Sprains.--Every joint is held together by ligaments which are attached to the bones forming the joint. If these ligaments are subjected to a sudden twist in a direction in which the joint is not constructed to move, the resulting injury is known as a sprain. The ligaments are stretched, though they may be torn apart and even small pieces of the bone may be split off if the wrench is great enough. The injury is an exceedingly painful one and frequently renders the limb useless for some time. It is always accompanied with some degree of swelling and more or less inflammation.

A sprained joint should be immediately put at absolute rest. The best dressing is the lead and opium wash. Two pints of it may be obtained at the drug store. Pour into a large bowl, saturate a large piece of thick absorbent cotton, wrap around the joint and bind in place. This dressing may be repeated as often as the cotton becomes dry. When the swelling has disappeared and the pain is gone, it is desirable to have the joint supported with strips of adhesive bandage. These must be put on in a certain way in order to properly support the joint. Consequently a physician should put them on. If a sprain is not attended to effectively there is danger of the joint being more or less incapacitated for life.

Dislocations.--A dislocated joint is one that has been put out of place. It is best to allow a physician to treat a dislocation. Unskilled handling of a dislocated joint may not only increase the damage but it may permanently put the joint out of business. Until the physician arrives the part should be kept absolutely at rest.

Wounds of the Scalp.--Children frequently get injuries of the scalp.

These wounds bleed freely and as a rule they occasion a great deal of unnecessary worry and apprehension. Usually they are not of much importance. We must keep in mind, however, the probability of fracture as a consequence of severe injury. The first thing to do when there is bleeding from the scalp is to cut or shave away the hair surrounding the wound. This should be done for an inch around the wound so that thorough disinfection may be possible. The wound should now be cleansed as previously instructed and an effort made to stop the bleeding. The best method is to first apply pads of gauze wrung out of very hot water. When success is evident a pad made of boiled cotton should be placed on the wound and held tightly in place for some time. If the wound is of such a character as to demand st.i.tches a physician should of course put them in.

Run-Around: Felon: Whitlow.--When pus germs enter around a finger nail and lodge in the soft tissue a "run-around" is the result. It is accompanied with pain, swelling, redness and inflammation. The loss of the nail may follow.

A felon or Whitlow is a more extensive and a more serious condition. It is not always possible to trace the cause of a felon. The fact that germs gain an entrance, however, is soon established. Sometimes a bruise, or scratch, or a wound is the primary cause. The last joint of any of the fingers may be the seat of a felon. A end of the finger becomes hot, tense, swollen and very painful; the pain is intense if the hand is held down. The surface may or may not be red. There is as a rule some fever. If the felon is on the little finger or thumb the condition is worse than on the others as a rule,--the inflammation extending to the hand and often into the arm. The condition affects the palmar surface of the fingers. If the felon results in the "death" of the bone, the last joint will have to be taken off and the hand may be distorted, crippled, and rendered permanently disabled. Blood poison may set in and death is possible as a result of this complication.

Treatment.--Every effort should be made to abort a felon. Continuous application of equal parts of alcohol and water night and day may abort it. Tincture of iodine applied to the entire end of the finger may be effective. The hand must be at rest, carried in a sling during the day and slung over the head to the bed-board at night. If these efforts are not successful after twenty-four hours hot poultices should be resorted to, but they must be changed every twenty minutes. If, at the end of another twenty-four hours, there is no improvement the finger must be freely cut open by a surgeon and the poultices continued.

Treatment of "Run-Around."--Apply iodine freely, cold applications, and if the inflammation persists use poultices. It is frequently necessary to incise the run-around. Patients suffering from either of these conditions need general tonic treatment and should be under the care of a physician.

Burns and Scalds.--Burns result from undue exposure to dry heat.

Scalds are produced by the action of hot liquids and steam.

There are always produced two results from a burn or a scald. First the local effect, and, second, the general effect. The general effect may produce shock, the symptoms of which have been described in the previous pages. The degree of shock depends upon the extent of the local injury and may be severe enough to result in death. If the local injury covers more than two-thirds of the body death as a rule takes place within two days.

How to Extinguish Burning Clothing.--The thought to keep in mind is to smother the flames effectively. If we deprive the flame of all air or oxygen it will immediately subside. This may be done quickly by wrapping the burning part in a carpet, rug, blanket, overcoat or any large woolen material at hand. If none of these articles are at hand the victim may roll on the floor and try to smother the flame by pressure, aided by the hands. It is a good plan to throw water on the patient immediately after the fire has been put out, so as to extinguish the smoldering fire.

When a person is scalded by steam or boiling water or other liquid, it is advisable to pour cold water freely over the wound.

How to Remove the Clothing.--When it is necessary to remove the clothing it is essential to be gentle in order not to do greater injury.

The clothing must not be pulled. The garment should be cut so that they fall off. If any part sticks to the skin, it must be left, not torn away. Later, it may be removed by moistening it with salt water.

Treatment of Scalds and Burns.--All slight burns or scalds may be effectively treated with Unguentine. This substance may be obtained in any drug store. It is spread on a cloth and applied directly to the injured part, bound securely on and renewed every day until the wound is healed. If Unguentine is not readily obtainable the part may be covered with any of the following mixtures or oils: carbolated vaseline, equal parts of linseed oil and lime water, olive oil, castor oil or kerosene, cloths soaked in a solution of baking soda, or a solution of phenol sodique.

In severe burns or scalds the mother should not attempt to treat the child. A physician should be summoned at once. The child may be given a little whisky or brandy in warm water, and if the pain is great a dose of laudanum may be given. The dose of laudanum is one drop for each year of life. If the child has a chill he may be put into a warm bath of 100F. It is not wise to cut a burn blister. The water may be let out by puncturing with a sterile needle, but the skin must be left intact until the new skin is grown. The treatment of burns must be done with the greatest cleanliness because if infected with germs they may prove serious.

MISCELLANEOUS

CHAPTER XL

MISCELLANEOUS

The Dangerous House Fly--Diseases Transmitted by Flies--Homes Should be Carefully Screened and Protected--The Breeding Places of Flies--Special Care Should be Given to Stables, Privy Vaults, Garbage, Vacant Lots, Foodstuffs, Water Fronts, Drains--Precautions to be Observed--How to Kill Flies--Moths--What Physicians are Doing--Radium--X-Ray Treatment and X-Ray Diagnosis--Aseptic Surgery--New Anesthetics--Vaccine in Typhoid Fever--"606"--Transplanting the Organs of Dead Men into the Living--Bacteria that Make Soil Barren or Productive--Anti-meningitis Serum--A Serum for Malaria in Sight.

THE DANGEROUS HOUSE FLY

Mothers should become thoroughly acquainted with the grave consequences which may result from fly-infected foods, and from the possible carriage of disease by means of flies, even where foods are carefully protected.

The transmission of the following diseases by means of flies has been conclusively proven: typhoid fever, tuberculosis, cholera, Oriental plague, inflammation of the eyelids, serious infection of wounds. Summer diarrhea of children is also transmitted in this way.

Typhoid fever and summer diarrhea of children in this country, and cholera and Oriental plague in the countries in which those diseases exist, may be transmitted through the various foods that are eaten in an uncooked state, if infected by flies, through cooked foods infected by flies after the process of cooking, through drinking water which has been infected by flies, and through milk similarly infected. Fruits are especially likely to be infected by the small fruit fly commonly found around markets and stands. Fish may be infected by flies, and in consequence will undergo rapid decomposition. Decomposition caused in this way has resulted in many cases of diarrhea and dysentery. What is commonly known as fly speck is the excreta of the fly, and frequently contains virulent disease germs. These specks are often found on foodstuffs that have not been properly protected.

Transmission of disease may also occur by the infection of open wounds through contact with infected flies. This is true of all pus formation in wounds. The simple contact of a fly infected with the disease may cause Oriental plague, sore eyes, and possibly granular eyelids. A fly infected with dysentery or typhoid fever may cause either of these diseases by simply coming in contact with the lips of susceptible persons.

The fly in the house should be relentlessly pursued and destroyed. The house which is carefully screened and protected from flies is infinitely safer than one not so protected. In the spring of the year the house fly begins to take on life. Eggs which were laid the preceding fall begin to hatch. At first the fly is only a little worm wriggling in some pile of filth. The eggs are usually laid and the grub developed in a manure pile or some ma.s.s of garbage or other filth. Before the grub develops into the fly it is easily destroyed. If everything in and about the house were kept scrupulously clean, and if every manure pile were kept carefully screened or covered so as to protect it from flies, there would be no difficulty in preventing the fly nuisance. The most effective way to accomplish this is to destroy the breeding places. The importance of this may be seen when it is considered that one fly produces one hundred and twenty-five millions or more of its kind in one season.

Stables.--Manure is by far the commonest material in which the fly lays her eggs. All stables should be kept scrupulously clean. No manure should be allowed to acc.u.mulate where it will be exposed to flies for even a few minutes. Immediately after it is dropped by an animal, it should be removed and covered. Manure may be treated with considerable quant.i.ties of lime without interfering with its fertilizing value, and in this way the development of the eggs laid in it by the flies can be practically prevented. The floors of stables should be thoroughly flushed with water at least once in every twenty-four hours.

Privy Vaults.--Human excrement also affords an excellent breeding place for flies. In army camps the latrines are the points from which much infection is transmitted to troops, and thousands of the men have lost their lives by contracting typhoid fever transmitted in this manner. During the summer time all open vaults and dry closets should be treated continuously with lime, crude creolin or crude carbolic acid, and they should be carefully cleaned out at frequent intervals.

Garbage.--As a medium for the development of flies, garbage may be considered next in importance to excreta. The eggs of the fly hatch in about twenty-four hours, and garbage which is retained in the kitchen for that length of time may contain flies in the grub stage. To prevent this development, all garbage should be covered and pails should be emptied as often as possible. In country districts garbage should be burned in the kitchen or buried in the garden at frequent intervals, twenty-four hours being the maximum time it should be retained.

Vacant Lots.--Vacant lots frequently contain appreciable quant.i.ties of organic matter in a state of decomposition, affording favorable breeding places for flies. These vacant areas should be maintained in a state of scrupulous cleanliness.

Foodstuffs.--In order to prevent contamination of foodstuffs, all foods that are eaten in the raw state and all foods that are exposed for sale after having been cooked should be carefully protected from contact with flies, by screens or covers.

A point where rapid development of flies takes place is along the city's water front. This is due to the fact that many of the sewers do not discharge below the level of the water. All open drains should be eliminated, whether they be sewers, private house drains or drains from cess-pools.

Precautions to be Observed.--Keep the house free from flies. Every fly should be considered a possible disease carrier and should be destroyed.

Keep the windows of the house, especially the kitchen windows, carefully screened during the spring, summer and autumn.

Protect children from exposure to flies, particularly children who are ill, and do not allow nursing bottles to be exposed to flies.

Protect milk and other foodstuffs from contact with flies.

Keep the garbage outside of the house, carefully covered.

Abolish open drains near dwelling places.

Stable manure should be frequently sprinkled with lime and kept covered.

Earth closets and privy vaults should be treated with lime, crude creolin or crude carbolic acid at frequent intervals.

Earth closets and privy vaults should be cleaned frequently in order to prevent excrement acc.u.mulating to an undue extent.

To Kill Flies.--Dissolve one dram of bichromate of potash in two ounces of water, add a little sugar to this solution and put some of it in shallow dishes and place about the house. Sticky fly paper and fly traps may also be used.

To clean the room where there are many flies, burn pyrethrum powder (Persian insect powder). This stupefies the flies and in this condition they may be swept up and burned.

Probably the best and simplest fly killer is a weak solution of formaldehyde in water (two teaspoonfuls to the pint). This solution should be placed in plates or saucers throughout the house. Ten cents'

worth of formaldehyde, obtained in the drug store, will last an ordinary family all summer. Don't smell formaldehyde in the pure state; it is very pungent and strong. In the solution of the strength used for flies it has no offensive smell. It is fatal to disease organisms, and is practically non-poisonous except to insects. Flies will not stay in the house when this solution is around.

Moths.--Late spring and early summer is the time to guard against moths and beetles. Many of these fabric-destroying insects are brought into the house on flowers.