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 stitches 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.