If you are unsuccessful after trying several times to replace a dislocation, get a doctor.

If no doctor is available, make the man sick by having him drink some warm salt water and then put his finger in his throat.

When he vomits the muscles and ligaments (tissue connecting the joints) will relax and you may be able to get the bone back in place.

After replacing the bones put the joint at rest with a large compress and bandage.

When uncertain as to whether you have to deal with a broken bone or a dislocated joint, give treatment for a broken bone, because rest and quiet for the injured part are good in either case.

The following diagrams show the usual methods of replacing dislocations:

[Ill.u.s.tration: Fig. 12

_To put the arm bone back into the shoulder socket_

1ST MOVE

_Rest your weight at elbow, pulling downward, until the muscles at the shoulder are tired and will stretch._

2ND MOVE

_Swing the elbow across, close to the chest, and place the hand on other shoulder._

3RD MOVE

_Keep the elbow close to the chest and bring the hand forward as if held out for a penny._

_This should twist the bone into the socket._

_Relocating the jaw_

_When the jaw bone is out of place, the man cannot shut his mouth._

_Put both thumbs (protected by a handkerchief) on the lower teeth and with the forefingers at the angles of the lower jaw push down in the back of the jaw._

_Relocating thumb_

_When the thumb bone is dislocated it must be PUSHED into place--not pulled._

_Relocating finger_

_Pull the finger bone back into place._]

=1493. Drowning.= _Rescuing._ Approach the drowning man from behind, seizing him by the coat collar, or a woman by the back hair, and tow at arms length to boat or sh.o.r.e. Do not let him cling around your neck or arms to endanger you. Duck him until unconscious if necessary to break a dangerous hold upon you; but do not strike to stun him.

A drowning person _does not_ come to the top three times before giving up.

_Reviving._ When a person is apparently drowned he is unconscious and not breathing because his lungs are full of water and his skin is blue and cold because no air is getting into his blood to redden it and warm it; _remember_ the heart does not stop until some time after the breathing stops. If we can get air into the blood and start breathing again before the heart stops we can save the patient's life. If we cannot get the breath started in time the heart stops and the patient is then dead.

Our problem then is this:

1. To get the water out of the lungs.

2. To get the air into the lungs and start the man breathing before the heart stops.

Emptying the lungs is precisely similar to emptying a bottle.

The lungs are the bottle, the windpipe is the neck of the bottle and the cork of the bottle may be the tongue turned back in the throat or mud and leaves from bottom of the pool and b.l.o.o.d.y froth in the nostrils. We therefore--

1. { Pull out the cork.

{ =Remove mud, mucus, etc., and pull the tongue forward.=

[Ill.u.s.tration: Fig. 13

_Pulling out the cork_]

2. { Turn the bottle neck down to pour out the contents.

{ =Place the patient's head lower than his chest so the water { will run out.=

[Ill.u.s.tration: Fig. 14]

Then lay the patient on a blanket, if possible, and on his stomach, arms extended from his body beyond his head, face turned to one side so that the mouth and nose do not touch the ground. This position causes the tongue to fall forward of its own weight and so prevents it from falling back into the air pa.s.sages. Turning the head to one side prevents the face coming into contact with mud or water during the operation.

Kneel and straddle the patient's hips, facing his head.

[Ill.u.s.tration: Fig. 15]

Roll up or rip off the clothing so as to get at the bare back.

Locate the lowest rib, and with your thumbs extending in about the same direction as your fingers, place your spread hands so that your little finger curls over the lowest rib. _Be sure to get the hands well away from the back bone_,--the nearer the ends of the ribs the hands are placed without sliding off, the better it is.

Then with your arms _held straight_, press down SLOWLY AND STEADILY on the ribs, bringing the weight of your body straight from your shoulders. _Do not bend your elbows and shove in from the side._

Release the pressure suddenly, removing the hands from the body entirely, and thus allowing the chest to fill with air.

Wait a couple of seconds, so as to give the air time to get into the blood. This is most important.

Repeat the pressure and continue doing so, slowly and steadily, pressing down at the rate of ordinary breathing. That is to say, _pressure and release of pressure (one complete respiration)_ should occupy about five seconds. Guide yourself by your own deep, regular breathing, or by counting.

Keep up for at least one hour the effort to revive the patient; and much longer if there is any sign of revival by way of speaking, breathing, coughing, sneezing or gurgling sounds.

Do not stop working at the first signs of life, but keep it up until the patient is breathing well and is conscious. If you stop too soon he may stop breathing and die.

Persons have been revived after two hours of steady work, but most cases revive within about thirty minutes.

If you are a heavy man, be careful not to bring too much force on the ribs, as you might break one of them.