Freeland tribune. (Freeland, Pa.) 1888-1921, 1890-04-17
sufficient to overcome the muscles that are pull

ton until he reaches his surgeon
The Sd topic is Disocation
by adislocation we mean when one or more
bones composing joint are put out of Joint
Tor In some, as the knee and elbow, we have
more than two bones forming the Joint NV
advice to you in dislocations is let them alone.
Do not pull them as in fractures, as is common
ly done. Often pulling increases the swelling,
making 1t more difficult for the surgeon to
manipulate, or irreparable damage is done by
tearing the capsule or bag that surrounds every
joint still more so that the bones will not stay
in place when reduced by the surgeon. Pull
ing may also, still further, dispace the bones,
making it harder and sometimes impossible for
the surgeon to reduce them at all. To reduce
joint properly one must understand the shape
and kind of joint that is dislocated and then
slide II into place by manipulation in certain
directions, rather than pulling in a straight
line, and trusting to luck and brute force.
Hence, in a dlsocation, let the man select the
position to hold it in that he finds the most
Portable; which he will not be long in doing
can assure you.
The 4th topic is Asphyxia.
This means suspended animation, due to the
non-conversion of the venous blood in the
lungs into arterial.
The patient looks as if he was dead. Asphy-
xia then can be produced by different causes
us inhalation of various gases, causing death
from want OF oxygen, as happens from the
various gases generated in the mines, or it can
son by the throat and pressing hard enough to
prevent air from entering the lungs or by
drowning, when the lungs fill with water in
stead of air. In treating this condition 1t is of
prime importance to remove the patient to a
cool place where the air is cool, and everybody
should not crowd around him to shut Off the
good pure air which means life to him, only
the requisite number to manipulate him. Eric
tions should be applied with warm fannes.
Artificial respiration should be employed, by
placing the arms along the sides slowly raising
them above the head and bringing them down
again to the sides. Repeat this movement about
times minute, which fills and empties the
lungs of air. This should be persisted i'm until
the patient is either restored to consciousness
or there is no doubt that life is lost. At the
same time stlmulants should be poured into the
throat through a tube or injected into the
bowel and some pungent stuff, such as am
mona, constantly held to the nose.
We will next consider the general care of
any case of accident. First. BE gentle and
methodical in all your movements The ends of
II broken bone are often pushed through the
skin, and a simple fracture converted into
compound and very serious one by rough and
hurried handling. Place the patient upon his
back upon the stretcher, expose the injured
rest all hemorrhage by any of the methods pre-
viously described. Cover your patient up
warm: do not all crowd around him, shutting Off
his air with every breath; do not exhaust him
by each one asking him how he feels, etc." or
making him talk more than necessary, for he
may need all his strength if an operation is
necessary, help him husband it, us exhaus-
tion brings on shocks and collapse all the more
quickly; do not give him water in large guam
Titles; for & how often have seen the stomach SO
overloaded that the ether at once caused dread
ful vomiting, taking longer to an@sthetize the
patient and making him weaker. If there is
tNlueHCt VI WeuhnesS give dDOuU u tHDlCSpOOn-
full of whiskey not a tumbler full Every l5
or % minutes feel his pulse, if you can not feel
1t plainly repeat the dose of whiskey; as stim-
uants given in small and often repeated doses
are more readily absorbed and less apt to cause
vomiting, than some of the generous doses
have seen poured out to be given to the patient,
just to give him u little courage to speak.
The patient is now ready TO be carried, bring
him out as quickly as possible, for feel certain
much time is often unnecessarily wasted before
the patient is brought into the presence of his
surgeon. NOW, you have gotten him either to
his home or to the hospital, and right here is
where, claim your duties as kind friends end
and the surgeons duties begin. Do not
all persist in crowding into the room to hinder
the surgeon in his movements and vitate the
needs, but politely retire, only those remaining
whom the surgeon may request to remain to
assist him to prepare the patient for his opera
tion, If any is necessary, or to dress the injured
parts. Now, by needing this advice and aiding
in its enforcement, you will always confer
personal favor to the surgeon in charge, and
indirectly assist your injured friend, for with
no crowd or annoyance around the surgeon he
can perform his duties much more skillfully
and expeditiously. Presuming an operation is
advised by the surgeon surgeons present,
never be guilty of attempting to influence the
injured man to resist and object to his physi-
ciarrsS advice, for-delay at this stage may mean
death, ana every moment is precious; you
know not when shock may come that danger
GUS condition ushered in by feeble irregular
pulse and breathing, CHASTITY pallor of the face
and that anxious expression of the counten-
ance, all of which symptoms indicate that
death is near, but always, on the contrary, CO.
operate with the surgeon (relying upon his
superior experience and knowledue7 to encour.
age the patient and calm rather than excite his
mind and nervous system. Right here wish to
draw your attention to one point-Dr. Keller
omitted to mention in his talk upon the evil eff
fects of alcohol, viz, when we have this dam
gerous condition of shock, how much better is
the fight for life which the Total Abstainer
makes than the victim of alcohol. His system
is now in that prostrated condition that he needs
the stimulating effects of alcohol to live; and,
haa has hna l.atl I,,
Docs his heart respond to the stimulant? Is his
pulse made stronger and fullerI Does he
breathe deeper2 Does that cold cammy sweat
leave his skin Does that pinched expression
leave his features? Does his eye brghten2 All
no, alcohol has mo effect upon this man, he is
TOO much accustomed to it. His surgeons hands
are tied; he can do no more for his patient. He
must die. Gentlemen this picture is not over
drawn: we doctors must often say "the man
was too badly hurt; shock killed him." when
we know the true cause of death was failure
upon the part of the patient to respond to the
stimulants, but that would be unkind to say.
We now touch the topics which are apt to en-
gage the attention of every person of the COM
muity. N
LIST. Poisons.
In this region it may seem useless to discuss
this topic for here we all know the doctors
medicines contain nothing but water, but still we
sometimes are called upon to aid victim, who
proceeding under this impression or the equally
fallacious one, that If teaspoonful of medi-
cine at a dose is to do any good the whole bot
tie Will be better and quicker in its action; or
OF medicine in the yard or street and drinking
its contents.
At once, in poisoning give the whites of a
few raw eggs and fill the stomach with luke
warm milk to prevent absorption Of and
to dilute the poison Then induce vomiting by
the free use of warm mustard water, and if
this does not act tickle the palate with feather
or hold the forefinger down the throat until the
patient gags and vomits. Stimulate freely if
there is prostration after vomiting
Next topic is Syncope Painting.
This is IL complete and sudden loss of con-
seriousness, with suspension OF pulsations of
the heart and respiratory movements. This is
alarming. Place the patient in a horizontal
posture, loosen clothing at the neck and waist,
elevate the heels and sprinkle the face with
cold water and apply ammonia to the nose.
3D. Convulsions or Fits.
A convulsion is an alternate contraction, vio-
lent involuntary, of those muscles which only
habitually contract under the intueuce OF the
Will. III usually accompanied by unconscious
ness. person affected with Il convulson,
working all over, frothing at the mouth, with
tongue protrnding and purple in the face is n
most torbldding and alarming object to his
friends Yet he must have aid or he will in
Jure himself. Place him on his back, hold arms
ana legs, unfasten clothing at neck and waist
put Weuge OF wood between his teeth, SO
that he does not injure his tongues give him
plenty OF air and sprinkle face and chest with
cold water. When he comes to handle him
I,siti tpr Dy exciting him he may be seized
will conclude with a few suggestions as to
N What each and every worker under ground
would advise the following things neatly wrap
peg up IN paper, so that they will keep clean,
,s,R 10 De Kept ra oy each man in his box Some old
llusNn rags, Two muslin bandages to 3 inches
wide and yards long, small bottle of am
monia, q small bottle of Mousel's solution, a
stypnc mud to stop bleeding, OF. of good
store string. IL each of you will furnish your
selves with these few things, which are not
costly, @ ana @ advise your friends to do the same,