First Aid and Emergency.

(Conducted by CHARLES R. DICKSON, M. D., Toronto, Can.)

NORTHERN PACIFIC BENEFICIAL ASSN.

(Continued from page 320.)

FIRST AID TO THE INJURED.

I. Don't give a drink of whisky.

2.

Don't pour ice or very cold water on wounds. 3. The patient should be placed on his back, with head. low, and this position should be continued in transporting. 4. If the person is suffering from "shock"-that is, pale, with pinched expression of face, drooping eyelids, and cold surface of body, with feeble pulse, give spoonfuls of hot tea or coffee; if this cannot be had, a teaspoonful of whisky or other alcoholic stimulant, in a tablespoonful of hot water, may be given every ten minutes. until five or six doses be taken. Wrap in a warm blanket and put bottles filled with hot water, or heated bricks about the body.

5. If a limb be crushed or torn, apply over the wound a thick pack of cotton wool or a folded clean cloth, fastened with several turns of bandage, handkerchiefs, or an elastic suspender.

6. Hemorrhage. This follows shock, and is rarely severe unless reaction takes place. Too much stimulation increases hemorrhage, and for this reason it is best to give only a little stimulant, well warmed and repeat the dose if reaction is delayed.

Bleeding is of two kinds; Ist, arterial, when the blood comes out bright and red and in spurts; 2d, venous, when the blood is dark and flows in an even stream.

A. To stop hemorrhage.-Avoid trying to stop bleeding by twisting cords or handkerchiefs around limbs with sticks. When the wound is large and blood comes out in spurts, apply the rubber band tightly just above the wound, previously raising the wounded part, especially if it be a limb. Be careful to put the band on uninjured flesh, if the limb be crushed, and about three inches above the crushed tissues, else it will slip down. and increase the hemorrhage. Be very careful to see that the band be firmly hooked and fixed before leaving it. Small wounds, even though the hemorrhage be arterial, require only a firm compress of the sublimated gauze placed immediately over the wound, and bandaged tightly in place with one of the muslin bandages. It is best after this to bandage firmly from the extremity (hand or foot) upward to beyond the wound with the muslin bandages.

B. Venous bleeding, which occurs when the wound is shallow (does not go deeper than the skin), as a rule, requires firm pressure over the wound and especially below it. If the wound be quite small, put a pad of styptic cotton into and over it and bandage tightly in place, and then apply a bandage from below upward over and beyond the wound. If the wound be extensive, fill it full of sublimated gauze and then put a thick wad of absorbent cotton over it and bandage tightly from below upward.

C. Bleeding from the head, if only the scalp is involved, may also be controlled by drawing the rubber band around the head, encircling it just above the eye

brows. This is very painful, however, and unless the bleeding be very severe it may be controlled by bringing the wounded or torn surfaces together and applying along the wound a thick layer of styptic cotton, and over this another layer of absorbent cotton and a tight muslin bandage. It is well to pass the bandage under the chin if the wound be on top of the head, as this holds it firmer and tighter.

7. Remove the clothing from a wounded part by cutting it away. Do not attempt to tear or draw clothing off, as this may further injure the wounded part. Always see the wound and know by your eye just what the nature of it is.

8. After hemorrhage has been stopped.-The next point is to prevent the wound from being infected, and thus prevent blood-poisoning. To accomplish this the wound should be cleansed, if badly soiled. If soiled by oil and soot or dirt, bathe it gently with a small quantity of soap and warm water. After it is apparently clean, wash it out carefully with a pint of warm water in which one of the corrosive sublimate tablets has been dissolved, using the bits of lint to do this. Then wet several layers of the sublimate gauze in a fresh solution of the same strength used in washing the wound, and lay them over the wound and bandage in place with a muslin bandage. Always cover an open wound with a piece of gauze wet in the solution of corrosive sublimate (one tablet to a pint of water) before transporting the wounded man. Never allow an open wound to remain unprotected longer than the time employed in stopping hemorrhage. Remember, a soiled covering is worse than none at all.

9. If a leg or arm is broken, straighten it gently and lay on a pillow, then tie the pillow up with several strips of muslin bandage; or splints of light pieces of wood, laths or barrel staves, padded with some soft material, may be used for this purpose. This should be done before the injured person is moved any distance.

10. Compound fractures are fractures accompanied by a wound of the soft tissues at the point of fracture, so that the bone is exposed to the air. In these cases treat hemorrhage and the wound according to the foregoing rules, and then apply splints. If the bones project beyond the skin, remember to bring them back into place by pulling the extremity in the direction of the displacement, until the ends of the fragments are quite free from any overriding. Be very careful always to cover these wounds with the wet sublimate gauze and bandage.

II. Burns. Carefully remove the clothing by cutting it off, if the part be clothed and apply immediately three or four thicknesses of the sublimate gauze wet in warm water, in which one tablespoonful of the bicarbonate of soda to the quart has been dissolved. As a rule, never attempt to clean burns immediately after they occur. Cover the wounded part as directed above immediately, and leave the cleansing to the surgeon afterward. Extensive burns are attended with great shock, as a rule, and require free stimulation. As burns are very rarely followed by hemorrhage, stimulants may be and should be given in considerable quantities.

12. Prostration from excessive heat.-In these cases (not sunstroke) the face is pale, lips colorless or blue, breathing slow and quiet, pulse slow and very weak.

Place the patient on his back with his head level with his body, and loosen clothing. Apply heat to the surface of the body and extremities. Bathe the face with warm water into which a little alcohol or whisky has been poured and if he can swallow, give the patient an ounce of whisky in as much water.

Prostration from drinking too much ice-water when overheated.—The face is red or even purple, breathing heavy and irregular, pulse irregular. Loosen clothing, place on back with head slightly elevated. Give hot drinks; apply heat to the spine and the extremities.

13. Position in which a patient should be placed after injury. Injuries to the head require that the head be raised higher than the level of the body. In all cases, if practicable, lay the patient on his back, with the limbs stretched out in their natural positions; loosen the collar and waistbands, and unless the head be injured, remember to have the head on the same level as the body; do not bolster it up with anything.

14. To place a person on a stretcher and carry him.Three persons are necessary to do this, two to act as bearers of the stretcher and one to attend to the injured part. Place the stretcher at the head of the patient, on a line with the body, the foot of the stretcher being nearest the patient's head. One bearer kneels on each side of the patient and joins hands underneath his hips and shoulders with the bearer on the opposite side. The third man attends to the wounded limb or looks after any bandages or splints that may have been applied. The bearers then rise to their feet, raising their patient in a horizontal position, and by a series of side steps bring the patient over the stretcher. He is then lowered gently on to it and made as comfortable as possible. One bearer starts off with his left foot, the other with his right; should they keep step the stretcher would roll badly. To Passenger Conductors:

The "Lees" Accident Emergency Box which has been placed in your charge should be kept in your train box and used for any cases requiring First Aid in injuries, whether to employes, passengers or others. The instructions printed in the lid of the tin box should be carefully read and followed in such cases which you or your train crew are able to take care of. When more extensive emergency work is necessary or desirable and there are surgeons or other competent persons upon your train, the contents of the box should enable them to perform such work as will in their judgment be necessary.

A brief report should at once be made of each case, also a list of articles which are necessary to replace those used, and sent to superintendent, so that the supplies may be forwarded from hospital at once and the box made ready for another emergency.

To Freight Conductors:

M. C. KIMBERLY, President. W. A. LAIDLAW, Secretary.

The First Aid Package for injured persons which has been placed in your charge, should be kept in the desk in your caboose and used for any cases of injury to employes or others. Upon the covering of the bandages is printed a list of contents and instructions for their use, which may be administered by any person. The tourniquet is to be used for arresting hemorrhages in severe wounds. where the injured person is liable to bleed to death.

To apply the tourniquet: Elevate the injured arm or leg and apply the tourniquet as near the wound as possible on the upper side or side nearest the body by passing it several times around the limb and drawing it just sufficiently tight enough to prevent all spurting or oozing of blood.

A brief report should at once be made of each case; also a list of articles which are necessary to replace those used, and forward to superintendent, so that the supplies made ready for another emergency. may be forwarded from hospital at once and the package

M. C. KIMBERLY, President.
W. A. LAIDLAW, Secretary.

PROPOSED SYLLABUS OF LECTURES ON FIRST AID INSTRUC-
TION BY LOCAL SURGEONS AT

Saturday, December 1, 1900.-The Heart and Blood Vessels.

Saturday, December 15, 1900.-The Brain, Nerves and other organs.

Admission tickets to these lectures will be furnished by heads of departments to members free of charge. FIRST LECTURE-NOVEMBER 3, 1900. Preliminary remarks as to lectures.

Object of instruction to be given and plan.

General outline of structure and functions of human body, including brief description of bones, muscles, arteries and veins.

Function of circulation, respiration and nervous system. Methods of lifting and carrying sick or injured, using the N. P. R. stretchers and emergency train boxes and packages to illustrate.

SECOND LECTURE—NOVEMBER 17, 1900. Resumé of first lecture.

The skeleton and muscles to be shown and explained. Signs of fracture and treatment for such accidents. Treatment of sprains.

Use of splints to be illustrated.

Method of lifting and carrying sick or injured, using N. P. R. stretchers and emergency boxes, as in first lecture to illustrate.

THIRD LECTURE-DECEMBER 1, 1900.

Resumé of former lectures.

The heart and blood vessels, to be shown and explained. What blood is and what it does, showing the arteries. and veins, so that circulation may be stopped; also the difference between arterial and venous bleeding.

Use of bandages, tourniquet, etc.

Method of lifting and carrying sick or injured, using N. P. R. stretchers and emergency boxes as in first lecture to illustrate.

FOURTH LECTURE-DECEMBER 15, 1900. Resumé of former lectures.

The brain, nerves and other vital organs to be explained.

The general health and physical condition to be stated. The treatment of those suffering from collapse, stunned, inebriated, fainting.

The treatment of drowned, suffocated.

The treatment of burns, scalds, etc.

Method of lifting and carrying sick or injured, using N. P. R. stretchers and emergency boxes, as in first lecture to illustrate.

deaf mutes, the postoffice and government building, the county court house and the city hall.

The soldiers monument before referred to was dedicated May 5, 1902, and cost $500,000. A magnificent view of the city and surrounding country can be obtained from its top. Nearby are statues of Gen. George Rogers Clark, Gen. W. H. Harrison, Governor Whitcomb and Vice-Presidents Colfax and Hendricks. Indianapolis is well supplied with parks and public squares. Washington street, the main retail thoroughfare, is a beautiful street 120 feet wide.

The City Hospital treats over 2,000 patients annually, and there are several smaller ones-St. Vincent's, Deaconess, etc.-besides some well-known private sanitariums.

The Medical College of Indiana (Medical Department of the University of Indianapolis) was founded in 1869, and the Central College of Physicians and Surgeons in 1879. There are two dental colleges also, the Indiana Dental and the Central.

One of the main features of the city from a business standpoint are its manufacturing industries. It has, according to the United States census bulletin, 1,910 mechanical and manufacturing industries, which employ an average of 25,511 persons and pay out annually to employes $10,882,914.

wards are to be used only for the most serious cases, where quiet is essential.

The material of which the building will be constructed has not as yet been decided on, but it is thought that a pressed brick, manufactured under what is known as the Whittlesey process, will be used.

The debris of the burned hospital has been cleared away and the construction of the new one is expected in the near future.

E. P. AND S. W. HOSPITAL.

Dr. Sweet is arranging to build quite a commodious hospital at Bisbee, Ariz., for the El Paso & Southwestern system. The doctor has as his assistants, Dr. A. R. Hickman, Douglas; Dr. W. L. Brown, El Paso; Dr. J. McLellan, Deming; Mr. M. C. McCorkle, Benson; Dr. E. W. Baum, Dr. D. E. Broderick and Dr. Louis Dysart, Bisbee.

HOSPITAL CAR FOR THE ERIE.

A combination car has been fitted up for the New York division of this road. It will be kept in the yards at Jersey City, and runs from there to Port Jervis.

There are six iron hospital cots, an operating room, etc., with a complete equipment.

HOSPITAL CAR FOR THE SOUTHERN PACIFIC.

The medical department of the Southern Pacific has

Has the largest plant in the country erected for the

exclusive production of mill machinery.

Has the largest buggy factory in the world. Has the largest exclusive saw manufacturing plant in the world.

Is first in the production of vencers.

Is second in the production of upholstered furniture. Is one of the largest live stock markets in the middle states, the business transactions aggregating more than fifty million dollars annually.

Indianapolis is the home of some well-known houses of interest to physicians; among them are Messrs. W. H. Armstrong & Co., surgical instruments, 224 South Meridian street.

W. D. Allison & Co., physicians' office fixtures, 133 East South street.

Eli Lilly & Co., manufacturing chemists, 214 East McCarty street.

NEW HOSPITALS AND HOSPITAL CARS.

SANTA FE HOSPITAL.

A new Santa Fe Pacific hospital for Albuquerque, to take the place of the one recently destroyed by fire, is soon to be a thing of reality.

Plans for the new building have been turned out of the office of the Santa Fe railway architect, Charles F. Whittlesey, and have been approved by the hospital directors of the Santa Fe Pacific.

The plans were drawn after suggestions offered by Dr. Morrison, chief surgeon of the Santa Fe coast lines, and Dr. Cutter, of the local hospital corps. The new hospital will be a one-story building and thus avoid running up and down stairs by the patients. It will accommodate thirty-five patients and provides for isolated wards. These

car.

CHLOROFORM NARCOSIS.

"It has been demonstrated that the total work performed by the heart of an animal can be determined before and after the administration of a drug," writes Dr. T. G. Brodie, in the British Medical Journal, November 23, 1901. "Chloroform markedly depresses the working capacity. Adrenalin Chloride greatly increases the rate of the beat, and largely augments the work performed. It is an antidote to chloroform. If adrenalin be administered before chloroform anesthesia, the heart withstands much larger doses of the anesthetic. In one instance a heart greatly depressed by chloroform completely recovered when adrenalin was injected."

MAKING THINGS CLEAR TO PASSENGERS.

A Japanese railroad advertisement reads:

"The through train service between two terminals of Osaka and Nagoya are operated five times, of which two being the express train from either terminus per day, with all the carriages of bogie system which accompany a uniformed attendant and provision sellers making themselves to be useful."-Railroad Men.

HORSE COMMITS SUICIDE.

The Wabash Railway, in a damage suit instituted by J. M. Sauvinette to recover the value of a horse which met his death on the Wabash tracks, sets up the novel defense that the horse committed suicide. Perhaps the animal had been reading the advertisements of the Wabash and got it into his head that it was the direct route to heaven.Globe-Democrat, February 27, 1903.