Wo m a n's D r ess c a t c h es fir e , pror: e e d a s fo ll o ws :-Lay the per::;oll flat on the floor at once. Place her so that the fln,me ' are ; that is to 'ay, if the front of the dre!:!' i ' 011 lay her 011 her back, and if the back of the dre!:!s 1. 0,11 tire, place her face downwards. l:eason for tIll '

i readily under tood when It that flames a ceml vertically; th,'\.t If the upl'lght po!:!ition i::; assumed, the flames will quick.ly as<..:end and en velop the body, neck, and face: or If the per!:!.on i throwll dowll with the flame unclcl'mo t, they WIll, if unextinguished, over and burn the limb ' and set fire to the re!:!t of the clre.·S. As. '0011 a::; the per

131

. on i placed flat, mother the flame. with anything at band, 'nch a rug, coat, blanket, tahle coycr, etc. If made wet .'0 lllllCh the better. A woman rendering a .honld hold a rna or lJlanket in front of her. 'elf ",hell approaching the flame ' . If a woman". dre:-;' catch fire ,rhen ])0 one i · In' l:ould lIe flame,' l1pperl1lo, t, . mother the Hame. WIth anytlu.ng handy, a table-coyer, mat. &c., and (;a11 for a s1.tance; on 110 account shoulc1he rush into the opell ail'.

'\ lTRIOL

Vitriol i" frcquently u,'ed a. a weapon for deadly 1l1JUl')'. If it i· devhed in the face it i:-; a yery serim1.· matter. If it. tonche:-; the eye it would venera]]" Il1I',tn 10, ' . of ig'ht; "hateyer part of th; ,'kill r tou(;hecl b)' the acid i ' flll'l'owed alld lml'llt.

. T,·elltmenf. - Cal'efully "a h aJ] the yitriol 10 .1bl.C frolll the 'kin, hy t:;q lH.'eZillO' a sponge dipped ill tepId \\'atcr to ,,·11ic11 "01110 wa hing or baking cla has added, the watcr to r1m gentl)' OYer the 111J nrecl part, then treat a.. an ordinary burn.

BlTEH OF .bDrAL.'

Hydrophobia is cau,' d by the bite of an animal . ufferillg from rabie.'. e'-eral anima].." ' nch a ' dogl', cnts, £oxe,', deer, &c., llecome rabid. The poi on is contain cd in the animal' 'aliya and may he 'om'eyed Oll the teeth beneath the ki;l and K 2

130

thU:i into the ])100c1 of human 'When the 1 'tc it) tbro\t",h the clothing ther' le.·s danO'er of the sa.liya. it:; \rip ccl. o Ii' Lho tee,th N l ?'

tIlL: clothing. It is thcrefore by way of .the pilXts (the lU1,nc1' and facc) that the p 1 'o n n eute rs the bocly.

Tn:atm,ent.-In of i\. bite 1)." ,1, dog or oth?r

. . . 1 do llut lo 'c time in the attempt to a '(;Crtalll ,llllln,1, , b' b d ,,'!lether the anim·\.l hi\" or htL's not !'it 10, ut proGce

. l'lt"ly" follows '-( 1) Preyellt thc YCnOll.' blooel lllUllCC I i '- '".

It'l)lll carrying the p t.hrongh the body .hy (lictteh' plcwing <1, cOllstndwn betwcCl: thc .\\ a,n.1 til(: Supp a 'e, for ox."\.mplc, a l.::! Inttell, :t ::.It,mld 1)0 <.:n(;irdec1 iLhovo the t)cat or tlte (th),tL \j

Oil lte of the wound the le,.U't " '1· 1 che Illl'e-h'lger ilnel thlll1l1J. A ',u0ll aH po '.'lll10 pitt,: !..! l li""LtLll'!..! (tha.t is, iL 'tring, '1, PlO(; O of tape a ,'tIll>, of llC1.nc1ker(;hief, ctc.) tiu'htly round tho ,root 01 the fino'or; (10 not ceasc tu com pre 'H wlth .the TIn,yet' thumb until the ligatnre h 1l,,' 1>een npphctl. (3)'" Suck the yigorou 'ly, lips 1lre ::lOllml, :::;Plttlllg out the "ethv,\.) (l.r (3) \\ ,u,h \mLcr (W<1,nn ,\'c1,ter l)y a,s 1t llleccling). (4) AH 'oo n c1. po:::;sllJle the wOll1?cl [:)honl<l

110 hy 1t fluid can -tic, :neh.a' (;,LllsLIC pota 'lI, pun, ca.r1Jolic acid, eitriu acid, or If <l.rc not 1 'Lll!l. uy a. rcel-hot wire, fll.'ee, It l' not (;<'llt to apply a solid cam;tlC, :::iuch a hUh\.l

U1.1l::; tic, to the wound; it rloe. not 1'('a<.:11 all:,' deeper than the .'kill, and the poi.'nn i:-, at th .. bottom of tbe wound, To C11.'l11'e the cau:-til' l'l'nchI1g the ,of the wOllnrl apply it (JJl a pICce of wood, .'11(;h n, a \\ oodeu Illatclt ('ttL Lo a poillt. (5) Dl'C, , the \\01111(1. awl ",hl>ll it l' in Lhe upp er extremity .'ling' the ann. (G) Trl>: hoek, if it o(;eul'::;, , X.A.l\:E BrTE.

The loi ,o ll of the ,nake is CllJlYL'Yl'd t'nllil Lv p()ison gTnncl along n l'll,llll1el in the .... fan!.!", that when a snak hite:::; the .cl'l'etion i COli \'cvul b"llcath the t>kin along the he,l1()\\ ill the' f;tIl).:" :'1]]<1 lhu,' gain .. direct Cll(.l'itll(;e tn the ll1()od. frnd , (!llJIpto}J/ ...:.- 'Within ct fc\\ IJlinlltes aftll hClllg lJitten the pnl't will swell and fed ..;titf: patiellt palc anel faillt; ,lllel if till' :O-l'rpe]]t i" (I1\(' of the hig1tl,\' :::;peci the tl'l,i]) ( f \']t1pt()II ]" \\ill it, rollo\\s: hll1'riecll)l'L'ctthiIJ!.!', quid, Pll:'''('' mel! tal excitclllell t, COIl\'ul. 'iom;, <lnd lili t \ . !r (!a tm enf.- Tic. a ligature (n striug', ]c<1thl.l: . trap, st1'lP of handken;lllef bnwe, ete .) at one(' l)l't\\ l'l' ll the \\ nlllld ,mrl the heart, so a to o],.-t1'\1(;t tIll vl'in ' le;t(lillg froUl the :::ient of the bite. T\\o ()l' thrL'e ,.llch lign.tt:l'c,' he nppliccl nt lip he 11Illb tIghtly (.\\"It>ted (tourniquet). Apply a fluid canstlC .'nch tV <':llllt>tiC purc earhoJi(' al'iel , or allY ;tcid Oil a pointed pieee uf wood, hllmi 19

132

decply '0 a to destr oy t h e p oison at t 1lC hottom of the wound . Wh en t h e ca;n. t ic h fts h een thorou()'hly appli ed, bu t not t ill t h ell, t h e ligatur cs mn.t' be r emoyed . Su cking the vwund is n ot with out c1ano'er hut if no can ,tic is at h and . llckiuo' lllH .' t co employed, the 'ali"nt being immediat ly :-;pat out and the mouth wa hed out with water or 'pirit" anel watl'1', and the wound may be burned " ' itll a fn. 'ec or in any other ayailable manner . Shock is to he treaterl in' the usual ,yay, and 'pirit of sa l volati le (a tea'poonful i n a winegla of water), or I'pirit. (\\ hiky or hrandy) , a r e to be freely aclministered . Bees , Wasps , Centipedes , Scorpions , Tarantulas, Spiders , ] e11y-Fish , HarvestBugs , etc ., may each give xise to severe '.rluptoms, ,tttended b:- actual dangep to life in Home imitance ' . Remoye the sting by squeezing the part, or by p res:m r e wit h the 1xtrrel of a key ,,·hen that i.' pos. ible . mop the p a r t freely witIl li q ammoniu, ' pi1'i t. ' of wine, or b r andy, whisky, etc. ; if t h e. e are not at hand, the application of the b lue-b ag, or ,trong solution,.; of em'bonate of soda or po t ash , " 'ill relieve pain; a p aste of bicR.rbonate of od a and sp irits of .. n,l volatile i ' an efficien t a pplicatio n. T he pa.tient'.' strength must be sup po r ted by t h e fr ee administration of alcohol or :al volatile. A t h e harvest-bug burie: i t 'e1£ ben eath the skin, i t is neee sar y to have the insect r emoved by a docto r.

135

CHAPTER V.

T HE HE PIRATOHY Y

'l'IIE air rea<.:hcs the luugf:l hy way of the nostril::; (or the mouth), the ph;u':' nx, the l<tryux, the trachea, alld the iJrUll(.: hial lnbe .

The Pharynx i ' the :pace at the lm.L:k of Lh e throat and no, 0, partly Heen l>ehind the Lon . il whcn tlte mouth i.' opelled widely; the pharynx pn.:-.:-.;tg'e to fooel n.nel ai r .

. The Larynx (the yoi ec-box, Adam's appl e) is s,ltuat ecl on the top of th e \\ illd-pipe ill the middle l ll\e of lleck: it i ' compos ed 01 cartilage (gri.'tle) and contams the yocal cords and the mw,de:-; COilterm'r l in the procludioll of th e \'oiue.

The . Trachea, or \\inrIpipc, i.. composed of :trips of carl1l.H{e 110l111d tog e ther hI' ela:-.tit: and fil)],(Hl . t i no"",, . 0 it.' tn form an tul)e; it extends frollt the bryu\. to two belo\\' the top of the In'L'a t -1JOue, \\herc it cliyic1 l' s into the rio'ht and left Ill'Ull Clli;t1 tulles. Eauh JJl'OllChu when it th e h lll!.!; di \'iele,' into , lllall and sLill 'maIler blhe unti l the ul timate rCC l'1i e1'i of the lung-th e ail' cells' or ail' space ' -are re itl' he (l.

Lungs , Hight anc1 Left, occupy the gr eater part of th e thoril\. : th ey li e imlllediat elnYithin th e rih:-.

HIlLI pract.icnll,\· \\ hCl'.en:' r a rib i ' felt, whether front; 1>:tl'k 01' sldL'S, thero 1!'J a portion of the lung beneath.

134

F w. 5 4. T UE L UNGS j ND B RO')'CJ[JAL TUBE<::

A. Trachea, or W ind-p ipe. B. Left Bronchu<:!. C. R je;ht. Bron ch us . D. Bronchia l Tu bes .

]37

Ea ,11 luug i, ' em eloped in a nue lllcmhmnc (thc )lI Pllt'l l ) "hiu h aUo \\ ,' it to lllO\' <': wit h in the (;hcst ell r in g l)l'C;1,t h ing \\'ithollt f1'idion.

T he Air elltcro..; tlw chc,t dnring Inspi ra i on, 111 )1 1 lcn,ycs it (lul'il1g Expiration. The IIlO\'Clll llts \ f

In'cnthillg caw-,eel pal' ly l,y the mn de.' of r C Sp l ] ,Lion attached to the 'lll;o..;t, lJllt dlicfh- 1,\, tll ' D ' 2phra g m the lill'g'C lllOyalJle ilHJ'titi oll \\ I ·11

'l'pnratc:-. the tllU1'1tX from the allClollwlI.

HC'ipimtioll C()ll it-; of two act, in s pir atIO n , (1 ]( 1 e x pi r ation . The procc ,,,' uf in:-,pil'i,tiull L chidl y 11 lllll:-'Clllal' aut: l'"Xpir'ltioll il'l \'\ lloll,\' lllc(;halll c. tl. 111 ill 'pimtioll the rill ' are rai ,cd by Illllclc:-; attach l d to thcm : ,w(l nlo the diaphragm , "hich in n sta e i:-,; COll\ x (Ol' L'lll'\ cd) l.Ip\\anb, l,ecIllll('.' n att (' lll'd , tllll il1(!l'ct"villg' the capacity of the thurax, and tbe ai r jill\\, ' ill. In expiratioll thc rih-; fall, and thl' d iilphl';1g'1I1 l)Ct;Olllel'l (!uuyex np" anb: tlli . le.., .... L Jh lhe capaciiy of the UH ,r<1X and forte. ' the ail' out . Th e lIlL'chani. lU of l'L'spimtioll i::i smUl'\\ hat like that o f (l)'(lill<ll'Y hum;el)()ld lmt witllOnt it \'ah' e. The J'i i> ' Ill,{y 1)0 tOlllpal'ed to till' l)uurc1. of th e l )c llo ' -<, while t h e (li'lphrnglll ClllTCSPOllcl:-; to the leather, tIll,; lll' I,eiu::.:· etjlliy tleut to the lloalL'. Fit'k c ll 'ig h tL'cn nrc takell pe r mjnute ill hC<llth . O ldrllctiol1 to hrcat hi llg WhCll L'Oluplctc, call. cs a ph)'xin, cxamples of which arc nr[(lrc1l'd in caes )1 d r owning, ' ufiot:<ltion, ch ok ing, ctc,

136

ARTIFICIAL RE PJRATION.

D1 ·. Sylveste1"s jJIethod.

RULE I. -A cVu t the patient's the patient on his back on a fiat surface if pos ible from the feet np\yard '. Remove all tight

FIG. 55.

cl othino' froID about the neck and che t, a.nd hare the front of the body a.s far as the pit of the stomach; unfasten the braces and the top button of ti'ou, ers in men and the corset,' in women. Rai e and ,'upport the' .'honlc1er. on a. small firm clvhion or folded article of dres. ' placed under the. houlder-hlades.

RULE II.-l1Iaintain a (ree-entrance of air into the

139

winr7Jnpe ....-Clean e the lip' and no. trill:;; open ana \ripe the mouth; draw forward the patient'::; tongue a. far as po.'sil)le, and keep it forward either by getting some one to h old it with a. handkerchief or piec.;e of cloth, 0)' 1):, p,v ·jllg n naITO\\", slightly twi 'ted Htrip of handkerchi f, n tring, or tape, oyer the tongue, a.' far lxlCk n.s the angle.' of the month" ill allow; l11'ing the ends uncler the 10'\'er jaw and tic them .e<.:ure1y. The ends may be again fa tened on the top of the hea.(1 to preyent . lipping. An cIa. tic hand lllay he usefl in tead of the trip of handkerchief, ctc.

RULE III.-I-mitrde the )J/Ovementfl of breathing.

Fir. ·t: Indu('e at a conyenient cli .. tanc;c hchind the patient' , head, o-msp the forearm .. ju.'t helow the eIl,o,,-; draw the ann .. upwards, outward.. and you, with a 1:;\\ ecping: moYcll1ent, making the elbow' a.lmo t touch the gronncl on cither .'iele of the patient' hea.d, or thc forearm ' oyer the top of the head. By this lUC<"ll1,' tllC cayity of the che t i ' cnlarg'cd, and ail' i · drawn into th "-

Secondly: Inr7'l.tce e.llJiratio71.-Bring the patient', fic'x.cd ann,' .. lowly forwal'll, elm\ llwnrcIH and in \Yard, prl'H' the arm.' elbow.' firmly again·t the hody \\ ith the clhO\\",' Homc fom 01' £lyc in<.:hcs from the ee also Drowning, pages 143 and 144.

138

140

1)j'cast hOlle (,' co Fig. ,)6). By mcnu" ;\11' I.' expell ,c1 from tho lungs.

Thirdly: Repcat IllOYCmcnts, altL' 1'l1atl'ly, {lolibcrt"Ltoly, and PCl'HcYcringly (l,t the rate (If ahlllt fifteen times a. minute. C'outinHc until SPOl1t , I)1L'On" hrcatbing j:-; 0 tcl.hli"hoc1, or un til il, c1odOl 'UTj \", S.

FIG. 56. EXPIRATIOX.

"Yhon spontaneom, hreathing comlllcncl':->, l'cgllbtL, the '1.rtifici::t.l l'ebpiratioll to witl) tIll' lliltl1J'al <>fi()]-t. Hopes of re:-;tOl'ing' rhe paticllt lllay Ill' l'ntert :-L]])ccl ovon aftcr t\\'o hOllrs' time.

ltULE rY.-E.{·cite alH1Yt'

Hloasure' ::t.re hoing taken, othor ll:->efnl may 1.(' el1lp]oyecl, NlWh <IlS <lp]11)'i11g lSlll(.:llillg' "all .. OJ' "llllff

t, ) tIl l' l}I)trib, Hnd eLl, hint!.' hot and l'01(1 wate , altl'l'1l<ltcly en'er tlte heac1 'lllel neck. l:ur .E \'.-lnt111ce I'trculation ;llld \\'i\l'lUtil after natmill hreathing' has he en ro::;tored. th e IMticll t ill dly blankets ()l' otllel' loYering, alHl rnl) tile limh- l'lll!ro·ctically tm\ arc.ls tho heilrt. Promote wannUI 1)\' llOt Halll{el", 11Ot-\\ ater bottleH, or hricks (\\ ill tt.tllllel) applied to the feet, to th· limhs awl hOlly . ,Yltcll thc POW ' 1' of :-;"'illlo\\ill!.( hn s rl'tlu'!\L,d \ ' e of hot t ea 01' coffee, , )1' of ",iuL', llJ'clllrly and ,,'ator, etc. The patient ..hould he kept in hl'(l aud ellconl'ag'cd to go to sleep. Lurg'i' plJllltiL'L'" or fOlllcntatioll.' applicd to the front a nd hlL'k of the dlcst \\ ill ,ern.: tll lJl'cathillg.

Watc:h the pationt carefully for ,. 01llO time to S C "' that till' hreathing cluc.' llot fail; honlc! Hllyig·ll o f faillll'l' appear, aL Ollec lJeg·ill artin c: ial rL' ·piratiol1. llJdhorl.-This method is e, po<.;ialh- ,Ippltcal1ll' tu caL'S ",hOll the paticnt ':-; :Inn i ' hroken 1Jl'al with tlte <.tIllI etc., :1S ele. crihul Illllkr lite ::;d\"l\,tcr uwtlwtl.

Tlll'll til(" paticnt on tit, h' lek. Pl1lco a roll of dolltillg' hC11eath the hody, ,n as to rai ·0 thc Ol tilL' ld)oYe the lcnl of <\,11)' other pnrt of the Pbce the paticnt'· hand' alJoye hi, hear!. Knl!L'l a ·tril1c the hip ' , and \\·ith thc hall' or the t!lIllllh:, rc'ling on either .. ide of the pit of thL' stOltl:lclt, leL the finger gntp the adj'll:cut part or

142

the che t. Now, using the knee, as a pivot, throw all your weiaht forward on your hanel,', and at the .'ame time the wai t between them n, if yon wished to force everything in the chest np\yanl toward the mouth; deepen the pres.'ure while yon can count 'lowly 1, 3; then suddenly let with a final pu 'h, \\ hich 'pring you back to Y011r iir t kneelin o' position. Remain erect on your yhile you count 1 2, 3. Then repeat the sam \ motions as before, at t"\, rate gradually increased from 4 or 5 to 15 times in a minnte, and continue the movement· with reo·ularity. Induce circulation und warlllth in the de ' criLecl unclcr Rule Y., Sylve ·ter's method.

\Vhen a ufticiellt number of a . si tant .. are prct-.cnt, Howard'::, and Syhester" method' lllay be comlJine(l, the prei",'nre on the chest being made simuHaneon .. ly.

When from anT ean. e, as fntcturecl rik, neither of the above methods can be carried ont, LaUDl'de's method of artificial l·espiration. . honld be trietl. It is especially useful in suffocated It i,' earried out as follow :-The pa.tient i placed on his back; the month cleared; the tongne i ,'eized u,'ing ..1, handkerchief or something to prevent it slipping from the fingers-the lower jaw depres. ed; the tongue is pulled forward and held for two .'econd· ill that position, then allowed to recede into the month. These movements should be repeatcd abollt fiftecn

143

time .. n minute. fter treatment is the . Utile a ' III 'ylve ter's and Howard's method..

To RE TORE TIlE ApPARE);TLY

Per.. on. completely illlDler.'ed in water for even tell or fifteen minute.. have been restored hy <'tl'tifi<..:in1 lllean . . If, therefore, the hody i· \\'ithin ,l I'ca.onalJle time, ah";ell') of 'ign ' of life i.. not to deter immcdiate attempt · to rc ,·tore animation. Jho\\'ning p'l',·on .. attempt to 1lrenthc whil t 'ublllel'gcd, and, in <..:onscqucn<.:l', watcr i' inhaled into their air and they be<.;ome a phyxiated and insell.·illlc. Thc fir .. t thing to do when the lJocly is reeoyered to get riel of the water and froth ing the air l)i\'s.. and then to artin<..:inlly re tore hrent hing. Thi i ' he ·t accompli hed by loo. euing the dothing amI opclling the month, and clearing' lloth it 11.))(1 the bn.<.:k of the throat. '1'he patient .. houlcl thcn be tnrned face with a pad helo\\' the che ·t and with the forehead upon the right f(;7'en1'1n. ,Yhil ·t ill thi .. pOt-3ition apply pre nre hy thc hand' to the ba<.:k oyer thc lowcr ribs, and keep the .. ure lip for thrce f.;e(.'on(1 ' . Turn the paticnt on the rit"ht sicle, maintaining' th,\.t po 'itioll abo for three .. e<.:olld ... H.epcat the,'e moyemcnt.' alternately, a ' long a froth aud \\ ater issue from the month. The e opcration::i in them ·clye.. tcnd to promote l'espinltiol1, hut it i.. Il::inal, whcn the air pa.. 'age " are clear of froth

a11(l water, to adopt SylYc::;ter\; or one of thc oLhe1ltlethods of artifiL:ial l'e::;pirn,tioll already c1e,'crihed, 'W hile porforming the '0 opera,tiolls ::;elld someonc to the neare ' t hou '0 to procure blankct::; and dry cloth lng, Iv)t-water bottlc.', ok., and to fctdl doctor, TRAKGULATIOX.

Owing to COil tridion of the 'rinc1pipc by a co]'(l, l\, l'dpC, or tightencd necktie, etc., round tho ne(;1\., the llL\_ atlling mel,y he arresLed anc1 a phyxia. enused. the (;on -tricting banel and comUetll'O a rtificlnl 1'0_ -pi ration.

CIIOKIXG.

,rhell <l foreign hody, as a coin or piece of ment 1 trnd the air p<ls.'age, 'uffo(;atioll may ell ' ue. T), patment.-Open the mouth, £or(;ih]y if Ill'ecl hc; pas. the forefinger righL to the lJtlCk I)f the throat anel a tempt to di::;lodge thc ohtl'llcting hody; if yomit results from thi::; ·tep .'0 much l)ctter. [f' Utl.'ll(;ce::;::;flll, thump the hade harcl between the' :-; 101llclcl" whilst the head i hent forward. " Thell thl' foreign body is l'emoYecl, lmt In'eatbing i:::; su 'pcnclcc1, emmnClwe artifieial respiration.

HANGING.

'p the lower limhs and raise the body to t d\.c tCl1'ion off' the rope. Cut the ropo, free tho nock, <:I tel couunen(:c artifieial re"piratioll.

14.1

• 'UFFOCA'I'lOX BY • ':\[()f\E (lit CASE

the patient illto the 1'1'e1'l1 air, loosen <.:ioLile.', and flip Lhe hare (;he.'t 'with it Lowel, "et "ith (;old water, for l.3ocond · . [f this fail. to Ie, toro

hl'e,tthing apply artificial rebpiration_ Before enterit full of smoke, tie '\ handkerchief, wet, If po . 1h]e, r01111cl the hC,ld, coyc'riu<Y the no '0 and IllOutll It. i.' WQll to slowly, koepil1t! low, or nell cra,,]mg, "\,luLt Jll a rooUl full of in .'em:eh a 1)er:-;011 . EYer}, opportunity of lettl11g 1Il fresh Hlr 1J)' op ning- door ' or ,,-indo,, -,; should be iicizccl.

BY YERY HOT '\ "ATEB.

Thi ' a(;cic1ent not infreCjuently ucenrs to childrell attempting to (ll-illk from the , pont of a kettle.

TJ'eatmrnt. - .Apply n . pOllgC or tianllcl (or other) cloth, wrung ont of very hot ,,-atcr, to the front of lhl' lled., from the chin to the t op of th brea t -hOlll" ilnd set the patient before the tirc. Giye ive to :mdif j l call be bad, or if not, cold wate l'. OliYe or ;' alad (IiI, n cle.... ert- ' poonfnl at a tim e, wi1l sooth e tho throat and tend to en e th e pain.

144

1+6

CUAPTER VI.

POI ON " ANI) POISONING.

WHEN a person lut.' tel ken poison, the ,'udden Oll'et of symptoms, appearance soon after having taken food or drmk, or after havinO' wallowed substance inadvertently, may bc fir t intimation of the danger.

SmDIARY OF SDlI'LE DfRECTION. FOR TilE l'nEAT]IE '1' OF POISOXING.

Send for a doctor at once , stating what has occurred .

When the patient is not insensible , give ;_

1. Milk. -It i. ' afe to {J'iyc copioml (,lrcnlO'ht:-; of milk. Milk, when \\ clot , or a1\d Lll . 0 J e pOlson may he thereby enelo. ed in tho mil],; -lot and the whole got rid of hy an emetic. \'Oc1.111 aud flour beaten up togetllCl' lllCl\' ho giYCll Ho' \\ell <l 0)' in tead of tho milk, "

2. Eggs. -Beat up ,L couple of nt\\' cgg:-; \\ itlt mi l k or water. The raw cut>' Hot::; or co,WUlntCH ill the stomach, and as in thc of milk il1cltl(lc nIL poison in the clot, .

3. Oils ,-GiYe 1-ievcml ,' pooufuls of ulin" 1"Ial:td, OJ' linseerl oils. ,Any yegetnHe or anilllal oil, as that in which wmlmo-.; .}''0 Iresen-eel or cod Ii \ 1 r ()il, may bc giYcn. .rJilloral oil:-; are not ' llifnl1ll, Till' ]47

oil soothf'. the . urfacc already inju r ed by the pnibon, l1.nd proLects th uninjurccl part. ' of thc ,-toll-weh or gullet. Oil is not to be ",hen ph o 'phorub i::; the ca:u. e of the poisoning,

--t. tC'H (n handful thrown into the kettle and uoilcc1) aet:-; :\ ,' a neutrali 'er of lllHny poi on ,mel i.' nlway .' .'nfl',

5. An an emetic, e.J·cept 1J,hen it is seen that the lip' alld ilWlfth al'e stained or bumed (by acids 0)' alkalies). TI,e t'llletic lllay be :-(a) a de ert'poonfnl of nHl.'tiucl in a tllUlblrriul of luke-warm water' (b) of &'tlt in a tmnblcl'ful of luk c-w<'tnu \VlLt '1' ,: (c) for a. young child a tea"poollful of ipecacu,mlm wine, l'npea tcd twice at intonal . of 15 minutcH, may h' instead' Cel) the or ,l, feather pas:-;ed to the hack of the throat llnd mOYed (tboui llU1Y ' CrYe to lln}();ul thc 't omach. The Cllletic may be trh' en fir.' t, or afier OlIe or more of the nhoyo l'cn;eclie ' ll<l.'\'c hl'en :lChllini ,' terc(1.

6. If an acid i. kllO\rn Lo haye b en , \\ aHo\\ ccl, giyc an alkali at 011CO ; and xhoulcl an alkali hit\ c been the poi . on, give all n -id,

7. Treat for Shock whell it occur',

In a11 cases, any vomited matter and food , or other substance suspected of being the poison , should be preserved . T ,)

B ROAD F ACT \ VORTHY OF ANCE.

When a person has swallowed a ,Poison and threatens to go to sleep , keep him awake.

When there are no stains about the mouth give an emetic, also milk , eggs , oils ( except in phosphorus poisonin g ), and end up with strong tea .

When there are stains about the give milk, eggs and oils , but no emetic .

PO I SON ARR T(;E D AUCORDL."G TO T HEIl{ .L CTION.

- A [{COTlC:-..

Opium, or one of tilt' llh,t<tllCC.: it, ueh a::; }'l orphia, or :-:lome OllC of Its prcpamllOlh, a ' LaudaulUu, 01' Paregoric, orome of Lhe popular r ell1ec1ies, such as Chlorml,\'lil', of pOpPll'K, allll y,triou::; soothing . yrup:-; ancl corchnl.., all th e poi,'onou nareotie pn)l)l·l'tic:-. a:-'ol'l,ttec1 \nth tllL' namc of opium . ,'!JlIlp t oms.-Tendelll,;), to go to 'leep, which C011tinue . to increa 'e until -leep he(:olllcs tleep and h r catltin!; 'tertorou ' . Finally, it lllil)' ue illl}JOl:;::;iLle th c pa.tient, and dcath imminent. The pnptl.., .m.'

149

<..:o n tmute d to the lltmo:-.t exten t (pin- p oint p npiL ) ; t h ey d o not re . p ond to Ji!-,:hr. Th e fac e pale, the :-;kin clammy, a ll d a sm ell like t hat of POPEyhcarh; may be detected ill t h e b r at h. ' :"

T reatment. - Ui \'e an em etic and k ep the patient ·a wnke . Never gi\ l' an ('meti<.: when t h e patient i.. in ensible. Keep the patie))t awake by walkinu him about , lapping hi . f,\ee clud neck or chet with a wet towel, and by giying trOll!; black coffee to drink . , 'lapping the solc:-; of the fed· with a ,'lip per may be tried w11 n otlll'l' mC;111t-. of 1'01.1 ing fail. Employ respiration if the hreathi ng ha cea 'cd.

t'OIlHO I\,E·.

Acids and Alkalies are the chief example of t h i ' .1a. of poi 011,'.

Acids .-The ;H.: id · 1110 t commonly tak n as poi '011:-; are, (the aIts of lemon alt . o f Cclrbolic: ,'ulphnric (oil of "itrol ): Ni r i<.: (n.qna forti ,' ): Hyc1l'ol'hlori<.: or (. pirit I:,)f al t) .

! ymptomg.-Blll'l1illg paill:-; in t h e mouth, throat, nnd stomach: acid t a.' te: , taining of the lip. and lIlonth of a whlte Yl,lltHY or dark-browu colour' retc h ing and :-.hock; CAhan tiOll anel (.'u ll ap e, or .. nffocatiull. \Yhen the poi on i ' carholic ;.teicl t h e Hmell of thL' k'eath help' to di -clo.e the fm·t.

T,·eaf1nent .-Fir t wa,::;h the' 1lI01ith out freely with lime ,Yater or other a lkaline mixture, such a' "ehalk, wh iting, magnesia, or wall piaster, in water, m ilk, or oliyc oil, and afterwar ds let thc patient sip some of it. Demulcen t drink' harley \\ a.ter, milk, ete., may be giv-en sub efluent ly, and beaten up with water or mille Trea,t shock.

Alkalies .-Oaustic Potash , Oaustic oda, quick L ime, and tl'ong Ammonia are the principal eXHlllple of a l kaline corrosive. 'rhe." cau .'e ,ymptom r esembling t h ose set up by acid::), 'md it i1) only by s eing the bottle label that ull1)killecl persons call lie sm'e of distinguishing letwel'n ne ifl and n.lkaliIIL' poi 'on '.

T? ·efltlllent . - "Wash the 1ll0uLh out with an aeid mixture, at; l<?mon j uice or Yinugar, diluted \\'ith an equal quantity of water. Afterwardt; gin' milk, olive, 'alad, linl:ieed, or cod liver oil, or egg' beaten up in wa tel' or milk. Treat shock. Do not give an emetic when the lips and mouth are seen to be stained by a corrosive fluid, whether acid or alkalin e, as vomiting is likely to further injure the corroded surface s of the stomach, etc .

IRRITA '1' (METALLIC POI ON ).

The chief substances contained in thi ' group are; - Ar'enic( F owl er'ssoll1ti on); MN'cury (corro iyesub-

lilllaLe): .\lltil1lony (buttcr (If antimony, ellle.tic); L(',\d (nQ:ar of len,d); 'opper (":erchgn.'); SllYer (lunar cau::;tit;): (rat pov()n,

, 'yl/1jJtoms.-A l>urnillg pilin ill throat aL t he pit of the .. tolllU.ch: a 1tletn.lhc ta'ie.' III the 1I10llllt; retehing and Yomitin!! lind u:rcat dread and aletrm. The appearance of the Yomit, .. nch as the culour in poisoning 1),Y topper, alld the. fet.·t tllilt pho. phoru. glow. ill the dark, lll<ly :1.:81 ,t III

tlL'lClI:lining the poi ' 011 takell.

'/'1'1'(Y{lIlent.-A ' ibt the hy an L'IIIl'til'. After or hefore it Jm . ade(l giY n couple of llCC'tten up in water or milk, or if the:- are ll?t ill hilnd gi\ e plain lllilk :-;tr()llg t ea, and, xee]Jt 111 tll(' n l:-iL' of phosphoru:, olive or salad . , . J':pL'eial1y after poi 'oning 11." H1ctalhc lrntant It is lIL'C ·.... to t;oulllcmcL 1), ' prompt trcatment the rlepl'l'"ing·illHuenee., of hOl·1\:. , .

O ther d ea dl y poisons lire. tl',YChnlllC, PrUlj, Ie .\cid, Cyanide of Pota Belladonna (dead1:' l)hmt) lJio'itali (ff)x-bo'love), Hcnl)ane, o ' 0 f . Ilel1llock, and seyentl Yill'ieties rlf plant.. , a ' ungI (often mi ·taken for mn ' hroom) , blmnmm 'ceel mOil k 'hooel, etc

.....'IIIII1't07l1 ·.-Eat;h of thebe lloi, (Ill ' ha . it.' o\\'n :-\\,1II pt01l1 ' . O1lYul 'ion ' and eyeral llel'YOn tom-, appear early in mo t, <lnll are the most pronullC.'llt l'\ iueut;c of the poison haying been taken. .

150

151

Tl'eatlJl,ent.- ...\.dmini. tel' all emetic before eonntlion or inbensibilit\" come on . and when ce. hation (If breathing threaten:-:' ,\pply artificial re.·piration.

GE ,-EH AL XOTE.

:Jlany hc1.\'8 n. double action, anrl tcchnically might be grouped under more th,Ul Ol1e of the hc'1.dgiven. The rule in decLling with a. poison ur thi:-complex nature i:::; to note the train of ymptolll"';, <lnd to treat the patient, itS the ymptom' <tl'i:-;e, Hccording to the general direetion given 011 page .. Ill) to I-tH.

153 ( ' IlAPTER \ -I1.

OP PErrAL ORU .. \.X. '.

TIIE EYE.

The. eyelid' 1ll0\:e llpOll the eyeball, llloi:stelling awl the hlll'faee; and when closed the cnli<l-.; pre\'cllt foreign bodie. injuring- the l'yeball. \ ItlUCOU.' mcmhmnc co\'cr;-; the ill 'ide of the 'c\'cliJs and the surface of the globe of the O\·C, and it'i.' OIl this me III brane tbn L foreign 1JOdie.' col ie<..:t.

BODY fK TUE EYE.

Treatment.-Preyellt the paticnt rubhil1O' the l':yL" Lyillg a child'::; hand:-; dowll if llcce ,ary. Pllll clO\\"l1 hc lower \\'hell if the foreign' body i:-- "Ll'Il , It can he readI1.\' ]'cJllcwcrl with camel'.' hail' 1,1'1hh, or the corner or n hand kcn;hicf twirled up alld wctted.

\Vhen the foreign body i::; beneath the upper eyclid:(l) :.-l'a 'P the upper eyelid between the fin'a er awl thumb ancllift it forward from off the eyeball; then pwh up the !owel' c ' elid beneath the upper, and let go. The hmr of the lower lid brlll:lhv the inllCl' :-,urface of the upper lid and lllelY di 'loelo' the hOth . . 'honld it single not he It two or three If llcceK, arv. If the fnrvi"'IJ hod, i.. not cli;-;lorlgecl, 'all the ,'Cl';'j(;C' of it dodo}' 0011 ,t,' po.. TT7/fn , howev er, !:!ki/ted lf/ll'

152

cannot ve had, a on ooard "hip. or e1.'ewhere, pro(;ccd as follow to examine the inside of Lhe upper eyelid :Seat the patient so a' to fate the light; -tand behind the patient, teadying the lmHl again ,t the che. ' t· pLu.!e n tooth-pick, wooden mateh, knitting needle, 01' any l11llTOW, firm rod, on the upper lid of the injnred eye half an inch aboye the edge, it oaek\mnt- a, hI' a,,' possible. TOW. eize the upper-lid eycla. 1,etween the finger and thUlull, audpllll thelll llpwnrcl::oyer the rod. 'rhe eyelid will lIe l'Yerted, Hnd thl' foreign body, if it iH then" can l)e readily :-;een nncl rcmoyed. (3) , Yhen a piece of .' ted i' embedded ill the cycbn 11, drop a, little oli \ ' e or e<1..'tor oil Oll the hall after pulling down thl' lowcr eyelid, the htb, a soft pad of cotton wool Oll the liel, and l')eC111'(.' 11." a bandage tied sullieiently firmly to ],eep the eyellltll -teady, and take the patient to n doctor.

FOREIGN BODY IX

TIlE EAR I>A t:lAGE,

When a doctor can be held, l'n:ll \\ ithill b\ enty-four hours, lleyer attempt to treat a patient with a foreign hody in the car, A pea ill the mr i. ' ,l ::;erioll:-' lu.: (;ident, and any attempts at remoyal mny lead to fatal con 'equences . If the :patient, n ehild e.'pl'cinlly, canllot be induced to keep the finger.' frtnn the cnr tie the down, or covel' up the cars tying a ha.ndkerchief round the head amI oyor the ear:-;, Ir all insect i' in the ear-patil'age, fin the ear with oliyo

155

nil, \\ Ilell the lll.'ec;i, will float: alld lllay Ill' removed ,;.; l'yer _'."ringe or prol)e the car.

FOREl(; , BODY IN THE I Y O. E. Il1clu(;e the paLient to 110\\ the llOI')C Yio]ently' gi\l'

a pilleh of nuff or pepper to the unaffcded no 'tril , () to inc1uec neezing. • 'nilling up water or '>.'Tlllf!'ing out the no.. tril with water may effect Th re i ' no imlllcdiate danger from a hocly, Set:; a shirt hUttOll, in the 110.' e .

THE C'nEHT ('l'IlOr..'. )

'l'ltl' thonl.x j. 'o01.lndl'cl in frout 1. ' " brcct ,t -1Jone ( ' tenllllll), and th rib cartilage. 1 hillel by the \ l'rtl'hm.l columll (the 12 c1nnml Yl'l'telme) , and on l'lLllel'i(lc by the l:ib... Aboyl', the thorax i.. l)ounded hy the stl'udurc.' at the root of the ncck; and belo,,', h.\· tile dinphntgm (midriff), the llloynl11e mu 'cular partitIOll \\ hich the the.'t nnc1 n lJ<10111 u.

TilE ORGANS OF 'l' IlE eHE T (THORAX) .

'l'lll' hcart and lung' oceupy the eho,t. The posi tiOl1 anel tructure of the Heart i.. de 'uribcd with tllc of the circulation ( ' ce pag' 69).

\ rUllllC.l of the heart arc w·mallv ill ' tallt:'l1eOU Iv fatnl. v.

The Lungs Ot(;UP." the -heHt-front, back, and :-.icle". They are del')eribec1 undl'I" thc He 'piratory '.'-:-.tClll (sec llagc 135) .

154

OF THE LUNG.

\Yhcll n rib i broken, and thc ends elri\'cll the plennt etnel lung eU'C npt to be torn . , '1'he-:e ol'g:nu..; may nlso be injur d hy a .'tnb with, a kmfc, t-i,111etto,o)'

h1 penetrating 'lihe ,rIb ' . A nfie tnwcl"C the \\'oundmg thc lUllg III I t:-\ pnsKag8, , . ' . .' /0.. i!:ns and of brcathmg, mpto m.' of colh"pse, faintnes:-;, sp1ttmg- of hlood (rcel illl,c1 froth.,. ' ), usually inclic{\,te injury to ,thc lung, ',\11' Ille"".)' J escape beneath thc .. kin or lllt() the l:,1 \"l ty {)f tl1c chc!-'t. Iutcrlletl bcclllorrhagc m;".Y rc:mlt, the '!lInd aceumuh"ting in thc cll,\'ity of the .cnn.. in o· pallor, .. lo\nw.':-; of hreath, blnH lc1 YI!-'Hm, feehle 1ml 'c, sighing, yn,\\'lling, clelirium, nne1 faintllc:-\:-\, -tt'Oillll' on to nncon.. cio u'me:-;:-;, pntient down with thL' he,tel 10\\', give ice to n.pp1:' icc over thc injul'cc1 p;lrt, keep ' the room cool frcc Ycntihtioll, tnl'11, the pa.tiCllt towards the injurc(l side . D? tIe il hanelagc round the chcl-;t \\ h Cll the lung 11-; lllJIll' Id ,n hroken rib, a' thcr is danger of til rough cnd 01 the fntcture Celll:->ing further clamnge to the lIllig'. ,' honld the injury he accompnnie(l by n, 'urfncl' \\ om ld, ;.l pply clean dre sings, &e.

TilE ABDmIEN.

Thc abdomen is honnde(l al)oYe by the

157

(1l1iclriff), below by the honcH of the pclYil-;, l)ebind ; ,\ the , 'e rtcln'al (;OlUlllll (the lumbar Yertehn:c), Clnd ill front and at the Hides by thc mus(;ular walL of tLL ahdomen.

Wounds of the front wall of t h e a bdome n

1\1i.1 \ ' he cither Yerticcll or tranversc. 'YbeJl the Cel \'ib of 'tile alx10lllcn i' opened, the inte'tine or othe'r may protrude through th wound.

Treatm en t -( 1) 'When the ,,'ouud of the front 'Hlll or the ahclomcn i.. Ycrtical, lay the patient dowll fiat \\'itlt the lowcr extremities, tmight ; coyer the \\ Ollllcl ()\ L'l' u," a p ttd of dry lint, 01' linen, and place n band,lg'L' ruund thc lJ()(ly fnirl,!' tight. (2) 'YbL'n tltL' \\'ollnc1 i.. tran '\'e 1" 'C bend the kllee.' so a to r L' lax the ti of the \\<t11 of the ::tUdOillCll, and l'ais( the houldcn; to allm\ of the edge.' of thc \\'()llil( l ('oming togcther; apply a pad and handagc. (3) \ YhCll the illtc ' tine ur other organ protrude tltron,;,lt t he won ncl in the abclominal \Yall, uenel thL' kn C'l"", the . hOlllder., and apply lint, a towel, or a l'lcilll "ponge wrappecl up in soft lincn wrulIg Ollt of \\ anll ,,"n,t '1', <tuel keep the part \\ <,rm until the doctor arriycs,

E \ wound th,tt illj nre::; thC' tOlU<tch, liYcr, plel l1, Ol' pnncrea. , 11l1l:->t tnwerse the ahdolllcll. mo()cl oj' thc <.:ontent' of the .. tomach or inte.'tine wit 1I1l'rdorc e 'capc iuto the ahdominal cayity, :-;Ylllpt()lll.' of illtern,tl hWlllorrhngc, .

156

158

THE ORGAXS OF THE ABDQ)lEN

The Stomach Ee:::; immediately beneath the" pit <of the stomach " just bdow the breast-hone.

Fw. 57.

Injuria of the l:itomach are hy collapse, and sometimes by retchmg, and VOllllbng, (It dark blooel like coffee g r olUldr:;.

159

Treatment. Llly the patient dowll on hi . baLk, <'\.pply au Ice-hag OYe], the pit of the stomach. NothiJlg l:ihould be given by t ile lllouth.

The Liv e r lie .' ill the apper part of the nhlomcl1. ",here it il:i mo., t1y co\'ered by the right lo\\er ril,,,. Il1jurie.' of the liYer IllCl.y ha cau'ed by a 1)10\\ oror

Lhe organ, hy fractured riul:i penetrating it, or by the :--tah of ct .'harp \reapoll, or hy a bullet. The great danger of a WOllllr] (If the i. luemorrbage, the lliooel e capil}O' illto the cavity of the abdumen. rrhe injury i' attellded hy pain Hnd l:i\Yelling in the regioll of the liver, and by the sig-I)" and l-l)'lllptOlll.' of intel'll1l1 hcclllorrhagc.

Tl'c({tment . - Lay the patient do\\ 11, give itc to ,' uck, ,tpply iec over the )'cg'iol1 of tile liver, turn the patiellt to\\,anll-l the right l:iicle.

Th e Sp leen lil'l:i hellcnth tile ribs at the 11ppor part of the left .'ide of tlll' all(lo111ell.

The can of inj1lry alld the dangers nrc .. imilnr to tho.'e of the liycr, a11(l the treatmcut is . imilar, only that the pati ent he tUl'llecl toward. the left sick lnj or tlw pleen nrc w-mally specclily fa tnl

In j urie s o f t h e Inte st in es <Janse · 'ymptoms or and intl'l'llal I1<l'lllorrhao'c may occur, 01' t1H' contenbl mily into tlll' of thc abdomen.

TJ'eatment.-Keep tIlt' patient lying down awl <1" II llieL nl:i pos.'ihle. .A ppl'y a large pad of flallnel 01' ("otton \\'001 to thl' nbtlullll'll, kept in place by n, towel

160

rlpplied faid,), tightly rounel the ahdoHlcll and piuned ill three or four p lace. ' . GiYe nothing by the month.

The Kidneys lie at the ba<:k in the region of the luiu. They may be injurcd ,yhell the Io\"e 't rib., (the lItll and 12th) are fmctured hy cru::;h, blow , or by llllllct or ::;ome ,' harp weapon. Blood wonld c 'C1lP with thc urine, and there would be paill and perhap,,. \\ DinC" OYer the inj llrctl kidney,

The Bladder liet") in the pchi, and lllay he II c>Llucled l}y a fmctnre of some of the l)chic bones. The signs symptollls would lJe either in<1,bility to [lllS · Imter, ur if a little i::; pas 'ed it is tiugcd with hl(}(}ll.

Tr eatment . -Wh en eithcr the kidlley or bLtdcler i... \\ olludcd, h.ecp the patient (Juict the doctor an'iye', and meantime apply hot fomentations o\"er tlte painful or iLLjnrecl part.

Rupture (hernia) (;onl:ii .. ts of a protrnioll of an intcl"ll<.tl org-an, lll:ilUllly tbe bowel, through the wall or tile nhdomcll. It most i'rctllleutl)' OCClll'S at the !.!.TOill. I houid a Hudclell swclling, accolllp1l.lliecl b.y l)aill anel 8iclme s, ta.ke plat:e, semI for it doctor ill and lllC1tl1 wbile pllt tile paticnt in an e,l::',' pnsiti('m, and place ice or culli \rakr application Ot till' atfected part.

161 CHAPTER '-III.

Esrr:arch's Triangular Bandage hil::; k'cll

(J '-;cril}eci in Chapter 1. It lllay be applierl to Hmpitt qt' the boch. "

For the scalp (Fig. 5 '). Fold a hell! alJout

I clle deep aluug the len\ l'l'

1 )1 mIcr, pJaee til bcl.l1c1age 011 lhu hl'ad '0 that the hem lie (Ill the forehead and the point Ilaug'. rl()\\'n ttt til, ln1.l'k; titelll'aJTY the b\'o cnd, roull el tile hl'ad "ill)o\'e the ear.", t:l'OS,., tllL'lll ill the hack, alld thClll rOn\ clni ilwl tie on lhl '''r<.'lJe,ul: then cln1.1\ the puillt dll\\lll\arcb, and tarn it up :Illd pin it Ull to Lhe top ot' tit" Ilead.

FI(;. ;)

in applying thi carl' lllllst be tuketl to put tilt' b('lll do' , cl0\\'11 to the eyeln'u\\,::;, to carr," the end l/ot over , the car, and tu tic them do 'e dO\\"1l to tbe eyehrow ', and not high up Oll the for 'Ill'acl.

For the forehead , side of head , eye, cheek , and for any part of th e body which is round (h rh' ,ll"ln or tlligh, ctc.) tlte llill'l'OW lUll t 1,_' . ",lit. t:entre hcillg pbcccl on the \\ollnd, and M

the ends being <:arriell ronnel the limb and tierl over the wound.

For the shoulder (Fig. the of a bandage 011 the iujnred .'houlder, with the running up the !:lide of the neck: turn up a hem, :FIG. 59. FIG. GO.

carry the ends ronnd the lllicldlc of tl.lC .ann and til' them: take a i:leconcl banclat!'e, rold l.t mto a lJr?;1(l banda'ae place one end o\,er the pumt of the til' 't, bandage: lina the arm by carrying the handage over the sound. h?l1lcle.l' side of the neck.i bring the pomt of the fir!:lt band,toe

163

lll1dcr Uw t p<.u'.t the re.-ting 011 the injured "houlder, clrn\\ .It tlgl.lt, tnrn It down, <1.11(1 pill it,

For the hlp ([ 19, GO).-'l'ie a nalTO\\' bandage rounel the budy alJo\'e tlJC haunch-bones trill'" the 't 1 . I ' v 0 on t 10 , IC e <1... the injury; take another }J<1 nc1 age, tnm up a helll H<:l.:onling to tJJC . izc of the patient, place it · centre on the wuund can,)' the ends

Fn .. tiJ.

l'OllllCl tIle thigh, anel tic them: then talTY the point up llmll' ]' the \I tbnnd, tum it down . the knot, <1))(1 pill it.

For the hand ( Fig. Gl).- pre;td out H bandage, pLtce the wri. ,t 011 the border with the finger.' to\mrd tIlL' point: then bring the point oyer the wri ' t, the two ends over the wril:)t, ero " , aud tie them, M :J

162

164

F or he foot (Fig. 6:2). ont a h.\,mlagf', ph1t:e the foot on itt-> l:Clltre with t h e tue lowl\,rns PCll ll t, draw up t h e point oye r t h e in.'tep. hring the two end' fo r wa r d, llnd ti e them either (lI\ the t-lo le (if to keep a. Bplint lIU) or rOllnd the ankle.

F IG. ()3. Fig. 64.

.l<"'or the chest 63 <lnd 6-l).-Ptill'O the m iddle of the ba.ndage on tilt! injurc(l wiLh tit pomt ove r t h e sh ou l der; carry t h e two cud' ronnd thL' \\a.i't and tic t h em; t h en clnl.w thc point oyer the 'boul der and ti c to one of t h e en d ' .

FIt;.

For the knee ,--Sl)l'<':,il

11 It, a lmudage, foIl <l 11111'J'()\ ,' 011 tbe l'o"'cr llonlc . by tile point on the alld the middle of the l'orde7 just Lelo\\ the kIlcecap, no s the fiJ'st 1,c lmH, the kneo, then {W ('r dll' thigh, again unde.]' till' klll (' aml tie in front helm\' knee-cap, Bring the p,I.'lllt cl()\\'ll to Cn) (:-1'(; J 19', Go) llllcl fasten with :\ a 'l'ty pin. If the hmc1al.!.l' i., IJ(lt large 0110l1O'11 to Ill' In'()ll[! 1t the .eclll1(l tillle Ilt'lo\\" lllL- knee. tic i:, IIll 11< lng], '

For ' t he elb ow .- T liB to that 1'01' tile

J\llt t. t 11< point and midclie f,f tht' lowCl' border hClllg" :!)mce<l 011 the back of tile ,Hill fwd 101'€<ll'\U retipectlycly,

166

CHAPTER IX. CARRYI JG PATIEKTS.

1n accident· wiler the patient has k'rll retlc1cl'('(1 nllR.ble to walk alone, he may be cn.rriccl hy th h,'stander: making either of the fullo\\,ing'eab-::-

(1) The four - handed seat i" made two

FIG. 66.

lk'r;-;otlS gra 'ping their left wri·t. with their l'lg:llt hn.nclH, then gTa 'ping each other" right \\}'i t \\ it It their left hand .. (m; Fig. 66).

After tile hands arc cla. ped together, Lhe 1lett rl'}" stoop dO\Yll behind the patient, who on thL' hands, and at the same time pl,u:e ' one arm rOHll!l the lleek of eH,eh hearer. -

167

FIG . 67. (

,cat is mlccl where the patient i, sntt1 'il'll, :' t' ll1seinm; to gil'c n:-,:-;i,'t<l.l1cC tu tht' 11eal'l'1' ill d it; able to nbe hi::; <ll'LUI'), lmt i' ml<ll lIe to \\ Hlk . rl\

]TJG, tiD,

lu\\-L'r the l,<ltient tile lH';tl'Cl',' -:tOllp (lOWll Ill' ,l,ncl'l Oue Iml'c, ;,!.Llltly plaee the patIent on a ehal1' l' I. , lb.:,; Hlld 1 ne); ()lHl \\,ithdra\y their hand ·"

169

The two-handed seat il') made 1»), t\\U ll L';\ll:-'; ela:-;pillg their h,mel.' ml in Fig', G7, Clm1 pInl.:ing their 'rcc haml on CHell I)Lh '1' I') :-,hollider, Jll ca,'c of he pat il'JlL l'cing l "hcrt pcrboll the hearers ,' ll oulcl plat' l llL'ir hand on '-'etCh lthel" hip (a' . hc)\\ n in h· figu re), in , tcau of on the .. hon lcler rll"tcnd of the grip in Fig, G7, eitlll'l' Ill' lh(J"ll 1."\\'11 ill Fi!.!', :.:iN cll1(} G9 lllily l)e n.ed, If ;-;h()\\ II in Fi:.,:', G9 lll' adopted, it i wcll tl "cal' !,d0 YL'" or to hold :t h'!l1(lkcn.:11icf :11 thc 'l(1])ch, Thi, I.' Ihed \\'hen the patwllt i.' llll,d)ll' ;:11

!...1\C any ;,:-;.i,tallcc "ith his arms, Hnc111!<l,\' l :c lice} iIlt ;\ patient:- . \ 011 c1.eh, 'ide of the pnticllt dll\\'J), 1 OIlC ,u'm \EHlcr thil!,'h , , nenr the klle' , all.] ;,11 "1>, tile b.lml of the ()thcr IJcal'l' !', The llc;u'cr" thell their ;11'111" ronnel tho hH'k of the patient ancI <;!'I'n:-p ('leI! otller'" "boulder (or Ilip), 'J'lllO\rcr tlJc patiellt hc h'<l}'('!'" 110111(1 "toop clowll or knc cl Oll kncc , \YhL']) till' 10Wl'l' part oj' thc patient',' h()(:y i,' resting' npon the hl'cl, or place wherc it i ' ell', ired to placc him, 11' lll'"l'el''' ... h(l111cl 1l11ela:-;p the haml .. which Hl'r uncler his 1111ttol'l,,,, taking l.:;d C to the upper part 01 the Ilocl,\ "hich ulll then he

The three-handed seat i' n. 11l0(1ifi('iltiClll \If thc ; I \ l', ,111<1 1" SOllll'timc' l1.c(l for <t 'llO!'t PL'!" un or e!Jild, j 1" madc 11 ' f"l]ows :-0110 hcarcr lJi:-: J wn

left forcarm . the other hcarer gm .ps thc right forc;lnll (jf the fir t hearer \\' ith hi ,' left hand, aiHI tbc firl:lt bellrer gT,t 'p.. the left forearm of tho sec:ond bearer \\"ith iti-.; Ipft hand; Lhe l->econcl bcarer plac:c' his right h<1.lld

Oll the left 'hol11ue1' of til fir!::lt bearer. Tile fore1U'ltl 'honlc1 in all ea ·c· l)e gru.;·ped l:>lightly alloyc the \\ ri"t (Fig. 70).

Tu lo\\'er the patient tho bearer' hOlllcl ,toop down 01' kneel Oll one kuoc, gently plato the P'1.tiCllt on <l ('llai1' herl, &e. Hnd unrla .. p cJ.l1cl withclraw their hand,'.

OIlC' hCetl' '1' may carry a patient by the F i r e m an's l i f t ;(1) follo,,"s;-

To Llfl Ihe Patieli! .-Tum tbe patient fetc(' c1o\\'t1-

\I ill'(!s with hi .. leg l'\lel1cled and anu-.; c;!ol->e to hi , .,idl' ; plac:c ,\ ()lll','elf at beael, ' toop down, . lightly rai...;e hi: heac1 etnd .. lwnlc1ol's, anel take hold of him clo ' uuc1cl' Hl'lUpit:-" locking' your hand on hi" hll'k., Hai 'c a:-; high <1:-; it can JlC lifted \\"jt b ,\ o1!t' and arlll, in thi position: tLell

hi .... horl,\ a .. far a.' po.':-;il)le on your loft knee', .. ltift

,\ (Hll' al'lUs <111(1 lakc 11im 1'olmd his wai:-;t, lock YOHr

lWll.1:-, and lift 11im to illl almo t llprig-ht ",itll

hi" hL':tcl Oll Y()\II' ll'ft .. honlcler, ,YonI' Idt thi,gll ,'1!p]>o)'tiu.,:· ,l:-; milch or his wcight m; 1 thc paticnt ill pOl'>itiol1 with \"0111' left

;[ I'lll, .. p h is left \\ risL \\"i th yonI' right hand, thrO\\' hi" left ill'lll oycr YOIlI' 11 'ad, and nt tbet1me time drop your. elf illto ht()opil1g pO'itioll; let go of the

170

171

natient ,yith yom l"ft ann, which then placo 11(' "(,Cll hi.' big'h,-. 'The pntient K hotly will 110\\ L 11

yc 11', houlders, yon Hhould 110\\- til : II ll}ir·!!I.t pu. ition, and balanc(' It Tr(ll,:-Il'r t-lJ8

I't· llt' ldt "ri.t to \Clnl' left [law!. .IIHl .n le;l\'('

(Ill!' hawl fret' 'for t-itc<tc1ying YU1ll'6clf 1\ 111'11

thc p<l t i 'lIt cleJ\\ 11, Lnil'l'l, or clown a ladder (. co ,. i-:'. j 1). . .

To J.()//'ff· the P(/fi PIi/ -Tnm, fer the pa lcnt.

idt "Ti..,t tu yUill' rig-lit bauel, take ,yuur left arlit frulll Fm, 72.

lId \\ L'C11 hi , thigh...; .tIlll placc It rOllnel them, bringing thelll II the I'l(,'lIt hauel side of ,UUl' ll(xl \' Si1l1- cluwll

UpOl1 ,\ 11111' k11et', let paticnt's legs l'C,.t on. the I \\ hill' ,\ IHlllppurt IllK hutly un :()lll' lett tll1gh, 1'1. h:L' yunr left «I'm ronnel hi, lct (I' hi" left \\ rist, ,mc1 putting yOllr nght ,Irnl under-

172

neath hi ,' left arm and rOlll1l1 hi,' back, plaec llilll gently on the ground (Fig. 7:!.).

N.B.-Th o.·e oearor:::; ,yh o prefer to eH.rry tIte "ei,!.!'ilt of the patient on the right . JWlllcl cr read ,: left" for "right" and vice vU'Srt throllgllOllt Ole a ooye instructions,

The plan of ca1']ping the patient by th e a7'1ns and lei/ s with th e face downwa1'ds, conwlOnly called thc ' "JJ'ugs' ?'la1'ch," must never ue as derdll, ma!l tllsue ,hutll this treatment.

" There a proper strotcher call1lot Le obtained, a temporary one may be made in L'itlll'l' of the follo\\ ill.!.!.' \rays :-

(1) The ,' leeyes of a coat lll<'ly l)e tul'llcc1 inside: b,'o :::;tOllt pole ' are tllcn pa::,sed tl}J'ongh them awl the coat buttoned. Thi .' makes a good ,·eat. (Fig. The patient ,·it.· on it, alld l'c::;t::; agail1:::;t the hlCk d the fir t bearer.

1£ ,t longer strotcllel' is r equired, two coatl!i mu::,t 1Ie treated ill the same 'ray, (Fig. 74. 1

(2 .) A sack may be taken' it, hole is mnc1e ill en.ch corner of tho Lottom, and two pole::, through the ack and out of the hole:::;. (Fig. 7.).)

(3.) A large piece of carpet, sad; illg, tnl'pmllill . ur a b lanket liay be spread ont, a])(1 t\\O stOllt po1L''i l'oJled up in the .'ide. ' .

Two hearers then stand on each ide. They gTa p the midd l e of the pole 'rith une lw)](l, allel lleal' the

en d with the other. To carry the pati ent they ml1st walk ,'icle \\,n,y ,' ,

(4.) A hui'dle, broad piece of wood , or shutter may

7G.

he employed a, a ,tret cher; llllt if either of them i,' 11 'cel, some tm \\', hay, or dotiling .houlel u? placed on it Hnd then a picee of tont doth or .'acklllg; the

174

175

FIG.

i:-; u 'efnl in tn,king the pa,ticnt otf thl' trctchL'r wholl ho a,rrivo" at tho hecl-:-;icle.

Always te t a temporary .. tretdlel' before the pn,tiont on it.

Tempol'cwy .. trctchor:-\ mnst h.:: (:(trricI t, :tmi t}lI'

p ,lticnt p1n.ced on them as bi(l clown in the" Stretcbc l' E\,cl'l:i"e:-; lJ

eyer allow ::;trot<.:hor:-; to be carried Oil the bearer,,' huulder::;,

1), gellcml rule CctlTy ll'ttient feot lUl'l'll1Cl1'lt. Till' exceptions al'o: (1) wholl going up hill \\ itl! it patient

\\ ho::;e lowor lim1>:-; arc llot illj mcd ; (2) when (own hill with a pa,ticnt \\'ho .. e lo\rer lilllb' are injnrcLl.

In ca.rrying a patient on it strotchel' care :-;Iwllht k t ilken to c),yoicl lifting tilt: ::;tretchel' OWl' (litchcl-i II' w·l.lb, hut where the.·e cannot 1)L' it\'oidl'd til ..: trdcher lUu't be carried in the follo\\ illt!,' \\it)"· :-

To I RO t:)<"> A DITCH,

In cro.·.. ing a ditch, the :-ltrctdll'l' ]()\\cl'ell on the ground, with it:-; foot one pttCl' from the edge f the ditch. No:::;. 1 and 2 then de:-l ·end. TI\(' , retcher, 'with tho pationt llpOll it, i' al'tcl'\\'i'lrd:-; wlntnced Xo·. 1 ctncl2 1)011.rer.,* in thl' ditch : .. the front end of the ·trotcher, \\ hile it:-. other elld re 't · on the edge of the aho\' e. "While the

"These numbers are explained later in the detailed teher Exercises.

177

stretcher i" tim,' :-lllpported, K o. :) (le cend::;. _\11 the K ()s .. no\\ the stretcher to the oppo::;ite ,'iele, uud tIle root of the is made to on the edge of the grollnd, \\'h110 the head of the stretcher is s:lpportcd hy I 0 .. :3 in the ditch. Xo. 1 dimb.. out, o. :.? remaining in the ditch to a ':-;i t o. 3. The f;tretc her i') Ii rtecl fon, arcl on the ground nboyc, and re t . there \\hile ITO•. :2uncl:3 tlillll) up. So.... 1 Hnd 3 then 1'es11111e the carriage of the stretcher.

To BO S A ,yALL.

Th l' stretcher i, lowered with the foot ahout one pact.: from the wall. N 00. 1 and 2 bearers then take hold or the foot of the stretcher amI 'So. 3 of tho head; thl'tretehcr j . mi 'ed till the foot placed on the wall. TO. 1 thell climb::; oyer the \\'illl and take,' hold of the f()ot ()j' the while X os. 2 and 3 'upport the hl'ad : the . tr'teher IH then carried forward till the h:"lCI rest" all thr \ntH, i\o. 1 ,tlpporting the foot. );Ch. :.? ;m(l then climh oyer the \\nll and take hoJd of the head of Lhe ,' trNcher, which is then ,'10\\1\1if ted all' the wall Oll to th 0 ground, and the hearel: " i akc their ll.'unl places.

To LOAD A ,y AGOS.

The stretcher i:-; lowered with the foot one pace from the l'llCl of the wagon.. No ' . 1 '1nn. take hold of the foot (If the :-;tretche r, X o. 3 the h ead. The ' tretL'her x

176

17i

IS t})t'n nti 'ed and CHl'ri(·d forward till the front wheel' re t on the floor of the wagon. No. 1 then jump into the wagon, while No. :3 goe- to the head of the tl'etcher and help ' :Xo. 3. Tho tr tL:hel' i.. then pu hed slowly into the wagon. If the tailboard callnot be :5hut. the Htretcher mu -t l)c la hed firmly to the side.' of the ,,-agon.

To r NLOAD A ,y AGOS.

:3 and 3 tn.ke hol(l of the he;l,d ofthe .tretchel" while No. 1 get::; intu the wa.gon; the .. tretchl'l' i.. then gradually dra \\ 11 out till the foot-whecl .. reo t Oll the edge of the \\'n.f(on. )lo. 1 jump. out of th' wagon and \"ith No. :2 take' hold of the foot of the stretcher, No.3 'uppurting the head. The .'tl'etehcr i ' then gently dntWll away one pace and ]()\ycrccl. rrhe hearer - then fnll in ill their u::;unl " Then four bearer:-- ,tre attending to the patient, X 0 ' , 1 and 2 would lift the foot of the .. trett-hcr while Nos. 3 a11(l -1 lift the head. Thi ' (\,pplie ,' to .. i11g a ditch 01' \\ a1l, a.. well as to loading and unloading a wagon.

'H.\.P'T.ER X. TRAN. PORT.

The "Furley" 'hetcher ' CJlodel 1 99 .. tbree yiz "0 '1' . , "" ) ale of :111c1 "Pol'. ,; I" lC 111el l': '. Tele. copic-hauc.lled " t] ICC. n general prmciple they are Ie component parts l)cing de ignated tIle ;oles:

jointed tra. r, l <lllcl ' .. lillO" \el. c foot-wheel, bed, piI10w n"

The I' r teller (Filf i-G) . i- . length and 1 foot 10' I M·. I ,1 I feet 9 mche .. in .' 111C 1(" wlele T] b d . III length, and the hnmlle ' 10 1 " 1e e 1 6 feet mi .-e the .' hetcllc. 41 . . J zll1che'. The foot-wheel ' 1 , 1llC 1(" fro tJ t 1.10 hcad of the strct .her " ,. )(' ground. .At lllllow .' ack) '}' 1 L ct Cell1\ <l oyerlay (th e \, llC 1 can he filled wit]1 st I ra,\y, lay, x Q

179

FIG. 76.-o.RDINAllY STRETOHER C - LOSED. FIG. STRETCffER-OPE •

clothing, etc., to form a pillow. The jointcd tr[t,er<;c bar are provided with joint -, -0 arranged La gnanl again -t the po ' -ibility of the bearer - catching thej r fingers in them 'when opening or clo.'ing the stl'ctchor. The poles are rounded on Lhe top, and hfl.ye an insiclc beyel to add to the comfort of the patient and prcyent cutting the canvas. The Tele '(;opi c-hancllecl pn.ttcrn (Fig. 77) is very Himib,r, but i ' 0 nrnmg('d that the handles can be Hlid ulldernea,th the pole .. , tl1n8 ing the length to 6 fect, the length or the bed hcing 6 feet. This t"\,rr<1,ngGlllent i - of great Y:llne\\ hell working in confined spaces, or when il. patient haH tp be taken up or down ft, nH,l'1'O\r ::;taircase ''lith -harp turn ' . The Police streteher is 'imilar to tb OnlinHl'y pattern, but is more ::;Lrongly madc and hil.s, ill addition, strap' for securing a ro£n1.(;tory patient. ,,"-hcn clo.'ed, the poles of the ::;tretc;ll"r 1](' d(),e too'ether, the tnwBn,c han; heing benL inwards, th' can,c\,' bed neatly folded on the top of the poll'H il1lll held in po itioa by the slings IY:lieh nrc Ini(l along lit(' CallyaS, and 'ecured by a strap placed tntnST,'e l'Hel:-' at the end of each sling being pa 'cd thrmlgh thu lHl'gl' loop of the other, round the poles nn(l bcd, au(l thl'll bnckled.

In closing a stretcher hon1d 11l' b\ken to mi:-'l' the centre of the canva when pUf:ihing in th' trayel' 'e bar, a.: it is otherwi e liable to got l'anght ill the joint or the traverse bar.

1 1

To prep'l.}, " or open, a, .'tretcher, unbuckle the tran .Y01'.'0 ::;traps of ach 'ling; rClTIO\'e the .'liug.' from the ;-;trctc.:hcr· sepamtc the pole.'; take hold of each travcr 0 and dn1.\\: it 'rhc ::;lillg. will 1hUll 1)0 folded to half theIr length, Olle l)eiug laid Ill'atly oyer thc haucllcH at eadl ond of the .'tl'etcher, T \. a geneml rule, the ... trL'lcher will be preparl'c1 11,\' 1\ O. 1 Hl1d 3 bearor' III E:xon.:i.. c::; 1. II. cll1d HI. ; and by Xo. :J in Exen.:i.'e IV. 'These bearer. will jH)\\ e\'cl', if rccluirec1, no' ist the other hearcr. a ttending to the p'1.tient's injurie . ,.,Yote.-Tho various movement::; detailed in the followino' Exercise::; ::;hould bu carried out steadily the hearen, workiuoLl' ill uni.'on, InllTyiuO' beilllJ' f ' 11 . 1 . IS 0 c II y aYUl( cd, and eyery attention heiug paid to the lx'arel' ,,'110 '0 duty it is to give tll' ,YOI'd.. of (;01111I1:111d.

• 'TRETCHER EXEHCI E , (lm\\'ll up 1)), Sir John Farle T, and reyj . ed III 190 l to llceord with the chill. \ldopted by the !{oy;tl Arllly :Jlcdic<.1.1 i orpH ;- <

EXEHCI E i{ o. l.

FOR FOUR BEARER::;, 1. '1'he Instrudor elect.. the bearer and number ' hem-I, 2, :3, 4-, at hi .. (li-cretioll. hou1l1 OllL' lllall Ill' taller etnd 1 hall the other', ho should be

styled No. :3, as he \,ill have to bear the heavier part of the burden.*

" Fall In. ''

.At the \Yords "Fall in," No. ' . 1, 2, and 3 take pO'ition on the l oft 'id e of and facing the patient. No.1

F IG . 7 .

places himself at tho patient'· blOCS, No. 2 at the hips, No. 3 at the patient'· shoulders. ALt the sallle time No. 4 pa ses the prepared stret<.:he r on tIle ground by the right Kle of the patient about t\y()

• Bearers should, how-eyer, be taught to take auy of tho po itions named in the following Exerci es . whether thn,t of No.1, 2, 3, or 4 bearer.

183

pacc. am1.Y from him, and then kes po 'ition 0ppo'ite to a.l1d facing J. TO . 2. 3. " Ready. "

The hoarcol" kneel down Oll tIll' left knee and take h 01c1 of the patient, o. 1 pa::;sing hi ' hands and fore 4 3 2

arlll l)eneath the patient'::., 1C!.!.':-, , hand wide apart. K os. and J pclK their hand ' ,1lH 1 forcarm ' beneath the patient" hip' and Hnd gl'il'p each other" hand , . To .:1 pa '0' hi' left hand ae ro' the patient' ·hC'.'t ilnd under the right -houlder, and hi right hand Leneath the left houlder.

4. " Lift. "

On the ,yord "Lift/' the bearer rait50 the pnticllt gently and rest him on the knee of 1- Ol::l . I, :2, "!lcl.3

bcarerl::l; as ,oon a' he il::l ecurely rc'ted NCl. 4ellO'age hand, with 1: 0.2, run round by thc head of the placel::l it lludor the patient, cloRetotheotber

fl'w. O.

hearer::;' reet, being c(trcf ul that the pill ()\y j:-. ill n nediately under the (Fig. 7c') ; lw.;hel,l. kll: Z18 dO\Yll ancllock ' lll, handl::l wIth tho 'c of o . ..J (li It! I'».

3. " Lower. "

The bearerl::l pla.ce the p<l,tient on the .'trelelJlr (Fig. 0), dii:lengage their han<18, alld theu ::lta.mlllp.

1 5

6. " Stand to Str etcher . "

o. 1 goel') to the foot of the ,tl' teller, with his h ,wk to tho paticnt: ::\(). to the head \\ ith 11i:-, t'at:e to the patient ; K()". :2 illlc1 -I remain 011 ea!'!l "ide of the 't l'etdwl'.

7. ' R ea d y."

0 . 1 Clllcl 3 pla('(' till' . lings (if "tn;cd) II\'CJ' t hcir :-,holllder., i:ltoop do\\ 11, :-;lip the loop, of the "ling'S on to tIle hnllclle,' of thl' , tretcher, ,\"hich they then gnll-'p.

As ,'(JOll ill-> all is right t lll' word i ' given

'. ( Lift. "

.\t the \\'01'(1, ... 1 amI 3 beHrerl-> :--ll'l'tchel' Htc<ltlily togcthcr ;lml·tand np.

J'HJ:-l' rile

.- .'os. 2 and 4- \\lll now ac1just the sliugf' (111 the -.;11ou1(lc1'':l of os. 1 an d 3, taking care that each j well helow thc l ,yel nt th cullar and lie . accurately iH the hullow of lhe ..,huulder in front. They \\"m alo 1elll?thc,n the slings, having to the patJCllt S IIlJlll'lC aIltl the relatiye heights of the bearcrs.

9. .. M arc h. "

The hC<.ll'el'i:l moye oli' :-.1 ' . 1, :3, and 4- . tepp inCf uti' with their left foot, <.llld o. 3 with hi::, l'io'ht foot (Fia. ,'I). be n. hortoneoft,, 'uty iuchc:';, al1d taken with 1) nt knee,. There "hoHld be no .'pring I'),Olll the forc part of the foot.

184

10. cc Halt. " n

The de tinatioll bein o' reac h ed, on the word c\ Halt b ein g given, t h e bear er b r emain steady ill p O'itioll. :Fig. 81.

11 . cc Lower."

At thi order the bearer p l ace t h e tI'etc h er gentl,'on t h e gr01md, . lip the l oop,' of the off the hn,ncUe of the stretcher, remoye the froLll the 1 7

:";/IOltldcl'S, aml theu ktawl np; care heillg take'} to l el the patient'.' feet rCHch thc gronnel before hi:) h eurl.

12, " Unload Stretcher - Ready. "

beare r s p r epare' to take thc patient· oft' the strcU.: iter, as at Or der.' anel :3.

1:1. Lift. "

.,. The b?l1.re l's. rai C thc paticnt a' at Ordcr -! (Fig. 79) ;

!'; (). 4, III thIS ca e, di:' cl1f!:age: hand' from X o. 2, reWO'"es the . tretcher (Fig. 7 and resumc ' hi:-; former positiull. If neces. ary, the bearers will then .·teadih" ri:-; . to!.!'ethcl', ,md car fnIly carry the pat:ent to th<e yc]nde, Lcd, or other phce to ,yhich it lin ,' lleo11 arra1lged to convey llinL 1..1. c· Lovller.' )

The p..'ltient is carefnlly lowered.

FOR BEARER

1. .1. -'Ilaher the bearers I, :2, 3 . will bc givcn by No. :J, \\'ho \\'ill l()()k after the injur d pnrt of the patient'.' body or limb. , t() ' l'C that no bandages or plint ' become di 'placed, altd also that 1\0. 1 UCllt'Cl', ill liftino' or canTino' the xtl'eteher, doc not touch tile patienf:-; fl'Ct. • ;::-

186

188

2. " Place the Stretcher. "

1 taking Lhe foot of the 'trctehel', a,wI - u. 3 the hea,d, phwc it in a line with the paticpt' ' l)()cly the fuot of ihe :stretcher "Going d ose to hettel. ;). " F a ll In .''

_ u. pla(;e::l on the left 'ide of paticut

3 2

1 9

nne htluLl Oil eHr h , ide cf tlw " t f" ,.) l' . e,l () Il1 )lHy1. • ..J allC .3 each other',' hanel::, Hilde): til' and thig'l, ' of the p<1.Li ellt (Fig'. R2).

Fw. 13-2.

ill <.1, line with his kllcet:>, No. 2 on the left . ide jm:>t l}eluw the patient's ::;honlders, Clnd No. ;3 at the rig'Jtt :-.ide, anfl tace' J o.

.t. " Ready. "

All kneel on Lhe left knee. No. 1 plaL:l" hi,' hand!:), well ap<Lrt, underncttth the lower linti):.;, <1.1 ways taking c,ue, in c,tse of <.t fmd nl", to \ttl \ C

0. Lift."

.\.11 tbree bO<1.1'e1' ri"e tobo'ether to thl'iI' j'c'c't 1-,,' t l t·. " ' \Cl. Plll f' ll' pn lent III n hOl'lzClut;tl po::-.itiol1. (Fig . . -

G, " M arch."

All take ""]lOrt 'ide-p<1CCfO, the patil'nt 0"1,'"

19 0

t h e, tl'etche l' until hit) head is immediately aboye the pill o\\·.

7. " Halt. "

All three bearert) remain teady. , Lower. "

The bearers 'toop down, genLly place the patient all the ·tr ekher, disong<lge their hand,', and then up.

D. " Fall In. '' On this order being given,

o. 1 place' him, '01£ at the foot of the OJ' \\ iill hi.. back to tho pl1tiont, 2 phce.. llt tho left :ide of tho p n,tient, and No. 3 at the heiHl, with hi.. face tow1uch; the pi\ticnt.

10. " Ready. "

K os. 1 and 3 place the, ling.. (if n eel) 0\ er their .. houlders, stoop down, and slip the loop' of the ..,ling.· on to tho handl s of the stretcher, which they then gra p.

As 0011 at; all i::; right the word i ' o'iycn-

11. " Lift. "

.It thi \yord, No ' . 1 and 3 hearen; mist' tlll' ::. tl·otcher steadily togethe r and stand up .

N o. :2 will now adju t the ;;lings on the , houlder,; of J.: 0 1 and 3, t 'eking car that each is well helu\\' the level of thc c')llar, and lie., ac<';ul'ately ill thc hollo\\' (If the shoul dcr in front. He will lCl: gth 11 OJ thc ling, ll'lving reganl to the patient's injurie3 and the relative heights or the hc :ucl''';.

191

] ., " March " 0

• 11 thi wo r d bei . . N ot';. 1 anel :} ,' top off 'wi t h th ng gIven, T "lth tho right. The ste sh e l Ieft foot, and :\0. 3 L inchC'." aud takClf be a short one of ....houlcl he no ..p1'iuO' from tl f Jent knee '. Thcre M Ie ore part of the foot

13 . ·' Halt. " .

The dc, tination beiu\)' re 1 d the hcarcr;:; rcmain steabcly Ie '. the word" Halt ., , < III PO::lltlOll.

14. " Lower. "

Tho })c1tl'cr.. place the 't' grouud, lip the loop- of ti gently 011 tIw of the t';tretl' hoI' relllO\:e tl ll1g' off the handle ' and thcn up' , s from the .. houIder·

• . , ' cal e }J(,llW trrke t I ' s f l't reach the (r' I b ':>f ( . n 0 et tJJe 10Un( e ore Ill' hoad .

1:3. " Unload Stretcher - Ready. "

The bearer:-> prepare to tal- 1 . ," trl'tuhcr, as at Order ' :3 anel ± '§f tlcnt off the

IG. " Lift."

Thc bearer ' )"lie lit, t' .. " l' , . e pa lell t, a.. '1 t 0 d - I (,UIY llln by ,hort iele .to ' c l' cr :), 'lll( to the ychidc 1 I ' . p, dear of the ' L1'etl'h '1' ) ' )e(, or othor place to \yhich it ha .'

Il Cll HlTHllgwl to (;Oll\'OY him (Fi u ") v hO .J .

] i. '. Lower ."

The patient i.' ('areflll1y 10\\ ered .

19:2

THREE BEAHE[{,' ARE AYAILABLE A D rIHE

'TllETCHER CAN o'r BE l'L\f'Ell A' ) ,T EXER I 'E 11.

1. The Instructor llLllnbl'r the 1)eclorers-1, 3. ordon; will be 11j'

2. ,. Place the Stretcher. ·'

;; u. 1 t,tking the fooL (If the stretdler, and X o. 3 the hearl, place it on 'tlll' grolwd 1»), the side of tho patient, ilnd ,v clm;e to ltil1l ,v pmdit:<lolJle.

3. ,. Fall In. ''

The three bearers take tlte same pO 'itiOlu; Oll one side uf the patient, as laid (lown ill Lxert:i,'e C\(). l.

4... Ready ."

1. :2, <lnd 3 klleel llo\\"ll on the left. knce, plating: them 'elves a,' do 'c to the patient as they tun eall, and llwll t,lkc hold of him iJ. ' directed in Excrei '0 i\0. l.

5. ,. Lift ."

Xo . 1, 2, and :3 reuse the l)Htient mi directed in Exercise ..L. o. 1., ,lond then mow in <.t kneeling pO'itioll up to the ·tretcher (Fig:. 84:).

6.. ( Lower. "

ThL' bea.rers belld fonntrcl, earefully lower the patient on to the 'trett:her, <l1lU di 'engage ha.nd · .

193

7. (C Stand to Stretcher. "

At this direetiol1 all the beareTs stand up' N 1 gO'8 to the foot () •• o. " 1 . 1 1., 0 . ...J l'emams III position at the SI( e, ,lnc 1., 0 3 O'oe ' to th I d f • 0' e lea 0 tl:J.e stretcher.

, " Ready. "

No ' , 1 and 3 place the, lings (if used) oyer their

3 2

Sboulder,', toop down, and 'lip the loop of the slinO's on to the halldle::; of thc -tretcher 'whicll tl tl 0 . ,lC) lcn grasp.

9. " LIft. '

X 0,' 1 and 3 bearer lql' tl t t h tl 'e le Te c cr teadily together and ·tand up.

.No. 2 wi ll now adjust the slings on the shoulders of N os. 1 and 3, taking care that each is well below the level of the collar, and lies accurately in the hollow of the shoulder in front . He will also lengthen or shorten the slings, having regard to the patient's injuries and the relttti\'e heights of the bearers.

10. " March ."

Nos. 1 and 2 tep off \yith the left foot, and TO. 3 with the right. '1'ho step hould he a short one of twenty inche, and takou \\"ith bent knee ' . There should be no spring from the fore part of the foot.

11. " Halt. "

T he destination being roached, on the word" H alt " the bearers remain steady in position.

12. " Lower. "

The boarers placo the 'tt'etcher gently on the ground, slip the locp of the ling.' off the handles of the stretcher, romovo the 'ling::; from the shoulder.. , and then stand up; care being taken to let the patient't:l feet r each the ground lJcforo his head.

13. " Unload Stretcher- Ready. "

No. 1 place himself on the left 'ido of tho patient, and in a line with hi knoe . , No. 2 on the left side just below the patient's shoulders, and J o. 3 at the right side, and face .' No.2 . 11 kneel on the left knee . No. 1 place ' his hand, well apart, llml meat h the lower limbs, always taking care, in ea 'e of a f1'<tl.:ture, to havo one hand on each side of the scat of

195

inj my, Nos . 2 and 3 gra p each other's hanrl lmder the shoulders and thighs of the patient. (Compare Fig, 2),

14-. " Lift. "

The hearers rise together to their feet, keeping tho patient ill a horizontal po.. ition, and carry him l)y .. hort 'ide step", clear of the stretcher, to tho yehide, l)ed or other plac;e to which it has Loon arranged to con\ oy him (Fig. ' 3).

15. " Lower. "

The pa.tiont is carefully lo\','ered.

EXER 'I E No . IY.

FOR U ' E IX :JIINE ' A 'D X ARROW ' UTTIXG "HERE Two 1fEx ONLY CAN DE EXGAGED.

No... 1 and \\ ill <'!1ll'dnlly place the 'tl'etcher in line with the injur'd nHtn'::, body, the foot of the 'tl'ctcber beillg', if # close to bit; head,

J.. T o. 1 .'tradcUe· ,t(;ro ' 8 the patient's leg', pln.c;ing hi.. right fool, \\ ilh the toe turned outward::;, n little below the patient ' . knee ' , and \\ ith tho toe of th e left foot tOllching tho heel of No. :2; he then stoops dowll

• It is not advisable to be too particular a ' to the head or foot of a stretcher in a mine, a it ,'{ould probably be ql1 ite impos ible to re\'erse it.

o 2

196

pas e the left hand under the patient's. and the right hand am'oss and under the patIent calYes. IO 2 places his feet oue on each of the patient between his body and ann, the toe of each foot as near the armpit a ' pos ible. He then stoop' do\Yn and pas e his h ands between the side of the chet and the arms underneath the shoulder., and lo ck the fingers (Fig. 5). If the patient" a1'111S he uninjured he may put them round the neck of No.2, and by this mean greatly a him in lifting.

'Vh en both are r eady, .e o. 1 \Yill give the order " Lift and move forward. " Th e patient then to be slowly lifted just ufficient to allow body to clear

197

the stretcher. Both bearer ' will slowly and gradually move the patient forward, .... T O. 2 by very short tep, No.1 by bending his body fo rw ard a. much as he can w ithold moving his feet (Fig. 6). No.1 now gives the on1er " Halt " whereupon No.2 remains teady, and No. 1 advcul(;es his right foot to hi left, and

F w. 'G.

ngn.ill nd'nlt1Ce his l eft foot till the toe touche the heel of IO.:) ITO. 1 then give the order " Advance " \\h'll the patient \Yill again be moved forward. Thc. e 1l10\-ement· are to be repeated until the patient i· ovcr the 'trctcher, \\'hen he i ' to lJe gently lowered.

The bearer' will then act in the ordinary manner as far as the nature of the locnlity will permit.

The Ashford Lit ter is made up of either of the stretcher mentioned on page 179 and 180, a under-carriageand,t waterproof hood and aproll, or, If preferred, a light canvas cover. 'rhe

stretcher is kept positi?n on the under-carriage hy the foot-wheels, whlCh fit mto lots in the .. ides of the under-carriage, and it can be removed at plea 'ure. under-carriage is fitted with a cranked axle, whlCh allows the bearers to pass with the stretcher 199

FIG. 87.

bet\\ een the wheeb in.tead of lifting it over them. At both ends are two legs nttcc1 'with automatic se1£locking' hinge ,\,hi·h allow the legs to l)e turned up as handle,' when wheeling tb liLter, and securely lock the.m eit her ,to' leg: or handle::;. The hood and apron fit sod,ets sere\\ eel to the .tretcher. In wheeling the care 'hou lcl be ictken to keep the patient in a hOl'lzont<tl po::.ition. . 'houlrl it 1) necessary, two bearers can easily lift the litter and patient.

198

200 CIIAPTE R XI.

( Being the Fifth Lectw'e fG?' Females only, in accordance with Syllabus 5 .)

BY E. MACDOWEL COSGRAVE, LD., F.R.C.P.t.

PREPARA.'rION FOR REC[PTION OF ACCIDENT CASES.

WHEN nClYS of an accident come., preparations hould at once be made 0 a' to hn,Yc everything ready before the inj ured per -o n i brought in. Of COUl't:;e the preparn,tions needful will YD.ry according to the nature and extent of the inj ury, but the follo\ying arc the chief things which may hn,Yc to bo dOllo.

CnOfCE AND OF ROOJf.

.A room mu.'t be cho ·en. In a had en thi.· 'llOUlc1 be one easily rea<.:hec1, as it i· difticult to C,llTY an inJ ured persoll through lltUTOW prv. 'ages aUf1 u p-. tail's. 1; nle's there il:l '01ll0 such r ea 'on ngaint it, the injured pert:;on'B own room is he. ,t .

The way to the room mll::;t be cleared, projccting furniture and loose mats in the hall or in lohbies should be removed. If the injured PCl'I'5011 i,' carried on a door 01' shutter, or even on n, stretcher, n. <.:ouple of -trong kit<.:hen chair' 'h onld be placed re<1(ly to support it, whereyer the bearers 'wonld be likely to require rest.

201

Useless fnrni tnre shonld be r emoved from the bedroom. The bed 'hould be drawn out from the wall so that both side' ca.n be approached, and the clothes turned back to one side to their full length. A hot boLtle hould be got ready. If there i' mnch collapse several hot bottle.' and hot blankets may be required; coyer the hot bottles with flannel.

If the inj my i yery ,eve re, if mud-stained clothe' haye to be remoyecl, or if exten -iYe dre 'ing ' lWTe to bc applied, it lllay 1)e nece: .. nry to haye another beel, <l conch, 01' [\, tallle p1..cccl ncar the bed to lay the l:lufTerer on in the in ·tance. '1 hi 'hould be ,'0 arnlllged that "oi ling may do no harm; old "heets, waterproof material', thin oilcloths, or eyen newspaper, lIlay be ll:-;ecl as [\, protection.

CARRYIXG .

If pre'ent at the place wbere the accident occurrecl it will he llece:-;:-;ary to .ce that the patient i care· fully lifted after proper "Fir, ,t . \..id )) ha been rendered.

'1.'he follOl\ rule ' hould be remembered :-,'elcct the propcr of pert:;ons to a' ist, and do not let them lift the patient until they thoroughly understand how thcy are to do it.

For cn C', " 'here the injured per 'on has to he lift ed a ycry o;.;hort distance, three helpers are l:lufficicnt. Two (" 110 , honld be a' far a· pos ible of

equ al height) ar e to bea.r the third t.o upport and take charo'o or the ll1Jured part. 'I In,' IS o 1 1 "I'" t best don e by a person who has been t 11' no' 1 a ill' Aid" cou r e.

If the injured person i ill en8ible, another helper should support his head.

The lifter one at ea.ch ide, shonlrl kneel on one knee, and their hand' under the patient's back at the lower part of the 8houldet-}llarles, anLl uncler the hips, cla ping each his right hand in the other' · The injured patient 'houlcl, if practicahle, place Ius a.rms round the necks of the bearers.

The third helper should attencl to the Heat of in.jnl'Y ; if thii> is a fractured limb, he should ,'upport It hy placing the palm of hi hands .the limb, ?ne above and one below the scat of the lllJury, it firmly but avoiding unllece ary pre .. nrc.

The helpers should remain thus until order "Lift" is given, and then they should all hft lowly and teadily, avoiding jars, attempts to change po. ition of hands, etc.

If the injured pe r son is to be placed 011 a or shutter, this should be previonsly placed mth the bottom end at his head; the bearers 'hould then move one at each side of it, until the patient is over it. The word "Lower" should then be given, and the injured per son should then be slowly lowered . A pillow or fo lded-u p coat should be ready, and as the

203

snfferer is lowered, tIli.. ..houlcl be p laced under his heael. ,';'

MEAXS OF CARRYING.

n , ides a tl'ctcher, and ulJstitutes such a a gate, a shutter, or n. door, other means of carrying can be improvi ·ed.

In .. light inj mias, \\'here the inj ured persoll i unable to \\alk, twu bearer.. can carry him by forming a fourhallrle(l three-Iumrlecl, or two-handed ·eat.

A four -han de d seat i.. formed as de 'c ribed on page 166.

A three - handed seat is made as described on 169.

The two - handed seat is made a rIc 'c ribed 011 L)Hu'e 169.

..:\. ing-Ie helper can lift hy upporting 'with one arm the two knce', and \\"ith the other the back. The arms lllUt I)e pa ' eel welll1ncler before commencing to lift.

.\. . ingle helper can give ."upport by putting his rig-Itt nnn round the wni ·t, gra. 'ping the right hips it ncl placing the injur d per 'on' left ann rounel his own 11eck, holding the left hand with hi ' own left hl1l1tl.

A cnpital 'tl'eteher can be improYi 'cd out of a, trolH.{ 'heet and two broom handle ' or other hort pole. Each ide of the 'heet i wound up on v.. broom

<If Full directions are giYen in Chapter X.

202

handle until there is just room for a person to lie between. This requires four bearers, two at each side, to prevent the sheet slipping .

CARRYING UP TAIRS.

In carrying a stretcher up tail's the head 'hould go first, and an extra helper . hould a i t at the lower end, so as to rai e it and keep the b'etcher nearly horizontal.

The t,,·o, three, or four-handed cat may he n .' ed for carrying up tairs; 01' a strong chair, the patient being carried up backwards. In the latter ca.' e one helper should walk after the chair and help to 'upport it, and to preyent the injm'ed person 'lipping out.

LIFTING INTO BED.

If the hed is narrow and there is room the tl'etch er should b e placed on the floor with the head to the fo ot of bed. The injured peron .·hould th en be lifted o\'er the foot and placed on the hed. If th e bed i too wide to admit of this, the .tretcher .. hould be placed beside it, and two helper:::; should .' tand at the far 'ide of the stretcher. One helper p<tHKe.' one arm ben eath the shoulder. and one beneath the middle the back, the other helper placing hi ' under the lower part of the back and under the kn eK. The injured person is then lifted, another helper pulL ' away the 'b'etcher, and after a single step forward the burden i::; placed on the bed.

205

PREPARATION OF BED.

A firm mattres, not a feather bcd, . hould be ·elected. If there i:::; much injury, or if dre.' 'iugs have to be applied, a dra\\,-.. heet ought to l) e placed on the bed. It should be of four or more thidme.' 'e.', extend aero '" the bcd, and reach from the middle of Lhe p<'ltient'::; back to the knees. A piece of waterproof . heetinO' 'Or of thin oil-cloth .. honld be placed under the dra.\Y-.'heet. the draw- 'heet l)eCOlll eS t:)oiled, the .'oilerl portion should be rolled up and <:1 dean part drawn .'llloothly under the patient.

In fracture of the leg or thigh, sprained n.llIde and .'ome other ea ·e.', a 'cradle" (Fig. ') ) Khonlcl be illlproYi::;ed, The ll. of a ' cradle " i ' to 'upport the bed-clothes and keep them from pre ino' 011 th e limh Band-boxe' (Fig. 9), three-legged .. tool::; (Fig. 90), and .. imilar article' may l)e ned. Li cork 'ercw pa ,' ec1 through the bcd-clothe ' with it.:; point guard ed 1>y a cork, and tied by ' Lring to the bed or a unil in the \rall, will relieyc the pre '. ure of the bed-clothe ' effcetually,

HE)WVIXG TilE CLOTHE '.

In taking clothe. ' ofF an inj ured pel' 'on a few rul e::; .'hould be borne in mind.

In .'eriou::; ea it i ' much better to 'n.crilice th e clothe ' than to run any ri 'k of inerca 'in o' the injury. In remoying a coat, ete., in n. eel 'e of fmctnred arm the tlllinj urcd ,lrm hould be drawn out fir 't.

204

FIG. 90. 20 7

In putting on anything the injured arm should be put in fir:st.

J11 burn.· H.n(1 .'l"alc1s nothing should ever be dragged ofl'. A sha?jJ pair of ·cis.'o rs should lJe u. 'ed, and cycrything not aelllcring should be cut away. If anything ac1hel'C'f) it 1:ihonld be left until medical aid can he obtaincd. The clothing adht.:ring may, with advantage lJC \\ ith oil. To remove the trou .'c r · from a 'cYe rely injured limh, the oulside :-,e<lm ·honld be ripped np.

PREPARATlONS FOR SURGEON .

A... 'oon a.. the inj med person ha ' been attended to preparation 'hould be made for the 'urgcon 's yi .. it.

The prepnnltiollS needful will depend upon the nature of the ell 'c . Thc follmring hint:::; liay be of u:se :-

fire in the room will generally be of ervice, even in summer. There . honld be plenty of \\ ater, both hot and cnld al:::;o . eventl ha in, plellty of clean tel\\ ell"> and f>oap. There should be something to elllpty "'ater into; a foot -bath doe ' ·well. '1 he bcvin shonld he on a table, covered with a cl ean white cloth: a large towel make ' a uitable cloth j thc towel' folded up 'hould be placed on the .'ame tilble, and the hot and cold water should be within

208

easy reach. The foot-bath should be uncleI' the table or close at hand.

In the case of a burn, cotton waddin o', ,'oft cloth!), old linen, oil, flour, bread, and bicar1)ona.te of soda. (baking soda) should be ready, and materials 'hould be torn up for bandages. 1£ n, chemi,t's shop within reach, carron oil and plenty of cotton \Yool sh0uld be sent for.

In the case of hECmorrhage, spono'e, ' , plenty of water, and at least two ba in Bhould he read r.

In the case of a person re cued from drowning the sheets should be taken off the l)ec1, plenty of hlanket. · hould be heated before the fire, and ,' cyernl hot bottles hould be ready.

If poultice are likely to be required, l)oiling water, linseed-meal, mustard, a loaf of -talc hrend, a , mall ba 'in, a large spoon, weet oil, and tow, limllld or handkerchiefs may be required.

For fomentation, have boiling water, fianll 1, a kitchen roller, and two tick, or a large towel.

'Vhen summoning a medical man to an a<.;cidcnt always let him know what kind of ca, 'e hc i ' rcqnirec1 to treat, so that he may bring whatcY'1' is needful. By this means valuable time may be &'1.ycd.

209

IN D E X.

Ab Page domen '" 1'"6

cases, u

t.lOn for. ... '" 200

A clll s? pC'lsoning uy '" 149

AlkalIe.., poi oning by .. ] 50

A.mmoma, pOisoning by 150

Anatomy... ... .., ID

A.nkle: ... 67 bhJaI artery.. 94

Antnllony, poisoning hy 1.'51

Aorta ... ... 69, 7

Apoplexy... ... 109 " to eli . tinguish collap c from clnnk... '" ... ] 11

Apparently c1ro"'nccl, to l'e , tore ... ... 143

Aqu1. fortis, poisoning by... '" .. . 149

Arm, hleeding from " 90 " oone of '" 25 " !racturc of ... 52

Al'l1lPI.t, ulceding from... 90

Arscn.lC, poisoning by ... 1.i()

Artenal h::emorrhagc ... 7:3 ".. " general prmclples of ancst of 74 ... ... 69, 'i

Art.Cl:IeS, course of the mam ... 7 Artery, axillary " brachial carotid '"

4 94 " digital... .. dol' aI, of foot " facial .. . . :: femoral. .. " iliac ... " plantar .. popliteal radial ... suhcla\' ian " tihial " ulnar :::

Back, bandage for 165 Backbone 20 B:mc1age, to 3, Bandage, to fold 37 Bandages 35

Danllagin cr 161 Bcd, ... 20 .') poi . onin" by 151

Bltes of animals .. . <=> 131

Bhdder '" .. Hr f'

Pane 83,86 83 79

Artiticiallcspil'<ltion Atlas Auricles ::: al tery ::: Axis ... ... 1 7!J 94 93 83 94 4 13 20 6q 3

Blood Page 69

Bones, general descripLion of .. - 20

Brachial artery... S3 'to digit:11

Brain ... " compression of ., concussion of Brea tbone " fracture of ...

Breathing, stertorous .,.

Broad bandage .. , ...

Broken bones, see Fracture.

Brooch-bone Bruises

Burns 9 102 108 10" 24 4' 10,) 37

Capillaries .,. .. . 69

Capillary hremol rha ge 73, 10 1

Cd-rotid arteries... ,9 " "wound of ,9

CaTpns...... 26

Carrying, means of 20:3 patimts 166 "upstairs 20'!'

Cartilage... ... ... 29

Caustic (Lunar), poisoning by... 151

Cerebro-spinal system ... 102

Cheek, bleeding from 1

Chest 155 bandage for 16'!'

Chlorodyne, poi soning by Chol{ing ."

Circulation of the blood

Circulation, organs of ... Clu.Yic1e

Pag e

" fracture of 14 IH 69 69 24

Clothes, removal of Coccyx

Parle

Digital artery w(\llncl of Digital CUlllpl Ub;;lOll 74

Digitalis, poisoning by ... 1;')1

Direct ... 74

Di reet violence... 31

Dislocations 64

" fracture of. ..

Comminuted fracture

Complicated fl'Rctnre .. .

Compress, gra.tluatcc.l .. .

Collap e from (lrink injury 1:2 ', 2(J') :n 110 106 24 4 34 3:2 73

Compl'e sion of the brain

Compound fracture

Concnssion of the bmin . . ,

Contu cd wound.

Conv'ulsion (infantile) ...

Copper, poi oning hy Corrosi,' e poi on Cradle

Cranium ...

" frac ture of Crepitus ...

Cyanide of potassium, poisoning by ... ..,

Deep palmar arch 4

Diaphragm 137

Ditch, to cross with streicher .. 176

Dorsal artery of foot .. . 9,*

Dress, woman'., on fir 130

Drink, collapse from ... 110

Drowning ... ... 1'*3

Ear-channel, hI ecling from 2

Ear ·pH,s;;age, foreign hoely in ... 134:

Ela. tic handage tourni· quet 'I

Elbo,,-, hal1l1age for 165

Elbo,,-, hlcctling from hend of ...

Elhow juint 30

Electric . hock 117

Emetics ... 147 " caution as to giying 150

Epilcp. y ... ... ... 112

Et'march triangular bandage... ... ... 31

Expiration... 1:37

External carotid artcry 79

1.-3

artery, to apply tourniquet

hallc1age for ... 161 , bleeding from 0 Foreign body in the

lOq 1:25 un 151 U9 2:2 4'!' 33

... ...

Face

211 Page Facial artery, to compress... .. . Fainting... .. . Femora.l arLcry .. . " , digit:11 1 11+ 93 (;ompressic)I1 of ... 96 I<'emoral

9 Femur

fracture of ;3 Fibul

of ... 62 Field tourniquet ... 77 Finger, bleeding from... 84 Finger bone, fracture

Flexion

Foot,

,. cru ' heel Forearm,

from I 16'* 95 2 64

sage 154 Foreign

eye 153 Foreign

the no e Four-handed seat p 2 155 166

Eye

...

'CoO

...

L......

Fibula . fracture

Fireman's lift 171 Fir t aid, meaning of 19 Fish hook embed(led 127

of lim b ...

bal1llag for bleeding fro111 bones of .,.

bleeding

bones of 25 , . fracture of .. . 5'* Foreheatl,

car pa

bocly in the

botly in

Page

Fracture, apparatus for treatment of .. .

Fracture, causes of 31 defi nition of... 31 general rules " for treatment 41 of arm 52 of bones of foct 64 of breastbone 4 of collar-bone 48 of finger bone 57 of forearm 54 of knee cap . .. 60 of leg 62 of lower jaw 46 of metacarpus 56 of pelvis 57 of ribs 46 of shoulderblade 52 of skull H of pine 43 of thigh-bone 5 signs and symptoms of " varieties of .. , 34 3')

Frost-bite 127

Fungi, poisoning by ::'51

Ganglia... 1·03

Graduated compress 75

Green-stick fracture 34

Gunshot wounds 125

21;2

Hremorrhage Page 7'2 74 92 arrest of .. " internal

Ham, bleeding from Hand, bandage for bleeding from " bones of Hangi.ng ... Haunch bones ., . Heart " contraction of Heat apoplexy ... " stroke

Hemlock, poisoning

Henbane, poisoning Hernia ... . .. 95 163 26 IH 26 69 71 115 115 hy 131 hy 151 160

Hip, bandage for Howard's methocl of 163 artificial rc!-'pil'alioll .. Hmnel'u .,. ., fracture of Hysterical fits ... HI 25 52 115

Iliae arterv 79 Impacted fJ'l1ct11l'c 34

Incised wounds ... 124

Indirect eompre:'\sion 74

Indirect violence 32

Injuries of .: pe eia l organs 15:3

Insects, stings o' ... 134

Insensibility ... 104 general treatof 104 Inspiration 137 213 Page I ntestines 159 compresSlOn '" 74

Internal carotid artery 79

Internal hremorrhage 92

Intel'Yertebral discs 21

Involuntary muscles 31

Irritant poison ... 150

Jaw. lower, fracture of 45 ,Joint, wounded... 126 .Joints 29

Kidneys ... . .. bandage for h .ncecap... . .. fracture of 160 165 28 60 37

Lahortle's method of artificial re. piration . . 142 eed , poisonwg by ... ... 151

Lacerated wounds ... 124

Large arm-sling ... 39,49, 50

Larynx..... . 135

Laudanum, poisonina bj: 14

L 'ad, poisoning by b 15 1

Leg, bleeding from 95 " bones of .. . 2 !' . fracture of... 62 and carrying 201 into bed 204

Ligh tning, effects of 11 D

L ime (quick), poisonin

by... ' " 150 Lips, bleeding from 81 Litter, Ashfo r d 198 Liver ... ::: 159 Lungs...... 135

Lungs, wound of 156

Mercury, poisoning by .. . Metacarpus ... .. . " fracture of Metatarsal bones, tUl'e of... ...

poi 'on;"

eelle, a Ten'es

Page

Meta.llic

Middle line of body Monkshood, poisoning 150 26 56 64 28 150 20 by Morphia, poisoning Muscle3 ... '" :Muscular action 151 by 14 30 32 poi ons arrow banclaae

N eryou

1\ose, from " foreIgn body in Oil of vitriol poi onina 14 37 125 1()-2 10'2 1 155 1 ' b ... .. ... 149 OplUm, poisoning by ... 148

ystem

214

P ad, to make 75 Pupil s P age ... 106

Page

Pal ate, b leeding from ... 1

Pal mar arches ... 84 " bleeding from 4: poisoning by 148

Patella 2 fracture of 60

Pei;is 26 57 26 57 " fracture of Phalanges .,.

Phalanx, fracture of Pharynx. . . .,. . ..

Phosphorus, poisoning by Physiology

Plantar arteries ...

Plants, various, poisoning by ...

Poisoned wounds 135 151 19 94 151 126

Poi oning, directions for treatment of . . . . . . 146

"Poi ons and poisoning 146 classification of 148 with double action ... 152

Popliteal artery .. . 93

Posterior tibial artery... 94:

Potash, caustic, poisoning by...... 150

Preparation for surgeon 207

Prussic acid, poisoning by

Pubes

Pulse

Punctured w.ounds 151 26 71,105 ... 124

Rabid animals, bites of 13 1

Radial artery S3, t6

" " bleofromding .,. '7

" " compression of 6

Radius 25

" fracture of ,")5

Respiration, artifici.l1 ." l:i

Respiratory system 135 Ribs 2:3

" fracture of... 46

Room, and preparation of Rump-bone 21

Rupture ... IG( ,acrum ." '21

, calds 12

Scalp, bandage for 161

" blee(ling from Scapula ....._ 24:

" fracture of 52

Seats 166

Screw tourniquet 77

Shin-bone 2 ) :Shock 106

, hock. electric 117

f3houlc1er .,. 24

'houlder, bandage for... 162 blade... 25

" fracture of 52 houlder joint ... 2 9

Pave

,ickroom, choice and preparation of 200 3:2 20

imple fracturo ... kcleton ." , ' kin, wounds and injuries of ]21 ,'kull 22

" fracture of 44

, 'liugs .. 39, 4:9 & 30

Small ann-Eling .. ,:10

Superfieial palmar arch '4 , llrgeon's vi 'it, prepamtion for ... ... 2'()7 SvlvesteI'" method of • artificial respu·ation ... 13 , ympathetie system 10:3 ,'yncope ... 114

Tail-bono Tarsll .. , Temple, blecclulg from .. . Thigh-bone ... .. . fracture of Three-handed. cat Tibia fracture of 21 28 3 26 5 155 169 28 62

Snake-bite... 1:33 ,'oda, caustic, poisoning lJy ... ,ole, arterial bleeding from , 'plccn , 'pinal cana 1 kpi;lc cord fracture of ... :-;pirit of ;;alt, poisoning hy ... ... ... kplint, angular .. . :-;plillts to secure :-;ternulll .. . " fral!ture of breathil}" of insects, ... ,":tretdwr exercises 150 95 1.'59 :W 1(j2 :20 4:3 215 •'tretcher, Furley to carry to prepar e Page 179 176 181 to make a temporary .. . 17<1 " transport ... 179 , trychnine, poisonulg by 151 :-;tunning ... ... . .. lOB ... 101 ,'uhchwiall artery 83 digital ... iOl/ ... m , l1iIocation by smoke or gases 145 ' uffoca tion by swallowing very hot water ... 145 ull,;tl'oke 115

Pag e

Throat, bleeding from inside of 1

Tibial arteries .. . 94

Tongue, bleeding from . .. 0

Tonsils, bleeding from ... 1

Tourniquet 'i 5

Trachea ... 135

Two-handed seat 169

Ulna 2:5

" fractur e of

Ulnar artery 55 4, ' 6 bleeding 'from

Ulnar artery, compres· sion of ...

Unconsciousness

Varicose veins

Veins 7 ,,6 104 100 71

216

Venons hremorrhage Ventricles

V erdigris, poisoning

V ertebra . ..

Vertebrre, cen"ical dol' a l " lumbar

Y ertebral co lumn

Yit ro l throwing , 'oice box

Y oluntary lllU cles Page 73, 99 69 by 151 20 20 21 21 20 1:31 135 31

W agon, to load allll un1 ad 177

W all, to cro s \yi tIl stretcher ... '\ ouncl of abdomen W otUld of lung ... W ounds .. . 177 135 ..

TABULATED FORM showing the several systems and the shortest periods in which it is possible to secure the medallion by passing examinations On the respective courses named helow . E xamina· tion. aaUR E.

Fir t. 'econc1.

Third.

First. econd.

Thin1.

YSTE::.r I.

First Aiel (certificate awardeu) . Home Nursing, a . per noteto ' yllab us 60, Yiz., beginning the nursing course a oon as the candidate's success in prc,"iou fir t aid examination is pu bli hed (certifi cate I awarded) .

First Aiel and Home Nursing. Questions to be a . keel in both subj ects (no certificate awarded) . ' Y TE::.r II.

Fir ·t Aiel (certificate awarded) .

Fir t Aid (voucher awarded).

First Aid - fina l (no certificate awarded).

Minimum interval after last preceding exammation 6 weeks J2 mths.

12 mths. 12 mths.

157 156 1:::1 217

- --1 _____

Examina· tion. COUR E.

--1-----------

$1. 30bn Bmbulance Hssociation . General Price List ,

First. econd.

Third.

First. econd.

Third. Y 'rEM III.

First Aid (voucher awarded).

First Aid (certi fi cate awarded). \

Home Nur iug (certificate awarded).

SY''rE11 IY.

Home Nursing-Thi caul'. c can ?l.lly be taken fir t on the comh tlUn named in note to I 'yllabu. 60, viz., that the course be preceded by a lecture embracing a general <;mtline of the structure and fun<:llOn.of the human body, and .instructions on the usc of the tl'langulal' bandage (certificate awarded).

First Aid (certificate awarded).

First Aid and Home Nursing. QUCHtions to be asked on both su hjcdH (no certificate awarded).

I N TROD U CTION .

This Price List, ."hich i subject to revision fr0111 time to lime, ha been compiled with a view to assist members of the Association and olhers in Lhe purchase of the nece. sary cq uipment for corps and divi. ion of the Brigade, ambulance statiulls, cIa.. es, and first aid and nursing work generally.

A complete and reliahle Ambulance Equipment is an actual neces 'ity, and experience ha proved that employers oflabour and other' intere. ted in the di trict readily suhscl'ibe for the purchase of such appliances. ollecting cards, tating the plll'poses for which subscription. are required, will be supplied gratuitously on application to the Head Oftice of the Association, where 0.1'0 any information with regard_ to its \\"Ul'k can be obtained.

fStore: of the yalne of lOs. or upwards will be sent carriage paid tu any part of the United Kingdom.

Owing to fluctuations ill market price it is impossible to guarantee that the ql1ok'ttiol1 herein can be adhered to.

Quotations will he furnished for articles relating to A.mbulance Nursing and Hygiene, not mentioned in thi list.

Order and carre ponden ce should be addressed to the t . .John Ambulanc As.ociation, .,'t. John's Gate, Clerkenwell, L()udon, E. C.

Remittance should be made payable to the t. John Ambulance A o<;lation and cro cd .. London and We tminster Bank, Lothbul'J' "

Minimum

12 mtll . UmOJ$. 12 mths. 12 mthR.

iutenal after last' preceding examination

HORSE AMBULA N CE CARRIAGES AND WAGONS.

A n umber of improved desig ns for Ambulance arriages have recently been perfected, and several specimens can usually be seen at t. John's Gate, varyi ng from a light vehicle, to be draWll by two men or by a pony, co ting with india-r u bber tyres to wheels £32 lOs . , to a large single or p air-horse wagon capable of accommodating three patients in a recu mben t position and an attendant inside. A fully illnstr ated: p rice list will be sent In application .

The" Ashfon1" Litter consists of a two-wheeled uneler-carriage fitted with elliptical springs, anel either of the " FlU'ley" tretchers, with a cover 0 arranger1 on a jointed frame that it can he folded up in ide the stretcher, or with a hool1 and apron (8ee page 6). The under-carriage ha.Ying a cranked axle, the bearers can pass between the wheels with the. tretchel', and thus avoid lifting it over them. "hen traxelling, the leg of the under-carriage are rai . ed. and thus form the by which to propel it. ,'hould it he necessary to pass over rough ground, two bearers can ea ily lift the litter and patient. The" Clemetson" stretcher can be nset1 instead of the" Furlcy" pattern.

The improvements in the" Ashford" Litter (1 9 model ) inclm1e all tho. e in the, 'Lretcher mentioned on page 9, and relale also to the mechanism of the combined legs and handle, which can now by one mO\-emellt only be in tantaneously rai ed 01.' lowered, and fixed with ab olute security in the proper po ition. The appearance of the Litter i enhanceel, and all fouling of the stretcher with the hancUe of the under-carriage is avoided . For Prices see page 5.

2 PRI CE LIST

P RICE. L I ST . 3 " ASHFORD " LITTERS .

, PRICES OF THE IMPROVED ASHFORD LITTER, 1899 MODEL. Without New Coupling Arrangement.

With Iron Tyree to Wheels. j 2:ith India. RUbber Tyres toWbeels.

Under-carriage (no Stretcher)

Litter complete with Ordinary I:) tretcher"

Ditto with Telescopie handled Stretched

Ditto, with Police f)tretcher:::

• Prices quoted for Litter with Ordiuary Stretcher include Wide Wbbbing Slings but llO Cheat Strap. LelLther, instead of Webbini' Slinll's, 55. 6d. extra; Ohest Strap, Is. 6d. extra. If supplied without auy Sliugs, 4s. allowed.

t Prioe quoted for Litter with Telescopio-handled Stretoher include wide Webbing Slings and Ohest Strap. Leather, iustead of Webbing Slings, 58. 6d. extra. If supplied without any slings, 4s. allowed; a nd if without Ohest Strap , Is. 6d. 1I,1lowed.

t Prices quoted for Litter with Polioe Stretcher include wide W ebbing Slings and Leather Strll,ps fot seouring a refractory patient. Leather, irutead of Webbing Sling , 5s. 6d. extl"!l.

Extra to any Ashford Litter or Under-carriage. Coupling arrangement as described on previous page , £110s. Od. raies (ret u rnable) charged 48. 6d. for each Litter.

H j:;' (1) (1) :><1 Q o o o p.. '0 (1) ctct(1) S S cJg g 0.: P. '<1 (1) (;' 0 0 (1) D «j 00' CD po g; g; g p.. P '"d P Q @ ct- po S· ,.., j:;'0 g; g B po ODj:;'j:;'DQ (1) (1) 0 rt- S' (i;' (JJ S P«:j:;'aq '0(1)(1) '0 ct- en (1) po D ;So :3 ° ° ;:: (1) C rt- p. B ° ::r (IJ v,,", g- (1) (1) S- 00' c+ n- '0 .... ° :3 Q ro g g ct- S 5 0 B g: (1) '-' g- :3 0 p (1) (1) ct- e- ro ': (;' ti $2 (1) 8 :t p.. ;. D 2 ct- D (1) S :;: (JQ po (1) S- «' j:;' u;. § g. oJ ;:l H 0 n- 3 e. n- :B j:;' 5' g- =? > tfl ::c ." o " o r =3 ..., m tfl t

Without Without I With Oover or Wlth Wlth Oover or With Hood and IIood flnd Oover. Hood and Hood :lnd Oover. A rOll Apron. Apron Apron. P . .c-s.- d. .t s. d. £ s d. £6. d. ,(; s. d. £ B. d.

8 10 o 9 5 11 2 '11 )0 112 2 o 11 0 6 )2 17 o 13 5 6 113 17 o III 15 U 12 10 6 14 7 o 14 15 6 15 7 o 114 5 6 16 2 o 116 10 6 17 2 o 6 o 6 "'" '"0 o t:<J t:

'"0 e: o t'J t: if. ;3 <:.1,

SPECIAL HOOD AND APRON.

THE "REA EDWARDS" UNDER - CARRIAGE.

The Hood and Apron illustrated abm-e l)oc11 duced to take the place of the coyer SOmclUnC!; supplIed a::: part of the "Ashford" Litter, afford n:lUch greaLer comfort to the patient. The materIal of wh](;,h they are made has been specially selecLetl 011 account lLs sLrength and waterproof qualitie '. They can be fitled to any "Furley" Stretcher or " Ashford" Litter. Complete extra, sets of sockets and studs can be supplied at a nominal cost.

PRICE.

Hood and Apron, complete ,,' Extra ockets and 'tuds, per set Wate r proof Sheet (washable) to be stretcher beel laid on the £ R, 11. 2 10 0 016 o 10

Thi'vehid i adapted to carry either of the "Furley" pattern ' tretchers, for particular' uf which :see page 9. In several 1'e peets the uillier-carriage marks a decided alteration. The wheels are cycle pattern, :2) illche' high, and are fitted \\ ith extra Lrong Plleumatic tyrc. . Owing to reducLion in the beighL of the wheels it i' ea. \" to liit a loaded stretcher over them, and Lhe cranked axle' ha therefore been replaced by a Lraight one, con tructecl of tubular ted. In 'tead of ha\'iug fOllr leg made to raise as handles, two fixed leg fitted with small india-rubber wh el or rollers are placed at the foot end, while a, combinell leg and handle, capable of being rai ed or lowered, and fitted with a cro sbar, is u cd at the head eml. The aclyantages claimed for this

6 PRICE LIST

PRICE LIST. 7

PRICE LI T .

arrangement are simpliciLy, ease and rapidity of maniptllatiun, and the facility afforded by the two fixed legs for rai iug the litter on to the pavement . The que. tion of balance has been carefully studied, and it has been found that l ly shifting the tretcher forward, so that Lhe middl of patient's body is several inches in front of the axle, a perf ct balan.ce is obtained when the tr tcher is in a horizontal po ition, and thus there i no weight on the hands of the per on propelling the litter.

Price £10 15s. Cl'ate (returnable) charged 4s. Gel. extra.

ADJUSTABLE L E GS F OR STRETCH E RS.

Primarily these legs which are indepemlent of and adelitional to the ordinary foot wheels are intend (1 lo facilitate the carriage of a tretcher in a railway compartment, in which case two on one side would be luwercd and adju ted by a telescopic arrangement to the proper height, so that the foot wheels on one side would re t on the seat, and the adjustable legs on the other side would rc t on the floor. They may also be used to raise the stretcher to a com-enicnt height when required. When not in u e they are }olc1ecl up immediately under the poles of the stretcher.

Pricelper et of four, 17'13.

PRICE LJ::,T.

"FURLEY" STR E TCHERS WITH T H E AT E ST I M PROV EMEN TS, .89 9 MOD E LS .

TELESCOPIC HA NDLED TRETCHER-OP,E:-'-.

ORDINARY TRETCHER-CLO ED.

The improyemcnt . ,'tr tcher, J 99 MOlle ' l III all patterns of the "Fu I -" 1) t' t' . , are nU111ero TI r e, a len 1 Increased. tI t, Ie comfort to ih anLl lighter, it fold.' u 1e I trmger, more riaid e more comfortable to a 'c! it handle the hands of the bearers l'n .orc! greater protection to way 0' pas 1110' thr h ' r pas age'. ,' hould it be I:> Dug Dtlrrow door- t lclth of. a 101decl stretcher in orclernece.:sary to reduce the nto a rallwav cal riage th ' b ' f01 example to carl'II't re t ' J ,IS can e 1 .' , S Il1g on the ground or su ,t (one, eIther 'when i i tr<?t1 ble and without the by th bearer, without pnce of the tretchers i 1 es Jar to the patient Th been most carefully All minor hay: confidently recommended as th' anbdl the stretchers are way. oroug y efficiellt . T III every c, he e stretcher are acla ted f .

A hford" Litter, and the e alone or a part of the rug, and waterproof h t . I, hood and apron ' for u e with th ee descrIbed in this li t ' .ar my e111. are mtable

Q :2

PRICES OF THE "FURLEY" STRETCHERS, WITH THE LATEST 0 IMPROVEMENTS ( 1899 MODELS ).

N.R-The prices of the Standard Models are shown in heavy type.

Withont Slings or Ohest Strap.

With Wide \ With Wide Webbing W ebbing Slings (no Ohest and Ohest Strap).

With L eather Slings (no Obest Strap)

With Leather Slings and W ebbing Ch est Strap.

Oeclinary Stretcher, for General and Beigade nse, taking the place of both the old ordinary and military vatLerns .. , ......

Telescopic-handled Stretcher foe in confined spaces . ..

police Stretcher, very strong, w:ith Ash Poles, and provided with Leather Straps to secure a refract.ory patientUomplete, with 'Ville 'V ebhing Nlil1gr:. " " Leather Nlings

SlingR, ,\, i<l e ,Yehbing v

pai r

Do. Leather per pair (o r if purchased 'with the :stretcher in stead of 'V ebbing Slings (5/6 extra) over for Stretcher

Superior Hood and Apron (see page 6 )

Npare Beel for Stretcher

Army Rug to cover Patient. OJI Stretcher

£ B. d £ 8 d. £ s d £ B. d.

1 6

19 6 117 6 236 I 19 0 \ 2 3 0 \ 2 4 6 2 5 0 2 9 0 2 10 6

]

el'

'"l C (') D" lJl 0 C;; S· et> =: et> £ s. d. 2 17 6 3 3 () 040 096 o 15 0 2 10 086 06 6 5' §= JE : c§: S ; ; >8' 0'" 6- ;;:-5 0 c-t- =: "0 0 ::;: 0 H 'lii ? e:fr it> >;j :- '" &'" et> _ ., -<:; "'d (') c..... U1 "t;' g > o. 8 ' > 0..0 C!> 000 ...., oPg () .,;If'- m ", '1 it> p. '" met> D" o:l . erC!> ;: q 0 et> ., .1; " -l "' '" ci- .j ""i P;-- po ...:. r (') c: :n et> m g. g • ctp' 0 po ::l !:l po '"d (') t<J t: w

LAMP.

This is fitted with: a _ ocket by )J / l' ( - \. which to fix it to a LiLter, or it can be onvelllently Jcarrie(l oy hand, or atLached Lo a:belL or the clothing. :

Price complete, 5s. : 6(1.

LAROE HAMPER FOR AMBULANCE STATIO N AND RAILWAY PURPOSES.

Dressing Basin, kidney shaped. made . of enam lied iron.

Price Is. 3d

Knife with strong blade ., . en.ch gel.; per doz. .

Pair of Scisso r s each Is.; P r doz. 10 .

Carrying Sheets for carrying patients up and down' tall' or otherwise about a house. Designed by J. C. q., Blackpool, and Irs. Alfred Paine, Bedford. The heet is fitted with rope handles and detachable bamboo pole, and may be placed on a stretcher without.disturbing th e patient.

Price complete 15s.

For contents see page.

PRICE LIST . 13

I Set of Cane plints.

1 Elastic Band Tourniquet.

pb. Carbolic 1 ,. In 'I 111 Ootton Wool .. , C

Pb. Boric Lint . ., \ ase.

1 Roll Adhe ive P la tel'.

20 Roller Bandages, assorted.

1 doz. Triangular Bandages

3 pieces Tape.

4 oz. al Volatile.

4 oz. Bicarbonate of oda.

4 oz. Olive Oil.

4 oz. pirit Ether Oomp.

l-lb. Tin Powdered Boric Acid.

4; oz . Tincture Eucalyptus B.P.O.

1 pair Pean's Forceps.

CONTAINS

I pair cissors.

1 Knife

12 urgeon's Needles .

I packet each afety a,nel Plain Pins.

Oarboliseel Ohinese Twist . Silkworm Gut.

I reel each Black and' hile

• ewing Thread.

1 Kidney-shap c1 Basin.

I topper Loosener

I Graduated Measure.

1 cake 20 per cent. Oarbolic oap .

1 Nail Brush.

3 Empty oz. Bottles.

Price Complete £4.

SMALL AMBULANCE HAMP E R.

cover and strap, for use in factories, collIenes, statlOns, and large works, as well as for parochial and domestic use.

CONTAIN I G

t Set 'plints. 1 Elastic Tourniquet. 3 Tampon, for \ra h· ing wound. 2 Packets Lint. 4 Roller Bandages (wiele and narrow). 4 Triangular Bandages.

Cotton " 7001 . . . . .. } I T' C Boric Wool ... .. . n III a es.

pool of Adhesive Plaster.

Knife, Sci or, Thread, Tape, Needles, and Pin.

Weight complete, Length, 1 ft. 6 in. Depth, 5 in. Width, 7 in. Price £1 lIs. 6d.

14 PRICE

LIST. THE HAMPER

PRICE LI T. 15

P RICE LIST.

SURGICAL HAVERSAC.

IMl'ROVED PATTEJitN, fitted with a tin, so arranged lhat any article can be taken out without disturbing the re t of the contents .

Contents: 1 Set of plints, 6 Triangular Banclag s, 6 Roller Bandages, wide and narrow; Cotton vVool, Boric Lint, in tin cases; 1 Roll Adhesive PIa ter, 1 pair cis ors, 1 Knife, 2 oz. Olive oi14 2 oz. Tinct. Eucalyptus B.P.C., 2 oz. ,'al Yolatile, 2 oz. pirits Ether Comp., 1 Graduated Gla leasure, 1 Elastic Band Tourniquet, Pins, Needles, a,nd Thread.

Price £1 lIs. 6d.

White Linen Ration Haversacs Is. gel. each.

PRICE LIST.

NURSES ' WALLETS.

ORDINARY PADLOCK RA P E. vVithout instrumentR, 48. 3J.

Fitted complete, containing Bow Dre ing Forceps, patula, Probe, :2 pairs cissors (round and sharp pointed), Clinical Thermometer, amI Knife.

Price s. 9d.

T. PATTERX, a illu tntted, but improved by the addition of Haps to protect the illRtrumcnt.

\Yithout instruments, 7 . 9d.

Fitletl complete, containing Bow Drc sing Forceps, Art ry Forcep' (also useful for dres ing), Spatula, Probe, Director with Ear coop, Z pairs I ' cis or (round and sharp pointed), Clinical Thermometer (minute, round), Knife, Pencil, . and Sa,fety Pins. .

CONTENT,' OF FIR, T AID BOX. (Ill u trated on previou page).

1 S et of "W ooden 'plints; 1 Elastic Band Tourniquet; Ca,rbolic ,Vool , Boric Lint, in tin cases; 1 Roll Adhesive Plaster; 12 Roller Bandages, as orted; 6 Triangular Bandage ; 3 Pieces of Tape; 1 Pair cissors; 1 Knife; 1 Kiclney'haped Basin; 1 Graduated Mea 'ure; 2 oz. Olive Oil; 2 oz. Tinct. Eucal,n)tus B.P.C. ; 2 oz. ,'al Volatile; 2 oz. ,'pirits

Ether Comp.; oz. Carron Oil; Pins, ,'afety Pins, Teedles, -

YRICE COM PLETE £2 10 .

Tourniquet , Ela.,tic

Braces or Tourniquet)

Splints, \Vooden, per set :2/6; Cane pel' et Tow for splint padding ... per lb.

First Field Dressing (Army regu lation pattern), Price each

Jaconette, -H inehe' wide per yard

Carbolized, or Styp ic Tow ... per lb.

Waterproof Lint (ill case to hang on wall) .. .

FIRST AID BOX FOR LITER OR AMBULANCE .. STATION... "

This is primarily desi gned to be placed on the A sh ford Litter (1899 Model), but it is further to be hung up on a wall. A de tachable leather handle IS a lso fitt ed f or c arrying purposes.For contents see next page.

Ambulan ce Station Pla t e , Enamellecl Iron, 3:-;. 6ll. each. Stretcher Depot Plate, Enamelled Iron, 3 . 6d. each.

18 PRICE LIl:lT.

PRICE LIST.

Tourniquet, Field Tourniquet Bra ces (sen'

SAFETY PINS. All fa. ten or unfa len on either sid s. el. I 6 2 6 2 6 7 6 0 6 0 9 2 3 0 9 :2 6 Facile J o. '6UO or " 60:2 per 3 doz. () 6 " ,,' 603 " 0 Dl1ches Duplex, TO. 2 per doz. 0 :2 ,Assorted 0 3 pecial Blanket "afety Pin. , 3 in. 1 U in. 1 6

20 PRICE LIST.

Nursing Chart, de igned by )1is I n d erwick , leI. each, by post, 2d. , per doz. 9d.

Temperature Chart, I d. each, by post 2d., per dozen gel.

Nursing and Temperature Charts in sets, to record - the J ur ing of a case for a fortnight, 3d. , by post 4(1. Registers. Class Attendance and Certificate (two to set), 6s.. Ca e Report Is .

Large Physiological Diagrams. For L cturer ' u e.

Comprising: The Human ' keleton, the I usculal', Arterial and Venons Systems, the Heart and Circulation of the B lood, 'imp le Fracture, Componnd F racture, Dislocation . Price, per set of six, 15s. These may be hired for a course of "First Aid" lecture , given under the auspice of the Association, for a fee of 5s., or with the addition of Splints, Tourniquet, and p lain Triangular Banda,ges, for a, fee of lOs .

Boxes of Stationery for the use of CIa ,ecretaries and others connected with the A ociation, cont.aining twelve sheets of high-class-paper, suitably headed, and tweh-e envelopes bearing the device of the A ociation. Price 6<1., by post 9d. Twice that quantity, price 1 ., by pmlt Is. Medallions , issued in accordance with special regulation , for which see leaflets No . 62 and 62A, to be had on application. Coinage Bronze, 2 .; ilYer, 7 . 6d.; <fold, £2 lOs. ; including engraving name and numbcr on back. Morocco velvet-lined case, 2s.

NURSING INSTRUMENTS.

Bow Dressing Forceps , fu ll size, Is . 3d.; mall, extra well finished, Is. 6d.

Scissors , round-pointed, Is . 3d.; harp-point.ed, for delicate work, l s. 3d . ; tronger, I s. 6d.; small round-pointed, b lades take apart for cleaning, Is. 9d.

Spatula, 9d. Probe, 9d. Director, with Ear Scoop , I s. 9d. Artery Forceps , 2s. 4d. Knife , very thin, ivor y handle, two b lades, I s. 9d.

PRICE LIST. 21 THERMOMETERS.

Round., Ordmary , l s . 6d. ; minute, 2s. ; hali-minute, 2s . 6d. ,tl"?ngly r as they will not roll. Ordinary, 2: .; rap](l (spccla lly selec t ee l and reserved for the AssociatlOn), WIth Yery open scale, :3s. 6d.

L e nse Fronted. \ V.hen in the proper position the c.olumn of .m l:cury maglllfied, anrl <;0 easily read. A ttle IS req to a certaL t he correct posi tioD Ill, whIch to hold the m tl'ument. Price, ordinary, :? . ; ll1lJlute, :2s. gel. ; half-minute 4s.

(to order)', Is. 3d. each. T.B.-These clthcr state that the instrument is correct or POlut out a?y slight error there may be; they are Hot u ually con Idel'ccl nccessary.

( BATH THERMOMETERS.

To Dr. Forhe' specification. Japanned with zinc scale 2.. :3d. ; Pocket size, 1 . 6d. '

So liabiLity is taken for breakage of Thermometer in transit.

TEXT BOO KS, «c.

"FIRST AID TO TIlE INJURED." By Jamcs Cantlie, F.R.C .. '. Th authori ed Text-book of the Fir t ..:lid OUl":::le. 1.; by post, Is. 2d.

"CATECHISlII OF }l'IRST AID." ompiled from Dr. )!anual. By J. Brown, L.R .P .. L.R.C .. , and J. ::\1. " Can-eU, M.R.C., ' ., L . . A. Price 6d.; by po t, Id.

HIXTS AXD HELPS FOR H OME NURSING A D HYlHExE." By E. )lacD?we.H Cosgrave, ::\I.D., illustrated, with chapter on the apphcatlOn. of the roller bandage, by R. J. ollie, ::\l.D. The authonzed Text-book for the Nul' ing Cour e. Is., by po t, 1 . :?d.

"HOME H YGIENE," By John F. J. ,ykes, D .• c., (Public Health) ::\1. D .• &c. Illustrated. The TextBook for the Home Hygiene Cour e, 1 ., b y po t , 1. . 2d .

22 PRICE LIST.

TEXT BOOKS, &c.- (continuecll.

OATECHISM: ON HOME N URSING, based on Dr. 00 grave's Text book}. By J. Brown, L.R.O.P., L.R.0.8., and J. M. Oarvell, M.RO. . , L .. A. Price 6d., by post 7d.

"QUESTIO S AJ."'<D SWERS UPON AMBULANCE WORK." By John W. Martin, M.D, of heffield, and John :Ma.rtin, F.R.O.. Ed., of Ruddersfield. I s., by po tIs . Id.

"QUESTIONS AND ANSWERS UPON NURSING. " By John ,V . M.D. Is. 6d., by pOiilt Is. Sel.

"FIltST AID TO THE I T JURED ( ix Ambulance Lectures)."

By Professor Frederich Esmarch. Translated from the German by H. R H. Princes Ohristian. 2s. , by post 2s. 2cl.

"ELEMENTARY B ANDAGIJ. G AND URGICAL ID RESSING." By ,Valter Pye, F.RO. . 2s. , by post 2s. 2d.

DR. G. H. DARWI N'S" FIR T AIDS " being a card to hang up, giving treatment of various accidents. 2d., by po t 5d.

To RESTORE THE ApPARENTLY D ROWNED printed in large Type with Two Diagrams. Unmounted, each 2el. M ounted with red border, and varni hed to hang up, 6cl., IJost free, packed, Is.

" H ow TO ACT WHEN OLOTHING TAKES FIRE." By J. E. H. Mackinlay, 'LRO.. Unmounted 2d., by post 3d Mounted on card and varnished, 4d . ; by po t, pa.cked, 7 tl

FIRST AID PRINCIPLES. Oard of concise directions for waistcoat pocket, each 4d. per dozen. pccial quotations for large quantities.

"SPECIMEN EXAMINATION PAPERS, Fir t Aid and Tursing Oourse. " 3d., by post 4d.

SMALL ANATOMICAL DIAGRAM. howing the human 'keleton, main arterie , and point where pressure should be applied to arrest bleeding. 2d., by post 3d .

LIST. 23

TEXT BOOKS ;

AIDE 1EMOIRE. On cardboard, in linen·lined envelope, \for the pocket. By the late , urgeon-Major P. ,'hepherd.

Oontaining useful hints for First Aid to the Illjured. 3d.; by post -iel .

GENERAL NOTE ON FIR T AID TO BE RENDERED IN OA E' OF POISONING. By Milne. Rey, M.A., M.R.0.8., L.R.C.P. Price 2<1. ; hy post 3el.

" EMERGE TCY BOOK, " for instantaneolls reference, giying concise instructions, Lo hang on wall. ,izc about one foot sq UC1.re. Price 28. 6cl.; by post::3s.

A HISTORY OF THE ORDER. OF THE PITAL OF ST. JOHN OF JERUSALEM. By the Rsv. 'V. K. R. BEDFORD, Genealogist of the Order, and Lieut.-Oolonel R. R. HOLBECIIE, Librarian of the Order.

In one Vol., Demy vO., :2:30 pp. illmllmted.

1)1'ice 7 . Btl.; by 7s. lOtI.

THE KNIGHTS HOSPITALLER.S IN SCOTLAND, AND THEIR PRIORY AT TORPHICHEN. By GEORGE THOMAS BEATSON, :'\1.D. .B. '''ith 15 pages of illu tratiolls. Price 2". BtL, bound in cloth. Po L free, 2.. d. R

ROLLER

BANDAGES. Fine Grey Oalico,or Opell Superior Wove Wbite OpeR Grey. Wove.

i in., 6 yards long, per doz.

'1 in . , 6 yards long

1 in., 6 yards long

-2 in . , 6 yards long in., 4 yards long in . , 6 yards long

3 in., 6 yards long

4 in . , 6 y ards long

-6 i n . , 6 yards long

ROLLER BAN DAGES in Assortment. 1 follows'- Each packet contains 6 bam; ages as '. l ' 6' I two 3-inch, one l-111C 1 , 6 yards long-one -111C 1, long-two

Fine Grey Calico ... per packet

Plain Triangular Bandages___ per doz . . 1 Bandages (after Esmarch), III t ted Tnangu ar 1 u ra l' t' s of the Triangular Bane age, showing 2 1 lCa lOn each with printed instr u ctions ...

Designcd by;Dr.:A. . Tun. tall. 6d. COTTON WOOL.

vVhite ab orb nt, good, 1 oz. packet, 2d.; 2 oz. packet, 4 oz. packet, 4t1. ; 1lh., 7c1 . ; lIb., Is.; uperior, lIb., Is. 6(1. Boracic, per lb ., Is. 6d.; Carbolic, per lb., J. d.; Alemln'oth, per lb., 1. 6d.; Double Cyanide, per lb . , 2s. 6d.J

LINT.

Medium quality, 1 oz. packet, 2d.; 2 oz. packet, 3d.; 4 oz. packet, 6d. ; lb. packeL, J Oct; lIb. packet. Is. 6<1. ; he t quality, 1 lb. packet, :2s, ; Boracic quality, lIb. packet, Is. 6el. ; 4 oz. packet, 6(1.

The. e are suppli 'tl inche.

Unmeclicated white .. . Alembroth

Double \'anicle Boracic GAUZES. in 6 yard lengths, width about 36

GAUZE TISSUE.

A layer of ab orbent cotton wool between two heet of per lb., Is . 6tl. ; l1perior, per lb . , 2s.

24 PRICE LIST.

B d. s. d . 0 9 1 0 1 3 3 6 3 6 2 0 2 6 3 6 4 6 Best quality, white, witb woven euges . s . d. 1 9 2 0 3 0 3 6 4 0 4 6

r doz.

4 yard d. o 4 6 o 6 4 6 PRICE LIST. ROLLER BANDAGE MACHINE. 25 )

per length 0 10 1

0 1 2 1 2

PRICE LBT.

PLASTERS.

Manufactured oy I e srs A. De St. Da11l11s & Co.

Leicester Adhesive Plaster all Cambric, in \;i11s of yard, 6 inches wlde . s . d o 6

The LeicCRter Adhesive

Ribbons, inl tin boxes, 6 yards l ong. inch wiele... 6el.

1 inch wide ...

National Rubber ive Plaster (Anti eptie). on spools.

5 yds. 10 yds. inch wide gel . Is.

1 " Is. Is. 6d.

2 Is. 9el . 2s . 3d. " " Ditto in box, t in . wide, t yds. long , , tm ,,1 " :] " i 3 5" ,,!i " 5 " COURT PLASTER, TRICOLOUR.

Large Size, 9d.; :Medium, 5c1.; • mall, 3d. lel.

BADGES

Arm Badges ,::;'with the device, issued under the authority of the Central Executive Committee, having been first approved by H.R.H. the Grand Prior as the sale official amI recognized Badge of the .As ociation and Brigade.

fl.B. -This d csig ll is l'(otrctt'd, ani must be obtal1lsd dtrect from the CentraL O{fico No.1, for the use of inelividual certificated pupils·- s. d. In erman. ilver ... ... ... ... . .. 0 9 'mall ize ditto . . 0 7i • ma.ll ize for button hole

6 In Electro Plate 2 0 •'mall. 'ize ditto .. 1 6 mall 'ize for button hole I 0 In Cloth and. 'ilk .. . .. . 0 9

In loth and, ilver (Registered Jumber, :3,522) ... 2 0

I n loth and 'Vor ted .. . .. . .. . ... 0 6

t::lmall Celluloid Badge for button hole, arm, or brooch... ._ ... ... ... . _ 0 2

v hite Batill Armlet, "ith woven Badge... ... 0 7!

N.B.-Th e. e are not to be worn a. de cora tion.

..• :3el. ... ·:M. 6el. 9el.

BUTTONS FOR THE U NIFORM OF THE ST. JOHN AMBULANCE BRIGADE.

Issue(l only for the use of OfficerR and Members of Corps and Divisions wearing the prescribed uniform.

Electro Plate, large .. . small .. .

German ilver, large .. . small .. .

Black Horn, large small

ELECTROTYPES OF THE ST. JOHN J IAMBULANCE DEVICE.

Series A. Series B for for Association. Brigade

No. 1. For Cards, Tickets, &c.

2. For Note Paper, mall Circulars, &c.

II 3. For Quarto and Foolscap Letterpaper, Circulars, &c.

4. For \ mall Po tel'S

5. For Large Posters

Complete eries

Prints of the above electrotypes, with the exception of No.4, which is shown on page 25, appear on the following ages.

30 PRICE

LeST.

s. d. per doz. 4 0 2 0 o o o 6 o 4

use. use. s. d. s. d 1 0 1 0 1 0 3 o 6 1 9 5 3 3 3 0 5 6

PRICE LI T. 31

ELECTROTYPES.

No.1 A .

ELECTROTYPES .

No.5 A.

For prices see P age 2 .

PRICE LIST.

BRIGADE F LAG.

For marking the position of Ambulance 'tations at Fetes, Exhibitions, &c., 4 ft . 1 in. by 3 ft. Price 12s.

UNIFORMS

These may be obtained direct from Hebbert a»c1 Co . , 35, Bethnal Green Road, E. Telephone No. 909, London "\Vall; Telegra,phic Address, " Otherwise, London."

CHIEF AND SURGEOX.

Tunic (Badge exira) ... ... .

Troll ers: Two-inch {ohair Braid side. eams

Cro s- hell, and Pouch: Black Morocco

Forage Cap an

All orders for the foregoing Stores should be given to the Local Secretary , or to the stores Department St. John "Ambulance Association, St. John's Gate, - Clerkenwell, E.C.

UPT. AND OTHER CalEF OFFICER. Tunic (Badges extra)

Patrol Jackel, (Ba<lge extra)

Fatigue Jacket (Badges extra) ...

Trou er : Two-inch Mohair Braid down side seams .

Cros -belt, "\Yhite Patent Leather and Black

Morocco Pouch (Batige extra)

Forage Cap an <I Cover ...

Field Cap (Badge extra)

Gloves

Leggings

(Badges extra)

: Two-inch Mohair Braid clown side seam

Cross-bell, "\YhiLe Patent Leather and Black

:Morocco Pouch (Badge xtra)

Forag Cap and ovcr

Fielu Cap

Legging.

34 PRICE LI'T. £ s. d. Flags bearing Association dcvice - 12 feet by 6 feet 1 7 6 5 feet by 3 feet 0 12 6

PRICE LIST. 35

1 Cover ... Field Cap Gloves heat Coal, )Bauge eXLra)

CHIEF

...

. .

... Great Coal,

£ s. d. 440 150 100 196 o 12 6 046 440 440 3 3 0 2 10 6 5 0 o 14 6 156 (J 10 ") 046 o 6 440 OPT. OF DIVI ION OTHER OFFWltR '. Patrol Jacket (Badges extra)... ...... Z 6 Trouser.

6 o

...

Glove

.. ... reat 'Coat

014 6 1 5 6 o 10 0 o 4 6 o 6 440

(Badge extra)

MESS DRESS FOR OFFICER.

Jacket (Badges extra) ... Vest . 1ST OLA ERClEANT.

Patrol Jacket (Badges extra) ...

Ohevron, 4: bars Silver, 3s. 6tl., ,YOI' ted

Trousers ...

Forage Cap (Badge extra) ...

Oro s-belt and Pouch (Badge extra) ...

Field Oap (Badge extra)

Buckskin Gloves ...

Cotton

Leggings...

SERGEANTS, CORPORAL, A D RANK AND

Patrol Jacket, Black Tartan (Badges extra)

Sergeant's Ohevron i ilver, :2s. 6el., 'Yorstecl

Oorporal s Silver, 1. d., ,VOl'. Led

OYCLISTS-SUPERINTENDENT.

Patrol Jacket (Badges ex.Lra) ...

Oap (Badge extra) ... ...

Breeches: Grey Serge ..

Shoulder Belt and Pouch

Gloves ...

Gaiters ...

Hose

Jacket (Badge extra) ... 'ap (Badge ext,ra) ...

Breeches: Grey, 'erge .. , houlder Beltl ..,

Glove (per pair)

Gaiters (pel' pair)

All Badges to be obtained by the Oorps or Division from ,'t. John's Gate.

If the Oorp or Division is out of London measurements to be _ su pplied Lo COll tractors free of charge. ' arriage ont. of London extra.

PRICE LI'T.

. ..

.. .

... .., ... . ..

Ooat

£ s. d. 3 :3 6 1 8 6 2 :3 6 0 1 4: 1 ] () () 10 9 011 0 0 2 8 0 4 6 0 () 0 3 6 o 1:3 6

Great

(Ohevron and Badge extra)

FILE.

0 ] I ()

() 9 6

extra) 0 '*

for Oap... .., 0 0 ,Yaist-belt and Pouch... 0 6 6 Field Oap (Badge extra) 0 2 8 Great Ooat (Badge ex.tra) 0 1:3 6 Gloves (per pair) 0 0 8 L

0 :3 6

Trousers, Black Tartan

Forage Oap (Badge

Oover

eggings (per pair)

0 I II

2 If) 0 1 :3 6 o 12 () o 10 6 04:6 o 4: (j 046 440 PRICE LI T. 'YCLIST -RANK

FILE.

Great Coat

AND

37 £ s. d. o 19 6 o 2 () o 12 0 o 10 6 046 046

INDEX TO PRICE LIST.

Ambulance Hampers '" ]3,15

" Station Plate 20

Ashford Litter 3, 6

Badges ... ... 27, 29

Bandage Rolling Machine... 25

Bandages ... 24

Basin, Dressing ... 12

Books ... ... ... 21, 22

Bottles (Water)... 11

Braces (Tourniquet)... 19

Buttons SO

Oarriag'es (Horle Ambulance) 2

Oarrying Sheet ]2

Ootton Wool 25

Oover for Stretcher or Litter 10

Diagrams, Large 20 "Small 22

Dressing Basin ... 12

Electrotypes ... ... 30, 33

Emergency Book ... 23

First Aid Box... ... ... 18, 19

First Field Dressings 19

Flags 34-

Gauzes 25

Gauze Tissues... ... ... 25

Hampers (.AJ:nbulance) 13, 15

Havresacs ... ... ... 16

Hood and Apron for Litter.. 6

Jacouette 19

Knife 12

Lace 29

Lamp 12

Lint ... ... 25

Litter (Ashford) 3, 6

Lowmoor Jacket

Medallions ...

Nurses' Wallets

NlLrsing Oharts " Instrumentfl

Plasters

Registers

Roller Bandage Machine

Rug ... Safety Pins

Scissors ... Slings, Stretcher Splint Padding Splints .. , Stationery ... .. Stretcher Depot Plate Stretchers ... Adjustable Legs for .. .

Temperature Ouart 20

Text Books ... .. ... 21, 22

Thermometers (Olinical aud Bath)

Tourniquets .. , Tow, carbolir.ec1 " plain

Under - carriage , Rea 21 19 19 19 Edwards" .. 7,8

Uniform Sundries 29

Uniforms .. , .. 35, 37

Wag'ons (Horse Ambulance) 2 Water Bottles 11

Waterproof Sheet 6

Waterproof Lint 19

Whi3tle and Obain 29 Wool (Ootton) ... 25

PAG!?

PAGE 11 20

17 20 20 26 20 25 10 19 12 10 19 19 20 20 9,10