The Topeka state journal. [volume] (Topeka, Kansas) 1892-1980, 1897-03-11
Lecture of DIR. Hunt Upon Rail.
way Surgery.
Gives Some Essen tial Facts Re-
garding the Care
OF MINOR INJURIES
Such as Smashed Fingers, Hand
Or Foot.
other Injuries and the RENE
dies Plainly Stated.

last evening upon Railway Surgery"
DR.. James G.. Hunt said:
Four-hfths of the injuries that a
railway surgeon is called to attend will
probably be classed under the head of
minor surgery, and it is these cases that
snow the true surgeon just as much
as the amputations, resections and on
erations of that class do. There are
several points that I wish to impress
upon you. and the first is the wonder
1ul recuperative or healing power in the
extremitieS. We are often called TO
look at a mashed finger hand or foot
Al nrSt glance there seems no hope of
saving the member and there is a dis
position to amputate. My advice is to
always look twice, and as long as there
IS the least chance of any circulation
either direct or collateral, always try
10 save the finger or the member 1t
may be that an amputation will have
10 pc performed, but nothing has been
lost by waiting day or two if the
proper precautions have been taken
Ihe eXtremitieS have a very abuud-
ant supply of blood vessels which trav-
erSe and rad1ate throughout every mus
cular fiber, and which forms such a
network over the fingers and toes that
unless the member is lacerated around
its entire circumference We may hope
that sufficient vitality remains to pre-
serve healthy regenerative action
A finger may seem of minor Importance
to surgeon, but to a railroad hand
WHO MAKES ms HV1ng by hard work
and whose life often depends on the
grasp of the hand. 1t is a most serious
matter. L make it a rule never to sac
r1t1ce the smallest part of a member
that there is any possibility of saving
as 1 think it is better surgery to save
one finger than to cut off ter.
"One of our greatest troubles is the
condition of the injured member when
brought to us. Nearly always we find
the torn tissues and the adjacent parts
black with coal dust and grease, and
to get an aSeptc condition is well
nigh impossible. Many accidents oc-
cur in machine shops. They may be
lacerated or confused wounds the
wrenching off of a finger or toe or
limb, or they may be crushed. Cog
wheels, saws, planning machines, etc,
tear off many a limb or parts of one
1t is such injuries these that almost
always occur when there is no surgeon
that can be had for some little time
and it would be well if someone in every
shop or on every train could have some
idea of what can be done until a doctor
arrives.
In case of hemorrhage, raise the
limb. wash it clean; if the blood comes
in bright red jets. apply the strap above
the bleeding points, just tight enough
to control the flow. Do not draw the
strap too tight, as it will cause useless
pain. If the blood is of dark color
apply cloths wrung out in hot water.
Fracture can be readily known
Compare with a corresponding limb
and place in a position as near like it
as possible 1t can be held in place
pieces of single, or a blanket rolled
tightly around it and tied with strips of
cloth.
For sprains, apply either hot or cold
water, and keep the joint quiet.
I'm dressing, wash every break of the
skin with hot water if possible, then
apply gauze or some clean cloth in lay
ers of three or four thicknesses, hold in
N1SoR hV a han6aRR and notify the
nearest company's surgeon.
If the injured man or woman feels
faint or weak lay him with his head
low and give him some hot drink. COT
fee is one of the best: brandy or whis-
ky if necessary, but not much
Many railways, especially through
out the west and south, have a case
complete with the instruments. ban
dages ETC. with printed directions
to the care of injured persons, on every
train 1t is placed in charge of the
conductor, who keeps it in his train
box.
shock may be caused by blow on
the pit of the stomach, or it may be
caused by fright; also by drinking
large quantities of ice water 1t IS
quite common after a serious railroad
accident. The signs are insensibility
dropping eyelids, feeble breathing, great
paIeness, with cold, clamny sweat, a
bewildered, stupid condition, feeble
pulse When you find a person in such
a condition as this he may die pretty
soon. and will before long unless assist
ance can be given him In such cases
it requires very prompt and persistent
effort on the part of those present Heat
must be applied to the whole body if
possible Roll him up in hot blankets,
or give him a hot bath if you have the
conveniences Bottles filed with hot
water answer very nicely. The two
important points to apply heat are at
the heart and pit of the stomach In
making your application of heat be
careful not to burn the patient, for in
his condition he would not feel pain
from any amount of heat which might
severely burn him For stimulant you
may give the patient hot drinks, with
whisky or brandy added, but in small
quantities. and repeat every ten MN
11tes until the surgeon arrives.
"A fracture may be partial, complete,
transverse, oblique, or longitudinal;
single, double or multiple; simple com
pound or complicated symptoms OF
fracture are loss of function, absence of
normal contour, and crepitus-