If the knee-cap only be fractured, tie the leg on a splint from hip to foot, and keep the limb raised.
Almost any firm substance which can keep the limb at rest can be used for a splint, but if hard it should be padded. If the fracture is accompanied with severe bleeding, stop the flow first before attending to the fracture. (See Wounds.)
Limbs, Inflamed.—Entirely different treatment from the above is needed for such a thing as inflammation of the elbow, wrist, shoulder-joint or knee.
Say it is an inflamed elbow that is to be treated. We describe this; but similar treatment, with very slight variation, such as common sense will suggest, answers for the other joints.
Have two large plain towels wrung out of cold water, and folded so as to wrap six ply thick round the elbow. See that the patient is otherwise warm. Place one of the towels round the joint, and gently press it (avoiding pain) so as to draw the heat out of every part. When this is hot substitute the other, and continue with fresh cooling—for an hour if necessary. The cloth may require to be changed perhaps thirty times; but the guide to this is furnished by its heating. When hot, change it. This may be repeated frequently, until the inflammation is subdued.
Limbs, Uncontrollable.—This trouble is found in the double form; first, of limbs which will not move when their owner desires to move them; and, second, limbs moving in excessive jerks when they are not desired to do so. These cases are often combined, the limbs being rigid at one time and jerking violently at another. There is no wasting or unhealthy appearance. We have found this condition caused by excessive walking, running, and standing, combined with exposure to frequent wettings. The result is, in essence, that motor power in the limbs is in excess, while controlling power is defective: the case is indeed similar to St. Vitus' Dance (see). Bathe the feet (see Bathing Feet) in hot water, and apply cold towels folded and wrung out of cold water (but not iced) along the spine. Keep this up for an hour-and-a-half at a time. By that time the hard rigid feeling in the limbs will probably have disappeared, but great helplessness will be felt. You have removed the excess of motor energy, and must now increase the voluntary energy. This will be accomplished by gently rubbing the back and limbs with hot olive oil, as in Limbs, Drawn-up. This treatment, repeated daily, will usually soon cure.
Liquorice.—See Constipation.
Liver, The.—Where biliousness prevails, without any symptom of real liver disease, it is well first to look to the state of the stomach and bowels. Take a teacupful of hot water twenty minutes before meals, and the liquorice mixture (see Constipation) after meals. Then give a strong blanket fomentation to the feet and legs for an hour in the evening. If there be pain or feverish heat in the region of the bowels, press cold cloths over the painful part while the feet are fomented.
When the liver is really swollen, hardened, or painful, the pulse will either be quick with feverish symptoms or slow with coldness. If it be a feverish case, press cold cloths over the liver, changing them when warm, for an hour: at the same time foment the feet and legs as directed above. See that there is heat enough to make the patient comfortable under the cold applications. Inflammation of the liver will readily yield to this treatment.
When the case is a cold one with slow pulse, use no cold cloths, but apply fomentations over the liver, as well as to the feet and legs. Smoking and alcoholic drinks must be entirely given up—these habits are peculiarly severe on the liver. The treatment will not be likely to cure in a day or in a week, but patient perseverance with the fomentations should eventually effect a cure. Too rich food throws a great strain on the liver, and a plain and spare diet with prolonged mastication is necessary with above treatment if a cure is to be effected.