HEALTH COLUMN.

Otago Witness, Issue 3105, 17 September 1913, Page 76

HEALTH COLUMN.

Bruises and Spiains. These arc some of the commonest accidents in everyday life. They are often found in association, and practically every sprain is accompanied by move or less bruising. Bruises in themselves arc of little importance, although the discolouration is apt to alarm the inexperienced. On the other hand, sprains are seldom* unimportant, because they occur in the neighbourhood of joints, which may bo injured at the same time. ■ A severe sprain may occasion more discomfort than many a fracture, and the effects of such a sprain arc often felt for weeks, or even months, after the time of accident. For this reason no sprain should bo neglected, and, if there is any doubt about the joint being implicated, no time should be lost in seeking advice. —Bruises. — A bruise is a discoloured swelling resulting from a knock or blow. Both the swelling and the discolouration arise from the rupture of some minute blood-vessels underneath the skin, and the consequent escape of blood, which diffuses itself to some distance under the skin around the site of injury. At first as a rule of a deep purple colour, as recovery progresses the bruise usually' becomes successively blue, bluishgreen, and yellow, afterwards returning to the, normal colour of the skin. Different parts of the bruise may recover with varying rapidity, so. that two or three shades of colour may be present at the same time on different parts of the surface. As already mentioned, uncomplicated bruises arc seldom of serious importance, the only inconvenience resulting from them being the pa*n and stiffness by which they are usually characterised, and the unsightliness of their appearance when on any conspicuous part of the body. —Treatment.— The best treatment for a bruise is the application of cold in some form ns soon after the injury as possible. A handkerchief or a piece of lint dipped in- cold water, or in weak spirit and water, may be employed for the purpose, or, when available, some ice may be used, enclosed in a gutta-percha bag. The cold applications should be continued as long as any tenderness to touch is present, after which their use may bo abandoned. Very little more need be done, as the bruise, after the tenderness has disappeared, will gradually diminish and fade; the process of absorption of the effused blood may, however, bo expedited somewhat by the inunction of some olive oil or some vaseline once or twice daily. The propriety of rest should bo decided by the amount of pain consequent on movement. —Sprains.—

Sprains arc caused by undue stretching or twisting of joints, the ligaments of which arc usually partially torn by tbe strain. There is generally also some stretching of other tissues in the neighbourhood of the joint, with rupture of small vessels and effusion of blood, giving rise to the characteristic discolouration of bruising on the skin over the joint. Sprains are of most frequent occurrence in the ankle, shoulder, wrist, and knee. —Signs of a Sprain.—

There is generally severe pain, often localised to certain points and increased on movement; there may ho inability to bear the weight of the limb; as a rule there will he swelling and discolouration from effusion of blood around file joint, and, later, inflammatory effusion into the joint cavity may occur. The absence of signs of fracture or of dislocation will usually suffice to distinguish a sprain from one or other of these injuries; hut where there is much swelling it may be difficult or impossible to be sure of this until the swelling has subsided. -^Complications.—

The consequences of a neglected sprain may be very serious, especially in rheumatic and gouty subjects. Thus, as the result of the incomplete absorption of the inflammatory products, the imperfect repair of the torn ligaments, the formation of fibrous adhesions in and around the joint, and the gluing of the surrounding sinews to their sheaths, a sprain may be followed by long-continued pain, stiffness, and weakness of the joint. At time's, in tuberculous patients, a sprain may be the starting point of destructive disease of a joint. —Treatment.— Until professional advice can be obtained the joint affected should be kept at perfect rest and in as elevated a position as possible. In sprains of the ankle and knee the leg should be placed on a chair somewhat higher than that on which the patient sits; while in those of the wrist or elbow, thc~ arm should rest on a table, or on a pillow if the patient is laid in bed. Cold applications similar to those used for bruises should be employed. Complete rest in the ease of the leg is obtained most easily by tying it into a pillow, the end of which is turned up against the back of a chair or tho foot of a bed. The leg is laid along the pillow, the foot being pressed against the upturned end, and one or two handkerchiefs or small lengths of bandage are tied with moderate tightness round pillow and leg together so as to make the pillow rise on each side of the leg and encase it as a splint. There is usually no difficulty in maintaining the arm at rest laid upon a pillow without any bandages. Slight sorains such as are apt to occur in the ankle joint, when they are weak or have been previously strained, arc best treated by immediate immersion in water as warm as can bo comfortably borne. The immersion should be continued for 10 or 15 minutes, after which tho joint should be bandaged and used with care for a few da vs.

The joint in any case of sprain is not to ho kept too long at rost lost stiffness should ensue. As *oon as all signs of inflammation have disappeared passive movements should be begun. In some cases stiffness is unavoidable owing to the formation of adhesions in the joint. Such adhesions may require to be broken down under an anaesthetic after all signs of inflammation have ceased. Septic Sore Tliroat. Septic sore throat, or follicular tonsililis, is an exceedingly unpleasant and painfid form of inflammation of the tonsils. It is usually due to some direct infection from drains, sinks, and sowers, but is also frequently met with, among medical students in hospitals, who are exposed to many

sources of infection. The attack usually begins with soreness and pain in the throat on swallowing; feverishness and depression, and occasional fits of shivering. The tonsils may bo merely swollen and inflamed, or may be actually ulcerated in places. The temperature gradually rises, often reaching 103dcg on the second or third day. The general health is affected both by the pain and the difficulty of taking nourishment, and food .must be given in a liquid and semi-liquid form, in the shape of jollies, beef tea, milk, and arrowroot, remembering that warm liquids are the most soothing .to the throat. The treatment consists in the. application of antiseptics to the affected part, and the administration of stimulants and tonics. Antiseptic gargles, sprays, and swabs are the best means of local application. When the condition improves, and the most acute symptoms have subsided, the food most be liberal and nourishing, and later a change of air with a brief rest from work and worry of any kind is advisable. Weak general health is one of the great pred sposing causes of sept'c throat, and anyone returning to work, perhaps to bo exposed to a new risk of infection must have quite regained hi« normal state of good health to do so with safety.