Chapter 56

FIRST AID TO THE SICK AND INJURED

=1478. Object of teaching first aid.= The object of teaching first aid, or early assistance of the injured or sick, is not only to enable one person to help another, but also in some measure to help himself, until a surgeon or other thoroughly trained person can be seen.

It is a mistake to think you must know many things to be helpful, it is only necessary to know a few simple things, _but you must understand them clearly and be able to do them well_.

=1479. Asphyxiation (suffocation) by Gas.= Asphyxiation by gas is treated the same as in the case of drowning, omitting, of course, the operation of getting the water out of the body.

=1480. Bite of dog.= } Either requires immediate and heroic treatment. =Bite of snake.= } _Lose no time._

1. Prevent the poison from traveling toward the heart and brain by putting on at once a tourniquet between the wound and the heart.

2. Suck the wound and be sure to spit out the poison and rinse the mouth afterward. It is safe, if you have no cuts or sores on the lips or in the mouth.

3. Enlarge the wound with a knife (in the direction of the bone, not across) to make it bleed more freely, and again suck the wound.

4. Apply to the wound any strong acid or caustic, such as carbolic acid, lime, wood ashes or tincture of iodine, or burn it with a hot iron. Telegraph wire will do.

5. Wash out the wound with hot water and pack with equal parts of baking soda and salt, and apply a bandage.

6. Then, in the case of a snake bite, loosen the tourniquet little by little, taking about half an hour so as to permit any poison that may remain in the wound to be _gradually_ absorbed by the blood. In the case of a dog bite, the tourniquet is loosened at once.

After the tourniquet has been removed, the patient must rest quietly for several hours. If he feel faint, he may have a stimulant,--alcohol, coffee or tea,--_but do not give the stimulant before the poison has been removed from the wound_, because stimulants increase the heart beats and thereby hurry the poison into the blood.

If the dog is not mad (rabid), the wound does not need treatment different from any other kind of a wound.

When bitten by a snake, kill it, if possible, and have it shown to a doctor for examination.

=1481. Bleeding.= The following comparison between the blood and the water in a city will enable you to understand easily the question of bleeding:

The {water } flows from a pump called {waterworks} through {_blood_} {_heart_ } {rigid pipes } called {watermains}. When there is {a leak } {_elastic tubes_} {_arteries_} {_bleeding_} the {plumber } stops the flow of the {water } by {_doctor_} {_blood_} {turning a key valve } between the {waterworks} and the {_pressing the blood tube shut_} {_heart_ }

{leak } and then proceeds to repair the leak {_bleeding cut_} {by soldering }. He then turns on the {water } by {_by sewing or by bandaging_} {_blood_} {opening the valve in the water main }. {_removing pressure on the blood tube_}

Fig. 2 shows where pressure with the thumb will squeeze the blood tube between the thumb and the bone.

In addition to the pressure raise the leg or arm or head above the heart. This will slow the flow of the blood and lessen leakage.

However, one cannot hold the thumb forever on the blood tube, so we make an artificial thumb, called a _tourniquet_, which is a pebble or other hard object wrapped in some soft material (to prevent injury to flesh), which is pressed down on the blood tube and held in place by a strip of any material which can be tied so as to keep up the pressure.

A tourniquet, therefore, is like the valve in a water main.

The above diagrams show how a tourniquet is applied.

When no one is around to assist you, sometimes it will be possible to plug the wound in your own body with the first aid packet or with your thumb or handkerchief.

When the bleeding is slight, or is from the scalp or palm of the hand, or sole of the foot, direct pressure upon the wound itself with the pad of the first aid package will often be sufficient to stop the leak.

Nature when left alone stops the leaks with her own solder, called blood-clot, which forms in the cut ends of blood tubes and corks them or seals them up until a scar forms a permanent seal.

=1482.= The dangers from a tourniquet are:

1. Gangrene,--that is, the death of a limb caused by the lack of blood, which has been cut off by the tourniquet. By watching the toes and finger tips and loosening the tourniquet if they are becoming blue black and remain white when pinched, gangrene may be prevented. However, the wound should be plugged before loosening the tourniquet.

2. Injury to nerves from pressure which may cause palsy (paralysis). However, that will generally pass off in a few days.

=1483. Broken Bones (Fractures).= A broken bone or fracture is known by pain in a particular place that hurts on movement or when touched. Also, by a deformity or a movable lump, caused by the broken end of the bone.

A broken bone should be handled with the greatest possible care. Careless handling may cause the broken ends to pierce the flesh and stick out through the skin. This is called a =compound= fracture, and is serious, because it adds fuel to the fire by making a doorway for germs to enter, which may cause death or the loss of the limb. Furthermore, careless handling may make the bones grow together in a bad position, causing a deformity.

The best way to treat a broken leg or arm bone is as follows: (Fig. 8.)

Pull until the ends come together. You can tell this by the relief the patient feels and by the limb assuming its proper length,--that is, the same length as the other side.

=1484.= To keep the ends of the bones in place, fasten to the limb two boards or any other substance that will not bend. Such boards or other substance are called splints. They act as artificial bones. All splints should be well padded with some soft material like raw cotton waste, grass (be sure the grass contains no biting insects), leaves, hay or excelsior, to prevent pressure of the soft flesh on the ends of the bones.

When the thigh bone is broken, put a splint from the arm to the ankle and use the other leg as a splint. Fasten them by bandages, belts, gun sling, etc., passed around the chest, waist, hips, knees and ankle.

When an arm is put in a splint, hang the hand and forearm in a sling. It will give much relief.

When the jaw is broken, the upper jaw makes a good splint.

When the collar bone is broken this makes a good treatment: Fig. 10.

A broken rib is treated by putting a wide strap or bandage around the chest and drawing it tight while all the air is breathed out.

This keeps the rib quiet and the man will breathe with his belly instead of his chest.

A broken skull usually makes a man unconscious and may cause death. It is recognized by a wound or swelling of the scalp and a dent in the skull. A doctor should be called at once. Always examine an unconscious man for injury to the head.

=1485. Burns.= If clothing sticks to the burn, do not try to remove it, but cut around it. Prick blisters at both ends with a perfectly clean needle, and remove the water by gentle pressure, being careful not to break the skin.

A good application for a burn is carbolic acid dissolved in water (a teaspoonful in a pint of water), or tincture of iodine dissolved in water (one teaspoonful in a pint of water, to which is added as much salt as will cover a dime), or olive oil, vaseline or butter.

Lacking the remedies named above, ordinary _baking_ soda or flour may be dusted on the unbroken skin, or a cloth dampened with salt water that has been boiled, to which may be added the same amount of whiskey or brandy as there is water.

Another application for burns recommended by some, is the scraping of a raw potato, renewed when it feels hot.

Different burns should be treated as follows:

=Sunburn=,--treat with olive oil, vaseline or butter, or with a glycerine or witchhazel, applying with a dampened cloth.

=Quicklime or lye=,--treat with vinegar.

=Carbolic acid=,--treat with alcohol.

=Other acids=,--treat with baking powder or lime water.

=1486. Burning clothes=, particularly those of women and children, has been the unnecessary cause of many horrible deaths, either from ignorance of the proper means of extinguishing the flames, or from lack of presence of mind to apply them. A person whose clothing is blazing should (1) immediately be made to lie down--be thrown if necessary. The tendency of flames is upward, and when the patient is lying down, they have not only less to feed upon, but the danger of their reaching the face, with the possibility of choking and of ultimate deformity is greatly diminished. (2) The person should then be quickly wrapped up in a coat, shawl, rug, blanket or any similar article, preferably woolen, and never cotton, and the fire completely smothered by pressing and patting upon the burning points from the outside of the envelope.

The flames having been controlled in this way, when the wrap is removed, great care should be taken to have the slightest sign of a blaze immediately and completely stifled. This is best done by pinching it but water may be used. Any burns and any prostration by shock should be treated in the manner prescribed for them.

=1487. Bruises.= The best treatment for a bruise is heat.

A hot brick or a bottle of hot water wrapped in cloth, towels wrung out of hot water, or even an electric light bulb, will give much relief.

However, always remember this: Never put the hot object on the bare skin--always wrap the source of heat in a thick cloth to hold the heat in and at the same time protect the skin. If not practicable to do this wrap the source of heat, then spread a towel over the skin before applying the hot object.

If you use an electric bulb, watch it closely, as it will char and possibly set things on fire.

The above treatment is also excellent for lumbago, stiff neck, and stiff muscles.

A tub bath as hot as you can stand it is fine for refreshing tired, stiff muscles. It is also good for lumbago.

=1488. Chiggers.= Apply kerosene oil. Bacon is also excellent, and so is butter or lard with salt.

=1489. Choking. Foreign body in the throat.= The common practice of slapping the back often helps the act of coughing to dislodge foreign bodies in the windpipe.

If this does not succeed, have the patient lie over a chair with his head down low or hold him as in the first step to revive a drowning person and have him cough. When in either of these positions have some one slap him on the back so as to induce coughing.

The above failing, give him a large amount of warm water with a little salt, mustard or baking soda in it, and then have him put his finger in his throat so as to induce vomiting which will often bring up the obstruction.

In children, and even in adults, the expulsion of the body may be facilitated by lifting a patient up by the heels and slapping his back in this position.

If none of the methods above described are successful, summon a physician, taking care to send him information as to the character of the accident, so that he may bring with him the instruments needed for removing the obstruction.

=1490. Cuts.= Small cuts should be treated with tincture of iodine or washed with alcohol (bay rum or listerine will do) and bandage up. Large wounds may be similarly cleaned and then closed by adhesive plaster.

=1491. Diarrhoea.= Apply warm bandages to the belly. Some woodsmen recommend the following: Fire brown a little flour to which two teaspoonfuls of vinegar and one teaspoonful of salt are added; mix and drink. They claim this is a cure nine cases out of ten. A tablespoonful of warm vinegar and teaspoonful of salt will cure most severe cases. Also, hot ginger ale or hot water containing a teaspoonful of witch hazel is good. Repeat any of the above drinks about every hour.

Take a purgative, which will usually expel the offending cause, generally too much undigested food.

=1492. Dislocations.= The place where two bones come together is called a joint.

When two bones forming a joint are knocked apart, it is called a _dislocation_, and the bones are said to be _out of joint_.

The first sign of a dislocation is the accident.

The second sign is immediate interference with the motion of the joint and awkwardness in using the limb.

The third sign is deformity of the joint,--it looks queer when compared with the same joint on the other side.

If you are unsuccessful after trying several times to replace a dislocation, get a doctor.

If no doctor is available, make the man sick by having him drink some warm salt water and then put his finger in his throat.

When he vomits the muscles and ligaments (tissue connecting the joints) will relax and you may be able to get the bone back in place.

After replacing the bones put the joint at rest with a large compress and bandage.

When uncertain as to whether you have to deal with a broken bone or a dislocated joint, give treatment for a broken bone, because rest and quiet for the injured part are good in either case.

The following diagrams show the usual methods of replacing dislocations:

=1493. Drowning.= _Rescuing._ Approach the drowning man from behind, seizing him by the coat collar, or a woman by the back hair, and tow at arms length to boat or shore. Do not let him cling around your neck or arms to endanger you. Duck him until unconscious if necessary to break a dangerous hold upon you; but do not strike to stun him.

A drowning person _does not_ come to the top three times before giving up.

_Reviving._ When a person is apparently drowned he is unconscious and not breathing because his lungs are full of water and his skin is blue and cold because no air is getting into his blood to redden it and warm it; _remember_ the heart does not stop until some time after the breathing stops. If we can get air into the blood and start breathing again before the heart stops we can save the patient's life. If we cannot get the breath started in time the heart stops and the patient is then dead.

Our problem then is this:

1. To get the water out of the lungs.

2. To get the air into the lungs and start the man breathing before the heart stops.

Emptying the lungs is precisely similar to emptying a bottle.

The lungs are the bottle, the windpipe is the neck of the bottle and the cork of the bottle may be the tongue turned back in the throat or mud and leaves from bottom of the pool and bloody froth in the nostrils. We therefore--

1. { Pull out the cork. { =Remove mud, mucus, etc., and pull the tongue forward.=

2. { Turn the bottle neck down to pour out the contents. { =Place the patient's head lower than his chest so the water { will run out.=

Then lay the patient on a blanket, if possible, and on his stomach, arms extended from his body beyond his head, face turned to one side so that the mouth and nose do not touch the ground. This position causes the tongue to fall forward of its own weight and so prevents it from falling back into the air passages. Turning the head to one side prevents the face coming into contact with mud or water during the operation.

Kneel and straddle the patient's hips, facing his head.

Roll up or rip off the clothing so as to get at the bare back.

Locate the lowest rib, and with your thumbs extending in about the same direction as your fingers, place your spread hands so that your little finger curls over the lowest rib. _Be sure to get the hands well away from the back bone_,--the nearer the ends of the ribs the hands are placed without sliding off, the better it is.

Then with your arms _held straight_, press down SLOWLY AND STEADILY on the ribs, bringing the weight of your body straight from your shoulders. _Do not bend your elbows and shove in from the side._

Release the pressure suddenly, removing the hands from the body entirely, and thus allowing the chest to fill with air.

Wait a couple of seconds, so as to give the air time to get into the blood. This is most important.

Repeat the pressure and continue doing so, slowly and steadily, pressing down at the rate of ordinary breathing. That is to say, _pressure and release of pressure (one complete respiration)_ should occupy about five seconds. Guide yourself by your own deep, regular breathing, or by counting.

Keep up for at least one hour the effort to revive the patient; and much longer if there is any sign of revival by way of speaking, breathing, coughing, sneezing or gurgling sounds.

Do not stop working at the first signs of life, but keep it up until the patient is breathing well and is conscious. If you stop too soon he may stop breathing and die.

Persons have been revived after two hours of steady work, but most cases revive within about thirty minutes.

If you are a heavy man, be careful not to bring too much force on the ribs, as you might break one of them.

In the case of women or thin persons place a roll of clothing under them at the waist line before beginning the pressure.

If you happen to be of light build and the patient is a large, heavy person, you will be able to apply the pressure better by raising your knees from the ground, and supporting yourself entirely on your toes and the heels of your hands, properly placed on the floating ribs of the patient.

Do not attempt to give liquids of any kind to the patient while he is unconscious, for he cannot swallow them. They will merely run into his windpipe and choke him, and furthermore, it will take up valuable time.

However, after the patient has regained consciousness you may give him hot coffee or hot whiskey, punch or aromatic spirits of ammonia (a teaspoonful in water).

Then wrap up the patient warmly in hot blankets with hot water bottles, and take him to the nearest hospital or put him to bed and send for a doctor. Why? Because the dirty water in the lungs has damaged the lining and the patient is in danger of lung fever and needs care and nursing.

Aromatic spirits of ammonia may be poured on a handkerchief and held continuously within about three inches of the face and nose. If other ammonia preparations are used, they should be diluted or held farther away. Try it on your own nose first.

The above method of artificial respiration is also applicable in cases of electric shock, suffocation by gas and smoke.

=1494. Earache.= Put a teaspoonful of salt into a quart of water and add 6 teaspoonfuls of tea. Boil it. As soon as it is cool enough to stand the finger, drip some into the nostrils until it falls into the throat. Clear out the nose and throat by sniffing,--_do not blow_ the nose.--and then gargle with the rest of the remedy as hot as can be taken, holding each mouthful well back in the throat. This will often open up the tubes running from the ears to the throat, and relieve the pressure against the ear drum. In addition, a little hot oil may be dropped into the ear. Repeat the treatment in one-half an hour if not successful first time.

=1495. Ear, foreign body in.= Lay the head over, with the affected ear up, and pour in some warm oil or soap suds. This will float the thing up, unless it be a vegetable such as a grain of corn or a bean. Turning the affected ear down and then jumping, jerking the head, or pounding it gently, may dislodge it.

A little peroxide of hydrogen poured into the ear will often dislodge the substance, especially if it be wax.

In case of an insect, a bright light held near the ear will often cause it to leave the ear to go to the light.

=1496. Electric Shock.= Failure of respiration following an electric shock by lightning or live wire is treated the same as in the case of drowning, omitting, of course, the operation of removing the water out of the lungs.

Do not try to pull a man away from a live wire until you have put on rubber overshoes or gotten a _wooden_ stick with which to get the wire away from him. Otherwise you will yourself get a shock.

=1497. Eye, foreign body in.= Close the eye for a few moments and allow the tears to fill the eye; upon opening it, the body may be washed out by them.

Never rub the eye.

The foreign body can often be removed by keeping the eye open with one hand and splashing water into it with the other, or by dipping the eye into clean water while holding the eyelid open with the hand.

If the body lies under the lower lid, make the patient look up, and at the same time press down upon the lid; the inner surface of the lid will be exposed, and the foreign body may be brushed off with the corner of a handkerchief.

If the body lies under lid, (1) grasp the lashes of the upper lid and pull it down over the lower, which should at the same time, with the other hand, be pushed up under the upper. Upon repeating this two or three times, the foreign body will often be brushed out on the lower lid.

(2) If this fails, the upper lid should be turned up; make the patient shut his eye and look down; then with a pencil or some similar article press gently upon the lid at about the middle, and grasping the lashes with the other hand, turn the lid up over the pencil, when its inner surface will be seen, and the foreign body may readily be brushed off.

If the body is firmly stuck in the surface of the eye, a careful attempt may be made to lift it out with the point of a needle. If not at once successful, do not try again, as you may injure the sight.

Lime, plaster or whitewash in the eye should be washed out with a very weak mixture of vinegar and water. Acids in the eye may be washed with baking soda in water. Olive oil will also afford relief.

After the removal of a foreign body from the eye, a sensation as if of its presence often remains. People not infrequently complain of a foreign body when it has already been removed by natural means. Sometimes the body has excited a little irritation, which feels like a foreign body. If this sensation remains over night, the eye needs attention, and a surgeon should be consulted; for, it should have passed away, if no irritating body is present.

After the removal of an irritating foreign body from the eye, salt water should be poured into it, then butter, lard or olive oil may be used for a salve.

=1498. Fainting.= Fainting is caused by the blood leaving the head. Therefore, we must get the blood back into the head, which is done by placing the patient on his back, with the head lower than the rest of the body. If necessary, make, by digging, a slight depression in the ground for the head, neck and upper part of shoulders. Also, the head may be placed lower than the rest of the body by putting a couple of folded blankets, or a few folded coats or any other suitable article under the body: also, by raising the feet by hand or otherwise. The clothing should be loosened by unbuttoning and the patient fanned. Give him as much fresh air as possible,--so, do not let people crowd around him. Mop the face and forehead with a handkerchief soaked in cold water.

=1499. Fish hook.= If a fish hook gets caught in the flesh, push it on through and when the end sticks out, break off the hook and pull it out the other way. Put tincture of iodine on the wound and bandage.

=1500. Fits.= The man falls over suddenly unconscious in a convulsion, which continues until he is blue in the face, when he gradually quiets down and regains consciousness. He is liable to injure himself by the fall and by biting his tongue. Put a stick or cork between his teeth and let him lie quietly undisturbed. Don't try to hold him down or make him sit up. He will come to no harm on the floor and you cannot stop the fit. Ammonia on a handkerchief held under the nose to smell will assist reviving consciousness. Put him in the hospital at once.

=1501. Fracture.= See, "Broken Bones."

=1502. Freezing.= If a man is overcome by the cold, do not take him into a warm room, or heated tent. Put him into a cool room without draughts and get a doctor at once. Meanwhile loosen his clothing and rub arms and legs towards the heart with cold water and a towel or sponge, using pressure.

When he revives give him hot drinks and wrap him up well in hot blankets and put him in the hospital.

When freezing to death a man feels overcome with sleepiness and stupor. Take a switch or stick and beat him unmercifully. Remember that falling to sleep means death.

=1503. Frost-bite.= The best way to get frost-bitten is to have on damp clothing, such as wet shoes and socks or mittens. The first feeling of frost bite is numbness, and the first sign is marble whiteness.

_Treatment._ Rub the frozen part briskly with snow or ice cold water, if the frost-bite has just occurred. If it has been frozen more than fifteen minutes, _rub very gently_ with snow, cold water or coal oil (kerosene). If you rub hard, it will break the frozen flesh.

Returning pinkness is a sign of thawing; if the parts turn a dark color, see a surgeon at once, for it means gangrene (death of the flesh).

When thawed out apply plenty of oil, tallow or vaseline.

If gangrene has set in and no doctor is available, then treat as a burn.

By all means keep away from heat. To toast frost-bitten fingers or toes before a fire is liable to result in chilblains.

=1504. Headache.= Among troops headache is usually due to intestinal indigestion, combined with a congestion of the stomach. Take a tablespoonful of Worcestershire sauce or 5 drops of tobasco sauce in a tumbler of hot water as a drink and put a small piece of soap up into the bowel to cause a movement.

=1505. Heat exhaustion.= The man falls out in a faint while marching, or on fatigue or parade. He looks pale, his body is clammy and cold, his breathing is sighing and heart fluttering. _What is the matter?_ His heart is weak from poisons in the blood, usually alcohol, but often too much carbonic gas and too little oxygen. This occurs when men are soft-muscled: so, young soldiers, recruits and fat soldiers and especially those who drink alcohol, use drugs or smoke or chew tobacco while hiking, are the first to have it.

_Treatment._ Loosen the man's clothing, remove his pack, lay him on his back in the shade, with head and shoulders lower than his hips and raise his feet in the air. This will make the blood flow to the heart and brain. If he has fainted, slap the bare chest with the hand or a wet towel and briskly rub the arms towards the heart. If he does not revive, apply hot bottles, or bricks to the chest and abdomen, and ammonia to the nose, as a smelling salt. Do not give stimulants until he is conscious. He should ride in the ambulance, or go to the hospital.

=1506. Lightning.= A man struck by lightning is treated the same as in the case of drowning, omitting, of course, the operation of getting the water out of the lungs.

=1507. Nose, foreign body in.= If it cannot be sneezed out, lean the head back and pour a little oil into the nostril. Then snift and blow the nose alternately. If this is not successful, take a lead pencil and try to push the object straight back into the throat. This must be done very gently.

=1508. Poison.= When poison has been swallowed, cause the patient to take a large quantity of luke-warm water and make him vomit by putting his finger in his throat. Repeat this and then have him swallow the white of two eggs or some milk into which raw flour or corn-starch has been stirred.

If you know he took bichloride of mercury, you may increase the amount of eggs and give one-half glass of weak lime water.

If you know he took carbolic acid, give him alcohol (pure alcohol or in the form of gin or whiskey) and plenty of it in order to neutralize the acid.

Get a doctor as soon as possible, and save the vomit and poison not taken, for him to see.

=1509. Scalds.= Apply at once common baking soda or olive oil and cover with a bandage. To sprinkle with flour is also good.

=1510. Scratches of cats and other animals.= Apply tincture of iodine or wash with soap and water.

=1511. Shock.= In case of collapse following an accident, treat the accident; then treat as for fainting. Apply hot plates, stones or bottles of hot water, or an electric light wrapped in towels over the stomach. Wrap up warmly. Keep the patient quiet, in the dark, and send for a doctor.

=1512. Snow or sun blindness.= Smear the nose and face about the eyes with charcoal, and wear a cloth over the face with small holes for the eyes.

=1513. Sore throat.= Gargling with hot strong tea or hot water and salt is often effective.

Listerine diluted in water and used as a gargle is also good.

Peroxide of hydrogen is a good gargle.

=1514. Spider bite.= Apply a cloth dampened with alcohol or weak ammonia and water.

=1515. Suffocation by gas.= See "Asphyxiation by gas."

=1516. Sprains.= The regular medical treatment is to plunge a sprained ankle, wrist or finger, into water as hot as can be borne at the start, and to raise the heat gradually thereafter to the limit of endurance. Continue for half an hour, then put the joint in a hot wet bandage, reheat from time to time, and support the limb in an elevated position,--the leg on a chair or stool; the arm carried in a sling. In a day or two begin gently moving and kneading the joint, and rub with liniment, oil or vaseline.

As a soothing application for sprains, bruises, etc., the virtues of witch hazel are well known.

=1517. Stings.= Stings of bees, jelly fish and other stinging animals are treated with a very weak solution of ammonia in water applied as a lotion. Or apply a very weak solution of carbolic acid in water, a strong solution of baking powder, a slice of crushed raw onion, a moist quid of tobacco, witch hazel, listerine, or a paste of clay.

Before applying any of these remedies, extract the sting, if left in the wound. Also, work out as much of the poison as possible by massaging and sucking the wound.

=1518. Sunburn.= Treat with witch hazel or listerine or vinegar well diluted with water.

=1519. Sunstroke.= In sunstroke the man has a blazing red face, dry, burning hot skin; agitated heart; snoring breathing; a high fever, and is unconscious and delirious. _What is the matter?_ The part of the brain which regulates the heat of the body is overcome by the heat and loses control,--the man is entirely too hot all the way through.

_Treatment._ First of all remove the pack and shoes and loosen the clothing. Then souse the man, clothing and all, with water. Lay him in the shade and fan him, keeping him covered and wet. This will cool him off without chilling too much. If possible, rub the chest and legs, but not the belly, with ice.

=1520. Wounds.= Wounds may be made in every degree of size, from the jab of a splinter to the loss of a part of the body from shrapnel.

No matter what form of the wound or the cause, we know the following fact to be of the utmost importance: A wound without germs in it will heal rapidly without pain, redness, heat, or pus and the patient will have no fever. He will eat his regular meals and act as though well.

Such wounds we see made by surgeons when operating. On the other hand, wounds infected with germs are painful, hot, angry, red, and swollen and form large quantities of pus or matter.

Pus is a mixture of germs, blood and the flesh that they have destroyed. This pus prevents wounds from healing and often burrows under the skin, forming abcesses which cause fever and chills, and the pus enters the blood causing delirium and death.

Our one aim in treating wounds is to keep out germs, and we accomplish this by means of the first aid packet.

=1521. The first aid packet= consists of two gauze compresses sewed to two cotton bandages. They are sealed in wax paper. There are also two safety pins wrapped in wax paper. These articles are placed in an airtight metal case which protects them from contamination.

Now, the one important fact about this first aid packet is that the bandage compresses and safety pins have been _sterilized_,--that is, they contain no living germs of any kind. It is, therefore, perfectly safe to put on a wound, _provided the pad touches the wound before it touches anything else and provided that the wound has not been handled_. Therefore, do not wash a fresh clean wound.

CAUTION. Have the wound ready before you open the packet. Do not touch the gauze pad with ANYTHING. Do not breathe on it, and be especially careful not to cough or sneeze over it. These things put germs on it which will grow in the wound.

By observing these instructions you may save a man's life. By not observing them, you may cause his death, or cause him much pain and suffering.

The life of a wounded man is often in the hands of the first one who attends him.

It is said that since the adoption of the first aid packet by armies, it has done more than everything else to save the lives of those wounded in battle by preventing the infection of wounds.

In an emergency a pad from any kind of cloth may be boiled for ten minutes to kill the germs, the water drained off to allow it to cool, and then placed on the wound. Or, the pad may be held over a clear fire until it is fairly scorched; then let it cool. A little charring of the surface will do no harm. Any kind of bandage may then be used to hold it in place.

When a bullet strikes a man first, the wound is clean cut and germ free and it will heal rapidly. If, however, it strikes something first, and bounces off (ricochets) and then strikes a man, it will be knocked into an irregular shape and, therefore, cause a ragged wound with much bruising. What is more important, such a bullet will carry germs into the wound from the object struck, and almost surely some shreds of clothing.

When a wound is infected it is extremely difficult to kill the germs (disinfect). Such a wound, before applying the first aid dressing should be painted with a tincture of iodine, or alcohol or be well washed with boiled salt water.

=1522.= The illustrations below show improvised litters.