Volume 2 — VIII. MEDICAL HINTS. (continued 4)

Treatment.—The patient should lie down. The operator removes his own boot on the same side as that of the patient’s dislocation, inserts his heel into the patient’s armpit and draws the arm steadily down, at the same time pressing the heel in an outward direction; the dislocated bone should slip back into its proper position. Put a pad in the armpit and bandage the arm to the side for a week; support arm in a sling for another week or two.

Elbow-joint.—Dislocation of the bones of the forearm backwards at the elbow-joint is fairly common.

Treatment.—This dislocation can usually be reduced by placing the knee in front of the patient’s elbow, and making firm traction on the forearm—which is at the same time bent a little around the operator’s knee. The patient can be kept sitting in a chair while this is done, and the operator can get his knee into the required position by placing his foot on the side of the chair.

Hip-joint.—Is the most common form of dislocation. The limb is shortened, bent at the knee and twisted inwards, the great toe of the injured limb resting on the instep of foot of the opposite limb. The outer side of the hip is swollen and distorted.

Treatment.—Grasp the ankle with one hand and the knee with the other. Lift up the leg and bend it at the hip, then carry it as a whole away from the other limb as far as possible, rotate the toes and foot firmly outwards, and in that position bring the limb back parallel to the sound one.

After-treatment of Dislocations.—After dislocations, gentle movement of the joints should be begun in two weeks, so as to prevent them becoming fixed.

POISONS.

It is impossible, in the small space available, to give anything like a detailed scheme of the treatment of the various poisons, but a few hints on the essential points must not be omitted.

I have therefore arranged a list of the commoner poisons, together with the special treatment appropriate to each. Following this are a few hints more especially adapted to the requirements of travellers.

Poison should be suspected (a) when severe and alarming symptoms of illness suddenly attack a person apparently in good health; (b) if the symptoms closely follow the taking of food, drink, or medicines; (c) if several people are attacked after having partaken of the same food or drink.

The points to be attended to in the treatment of cases of poisoning are:—

a. Remove as much of the poison as possible from the stomach. To do this, it is usual to give an emetic, such as mustard and water, or zinc sulphate, thirty grains; or to pass the soft rubber tube down the gullet, and wash out the stomach with water.

b. Counteract the effect of the poison by an antidote.

c. Keep up the patient’s strength till the poison is removed from the system.

d. Relieve pain.

Travellers may be poisoned in the following ways:—

1. By poisonous bites, arrow wounds, etc.

2. By eating food poisoned by natives.

3. By eating poisonous plants, etc.

4. By eating bad meat or fish.

The treatment of snake-bites and arrow wounds has already been dealt with.

Poisoned food and poisonous plants.—Food is occasionally poisoned by natives, either by adding strophanthus leaves or other poisons. The eating of such articles may be followed by severe pain, colic, vomiting, diarrhœa or other symptoms. The general line of treatment should consist in giving emetics promptly, washing out the stomach by means of the stomach tube, and administering large quantities of water, milk, or gruel. Distressing symptoms should be treated as they arise; thus, if convulsions occur, large doses of chloral or potassium bromide should be given; if stupor or drowsiness comes on, the patient should be forced to take hot coffee, stimulants, etc., and made to walk about. If collapse supervenes, stimulants should be freely given, the patient wrapped in blankets, and hot bottles applied to the feet.

Poisoning by bad meat, fish, etc.—The symptoms of poisoning by bad meat, etc., are severe pains in the belly, cramps, and shivering fits, followed by vomiting and diarrhœa coming on soon after its consumption, occasionally within an hour or two. The vomiting and diarrhœa are usually alarming and very severe, causing great collapse, and unless urgent remedies are applied, death may occur. The bodies of patients may be covered all over with irritating blotches, red rashes or with nettle rash.

Treatment.—Give an emetic at once. Administer a sharp purge to clear out the bowels. Use stimulants freely. Apply hot-water bottles and blankets. Give opium or chlorodyne, fifteen drops every four hours until the pain is relieved. Milk and gruel or arrowroot.