Wounds in the region of the chest are often complicated injuries to the lungs or stomach, which fact can be recognizer by coughing, difficult breathing, and the spitting of bloo Wounds of the abdomen are especially dangerous if sever enough to injure the bowels or intestines.

Treatment. Always expose a wound and examine it can fully. When clothing covers the wound it should be cut ripped in order to obtain a view of the wound. The clothin should be turned back so that it does not touch the wound, all clothing will naturally contain more or less impurities.

The wound and surrounding skin should be thoroughly di infected with a solution of equal parts of tincture of iodin and alcohol. When the wound is covered with dirt or greas it can be cleansed by using a piece of gauze moistened with turpentine or alcohol.

As a rule, it is much safer temporarily to bind up a wound dirt and all, than to touch it with unclean hands. Such temporary dressing should, however, only be kept on until the injured person can be removed to a place where the woun can be properly cleansed.

In dressing an open wound, never touch it with the ba hands unless absolutely necessary. Never use a cloth or bas dage that is not surgically clean, and never wash a wound

unclean water.

If the wound must be touched with the bare hands, cleans the hands as follows: Bare the arms to the elbow, remove all rings from the fingers, and, using boiled water, scrub the hands thoroughly with antiseptic soap and dry them on clea gauze or lint. Pay particular attention to the finger nail After washing the hands do not touch anything not surgical

clean.

Never cover a wound with adhesive plaster, as in that wa the disease germs are sealed up within it. Small strips adhesive plaster should, however, be placed across very lo cuts, etc., to hold the edges of the wound together (fig. 21).

In cases of wounds caused by foreign bodies, such as lar splinters, bullets, etc., it is less dangerous to allow the foreig

dy to remain in the wound until the patient has reached a
rgeon than it is to remove it. In removing a foreign body
is easy to start a serious hemorrhage by also removing from
e wound a blood clot or by uncovering some large blood
essel to which the foreign body is acting as a plug.
Small splinters, thorns, fishhooks, etc., should be removed
om the wound with tweezers which have been made clean
boiling in water. Then treat as an ordinary wound.
Sometimes a small wound caused by a rusty nail or some
milar object penetrating the skin may result in lockjaw.
ny wound of this character should be promptly shown to a
octor, even before any symptoms of the disease may present
emselves. All such wounds as soon as received should be
ade to bleed freely by pressure, cleanly dressed like other
ounds, and not sealed by plaster, collodion, newskin, or the
ke.

In order to have a wound heal promptly rest is essential.
Contused wounds.-Contused wounds may be of two
arieties one in which the skin is broken and the other in
hich it is not. They may be caused by a kick from a horse,
blow from a stone, a rolling log, or a wagon wheel passing

ver one.

If the injury is very severe, the patient may die on the spot rom shock or loss of blood. In some instances, although erious injury may have been inflicted, there may be no outward evidence of the fact, the hemorrhage being internal and 10 blood being outwardly visible. In these conditions there s usually great shock, and the patient is apt to vomit and be very nervous.

In contused wounds, the blood vessels being injured, the itality of the injured part is likely to be impaired or detroyed, causing the death of some of the tissues, and there 3 great danger of secondary hemorrhage occurring when this ead tissue separates from the living tissue, which usually ccurs between the fifth and tenth day after the injury is eceived.

Gangrene (death of the part) also frequently follows the class of injuries.

In treating these wounds we must arrest hemorrhage, lim the inflammation, and try to promote the absorption of th blood or fluid contained within the wounded area.

All of these cases should be placed in the hands of a su geon immediately. Until the surgeon can be reached, how ever, the patient must be kept absolutely quiet and, if neces sary, stimulated, and the injured part should be kept co stantly wet with a solution of one-half alcohol and one-ha water.

Gunshot wounds. In gunshot wounds there is a woun at the point of entrance of the shot, and frequently one of more wounds at the point of exit, if the bullet passes throug the body.

When the shot is lodged under the skin it should never removed by the first-aid man, but should be left where it until a doctor can be reached.

In this class of wounds there will usually be great shoc which will demand proper treatment. (See "Shock," p. 57

Wounds of the abdomen.-In wounds of the abdomen, the bowels are exposed, they should be kept warm and p tected from the air, until surgical aid can be obtained, cloths wrung out of hot salt water and changed with sufficie frequency to prevent the bowels from becoming dry. These cloths should be held in position by a broad bandage, which will aid them in retaining their warmth and at the same time offer some support to the abdomen.

Severe shock accompanies abdominal wounds and should b properly treated. (See Shock," p. 57.)

BRUISES.

Always make a careful examination of the bruise to see the skin is broken. If it is, treat as for wounds. (S "Wounds," p. 29.)

Treatment. Slight bruises should have ice, or a wet cloth with very hot or cold water, or half alcohol and half water, applied to them.

In severe cases with great prostration, in addition to the above, the body should be kept warm, and hot drinks, preferably coffee, should be given. Rest is important in such cases. In severe bruises of the back, strapping the parts firmly with strips of adhesive plaster, extending some distance in all directions beyond the bruised tissues, will often afford great relief.

When the arm is severely bruised it should be carried in a sling.

BLEEDING (HEMORRHAGE).

There is more or less bleeding from all open wounds, but unless some of the large blood vessels are injured the hemorrhage is not dangerous.

When the hemorrhage is of a dangerous character there will be faintness, with the face pale, skin cold, pulse weak, breathing irregular, and dizziness or loss of consciousness. Hemorrhage occurs from

Arteries.-Bright red blood which comes in spurts
(this form is the most dangerous); blood is lost very
rapidly and an injured person may die in a very few
minutes.

Veins.-Dark blue blood which flows in a steady
stream.

Capillaries. Blood slowly oozes out.

Treatment-Bleeding from the arteries.-Have patient lie down with head low. If the wound is in a limb, elevate the limb.

Apply pressure directly to the bleeding part or above the wound (between the wound and the heart) with the thumb or fingers. (For points at which to apply pressure see figs. 22 to 25.) Then substitute for this a tourniquet or compress, using only sufficient pressure to barely stop the bleeding (fig. 26). 85510-17- -3