AGRAWAL Y.R. , Homoeopathy in Accidents and Injuries (awy3)
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Accidents and injuries
 Accidents can happen any time, any where and the first aid in accidents is often crucial to life and limbs. Look first to three ‘Bs’ – breathing, bleeding and broken bones. If the victim is not breathing, give him artificial respiration. If the bleeding, stop it with pressure. Look carefully for broken bones. Fractures must be put in splint before the patient is moved. Handle victim gently at all times. Do not move him or let him move. Do not pull him or try to get him sit or stand up. Do not give an unconscious patient any thing to drink. Keep the victim quiet, warm, and as comfortable as possible to minimise shock. Loosen tight clothing especially the collar and belt. Cover burns and wound as soon as possible with sterile gauze. If the victim vomits, turn his head to one side so vomit will not go into his lungs. Remove victims of gas poisoning to fresh air.
 An accident causes injury either in the form of bruise, concussion, cut, haemorrhage, wound or in the form of fracture. All these conditions need proper care as described below :
 Bruises
 Bruises or contusion is the result of a blow or fall that breaks the skin capillaries, usually without breaking the skin. Blood oozes into the tissues, making the bruise at first red and swollen. Later as the blood clots, the bruise becomes discoloured, ‘black and blue’, black eye is a bruise.
 In treatment of bruises, nothing is more efficacious than the application to the injured parts of cloths (linen is to be preferred) dipped in cold water, and the internal administration of Arnica. In very severe cases followed by fever, give Aconite, and sometime afterwards Arnica. If it seems necessary, occasionally, Arnica may be again necessary after a few days. A lotion of Arnica tincture, made of the root, in the proportion of half a teaspoonful to a tumbler of water, may also be used.
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 If a limb is crushed and flattened, or otherwise disfigured it should be pressed by hand from time to time, until it returns to its proper form; or it may, if necessary, be straightened and kept in its natural position by means of piece of pasteboard, wet with hot water and so softened that it can be moulded to the limb; a bandage must be placed over all to keep it in its place.
 If suppuration ensues, Hepar Sulph. must be given. If in the accident bone was injured, or there was a fall or blow, directly on a bone, for instance on the skin, apply a cloth kept moistened with water, in which a few drops of Ruta have been added. This will be particularly beneficial when the injury was very violent, and pain seems to be deep in the bones. Ruta is also to be given internally and apply its solution in water if the pain is more external, so that it is only painful to the touch, or the wound assumes a red appearance, which extends and increases like erysipelas.
 But should the incipient signs of mortification present themselves in the form of increased swelling and pain – pain of pungent burning kind, loss of sensibility, heat and colour, and wound begins to change to a darker hue, Cinchona be thought of. If the skin assumes a dark, livid colour, recourse must be had to Lachesis, which should be given at short intervals, and may prevent the loss of life and limb. Amputation be postponed as long as possible.
 Following medicines are very useful in different types of bruises :
 Bruises of bones : - Arnica, Calcarea Phos., Ruta, Symphytum.
 Bruises of breast : - Bellis P., Conium.
 Bruises of eyes : - Aconite, Arnica, Hamamelis, Ledum, Symphytum.
 Bruises of parts rich in sentient nerves : - Bellis, Hyper.
 Bruises with persistence of ecchymosis : - Arnica, Ledum, sulphuric Acid.
 Bruises old : - Glonoine.
 Orchitis : - Zincum.
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 Therapeutic hints
 Arnica Mont. : - It is the first medicine to be thought of in the bruises of any kind. However, it is more useful in bruises due to blunt instruments.
 Ruta Graveolens : - Bruises of the periosteum.
 Conium Maculatum : - Condensation of cellular tissue and induration of glandular structures, accompanied by a sensation of numbness; spine ill effects.
 Hypericum : - Crushing, as mashed fingers, especially tips.
 Ledum Pal. : - Discolouration remaining after pain and inflammation subsides.
 Sulphuric Acid. : - Bruises when ecchymosed.
 Acetic Acid. – When dry heat follows.
 Baryta Mur. : - While riding on horse back. (Polo).
 Crocus Sativus : -Painful suppuration.
 Kali Mur. : - When swelling remains.
 Sambucus : - Tension in skin.
 Kali Sulph. : - After a kick of horse, varicose ulcer on right leg just above instep, eight inches in circumference, concave, dark blue, emitting a fetid odour.
 Bruises about the eye : - Bruises about the eyes from blows with the fist, a stick, a stone, a flying cork, etc., are to be treated by the application to the injured parts of cloth (linen to be preferred), dipped in cold water; change the pieces of wet linen as soon as it becomes warm, for a cold one, and bandage the eyes for protecting them from light. Whenever the pain increases, give Arnica or Aconite according to the symptom.
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 Bruised head of a child after birth
 It is caused by the pressure during birth. It may be either an extravasation of lymph or blood into the cellular tissue, in which it is called caput succedaneum; or it is an extravasation of blood between the bones and the pericranium; causing the affection called thrombus neonatorum.
 The Caput succedaneum may extend over the fontanelles or sutures of the bones; it may be formed on any part of the head sufficiently exposed to a great pressure of the pelvis, or the forceps, during labour. It has a soft, doughy feel, and the outer skin looks bruised.
 The thrombus, however, is confined generally to the parietal bones, and never extends over the sutures of the bones, because there the pericranium adheres firmly to skull. It feels elastic and fluctuates, and shows no discolouration of the external skin.
 Both forms are bruises in their nature and are to be treated like bruises. Arnica will usually do what is required; in some cases, Baryta Mur. and Mercurius have been successfully applied.
 Ecchymosis
 This is discolouration of skin following a bruise and is produced by extravasated blood under the skin. It is first of reddish colour, but speedily becomes black. During recovery, the parts change, first to a violet colour – the line which defined the bruise becoming indistinct – afterwards to a green, then yellow; and thus sooner or later, according to the health of the individual, or the quantity of blood poured out, the discolouration disappears. Black eye is a common instance of ecchymosis.
 Arnica * lotion has great power in preventing this condition if used immediately after an accident. When extravasation has already occurred Hamamelis lotion (1 part of 6 of water) is more appropriate. Acetic Acid., Badiaga, Calendula, Ledum, Rhus Tox. and Sulphuric Acid. are other remedies to be used according to symptoms.
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 Therapeutic hints
 Sulphuricum acidum
 Is useful in black and blue spots in the skin as a result of bruising and practice corroborates it. It has greater affinity in cachectic or weakened constitution. It follows well after Arnica.
 Badiaga
 Lesions, pains and suggillations after concussion or contusion, brown and blue spots on skin which is sore to touch.
 Nux vomica
 Ecchymosis into the conjunctiva or sclerotica, for this Nux Vomica is specific.
 Ledum palustre
 It is one of our best remedies for ecchymosis from bruises – black eye for instance. This medicine is more useful for bruises under the skin. Nash remarked that for black eye from a blow of the fist no remedy equals Ledum in 200th potency.
 Concussion
 Concussion of the brain is a bruise of the brain from a blow, fall or other violence to the head. The skull may or may not be fractured. The symptoms vary, depending on the severity and extent of the injury. In mild cases they may be no more than slight dizziness or giddiness and headache that passes off in an hour or two. In somewhat more serious cases there is partial or complete insensibility, pale face, rapid, irregular, small, slow, shallow or imperceptible pulse, irregular breathing; cold extremities etc. By shaking the patient, or calling his name in his ears, he may give a surely answer, and soon becomes insensible again. After a time, longer or shorter according to the severity of the injury reaction comes on, and unconscious returns, with rise of temperature (101° F. to 102° F.), and some irritability; often there is vomiting. In very serious cases the outstanding symptom is unconsciousness (coma), sometimes lasting for weeks. The outlook for recovery is usually good, though often slow. During convalescence, the patient may be extremely irritable and suffer memory lapses.
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 In severe cases in which bones of the skull might have been cracked, stupefaction might disappear and patient apparently improves, yet death ensues in a few days. In such cases it is essential to ascertain whether there is fracture. If pain is felt, by distorting the face, Hypericum in water is sometimes serviceable. The patient should also be kept very quiet; he will generally find the best position for his head himself. If one side is more fractured than the other, let him lie on the less injured side; if it is internal keep his head in an elevated position and place a small round pillow at the nape of his neck. The doors must be closed gently and every one in the room move with the greatest precaution.
 A few teaspoonfuls of cold water, immediately after the injury will often be of a great service in reviving the patient, and should always be resorted to, as water can do no harm. The application to the head of cloth dipped in cold water to which, in case of external injury a few drops of tincture of Arnica may be added.
 In active inflammation of the brain, Aconite, Belladonna be used notwithstanding the use of the means recommended above.
 Concussion of other parts of the body may occasion a variety of unpleasant effects. Sometimes internal parts are distended to torn, pain arises, which increases the following day, violent headache, giddiness, pain in the chest, asthma, hacking cough, spitting of blood, pain in the back, descending pains in the belly etc. In all such cases Arnica is the chief remedy. The patient should remain as quiet as possible; drink plenty of water, wash the painful parts frequently in cold water, or with water containing a few drops of Arnica tincture; neither eat nor drink any thing that has a stimulating effect; make use of no wine, brandy, coffee, tea or spices; of but little salt, but nothing sour.
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 Medication : -If the accident is attended with sudden fright, give Opium first and some hours after Arnica. If the patient faints, or is senseless and stunned, wash his head, face and arms with cold water and give, if it can be done immediately after accident, but if fifteen to twenty minutes have elapsed, Aconite or Glonoine, and afterwards, if necessary Arnica. Bleeding is always injurious.
 When a pregnant woman, in consequence of a fall, slip, or other violent concussion, feels pains in the abdomen, which may often be the precursor of a miscarriage, give Arnica and let the patient keep quiet, if possible in horizontal posture, and avoid for several days, every exertion. Should the pain becomes very violent some hours after Arnica, Chamomilla or one of the other medicine recommended for miscarriage be tried.
 In headache from concussion give Glonoine, Belladonna or Phosphoric Acid., whichever may suit best according to the symptoms. If a dull pressure, give Arnica, if very violent and eyes are painful, give Hypericum.
 Affections of chest caused by violent concussions are removed by Arnica. Sometimes Aconite or Rhus Tox. is required.
 Therapeutic hints
 Aconite : -It should be administered alternately with Arnica if fever attends the return of consciousness. But if there be danger of cerebral disturbance – headache, flushed face, or other heads symptoms, Aconite and Belladonna be alternated.
 Artemisia Vulg. : - Epilepsy, from a blow on head, commencing three year after.
 Badiaga : - Lesions, pains and suggillations.
 Chin. Sulph. : - Deafness.
 Cicuta Virosa : - It is a good remedy for the effects of concussion of the brain or spine, if spasms are in the train of chronic affects therefrom and Arnica does not relieve.
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 Calcarea Carb. : - Headache.
 Conium : - Ill effects to spine.
 Dulcamara : - Furuncles on places hurt.
 Ferrum Phos. :- Haemoptysis.
 Hyoscyamus : - Delirium, low or furious – a dose every one, two or three hours.
 Marum Verum : Injuries to hand.(Natrum sulph.).
 Opium : - Stertorous breathing, constipation remaining after concussion.
 Sprain
 A sprain means that the ligaments around the joint has been torn or stretched, so that there may be some blood or other fluid that seeps around the joint and discolours the skin. It also means that the synovial membranes are slightly inflamed and reaching by pouring out fluid, thus stretching the joint capsule and accounting for part of the pain and swelling.
 The immediate treatment for a sprain consists in the application of hot water, as hot as can be borne, until the pain is considerably modified, followed by a compress of cloths moistened with the lotion of Arnica, Rhus, Ruta or Hypericum and covered with flannel. The remedy used for lotion may also be taken internally. In severe sprains, let the injured part be placed in water as hot as can be well borne, in which Arnica ¨ (a tablespoonful to the pint) has been mixed. Let this he repeated every three or four hours, and the part supported in the intervals by a light bandage and kept warm. Internally give Arnica to be repeated frequently for first hour. When the pain has ceased and the swelling subsided, external application be discarded and only medicines alone be given. Rest is necessary but the joint must not be allowed to become stiff, and after all signs of inflammation have subsided movement must be encouraged. If there is no improvement within 48 hours Arnica be substituted by Bellis Perennis (Bellis ¨ for hot bath and Bellis 3 or 30 internally). Rheumatic pain and stiffness remaining after a sprain, especially if the pain is agg. at night, and by rest, Rhus Tox. be given. For bruised pain in the bones Ruta is to be given. Hering says that Bovista is good for oedematous swelling of foot even years after sprain.
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 The general rule is, when it begins to hurt or ache, stop moving. Application of heat in any form usually speeds healing. Light massage at first, gradually increased to firm massage, to improve blood circulation is also of a help. Medical attention such as X-rays should be immediately obtained to be sure that the sprain is just a sprain.
 If swelling remains very long with more or less pain, use applications of warm vinegar. If the swelling about the joint is so soft, as to leave a pit when pressed by the finger, Sambucus will give relief or else compresses of the moistened elder blossoms.
 In any case of sprained ankle it is worth while to have the patient stand on uninjured foot, the toe of the injured limb on the ground lightly and move the heel in a circle two or three times.
 Most sprained ankles are seen after shock has passed off, and require Rhus Tox. If shock is present, e.g.  within half an hour or so of the accident give a few doses of Arnica, and follow with Rhus Tox.
 Therapeutic hints
 Ammonium Carb. : - It has been used for sprains, when the injured joint is hot and painful. It follows Arnica.
 Ammonium Muriaticum : -It has some influence on the joints. It causes a feeling of constriction on these parts. It is one of the remedies that have been used in the treatment of chronic sprains. It affect the fibrous tissues about the joints. It is one of the remedies where there is contraction of the hamstring tendons.
 Acetic Acid. : - Dry heat follows.
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 Agnus Castus : - Sprains from lifting.
 Arnica : - It is the first remedy to be thought of in sprains. It has bluish redness, intense soreness, swelling.
 Calendula : - When muscles are ruptured.
 Carbo animalis : - Sprains easily from lifting small weight.
 Bovista.: - Oedematous swelling of foot year after the sprain.
 Ledum Pal. : - Sprains of ankles and feet.
 Natrum Carb; : - Disposition to sprains from any little exertion; old sprains.
 Rheum : - Lameness of wrists and knees.
 Rhus Tox. : - Sprains from wrong step and stepping, by lifting or stretching.
 In cases of sprains from wrong step and slipping Rhus Tox. and Arnica work well and if the pain persisted even after the two medicines, Strontiana Carb. completes the cure.
 Ruta :- Lameness, especially of wrist and ankles. It is better than Rhus Tox. in many cases of sacro-iliac strain.
 Strontiana Carb. : - Very useful in chronic sprains (old sprains) particularly of ankle joint when both Arnica and Ruta fail.
 Other remedies which may be required at times are Bryonia and Sulphur.
 Bumps
 Bumps on the head of children should not be pressed with a knife, but treated with application of cold water, or water with a few drops of Arnica tincture in it; and the internal administration of Arnica. If bad symptoms occur later, if the child has dizziness after shaking the head, or pain and dilated pupils, if it bores the head into the pillow, and has fever convulsions, water on the brain (hydrocephalus) is to be feared, Belladonna or Hyoscyamus should be given.
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 Injuries due to overlifting
 In most cases, Arnica and Rhus Tox. are nearly sufficient. Externally, linen moistened in 8 or 20 drops of Arnica tincture for external application in half pint of water may be applied over injured part. If lifting or carrying heavy loads, or any sudden exertion of strength produces pain, give Rhus Tox. When from this cause very violent piercing pains are felt in the small of the back which become worse on every motion of the body, give Bryonia. If this does not relieve entirely, give Sulphur. When headache ensues, Rhus will not remove it, give Calcarea Carb., Carbo Veg. is to be given when over lifting causes great debility. Cocculus/Nux Vom./Sulphur in general hernia. In prolapsus of uteri, think of Aurum Met., belladonna, Nux Vomica, Sepia. Other medicines are :
 Carbo Animalis : - Easily sprained from lifting even small weight, ankles turn when walking.
 Berberis Vulgaris : - Soreness in the region of kidneys when jumping out of a wagon or stepping hard down stairs or from any jarring movement.
 Agnus Castus : - Strains from over lifting; sprains and luxations of joints.
 Fractures
 Fractures are broken bones. These are many types of fractures. In a simple fracture the overlying skin remains intact. In a compound or open fracture bone fragments stick through the skin making a wound. In a green stick fracture, most common in children with still flexible ones, the bone is split like the end of a green stick, one side being broken and the other bent. Colle’s fracture is a break in the lower end of the large bone of the forearm (radius) near the wrist; the lower fragment is so displaced that the hand and wrist look like a reversed silver fork. Bumper fracture is the break of one or both legs immediately below the knee, as a result of being hit by an automobile bumper. In some diseases bones break without application of violence; these are called spontaneous fractures or pathological fractures.
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 Fractures of the skull, neck or spine are usually the most dangerous. In skull fracture the brain is often injured; bleeding from the ears, mouth, nose, or into the eyes is often a sign of skull fracture. In neck or spine fractures the spinal cord or the nerves coming out of it are crushed and pinched between fragment of the vertebrae. If the victim can not move his fingers, his neck may be broken : if he can not move his legs, his back may be broken.
 Do not transport a fracture victim unless absolutely necessary. Do not move a person with broken limb until splints  *are apples. A victim of broken back must be transported face downward. The victim of broken neck must be carried face upward. Never tilt his head forward or sideways. The patient should be kept warm and quiet, lying down, until professional help arrives.
 In all cases of suspected fractures, send for skilful surgeon, and not for ‘the first best’; for the mistakes committed under these circumstances can hardly ever be remedied. When children are the sufferers more despatch is required. But in ordinary cases, a day or two my elapse without incurring any risk, for a broken bone does not unite so very readily.
 Before the surgeon arrives, the broken limbs should be moved as little as possible, on the painful part put linen bandages dipped frequently into cold water, or diluted Arnica tincture if the soft tissues have been bruised, internally give Aconite, if the patient is very weak or faint, and some hours, after, Arnica. Only when the pains are insufferable, and occasional convulsions, give Chamomilla, then Hypericum. In very rare cases when the pains are excruciating, and other bad symptoms appear, stretching of the limbs will afford any relief. To do this wrap towels firmly above and below the part of the fracture; then fasten to them long pieces of cloth and tie one of these, say the upper, to the head-board of the bed; then slowly on the lower, and when extension enough to relieve the pain has been gained, fasten this piece to the lower bed-post or foot board, and so retain the limb in a painless position till the surgeon comes.
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 Treatment of fracture is three fold, (i) the fracture is first reduced, that is, the broken bones aligned in proper position by manipulation, traction (pulling), or surgery. This usually requires X-ray observation and anaesthesia. (ii) Reduced fragments must be held in place until they unite, a process that may take a few weeks to many weeks. This may require plaster casts, splints, traction frames, and insertion of metal nails, wire, screws, or plates in the bones. Complications must be prevented; for example, pressure sores and infections. (iii) The function of the muscles and joints around the broken bone must be maintained and require much physical therapy, including massage, graded exercise, application of heat.
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 Fractures generally heal more slowly in older persons. A particularly disabling and often slow healing fracture common in older people is fracture of the neck or head of the femur (thigh bone). With continued proper treatment, however, these fractures do eventually heal. Discouragement is unwarranted.
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 After the bone has been set, give Symphytum. Should the bone not unite readily, but remain loose as sometimes happens with aged persons give Calcarea Phos., or if not to be had, mix a small portion of diluted phosphoric acid with lime water, dry the sediments which will be formed in this mixture, and give the patient as much as of it as will lie on the end of a pen knife, once a day.
 As already said, all fractures require expert orthopaedic treatment. By way of first aid, control any bleeding; then for very severe pains of the fractures give Hypericum 30 or 200, one dose every five minute for several doses. If this does not help give Chamomilla 30 or 200. The key note of Chamomilla is the state of mind where the patient says, “Do something? I can not stand it any more.”
 Bryonia 30 or 200 one dose at a time, will often relieve the pains of broken rib and promote healing. Once the pain is better start giving Symphytum to speed up the union of broken bones.
 Pain in a fracture of the tibia may yield to a dose of Anthracinum 200 to be repeated infrequently only if it helps the first time. The pains of a broken floating rib will most likely respond to a dose of Ranunculus Bulbosus 30 or 200 to be repeated when the pain grows worse again. Give Symphytum or Ruta later to help the healing.
 For sleeplessness after a fracture try Sticta Pulmonaria 30 or 200, one dose, not to be repeated more than twice a week.
 Therapeutic hints
 Calcarea Phos. :- It favours production of callous. (Symphytum).
 Arnica Mont. : - It is the first medicine to be thought of in simple or compound or any type of fracture.
 Symphytum : - To facilitate union and lessen pricking pains.
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 Ferrum Met. : - It is to be given in beginning for injury to soft adjacent parts which are red, hot, painful. It is also useful when broken ends unite slowly.
 Calendula : - Fracture of skull particularly compound; bone splinters, protruding.
 Dislocations
 The removal of the head of a bone from its corresponding articular cavity is termed as dislocation or luxation. It is caused by the same types of violence that produce sprains, strains and fractures. There is usually less pain but the joint cannot be moved, the limb may be in an odd position, and its contours may differ from those of other limbs.
 It is characterized by violent pain, loss of motion, swelling alteration in the shape, length and direction of the limb. An unnatural depression or prominence can generally be felt in the vicinity of the injured joint; and there will also be a peculiar rigidity of the limb and fever. By comparing the injure with the sound limb, the deformity will at once be apparent.
 The first aid treatment for dislocation is the same as that for fracture. In fact, fractures often accompany dislocations. Put on a splint, bandage, or splint to immobilise the injured part, and keep the patient quiet. Resetting of dislocation must be done preferably by an orthopaedic surgeon. When the dislocated bones are reset in their natural position, they are usually immobilised for a length of time with casts or splints then heavy bandages, to prevent recurrence. Early and immediate movement of the part is not indicated.
 Message and passive exercise of the part may begin in a few days and gentle active movements be permitted in a week or ten days, depending on the severity of the case. Casts or splints, if used, are usually taken off at this time; but elastic bandages may be advisable for at least another two to three weeks.
 Dislocations occur most commonly at the shoulder and elbow and in the fingers and toes.
 Congenital dislocation of the hip is more frequent in women than in men. The head of the femur lies outside the socket of the pelvic bone (acetabulum), in which it is supposed to fit. If this occurs on one side only, the person walks with a limp; if on both sides, with a waddling gait. The treatment is competent orthopaedic surgery, preferably early in life.
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 Dislocation of the jaw forward sometimes follows a wide yawn or other too wide opening of the mouth. It can sometimes be snapped back into place by pressing down hard with the thumbs on the teeth at the back of the mouth while at the same time pressing up on the chin, being careful not to get the thumb bitten.
 Homoeo treatment
 The first thing to be done is to give Arnica; or, if there is already redness and inflammation, Aconite, and to apply cold water. By these means some relief may be obtained until a Surgeon can be called, which should be done at once. It is not necessary to do anything more after the dislocation has been reduce : all poultices, salves, bleeding, etc., are injurious. A proper bandage must be applied and as soon as inflammation abates, which after taking Arnica and perhaps Aconite, will soon take place, the limb should be moved often; but carefully, lest it grows stiff.
 In easy dislocation medicines advised according to symptoms are : Ammon. Carb., Bryonia, Calcarea, Cannabis Indica, Carbo Animalis, Carbo Veg., Conium, Hepar, Lycopodium, Mercurius, Natrum Carb., Natrum Mur., Nux Vomica, Petroleum, Phosphorus, Rhus Tox., Ruta, Sulphur, etc. When inflammation is under control, to hasten curative of joint, Ruta is needed. Calendula is required in the injuries to soft parts.
 Haemorrhage
 Haemorrhage means abnormal flow of blood from any part of the body. Menstrual bleeding, however, is normal although abnormal bleeding from the vagina can occur. Bleeding is obviously caused by cuts and wounds. Control of bleeding is an important part of operative surgery. If there is a loss of blood due to bleeding from any cause, blood pressure will fall. If the bleeding is rapid, the effect is marked. In slow bleeding the effects is less marked.
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 When the blood is rapidly poured out of a large artery the patient may die in a few minutes of syncope. When, however, the bleeding is less severe, the face and body become white and cold and the lips pale. The pulse becomes feeble and rapid and then imperceptible. The skin is bathed in perspiration, the respiration becomes of the nature of a sigh, the sight gets dimmed and thought get confused. Graver symptoms may follow ending the swooning and then death. The patient may slowly recover from any of these stages.
 In order to stop bleeding pressure is to be applied on the point. Most bleeding can be stopped by simple direct pressure continued on the bleeding area until the blood stops. This pressure is preferably applied by a sterile gauge bandage (pressure bandage), padded as thick as necessary to soak up the blood. In an emergency pressure may be extended directly with the finger. If pressure at site is not enough or if it can not be conveniently applied, then pressure will have to be put on the artery a little further up. Elevating the bleeding parts also helps. Cold water application and often renewed, will frequently stop the bleeding, yet there are cases where it does not suffice.
 When the blood is gushing out of the wound (when the wound is on the neck) the superior and inferior part of the thighs or arms, the whole limb or side of the neck should be compressed till the bleeding ceases and a surgeon procured immediately.
 The haemorrhage is still more dangerous when bright red blood flows from the wound, and the blood spurts at intervals as the pulse beats. Hasten, in such a case, to obtain the assistance of an experienced surgeon; but as every delay is dangerous, tie a cloth around limb above the wound, in the direction of the heart; this will stop the bleeding, but the pressure will be painful, so one can now more leisurely feel for the artery above the bandage on the anterior part of the limb, which will be known by its beating. Place lengthways on this spot a medium sized cork, press it well and put over it a compress two or three inches square and as thick as a finger, and over this bandage, which firmly tighten, and loosen the other somewhat. If no bleeding follows, the first bandage may be taken off; if bleeding does follow, tighten this last bandage till the blood ceases flowing; or if necessary re-apply the former bandage.
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 If the blood does not come in jest with every beat of the heart, but runs in a steady stream and not very profusely, or if the wound is so situated that the entire part can not be encircled with a bandage, a compress may be put directly over the wound and a bandage be firmly applied.
 Give the patient a little salt, and if it does not help him, give some vinegar and water. Do not give him much drink, particularly nothing warm. Let the wound part be elevated, and see that there is no more pressure on any part of the body than can be avoided. Should the patient faint, leave him at rest, and do not annoy him with smelling bottles. Fainting is always beneficial as in that stage the blood flows less rapidly, and is more apt to congeal in the wound, especially when aided by application of cold water.
 Bleeding from Palms r Fingers : - Pressure should be put on radial and ulnar arteries. Radial artery is the one on which we generally feel the pulse. Ulnar artery is opposite to it.
 Bleeding from Wrist : - Pressure should be applied on the bronchial artery which is just behind the prominent muscles of the upper arm known as biceps.
 Bleeding from Armpit : - Pressure should be applied on the sub-clavian artery. This is at a place just below the collar bone.
 Bleeding from the Head or inside the Brain : - Pressure should be applied on the carotid artery. This pulsates on the neck and we can feel it. In debilitated persons it is often visible.
 Bleeding from any Foot : - A tourniquet should be applied on the thigh as the artery there is very deep-seated. In case of bleeding from the thigh pressure should be given just on the loins. The tourniquet must be released every 20 minutes or gangrene may result.
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 Homoeopathic therapeutics
 Cinchona : - If the patient turns quite pale, and becomes blue in the face, or has jerking of the limbs and position is dangerous. After this, if worse again, give him a little good old wine, and after that, if necessary, repeat Cinchona. This remedy be given after much loss of blood, but when bleeding has ceased, the patient may drink small quantities of cold water as often as he asks for it.
 Arnica Mont. : - To stop the bleeding, when the first bandage and application of cold, wet rags do not do it, give Arnica; if this fails Ipecacuanha.
 Millefolium : - Haemorrhage after a fall or other injuries if Arnica failed in such cases.
 Application of Alum. or Ferrum Phos. 3x (in powder form) controls bleeding.
 External Haemorrhage : - Apply Calendula tincture in all cases of external haemorrhage and it never fails to act. Capillary haemorrhage, bleeding due to large cuts, due to any cause will be stopped almost immediately after Calendula tincture is applied. It may be followed by a few doses of Arnica afterwards.
 Nose Bleeding : - The usual method of applying cold over the nose and the spine at the level of the collar and putting the feet in hot water may act reasonably well, but Vipera 12 used every fifteen minutes, is much more efficacious.
 Passive Bleeding from Varicose Veins : - The patient be kept in lying position with the leg up at right angles to the body. Bandage be applied on both sides of the bleeding vein. Internally give Hamamelis every fifteen minute interval for an hour and later lengthening the intervals until the bleeding has stopped. Two or three doses may be sufficient. If the patient is thin, shrivelled up elderly woman and blood is dark, almost black and watery, Secale Corn. be given at an intervals of fifteen minute until the bleeding ceases.
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 Internal Haemorrhage : - Internal bleeding from accidents or blows are always serious. Internal blood comes out through nose and through lungs by mouth or it may find exist through urine and stool. It is advisable that the patient be admitted in the hospital for expert medical care. Till he is admitted; give him repeated doses of Ferrum Phos. or Ipecac. if the haemorrhage is of bright red colour and gushing. Aconite be given if the patient is extremely restless and shows evidence of extreme fright and fear of death. Arnica may help if Ipecac. fails.
 After Effects of Haemorrhage : - In after effects of loss of blood when the patient is pale, white and bloodies, feels cold and shivering, is extremely weak and easily exhausted, China given at fifteen minutes interval will quickly put such person in recovery position. In cases where there has been much loss of blood, the patient is much debilitated, there is little haematin in the blood, material doses of iron may be necessary. Ferrum Protoxolate 1x three times daily, extended over several weeks will do what the material doses of iron can do.
 Wounds
 A wound is a break in the continuity of the surface or internal structure in any part of the body made by cutting, tearing or pressure. When only the surface layer of the skin is taken off by a fall or blow or friction, it is called abrasion. When a sharp instrument gets into the body for some distance beyond the skin, it is called an incised wound. Injury from a blunt instrument results in a lacerated wound, the edges of which are irregularity torn. A sharp blow or severe pressure may inflict a wound which may look like an incised wound but a careful examination lacerated edges of the skin will be found. A contused wound is a variety of lacerated wound in which the injury is greater inside, the surface often having suffered little bleeding. A stab causes a punctured wound. Internal structures or deep seated arteries and nerves are likely to be involved. These wounds are dangerous. Gun-shot wound  * is termed penetrating when the shot is lodged in the part, perforated, when it passes through it.
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 The first thing in the treatment of the wound is to arrest the bleeding. In most cases, the elevation of the part, keeping the bleeding surface upper most, and pressure will suffice. A Calendula lotion tends to arrest haemorrhage and checks suppuration. In severe wounds involving arteries, the parts should be laid open by a surgeon, and the damaged vessels ligatured.
 Cleansing of the wound
 All foreign substances like dirt, sand, hair, glass, fish bones, shot or rags, clots of blood, etc., should be speedily removed by forceps, or allow sterile water to trickle over the wound. When a person has run a nail, fish bone, splinter or glass into his foot, they can not always be removed entirely. In such cases surgeon’s assistance be taken. While washing and cleaning a wound antiseptics be used. Iodine if not diluted sufficiently may be source of irritation and prevent early healing. Boric acid is weak antiseptic but it is practically non irritant. As a domestic medicine, hot neem leaves water should be freely used. If this is not available, use boiled water to clean the wound. Homoeopathically Calendula ¨ (external) mixed in clean water in the ratio of 1:8 be used to clean the wound.
 Dressing of wound
 The most important thing in the healing of a wound is to bring the sides in close contact and exclude the air. Small, superficial wounds may be closed by pressing the sides together, and tying a bandage around the limb to keep them in that position. Common, small cuts on the fingers are often troublesome for a considerable time, as they prevent us from using the hand, but they will heal quickly with healthy persons, if sewed together, or drawn together by means of adhesive plaster or common court plaster. Plaster is also made with Calendula, Ruta, Hypericum lotion. The hair around the wound should be shaved off.
 Deep lacerated wound, or long cuts in the face, lips, eyelids, neck, etc., have sometimes to be united by deeper sutures, which a surgeon alone can do properly.
 When a wound is dressed, say once in every twenty four hours, lint soaked with warm sterile water should be laid over the dressing, so that it may be removed without the risk of disturbing the surface which may have partially united. Lotions may often be renewed by dropping lotion on the lint, or pouring it on by means of a spoon.
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 If dressing was necessary put on a tight one, loosen it somewhat when it becomes troublesome, the next day. If not too tight leave it undisturbed for two or three days, if the wound does not suppurate, and always remove it gradually. In removing a piece of sticking plaster, always begin at both ends and proceed to centre; begin to remove the strips, at one end of the wound, replace the strip removed immediately by another, and continue in that manner till finished, in order that it may not open again or be dragged as under. If possible, leave the dressing until the wound is healed. In summer, however, and when wounds suppurate freely, the dressing should be changed frequently. The threads in the sutures are to remain until they drop off.
 Process of healing
 If a healthy person’s skin is sterilised and then a cut made and then bandaged with aseptic precautions, the cut ends coming together, the process of repair begins immediately and provided that the wounded part is given rest, the wound would heal without suppuration. This is the natural process. From either side of the cut edge a white substance exudes joining at the beach. Through this line repair goes on by formation of new tissues which interweave with the opposite faces. If the wound is separated at this stage it will be seen that the white exudation has got new blood in it and that the process of repair has preceded far. If after some more time the wounded edges are again separated, it will be seen that there is simply a white line where the cut was. After further lapse of time this line may also be absorbed and may disappear.
 If the skin is not made sterile and pus forming bacterias find entrance, such wounds suppurate. All wounds which suppurate badly, are to be treated as ulcers. Wounds of this kind must not be treated with cold, but with warm water dressings. Twenty or thirty drops of tincture of Calendula put into a cup of water, and the lint soaked with this solution is best. All lacerated wounds, and others, which can not be accurately united, must be drawn together and treated with cold water, unless they suppurate.
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 To all wounds over a bone, or the head, the breast bone, the elbow, finger joints or the knee, the shin bone, the ankle, apply nothing but cold water without any tight bandage – unless in the beginning, to stop the bleeding, you may make use of pressure; afterwards merely tie something over the wound to keep out the air, particles of dust, etc.
 Medical treatment
 The patient is to be given remedies prescribed for wounds. If after such a medicine, the fever increases and is attended with dryness of the skin and great restlessness, give Aconite; but if the restlessness is accompanied by great excitement, give China. Other medicines to be given according to symptoms are :
 Apis mellifica
 If the punctured wound becomes red, very sensitive to touch; particularly if the pain is burning, piercing, continuous and if redness spreads like erysipelas. If the redness runs down the inside of the arms or legs in interrupted stripes, Rhus is better and afterwards Arsenicum.
 Arnica montana
 If the injury has more the nature of a bruise than of an open wound, the parts affected are brown and blue, or become so; if the wounds can be well united; if it was merely in the skin (remembering that the skin in some places is very thick).
 Calendula officinalis
 Lacerated * wounds, deep gash, whose sides can be but imperfectly united; if moving causes pain, even after the wound is dressed; if the skin or flesh has come off in pieces, if the wound looks torn and jagged. It answers for the worst kind of pains when Hypericum is ineffectual. Calendula is most satisfactory wound dressing. It is not antiseptic in true meaning of the word, but germs do not thrive in its presence.
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 Hypericum perforatum
 It is suitable for all wounds either from a thrust, a cut, bruise or tearing asunder. If the pain is usually violent and particularly if it lasts long and is similar to a violent toothache, extending far around the wound and up through the limb, Hypericum is the remedy. It is also indicated when children have spasms after every slight injury. Hypericum lotion can be interchanged with Calendula lotion.
 Staphysagria
 Clean wounds, deep cuts in the flesh made by sharp knife, or glass, or consequent upon surgical operations.
 Hamamelis virginiana
 Incised, lacerated or contused wounds, dissecting wounds, burns, etc. It checks haemorrhage, removes pain and soreness and promotes healing.
 Iodium
 Cellular inflammation after following a punctured wound or incised and slight wound.
 Crotalus horridus
 Dissecting wounds, symptoms those of phlegmonous erysipelas, accumulation of pus in distant parts, typhus conditions supervening.
 Anthracinum
 Dissecting wounds, become gangrenous (Arsenic, Lach.).
 Phosphorus
 Slight wound bleeds much.
 Lachesis mutus
 Useful for bad effects of injuries, as penetrating wounds, with much haemorrhage or gangrene. It is one of our best remedies for gangrene after injury, when edges of lacerated wound turn black.
 Punctured wounds
 Ledum palustre
 Punctured wounds by sharp pointed instruments such as sticking of a nail into the foot or an awl into the hands, etc. It is useful if the wounded part feels cold to touch.
 Calendula officinalis
 In articulation, flow of synovia.
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 Hypericum perforatum
 Nails or splinters in feet, needles under nails, nerve tissues mainly concerned.
 Cuts
 Cuts are incised wounds or stabs. The treatment of such cuts is simple. The edges of the cuts should be brought together and maintained so by narrow strips of strapping plaster, then if necessary a bandage applied over the plaster. In two or three days plaster should be removed without disturbing the union, and replaced by new. If, however, inflammation and pain occur, the application of lint, saturated with Calendula lotion, covered with oil silk, and a bandage over all, is necessary. For deep cuts in flesh made by knife, Staphysagria should be given to the patient Rhus Ven. be given when the cuts are surrounded by miliary whitish rash. Calcarea Sulph. is needed to control suppuration, thick yellow matter and Kali Mur. in swelling. Plantago is very useful in erysipelatous highly inflamed cuts. Cuts which inflame, suppurate and heal rapidly respond well to Plumbum.
 Abrasions and lacerations
 Abrasion means rubbing or scraping off skin in mucous membrane, as on a knee’ skinned by falling. Laceration means a tear, any wound or injury in which skin, muscle, or other tissue is torn.
 Calendula lotion externally and potency internally and if the abrasion is on the scalp, Hypericum internally and Calendula lotion externally is to be applied.
 Other medicines
 Carbolicum acidum
 Laceration from blunt instruments, bones base, or crushed and splintered.
 Calendula officinalis
 Abrasions of eyes, lips and laceration about the pelvic organs and in perineum. Loss of soft parts when no union can be affected by means of adhesive plaster. Torn and jagged looking.
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 Hypericum perforatum
 Members separated from body. Laceration of nervous tissues.
 Plantago major
 Painful swelling and tendency to erysipelatous inflammation or sphacelous.
 Tetanus
 Tetanus is an acute infections disease caused by tetanus bacillus. These bacilli occur in garden earth, in stable soil, in decomposing fluids, in manure and dust, particularly in stable sweepings and in the excreta of certain animals such as horse. The bacilli find entrance into the human body through a wound or even scratches or through raw surface of any dysenteric and other ulcers of intestines or through umbilicus of a new born child and there begin to produce toxins which act on the spinal cord and cause intense exaggeration of reflex excitability. The time taken by the poison created by the bacilli to travel up to the spine is regarded as incubation period of the disease. The longer the period of incubation, the milder is the disease. This period may be from two to twenty days.
 The onset is characterised by spasms of the muscles usually beginning with those of the face, neck and jaws. The neck feels stiff and the jaws are moved with difficulty. The angles of the mouth are drawn down and the eyebrows are elevated. There is difficulty of swallowing, leading to violent ejection of fluids from the mouth or through the nose. In course of a few hours or a few days the jaws become firmly closed. This is called lock jaw. Spasms of the limbs and body set in. The patient may assume the shape of a bow resting on his head and heels, the whole body being bent and out of contact with the bed. The muscles of the face get contorted giving a frightful appearance. The pain in the limbs and at the pit of the stomach is agonising. The thorax is effected and breathing becomes difficult. The patient may die from suffocation or from exhaustion.
 The temperature may remain normal but in some cases very high temperature is reached. Frequently there is suppression or retention of urine. Profuse perspiration is common.
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 Tetanus can be prevented by taking antiseptic precautions about wounds or open sores or cuts, however, trifling. In the performance of operations, neglect of asepsis may result in tetanus.
 Owing to the extreme excitability of the nervous system the patient should be isolated into a darkened room and kept absolutely quiet. Liquid food should be given. When the jaws do not move, the patient may be fed by passing a catheter through the nose and into the oesophagus. This is possible when the patient is moved to a hospital.
 Homeopathic therapeutics
 If the patient who has been wounded complains of pains in the bowels, without any further cause, lock-jaw is to be feared, Staphysagria or Colocynthis given according to symptoms may prevent it. Other medicines required according to their symptoms are :
 A.T. S. 30 : - In casually ward of a hospital A.T. S. injection is given as a preventive to tetanus but this can produce symptoms such as urticaria but these can be removed by one or two doses of A.T. S. 30.
 Hypericum : - If a nerve has been injured, or if the trouble has come after a severe fall on the back, Hypericum given in potencies will prevent tetanus.
 Ledum : - It prevents and cures if the tetanus is caused by animals bite.
 Ignatia : - When the patient complains of much pain in the neck, or excessive stiffness in the neck and back, especially if this is preceded by a good deal of stretching of all limbs; if he complains of cramps, or pains resembling cramps, in the joints of the jaw or in the cheeks near the ears; if the feels constant inclination to yawn, and yet is unable to open his mouth sufficiently; if he is fretful, irritable and difficult to please, give Ignatia until there is improvement.
 Mercurius : - If even after several doses of Ignatia, the patient grows worse, if lock-jaw takes place, if his back is stiff and rigid, give Mercurius; if this fails Belladonna especially if his face is red. Aconite if it grows pale and red alternately.
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 Bryonia : - In some cases, where the sufferer becomes very cold, Bryonia or Veratrum may be effectual; if warmth makes him worse, Secale.
 Cinchona : - If the patient goes worse whenever he is touched or handled; if touching causes more pain and then make the patient worse, give him Cinchona.
 Ruta, Rhus Tox., Hyoscyamus, Strontium Carb., Camphor or other medicines may be required, if there first appears a redness around the wound, resembling erysipelas. In general it may be said that the choice of the proper medicine often depends on the most minute circumstances.
 Viburnum Prunifolium : - Is said to be the best remedy in the world for tetanus.
 In injuries especially sports injuries give Arnica 10 M; If the tetanus manifests, the specific is Stramonium 10 M or 200 (opisthotonos). Then Tetanotoxin 10 m, thrice daily.
 Shock  *
 Shock has many meanings : primarily, the rapid and sometimes, fatal fall in blood pressure following injury, operation or the administration of anaesthesia. It also means electric shock, caused by passage of electricity through the body, and electric shock (shock therapy) given in some cases of mental illness.
 The word also refers to psychic shock, the emotional experience that follows a sudden terrorising event; to anaphylactic shock, the violent and fatal reaction to a second dose of some drug or serum to which a person has become abnormally sensitized; and to many other kinds of shock, like ‘shell shock’, which is the form of mental illness. Here we are discussing about shocks caused by injuries.
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 The basic reasons for the occurrence of shock following injury, such as a skull fracture or surgery remain unknown, despite great and continuing research attention to the problem. Main effort today is given to preventing and treating shock promptly, if it should occur.
 The well observed basic mechanism in the presence of shocks is a decrease in the circulating fluids of the blood; that is why extreme uncontrolled bleeding and large blood loss also produce shock.
 When a patient gets a shock, he turns pale, his skin becomes moist and clammy, his blood pressure falls, his pulse becomes fast and feeble, his breathing slows down, he often complains of thirst, he becomes restless, anxious and sometimes unconscious.
 The immediate treatment of shock is to keep the patient lying down at rest and warm – but not too warm. The legs may be elevated, the limbs loosely bandaged (to improve the circulation). Plasma or whole blood infusions into the veins are often required restore to blood volume.
 Homoeopathic therapeutics
 Arnica montana
 Do not forget Arnica to combat the shock we get in those terrible auto accidents. It is better than any opiate. Shock after injury, sickness of stomach or vomiting from shock, agg. from motion and from rising; wants the head low. (Arsenic and Bryonia high); wants to be covered warmly, the whole body if ice cold, excepting the head and face, which are warm and hot, bruised feeling all over the body. Slow, weak pulse.
 Aconitum napellus
 It is to be given immediately after the accident, to counteract the nervous shock or when reaction has taken place, and there is dry burning heat of the skin, head hot and painful, face red, pulse hard, frequent and contracted, great restlessness, fear of death.
 Camphora officinalis
 Shock from injury, cold extremities, trembling of tongue, hands and feet, excessive weakness, prostration and exhaustion. Insensible to touch and cold as marble. Icy coldness all over, with death like paleness of face, diminished circulation to parts most distant from heart. Cold clammy weakening sweat, conditions of collapse from loss of serum as in asiatic cholera and like.
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 Helleborus niger
 Shock after a blow or fall on the head, drowsiness. One pupil larger than the other, semi consciousness; breathing heavy and slow; pulse full and easily compressed, agg. from 2.30 p.m.  to 6 p.m. 
 Opium
 Shock from injury (Arnica), severe cases. Rapid breathing; every breath a loud moan; face livid or pale; lips livid. Cool clammy skin; eyes fixed.
 Hypericum perforatum
 Shock from a blow in the direction of medulla oblongata, either from the top of the head or from lower end of spine. Shock resulting from injuries to spinal column.
 Carbo vegetabilis
 An almost corpse reviver. Lack of reaction after some violent attack. It is very useful after surgical shock, collapse; and danger of dying of shock.
 Veratrum album
 Rapid sinking of forces, complete prostration, cold sweat and cold breath, conditions of collapse (Camphor), cold as ice, tongue cold, great weakness, distorted face, expression of terror, shock from injury. In aqueous solution given intravenously relieves the patient. The pathology of shock is the unusual combination of increased peripheral tension with a falling of blood pressure. Camphor does not have this but Veratrum does.
 Sepia officinalis
 Free and sudden perspiration breaking after the shock is passed and when the patient is resting quietly.
 Psorinum
 Protracted cases with despair of recovery from sequelae of the shock and nervous exhaustion.
 Gelsemium sempervirens
 Is opposite to Coffea. Desire to be quiet, does not wish to speak nor to have anyone near for company, even though the person be silent. Fear of death; has no courage. Every exciting news causes diarrhoea. Fear overpowering with fatigue.
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 Coffea cruda
 Affections from sudden emotions, particularly pleasant surprise. Physical excitement through mental exaltation. Fainting from sudden emotions.
 Nux moschata
 Constant sleepiness; skin cool and sensitive to exposure; oppression of pit of stomach to chest, slow rattling breathing, least exertion causes great weakness and sleepiness; diarrhoea. Shock from injuries.
 Aceticum acidum
 Prostration, vertigo and fainting; dry heat after much bruising or sprains, eyes sunken and surrounded by dark rings. Shock due to anaesthesia.
 Digitalis purpurea
 Great cardiac debility, slow, irregular weak pulse, patient bluish pale, sinking at epigastrium.
 Chamomilla
 Fainting, uneasiness about heart, twitching oppression of chest.
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 Bites and stings
 Animals (Poisonous) : In general : - Arsenic, Belladonna, Causticum, Lachesis, Pulsatilla, Senega.
 Animals (Non poisonous) : In general : - Arnica, Hepar Sulph., Hypericum (injured nerves from bites of animals), Ledum, Sulphuric Acid.
 Bee sting : - Salt water is the chief remedy. It should be constantly renewed. In cases of stings in the mouth or throat, let the patient swallow some salt water or rinse and gargle with it. Honey applied also relieves. In cases of great swelling, itching or great weakness, give Apis Mel. When there is much pain, give Arnica : for remaining symptoms Natrum Mur.
 Cat : - Ledum, Lachesis (carbuncle in thumb due to cat bite).
 Cat (mad) : - Acetic Acid be given in lacerated wound, upper and lower leg swollen externally and internally.
 Dog : - Immediately after the bite suck the wound, while sucking, press the parts around the direction of the wound. After everything possible has been drawn from the wound, the best remedy is heat –whatever is handiest – red hot iron or coals, or lighted cigar to be brought as near the wound as possible without causing violent pains and without burning the skin as close as the patient can bear it. The skin around the wound may be smeared with oil. All that oozes from the wound should be wiped away. The application be repeated three or four times a day, for an hour each time until shuddering appears, and this should be repeated several days. Lyssin 30 be given three times a day for a week, and then Belladonna 3 night and morning for six months. Should Belladonna not succeed Stramonium 12 every half hour. If there is excessive sensitiveness and patient wants to tear the clothing away from his throat, give Lachesis 6 every half an hour.
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 To prevent convulsions, give Lyssin evening and morning every week, until it produces fever, diarrhoea, etc. If the patient labours already under Lyssin, give Belladonna at every return of convulsions. Even if convulsions continue, give Hyoscyamus; if this fails Cantharides.
 Other remedies recommended are : Agave ¨ two hourly and Fagus hourly or two hourly. Spiraea Ulmaria has been used for eclampsia, epilepsy and hydrophobia.
 Horse : - Hypericum.
 Human : - Lachesis.
 Insects : - Grind., Natrum Mur.
 Leeches (gangrenous) : - Lachesis.
 Mosquito : - Apis Mel., Ammon. Carb., Ledum. Apply Arnica or Ledum tincture or lemon juice. Caladium for burns and intense itching.
 Scorpio : - Apply Echinacea ¨  * and administer it internally in 10 drop doses every 15.30 or 60minutes interval. Ledum Pal. if the cold application relieves. Viper : when there is a feeling of bursting : Tarentula Cubensis in burning sensation. Guaco 3rd to 6th potency antidotes the bites of scorpio and serpents.
 Rabid animals : - Chronic Acid.
 Rat : - Ledum Pal.
 Snake : - Snake poisons are chemically cyanide hydrate of soda and other salts of which alcohol is the natural antidote. Administer every twenty minutes till the signs of intoxication are apparent, ¼ pint, about five ounce of alcohol at a time. The first thing to do is to ligate above the wound. The bitten place be exposed to heat, steaming from any hot surface, a heated iron, stove, lamp, etc., without bringing the wound in actual contact with hot surface. The skin around the bite be smeared with oil or fat or soap or saliva whichever is at hand to protect it. All that oozed from the wound should be wiped away and burnt. A few pieces of iron should be put in the fire so that one can be used as another cools. This application be repeated three for four times a day for one hour each time or until shuddering or stretching appears and this should be done daily for several days. After the wound has been treated as directed above rub into it fine common salt and internally give common salt, or salt water or garlic, whichever is at hand.
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 Homoeopathic therapeutics
 Golondrina : is an antidote to snake poison. Its use also renders the body immune to the influence of snake venom and thus a prophylactic.
 Euphorbia Prostata : is an infallible remedy against the poisonous insect and snakes especially the rattle snake.
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 Plumeria Celinus : tincture internally and locally every 15 minutes for snake poisoning. (Dr. Correa).
 Iodium : tincture for rattle snake bites externally and one drop dose every ten minutes.
 Crotalus : it is an antidote to rattle snake poison.
 Belladonna : it should be given at once before difficult respiration sets in after serpent’s bite.
 Echinacea : in cases of snake bite tincture of Echinacea with equal parts of boiled water may be injected hypodermically or one to ten drops dose be repeated frequently.
 Hydrocyanicum Acidum : for fainting collapse in 10 M potency. (Moschus 10 M). For Chronic sequelae of serpent bite think of Mercurius, Acid Phos., Viper., Camphor, Lachesis, Thuja, etc.
 Ammonium Causticum : this is a powerful cardiac stimulant as such in syncope, thrombosis, haemorrhage, snake bites, chloroform narcosis may be given by inhalation.
 Cedron : it has the power of antidoting snake bite and stings of insects.
 Spider : apply indigo in strong solution. Selaginella ½ dram of the moss macerated with milk be applied locally and drunk internally for bites of snakes and spiders.
 Tarentula : lachesis 6 every ten minutes.
 Wasp Sting : the strong tincture of Arnica applied to a wasp sting prevents the pain and swelling, and in couple of hours the sting is forgotten. For symptoms of collapse in bee or wasp sting, give Apis Mel. 30 or 200 every five minutes.
 In case of wasp sting, see that the sting does not remain in the wound. In the cases of stings in mouth and swollen tongue the medicines given do not relieve, give Belladonna particularly if worse on the fore part of the tongue : Lachesis when worse on the back part. Vespa Crabro is very useful in burning, as if something were sticking and drawing out; chilly cold sensation all around red middle, followed by chill running all over him in short intervals like waves.
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 Be careful not to check the inflammation from the stings or bites of insects too quickly, when they are numerous, by external applications, the consequence are the same as when an eruption of the skin is suddenly checked; rather give Aconite, and some hours later Arnica. If this does not help, give Natrum Mur. next day.
 For the bites of any angry animal, if pus or other diseased matter gets into a wound and if you heave been obliged to touch persons or animals labouring under a contagious, dangerous disease, it is better to expose your hands five to ten minutes to as great a heat as you can bear, then wash them thoroughly in soap and warm water and take Arsenicum.
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 Burns and scalds
 Burns result from the application of too much heat to the skin. Scalds are caused by hot liquids or vapours. When boiling water scalds a person the injury may be less severe, for the water quickly cools and also runs off. But if the scald is produced by boiling oil, it adheres to the part and causes serious wound. On account of flowing of fluids, scalds usually cover large surface.
 The effect of burns or scalds on a person depends not only upon the intensity of burn but also upon the extent, situation and age of the person. Burn may be only superficial, yet if it is extensive and on face, head or trunk, it may be more serious than if there is a deeper but limited burn on the extremities. In extensive burns the prognosis is bad.
 It is customary to classify burns into degrees according to the intensity. A burn of the first degree is only redness of the skin. Burn of the second degree means vesication, while in a burn of third degree the injury is represented by destruction of the cuticle and also part of the true skin. In the fourth degree destruction of the whole skin is accomplished. In the fifth degree the burn runs deeper and muscles are reached. In the sixth degree burn, the whole limbs are charred.
 The effect of burn is constitutional. In slight burns of small extent there may be no constitutional effect. But if the burn is extensive and involves chest, abdomen, head, neck or genitals, the results may be serious, especially if the patient is child. The first effect of serious burn is shock. The patient becomes pale and shivers, extremities get cold, the pulse becomes small. If the shock is so great that the patient feels little or no pain, then the possibilities are of the patient passing into a state of coma after which death ensues.
 After the stage of shock is over, in 24 to 44 hours comes the stage of reaction. Inflammation sets in. There is fever. The pulse becomes full, strong and rapid. This is noted from third degree burns onward. In fifth and sixth degree burns in addition to above sympathetic affections of bowels, such as colic, diarrhoea, intestinal haemorrhage and destruction of more than half of the cutaneous surface is seen. In the second stage onward the burn area is likely to become septic and poisonous products may then get absorbed causing septic fever, etc. The sloughs also begin to separate.
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 While accidentally clothes take fire, the man should lie on the ground and roll him on order to extinguish the fire. If thick clothing is available, this should be put over and rolled to smother the fire. Running about is most dangerous as it allows the fire to spread and burn with vigour. Covering with blanker is very useful.
 In the treatment or burns or scalds it should be remembered that the patient’s life is in danger from shock. Shock is to be prevent Cantharis in potency in water be given in repeated doses. It should be combined with a local application of the same substance. It will reduce the death list die to shock. Arsenic has burning and would suit well the erythistic type of shock with its anguish and restless. If this does not help and pulse is very weak and if it is possible to arrange for saline infusion, it should be done so that the patient may not succumb. Opium is to be given or any hot drink as soon as the patient is able to swallow. Treatment for shock is to be continued till there is reaction.
 The skin should be examined and should be attended to. For scorches and blisters, air or water or antiseptics cause irritation and pain. Carron Oil is the thing to be applied as it shits out air and soothes. Any bland oil such as coconut or linseed oil, mixed with equal part of clear lime water (lime shaken with water and allowed to settle) will make carron oil. A little turpentine may be added to it with advantage. The surface should be wiped free from dirt and adherent matter with carron oil and hot water. A piece of clean cloth should be saturated with carron oil and put over the part. Homoeopathically carron oil can be substituted with Cantharis. The tincture of Cantharis diluted in the proportion of five to eight drops of the tincture to half a cup of water, is one of the most efficacious remedies for burns. It may be applied by dipping rags (those of linen are best) into it applying them to the seat of the injury, renewing them or three times a day, or whenever the pain begins to get worse again. It may be used in slight and severe burns, immediately after the reception of the injury or at a later period, after proper or improper remedies have been used.
 PAGE 39
 Blisters must be emptied by pricking with a fine needle, or sewing a thread through them so that the epidermis may remain intact. It is of great importance that the air should be excluded from the parts involved. Raw cotton; not glazed, and even free from seeds, is excellent for this purpose. Some physicians moisten its surface which is intended to come in contact with the burn or scald with the tincture of Calendula, or Cantharis before applying it.
 For burns in the mouth, throat or stomach, caused by taking too hot food, dissolve a few globules of Cantharides in a cup full of water. Take a tea spoonful occasionally, and keep it in the mouth for a while, use this medicine in the form of injection, but if it does not good, give Arsenicum, Causticum, Sapo, Rhus or Carbo Veg.
 Burns from sulphuric acid or other acids require lime water, or chalk mixed with water; if caused by an alkali vinegar will prove beneficial or scraped applied. In burns due to phosphorus there is no better remedy than sweet oil, renewing its application until the pain ceases.
 Homoeopathic therapeutics
 To prevent shock or to help the patient to get out of shock, two remedies first to be thought are Cantharis and Arsenicum. The mode of application of Cantharis has been discussed in detail. Similarly symptomatology of Arsenicum in shock has also been described. Other medicines are :
 Carbo vegetabilis
 Shock with symptoms of collapse; extensive deep burns with symptoms of imperfect oxidation of blood; humid gangrene with great foulness of secretions and great prostration.
 PAGE 40
 Chamomilla
 In convulsions arising from severe burns, Chamomilla has proved beneficial.
 Opium
 Shock, tendency to convulsions, especially in children, sleeplessness.
 Aconitum napellus
 It is to be given immediately after the accident to counteract the nervous shock or when reaction has taken place, and there is dry, burning heat of skin, great restlessness, pulse hard, fear of death.
 Calendula officinalis
 Hering says that it prevents gangrene, disfiguring scars, exhaustion from loss of blood and excessive pain with delirium, promotes granulation, favours cicatrization with least possible amount of suppuration. It should be applied externally in tincture in the ratio of 1:10 drops of water.
 Arsenicum album
 Great restlessness, sinking of strength, colic and diarrhoea. Internal burns. In all burns as long as pain is present or when vesicles turn black, showing tendency to gangrene.
 Arnica montana
 It says abundant suppuration. Skin and cellular tissues inflamed with extreme tenderness and painfulness; sequelae of nervous shock after severe, deep burns, septicaemia, erysipelas following the burn.
 Asa foetida
 Ulceration from burns and scalds of an erysipelatous vesicular character, superficial ulcerations caused by burns, with burning pains and lachrymation, tetanic or epileptiform convulsions, followed by coma.
 PAGE 41
 Hepar sulphur
 Excessive suppuration, a great drain upon the system, retarding healing process.
 Lachesis mutus
 Wounds do not heal, take a purplish aspect.
 Rhus toxicodendron
 After burns or scald vesicles, bullae, pustules, extensive but more superficial affections; tendency to erysipelas, with typhoid symptoms.
 Kreosotum
 Ulcers from burns bleed easily; discharge fetid and wound bluish.
 Causticum
 Old burns that do not get well; ulcers remain after burn. They can be treated with the soap plaster or with causticum applied on cloth, which should not be removed, but kept continuously wetted with the causticum solution (Causticum in 3rd or 6th dilution).
 Urtica urens
 Burns involving only skin, intense burning, itching nettle rash sensation.
 Stramonium
 It is useful in extensive burns of the third and fourth degrees, when ulceration of the duodenum seemed imminent.
 Remark
 Extensive burns are sometimes attended by diarrhoea or costiveness, but nothing should be done for either, unless the latter lasts longer than 4 or 4 days, then injections of warm water be given. If the diarrhoea is attended with pains in the bowels, give Pulsatilla, afterwards Sulphur. The diarrhoea which sometimes makes its appearance is essential to the preservation of life, and ought, on no account, be interfered with, unless it continues for weeks after the burn has been cured; then give, Calcarea; if it is more frequent between noon and midnight; Arsenicum. If more towards morning and in the forenoon; if hands and feet or the whole body become much swollen, give Calcarea.
 PAGE 42
 Foreign bodies  *
 Foreign Bodies in the Eyes : - If sand, flies or hair are between the lids and globe, they should be removed immediately by immersing the eye immediately in a vessel of cold water and holding it there. Eye is to be dipped into it and opened and closed. This will frequently remove the cause of irritation and afford relief. But if the substance can not be removed this way, the eye lid should be gently wiped with a soft, moistened handkerchief. Rubbing of the eye should always be avoided, as it merely increases the irritation. Sweet oil will mitigate the irritation, when acid or caustic salts have caused it; but it is injurious when caused by the powder of spanish flies or dead insects. Pure castor oil dropped into the eyes will be especially useful, when sparks of iron, dead insects and other highly irritable things get into the eyes.
 Mortar or lime is rapidly destructive. If seen immediately, the eyelids should be everted, and every particle of lime removed. The eye should then be washed with a strong solution of sugar and a few drops of oil instilled. Water must never be applied to these cases.
 Particles of iron, particularly those projected hot into the eyes when striking fire, or from smithy, usually adhere very tenaciously; sometimes one may succeed in extracting them with a lock of hair introduced under the eyelid and move backward and forward, or with a clear ear pick. A magnet of suitable power is sometimes of use, and should be tried. In the absence of the magnet, diluted copper sulphate solution (3 grains to an ounce) may be dropped into the eye. This will tend to dissolve the iron and make it loose where it may be embedded. The speck then may be washed out.
 PAGE 43
 Medical Treatment : - When the foreign body is removed, a weak Arnica lotion should be applied to the eye by means of a lint or soft linen and covered to prevent evaporation. Sleep sometimes diminishes the pain. If the eye is red and inflamed after the removal of foreign body, give Aconite which is also of service if it can not be got out, and will diminish the pain until you can procure a surgeon. If after giving Aconite several times, the eye continues to be sensitive and red, give Sulphur and in case it does not prove efficacious, Calcarea or Silicea. If the eyelids are spasmodically closed, and will scarcely let tears escape, belladonna generally relieves; sometimes it will be necessary to give Hyoscyamus.
 Foreign Bodies in the Ear : - Peas, stones, slate, pencil, glass beads, shells, etc., are sometimes found in the ear passage. Sometimes a cotton wool is left in the ear. When insects get in the ear, crawl and cause pain, they should be drowned by pouring in oil at body temperature and then drawn or wiped out. For peas, seeds, etc., which get swelled by contact with water, warm water should be used which should be kept in contact with them for some time by plugging the orifice so as to fully soften them. After softening, the opening of the ear should be pointed downwards and in this position it should be syringed so that the object may drop off, by the movement of water on account of gravity. If peas have had no time to swell, then oil should be syringed in and not water, so that it may not swell but drop off by back current. If the foreign body can not be removed by gentle means, the case be handed over the surgeon.
 Medical Treatment : - If pain and inflammation of the ear remain, give Arnica, and after a few hours, Pulsatilla. Pulsatilla is also of use when the inflammation is considerable and the ear canal is so much swelled and that nothing can be got out. In some cases, when the children are in great pain, have fever, speak incoherently, or are delirious and Pulsatilla given foes not suffice, give Belladonna, and afterwards, if there is till some pain left, Sulphur.
 PAGE 44
 Foreign Bodies in the Nose : - Seeds and peas or similar objects may get into the nose. Foreign bodies, if not firmly fixed, may be removed from the nose by taking a full inspiration, closing the mouth, and expelling the air forcibly through the nostrils; or by trickling the nostrils with a feather, or a little dry snuff to bring on sneezing. Sometimes obstruction may be removed from the nose with forceps. Do not make too many experiments but rather apply to a surgeon who has the necessary instruments.
 If the leech gets into the nose, salt water should be injected to loosen its grip, after which it will be washed out. A syringe may be used and when it is not available saline water should be sucked in by the nose.
 Medical Treatment : - the swelling which will sometimes prevent the extraction of an object, or which may remain after it has been extracted, may be considerably lessened by Aconite, and later by Arnica; or if these do not succeed, by Belladonna or Rhus. For remaining pain and suppuration, if any exists, give Sulphur.
 Foreign Bodies in the Throat : - If a foreign substance lodges in the throat, the head of the patient should be drawn back and the tongue pulled out. Light should be thrown in. This will allow inspection of the position of the object. If the object is very near it can be taken out with the fingers. Blowing into the ears is said to produce reflex action in the throat or gullet, and so the foreign substance is forced out. Beating or pressing the patient between the shoulders also helps in extraction. If after the object has been removed, the sensation as if it were still there remains, particularly after pointed substance, it shows that a wound has been made, and all acrid or highly seasoned things must be avoided in food and drink.
 If a large piece of food remains fast in the throat on account of its size and hardness, it is advisable to excite vomiting, particularly if upon retching, you perceive the obstruction moved upward. If the substance has already decended so far that it can not be felt in the throat, and it seems as if it were sticking fast in the chest, it must be forced down into the stomach, particularly if it is soft, smooth and soluble, and is only arrested on account of its size.
 PAGE 45
 Medical Treatment : - If a contraction of the gullet takes place, which prevents the substance from being moved, or if pains, difficulty of breathing, and other symptoms make their appearance, give Ignatia; and if this fails to relieve, Chamomilla; then sweet oil or butter; and after this, try again to push the substance down; if the face is pale. If there is nausea, worse after speaking, give Cocculus; if the face is red and if there is constant inclination to swallow, Belladonna. Frequently the sensation of something sticking in the throat will remain although the substance has already decended, but this will disappear of its own. But if the pain increases and passing of fluid over a sore spot produces pain, Arnica be given and afterwards if necessary Mercurius. If the patient feels as if a small splinter or fish bone in the throat, give Hepar. If, however, on the other hand there are small particles still remaining in the throat, producing constant irritation, give Silicea. When a bone remains in the throat, which is so large that it can not be taken out, surgeon should be called.
 Foreign Body in the Trachea : - It may cause great distress and suffocate. As in the case of throat, the position should be determined and the object manipulated out of finger. If this is not possible, a hook is to be slid past the obstruction and the object pulled out. The patient must be helped with artificial respiration if there is breathing difficulty on account of obstruction, while attempts should be made to pull up the obstruction.
 Vomiting relaxes the muscular tissues. For obstruction in the trachea vomiting may be useful in making the grip loose and in introducing wire hook beyond the object.
 Foreign Bodies in the Stomach and Intestines : - The children often swallow foreign substances such as buttons, coins, rings, etc. Some of these pass off through the bowels without much pain, unless they are too large that they may cause very serious disturbances or death. Their passage through bowels may be facilitated by eating plentifully of boiled rice, porridge, or some farinaceous food which will in its passage distend the stomach and intestines and help to carry off the extraneous substances. In order to ascertain whether the article swallowed has been discharged, the excrement should be allowed to fall in a vessel containing water, where from these can be traced. If needles have been swallowed, they sometimes make quite a different passage for themselves. If they remain too long, Silicea to be followed, later by Hepar. When needle has been swallowed give the patient isabgol which in the stomach surrounds the needle and will stick to it. This will prevent any untoward accident.
 PAGE 46
 Medical Treatment : - If some time after needles or coins have been swallowed, bad symptoms make their appearance, such as violent pains in a particular part of the abdomen, as if some thing were wedged there, give Ipecac. If it does good, repeat it. As soon as symptoms get worse again, give Veratrum Alb. or Nux Vomica. should, notwithstanding, more violent symptoms, severe colic and constipation appear, give Opium, frequently repeated. If violent attacks occur, with a throbbing pain in a particular spot, as if suppuration was about to commence, give Lachesis.
 When live creatures find their way into the stomach, if insects, let the patient swallow some sweet oil or fresh salted butter; and if that fails to relieve him, a bit of camphor, the size of a pea, ground up with oil. When worms, snakes, frogs, etc., get into stomach, let the patient drink sugar water and eat sugar, until it acts as a laxative, or take and emetic of mustard and warm water. The bad effects remaining after the emetic has produced its action, will be obviated by smelling camphor and giving Ipecac. several times or Nux Vomica.
 Foreign Bodies in the Skin : - Sometimes pointed particles such as thorns, thistle-prickles, chestnut-burs, great numbers of which stick in the skin. In case they can not be extracted with a pair of pincers or tweezers, or by sticky substance applied as a plaster to the skin and taken off, bringing the offending points with it, put oil on the spot, then take a common knife, not too sharp, and scrape the skin slowly, applying the whole blade, as in shaving, and bear on moderately hard. If the thorns have entered obliquely, scrape the skin in such a direction as to pass first upon the point. Continue this operation, applying oil constantly, until every thing is extracted. But if this is very painful, allow it to come out by suppuration, if they can not be extracted by forceps, apply poultices to hasten the suppurative process.
 PAGE 47
 Medical Treatment : - For inflammation give Arnica; for suppuration Hepar, followed, if necessary by Silicea, and in case the suppuration should be profuse, and wound becomes deep, and neither Silicea nor Hepar brings improvement, give Lachesis or Mercurius.
 Needle under the skin should be taken out quickly by an incision at the point of entrance and pulling out with forceps. Needles may penetrate and leave the place after sometime, so that the position should be determined first before an incision is made.
 Foreign Bodies in Private Parts : - If the objects are of such a nature that they can be felt by the finger, then forceps should be used to pull them out. If an object is beyond reach and has entered the uterus, the patient should be taken to a surgeon for operation. If a leech gets in, solution of salt should be injected in by a syringe which will loosen its grip and also wash it out.
 Foreign substance such as moles, water or air from the uterus are expelled out by Sabina and also by Cantharis. Natrum Carb. is also one of the best remedies useful for expelling moles or the products of false conception.
 PAGE 48
 Asphyxia – apparent death
 Asphyxia means suffocation or choking to death, because the airways to and in the lungs are clogged with water, as in drowning, or as a result of electric shock or other disease or accident.
 In all cases of apparent death particularly from external violence the body should be treated with the greatest care; if they are treated as the dead, generally are, viz., laid out on a board in a cold room, perhaps covered with eyes, they certainly be dead very soon, if they were not so before.
 Apparent death from hunger
 There are cases of persons, who for want of food have been so much weakened that they faint or are apparently dead. All such persons must of course have food as the first thing, but the longer they have been without it, the less of it they should have at once. Eating too much and too fast may kill them. In the worst cases give repeated injections of war milk; when they show signs of returning life, give the milk to drink, at first a few drops, afterwards more and more; if they want more, give a few spoonfuls of food toast water, broth and a little wine. When a sound sleep succeeds, cover them up warm, and not until after that sleep, give them more solid food in small quantities.
 Apparent death from a fall
 Place the sufferer carefully on a bed, with his head elevated, and in quiet place, put a few globules of Arnica on his tongue and wait and also find out if there are fractures. When the patient has lost much blood from wounds, or from injudicious bleeding, give China and a little wine, a few drops at a time and afterwards Arnica. If there are fractures these should be attended by the surgeon. In shooting and jerkings after fall, give Hypericum.
 Apparent death from lightning
 In asphyxia from lightning the patient should be at once placed in recently dug soil, half sitting, half lying with face towards sun and be covered all over except his face with fresh ground. As soon as he moves the eyes, give a few globules of Nux Vomica by placing them upon the tongue and repeat the dose in half an hour. If there is no sign of returning consciousness the same remedy can also be given in injection. The complaints which frequently follow restoration, may generally be removed by Sulphur and Nux Vomica. For blindness give Phosphorus.
 PAGE 49
 If you can not place the patient in the ground, put him in a current of cool, fresh air and dash plenty of cold water over face, neck and chest, and use Nux Vomica as above.
 Apparent death from drowning
 Drowning is the most common cause of suspended animation though cases of hanging and of suffocation from noxious gases occasionally occur.
 There is no breathing or action of the heart perceptible, eyelids are generally half closed; the pupil dilated, the jaws clenched, the fingers semi contracted, the tongue appearing between the teeth, and the mouth and nostrils are covered with frothy mucus. Coldness and pallor of surface increase.
 Treatment : - The points to be aimed at are : (1) immediate restoration of breathing, (2) after the breathing is restored, the promotion of warmth and circulation.
 The mouth and nostrils be cleaned from saliva, dirt, etc., after opening the mouth of the patient, the tongue be drawn forward and kept forward with the help of elastic band over the tongue and under the chin. The drawing of tongue forward is essential as it keeps open the wind pipe. Tight clothing from and about the neck and chest removed.
 Resort to any method of artificial respiration  *. Holgen Nielsen’s back pressure arm lift method is one of the methods MOSTLY RECOMMENDED. In this procedure, the operator takes a position kneeling above the head of the patient, who is lying face down. He compresses the lungs by leaning forward and pressing down with the palms of his hands on the patient’s back. As the operator rock’s back to the erect kneeling position, he grasps the patient’s arms just above the elbows and draws the arms towards him finally he releases the arms and returns them folded back again to the ground. This cycle of operation is repeated steadily 12 to 15 times a minute until the patient breathes again or is pronounced dead by the physician.
 PAGE SCAN 50
 PAGE SCAN 51
 PAGE 52
 During the employment of the above method, excite the nostrils with snuff or smelling salts, or tickle the throat with a feather. Rub the chest and face briskly, and dash cold and hot water alternately on them.
 After natural breathing is restored, wrap the patient in dry blankets and commence rubbing the limb upward, firmly and energetically. The friction must be continued under the blanket or over the dry clothing. Promote the warmth of the body by hot water bottles or even hot flannels and heated bricks, etc. Care must be taken that the patient does not get burnt by over heating or too much heated appliance.
 On the restoration of life, when the power of swallowing has returned, a teaspoonful of warm water, small quantities of warm wine, warm brandy and water, or coffee should be given. The patient should be put into a warm bed, in a room well ventilated and be encouraged to sleep. Great care is required to maintain the restored vital actions and at the same time to prevent undue excitement.
 Homoeopathic therapeutics
 Antimonium tartaricum
 Asphyxia from drowning, accumulation of mucus which can not be expectorated. Drowsiness or coma, pale or dark red face, blue lips, thread like pulse.
 Lachesis mutus
 It has relieved when with trismus and spasm of the larynx there is blueness from asphyxia and patient sleeps into paroxysm.
 PAGE 53
 Apparent death from suffocation, hanging, pressure and choking
 The method recommended for apparent death from drowning is to be followed.
 Apparent death from being frozen
 Where freezing causes suspension of animation, attempts are to be made for its restoration. Great care need be taken in moving the patient so that no part of the body is injured. The patient can be taken from the open air under the cover, but consider that even moderate heat may kill him. A cold room or a barn where there is not the least draught, is the best place. Cover the patient entirely with several inches of snow except his mouth and nostrils. Place him in such a position that melted snow may run off easily and be replaced by fresh. When there is no snow put them into a cold bath, the temperature of which has been reduced by the ice. If ice is attached to the body or to the clothes, remove it. Thaw the body until every part becomes perfectly pliable, then gradually remove the clothing, if necessary by cutting it from the body. If the limbs become soft and pliable, commence rubbing them with snow, and continue until they become red, then place the patient on a dry bed, and rub him cold flannel cloths, stockings, old pieces of felt, etc.
 If signs of returning life do no manifest, small injections containing camphor-(a drop of spirit of camphor to half a tumblerful of water)-may be administered every fifteen to thirty minute. If the patient begins to revive during the friction, or after taking the camphor, and gives symptoms of returning animation, administer small injections of lukewarm coffee without milk – and as soon as he can swallow, give him some coffee – a teaspoonful at a time.
 It frequently takes hours to restore life, but we ought not to be sparing of labour. For the violent pains which are felt sometimes after the sufferer has revived, give Carbo Veg. every 5 to 6 hours, and if this proves unavailing, Arsenicum. If heat or stinging pains are felt in the head, a few doses of Aconite will be of service. If the patient craves brandy or wine, a small quantity may be given to him.
 PAGE 54
 A person who has recovered from freezing, must avoid the heat of the stove and of the fire for a considerable time, as serious maladies, particularly diseases of the bones, are liable to result therefrom.
 Asphyxia of new born
 PAGE SCAN 54
 The child may get exhausted during labour. While in the vaginal canal under abnormal conditions it may have sucked in some fluid thus closing the air passages. This prevents him from breathing. When a new born does not breath in a few minutes after delivery, and he looks to be apparently dead, his breathing should be revived. Put the child in warm water. Examine the throat and if there is mucus draw it out the helps of little finger. This may be conveniently done by holding the child by the legs with head as shown in the sketch. A glass tube with a bulb in the middle, bent and round at the end may be used for sucking in the mucus from the mouth. The bulb in the middle retains the mucus which cannot run to operator’s mouth.
 It should be noted that artificial respiration should never be attempted without clearing the throat. For at the attempt at respiration the child will then draw in the mucus in the air passages and get choked.
 The body and limbs should be wrapped in warm clothes preferably in flannel and the hands chest gently rubbed with a piece of flannel. If after a short time, pulsation can be felt in the chord, and beatings of child’s heart become perceptible, respiration will soon be established and nothing more to be done. If after continuing these efforts for 5 to 10 minutes no pulsation can be felt, the cord should be cut and the child immersed in a warm bath, being careful to keep the face out of the water. In this bath rub and squeeze the chest and limbs gently. Much benefit can be derived by placing the mouth  * over the child’s mouth and blowing gently so to inflate the lungs, closing the child’s nostrils at the same time between the thumb and finger to prevent the air from passing through the nose. Care should be taken not to force too much air into the child’s lungs at once. After the lungs are filled, the chest should be compressed gently with the hands. This effort should be repeated several times, allowing a few moments to elapse between each.
 PAGE 55
 If no signs of animation are manifested after 5 to 10 minutes dissolve about as much tarter emetic as will lie on the point of a penknife in half a tumbler of water, and after stirring it well, apply a single drop of the mixture to the tongue of the child with the point of the finger. Antim. Tart. 3x or higher trituration when dissolved in water and applied will be still better. If no relief occurs in fifteen minutes time, repeat the experiment again. Even then no relief occurs in 15 minutes, put one tea spoonful of mixture into a cup full of warm water, and use it as injection. Sometimes putting the infant, alternately, into hot and cold water a few times is of great use. Infants have sometimes been restored after labouring with them for two or three hours, hence we should not give up our efforts.
 Homoeopathic therapeutics
 Antimonium tartaricum
 It is indicated in the asphyxia at the beginning of life – asphyxia neonatorum, when there is rattling of mucus in the throat.
 Laurocerasus
 Is useful in the asphyxia of new born when there is a great blueness of the face, with twitching of the muscles of the face and grasping without really breathing.
 PAGE 56
 Aconitum napellus
 Pale, Breathless, cord pulsates.
 Opium
 When pulse remains imperceptible, face purple.
 Asphyxia from charcoal fumes
 Fresh air inhalation of pure oxygen, cold douche, artificial respiration are required. Besides this accessory treatment following Homoeopathic medicines be made use of.
 Bovista : - Bovista produces some symptoms of suffocation. The symptoms of asphyxia are very much like those produced by fumes of charcoal.
 Ammonium Carb. : - It is also of use in poisoning by charcoal fumes.
 Carboneum Sulph. : - Asphyxia from alcohol or coal gas.
 Opium : - It is useful for the bad effects of inhalation of charcoal vapors. Bovista and Arnica.
 Carbo Veg. : - In suffocation due to carbon monoxide/coal gas poisoning Carbo Veg. be given in repeated doses every ten minute (in granules dry on tongue) until consciousness returns, when the doses can be spaced at longer intervals.
 Bryonia : - In slight cases of gas poisoning Bryonia will be effective.
 In coal gas poisoning the face of the patient looks pinker than the normal and the patient appears to be in the best of health; this one should not be misled by it.
 Asphyxia from hanging
 Resort to artificial respiration and give Opium in potency.
 PAGE 57
 Electric shock
 The literary meaning of the word shock represents Psychological effect whereas the electric shock has physiological effect although psychological effect is also sometimes traceable.
 The electric shock brings physical changes inside the body. Sometimes the burns occur at the surface of the skin and cause deformities of the tissues. Suspension of heart due to electric shock for even for few seconds can bring brain haemorrhages. Besides heart being affected, respiratory system is also affected. Electric shocks may cause paralysis, burning of blood and even death.
 The victim must first of all be detached from the current with the help of an insulation material. He should be laid on floor and respiration should first of all be checked. If respiration is lacking then proceed as from first aid point of view and try to restore respiration by artificial respiration methods (see page 50 and 52) or mouth to mouth resuscitation should be given and if possible a massage till the doctor arrives and takes charge of the patient. The current passing internally through the body may generate temperature as high as 10?000° C and cause extensive carbonification of skin and immediately underlying tissues or flesh burns. Such burns often ignite the nearby clothes and that may also cause burns, known as flame burns. There is also direct injury due to direct heating of tissues. There may be fractures because of muscular contraction and falling. High tension may damage the kidney and results in the renal failures. Visual disturbance is the after of electric current.
 Skin burns and fractures caused by electric current be treated on the same lines as other burns and fractures. If burns are severe, Cantharis/Calendula dressing be applied according to their symptoms. Cold water may be drunk and smelling salt applied in moderation.
 PAGE 58
 Caution : - It should be remembered that an unconscious man should never be given any drink. It may cause shocking effect.
 The external cardiac massage should be given in case of absence of heart beat. Homoeopathically Electricity 30 and Morphia Aceticum 200 are two prominent medicines to do away with the after effects of electric current.
 PAGE SCAN 58
 The victim be laid on his back. Be sure that his air passage is clean. Wipe visible foreign matter out of his mouth. Put one hand under victim’s neck, while other hand tilts his head back and down as far as possible, so that chin points upwards. Place your open mouth tightly over victim’s mouth and pinch his nostrils shut by your two fingers. To expand the chest of the victim blow your mouth air vigorously into victim’s mouth. Remove your mouth to let returning air escape.
 If you do not get air exchange, turn the victim on his side and give several sharp blows between his shoulder blades to dislodge foreign matter that may block his throat. Clean his mouth again.
 Blow on vigorous breath every 5 seconds if victim is an adult. It is preferable to blow through a handkerchief placed over victim’s mouth and nose, to avoid direct contact.
 PAGE 59
 Fright
 This does not come directly under injury or accident though it is difficult to separate it from the cause or effect. How do you expect that a fall, etc., will have no fright?
 Homoeopathic therapeutics
 Aconitum napellus
 In mild shock and fright Aconite is the first remedy. It acts well if there is simple vomiting sickness of the stomach or pains caused by fright.
 Opium
 After a common fright caused by a sudden, or ill time practical joke, etc., give Opium if it can be given immediately; but if an hour or more should have elapsed, Aconite is preferable. Opium is also useful in fright with great terror, or if the fear of the fright remains especially in children; great heat in the head and twitching around the mouth; twitching of limbs, difficult breathing. When the children have been frightened into fits and scream, tremble with twitching in the arms and legs, if the head is hot, with much perspiration and redness of face, give Opium every 5 to 10 minutes. If no better in half an hour, give Belladonna.
 Ignatia amara
 Fright followed by sadness or grief.
 Gelsemium sempervirens
 Diarrhoea caused by any sudden emotion, such as grief, fright, bad news, the anticipation of any unusual ordeal.
 Veratrum album
 If coldness and trembling are associated with diarrhoea.
 Phosphorus
 Fear of thunder storm. But one affected by thunder storm should take Bryonia during storm and later Silicea.
 Coffea cruda
 Fear of surgeon.
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 Sports injuries
 Sports injuries are to be treated in the same way as other injuries are. It is the type of injury that matters and not the names of sports during the play of which injury was caused. Sports injuries like other injuries are classified under the head – stock, sprain, bruises, contusion, wounds, fractures, over exertion and cramps, etc.
 For all shocks either from skiing or boxing or any other sport Arnica is the first medicine to be thought of. Nervous shock, nervous fright before a fright as in boxing call for Gelsemium 200 two doses.
 Sprained ankles (skiing); sprains with distension or tears of the ligaments or tendons (boxing); sprain, straining of ligaments/synovitis/dislocations/luxation (soccer) call for Rhus Tox. as the main remedy.
 In bruises and ecchymosis (boxing) Arnica 30 is a good remedy. Where there is a strong ecchymosis better by cold water, Ledum 200 two or three doses several hours apart. If the black eye came in a moment of anger, or rage during the fight as in boxing, Staphysagria is the remedy. If there are no modalities, Symphytum 200 two to three doses, two hours apart. If that is not enough Arnica 10M two doses twenty four hours apart Baryta Mur. for bruises while riding on horse back (Polo).
 For contusions of head from blows as in boxing, Arnica/Natrum sulph. are to be used. In after effects of concussion which sometimes manifest year after the blow, Natrum Sulph., Lobelia Aceticum 200 and 1 M may be used. Hypericum is to be given in contusion of the base of spine.
 All wounds whether due to skiing, boxing or due to athletic shoe are to be treated first by Calendula 200 and Pyrogen 10M. There is no need to rush off for a piece of raw meat to hide the wound after boxing, Arnica will do much better. In wounds from shoe spikes apply Calendula ¨. Ledum is to be given every hour until the pain goes. If there is strong bleeding Crotalus 30 or 200.
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 For fractures, Symphytum 30 and Calcarea Phos. 6X are the remedies.
 Over exertion, exhaustion, stiffness after any form of excessive physical exercise such as tennis, gardening or boxing, etc., cause fatigue. This may be more in athletes and swimmers. Arnica here is most appropriates remedy. For cramps in calves of athletes and cramps in swimming Cuprum Met. 200 is very useful remedy. Cuprum Met. 200 given ten minutes before a fight (boxing) will prevent cramps in calves.
 Injuries due to blow as in boxing, blow of hockey, cricket, tennis ball require following medicines :
 Arnica  * 200/Cactus 200 : - A blow over the heart (boxing). Compress of cold water to which 10 drops of Arnica 1X added. If this does not help Cactus 200 every half hour.
 Natrum sulph. : - Blow directly on the head from a ball or a bat.
 Ruta 200 : - blow on the legs (hockey, cricket balls).
 Hypericum : - Blow on the finger (hockey, cricket balls).
 Epistaxis nasal haemorrhage may be caused by blow especially in boxing. For such haemorrhage Arnica 200 is required. Vipera Redii 200 also acts well, especially if the patient has varicose veins on the legs. In epistaxis (soccer), Ferrum Phos. 200 be given after Arnica 200.
 Pains following sports injuries following medicines :
 Hypericum : - Crushed and pain along the nerves (boxing).
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 Arnica/Rhus Tox. : - Muscular pains, wrenched muscles, sprains (hockey), cricket, tennis, badminton, etc.) require Arnica 200 morning and evening. If it does not help Rhus Tox. in successively high potencies.
 specific medicines for specific game’s injury
 Tennis
 Ball in the Eye : - Symphytum 30 every hour. If this does not work Hypericum. Bothrops 200 or Crotalus 200 when there is a simple hyphaemia.
 Tennis elbow, Epicondylitis : - Rhus Tox. 10M, Agaricus 6, Ambra Grisea.
 Traumatism of Genitals from Tennis ball : - Arnica. If there is no irritable pain Hypericum.
 Athlete
 Coup De Fouet : - This is an excruciating pain in the calves which runners get, give Agaricus 6 morning and evening for one week. But when this condition is intense and patient can not move Bryonia 30 every half hour until sedation.
 Weakness of Knees/Ankles : - Runners who suddenly feel as if their knees would give or bend are to be given Calcarea Phos. 30 or 200 morning and evening for several days.
 Blisters from Heel rubbing against the Shoe :- Calendula ointment to apply. Causticum 30 internally.
 Swimming
 Rhus toxicodendron
 Is the remedy if a swimmer suddenly gets cramps and pains in cold water.
 Aceticum acidum
 In cases of stings from a sea anemones, blue bottles or jetty fish give Ledum 30/200 every fifteen minute until the pain ceases. If this fails Acetic Acid 200 once of twice a day for several days.
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 Tabacum
 30
 In sea sickness Tabacum 30 in hourly dose when there are cold sweat and constant desire to swallow his saliva.
 Cocculus indicus
 200
 In nausea, vertigo, tendency to faint, the medicine be taken every half hour or three doses before the race.
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 War injuries
 In the battle field every soldier is provided with a pad of cyanic gauze or a sterile gauze, an ampoule of iodine and a bandage. This is meant to be applied on a wound. Here Calendula can be substituted for iodine. At the regimental aid post, the medical officer examines the wound/gunshot wound, takes out the bullet and applies dressing and if need be splints too. At the main dressing station, operations of emergency nature can be undertaken as for stopping haemorrhage or for removing a hopelessly mangled limbs. The preliminary dose of anti-tetanic serum is given. Dressing could be done with Calendula ¨ mixed with distilled water in the ratio of 1:4 and anti-tetanic serum can be substituted by Hypericum.
 If the patient is suffering severely from shock, he is placed in the resuscitation ward where measures considered necessary to combat the shock are taken up. These include test in recumbent position, warm blankets, warm drinks, heat of electric lamps and if the patient is unconscious normal salt solution per rectum or even hot coffee per rectum. Operation is postponed till the condition is improved for relieving pain injection of morphia is given which can be substituted by Arnica. Where operation can not be postponed the missiles are localised by X-ray an the patient is sent for operation at once. The treatment of fractured bone is done like the one caused by other factors.
 Besides wounds and fractures miliary injuries can be broadly covered under following categories :
 Haemorrhage : - In addition to surgical aid, hemostatic drugs such as Arnica, China, Phosphorus, Lachesis, Hamamelis, etc., are required.
 Shock :- We have good remedies for shock also. For example, Aconite, Carbo Veg., China, Veratrum Alb., etc.
 Tetanus : - Hydrocyanic Acid., Arnica, Aconite, Hypericum, Rhus Tox. are the drugs recommended for tetanus. These are to be used on the symptom similarity. But in times of stress and strain, when there is no time sufficient for finding out a perfect simillimum, we may first administer anti-tetanus serum and then homeopathic drugs.
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 Gas Gangrene : - during wars gangrene was usually found to follow wounds caused by ragged pieces of shell, caked with mud and carrying in the clothing of the soldier. Thus the buttock, thigh, calf an deltoid regions were danger zones. During first world war this infection was found to be very common.
 Early signs of incipient gas gangrene are brownish, sticky swelling, serosanguineous discharge from the wound and escape of gas bubbless from the wound when the surrounding parts are compressed. Then follow tympanitis, crepitus, marked changes in the colour of the skin, sometimes loss of peripheral pulse. Resonance on light percussion is a most valuable sign in early case. Radiography is also helpful. In the presence of the signs mentioned above, amputation of the limb can save life from the surgical point of view.
 Toxaemia develops in this disease, and the symptoms arising from toxaemia also aid diagnosis, these symptoms are pallor, vomiting, rapid pulse, a furred dry tongue and anorexia. Later we find in this disease breathlessness and persistent vomiting and these bring about a stage of complete collapse. Here, however, the consciousness and a curious feeling of well being often remain until death ends the scene. This curious feeling known as euphoria indicates homoeopathic remedies such as Apis, Arnica, Arsenic, Cinnabaris, Hyoscyamus, Kreosote, Mercurius, Pulsatilla.
 Occasionally septicaemia and pyaemia develop resulting in secondary gas containing abscesses on buttocks or at the sides of hypodermic punctures (made by injecting needles) from mere pressure. (In bed ridden patients bed sores are formed on pressure but they do not contain gas as in gas gangrene).
 Surgical Treatment : - Effective excision of the wound as soon as possible is the most certain preventive against further trouble. But as soon as the pressure of gas gangrene is determined, the case becomes urgent, and then the most thorough eradication of the infected area must be undertaken. The eradication is complete when we reach the healthy bleeding tissues. No attempt should be made close the resulting wound; it should be dressed with dry sterile gauze soaked in Calendula solution. Some of these operations are no doubt mutilating if the patient is to be saved, even amputation may be required.
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 General Treatment : - General Treatment should be on the line of shock. Glucose per rectum may be required if vomiting is severe and persistent. Anti gas serum has been given extensive trial. It at least attenuates the virulence of the infection and is thus helpful to surgical procedures.
 Homoeopathic therapeutics
 Homoeopathy offers many remedies for gangrene of lungs, mouth and other parts. Jousset suggests under gangrene of mouth Mercurius, Arsenic and Lachesis. Arndt recommends Arsenic, Lachesis, Carbo Veg. for gangrene of the lungs. According to Bartlett medicines such as Arsenic, Lachesis, Carbo Veg., China, Camphor, and Kreosote are important for gangrene of lungs. Raue suggests Arsenic, Carbolic Acid., Carbo Veg., Kreosote and Silicea for gangrene pulmonum. Lilienthal gives under traumatic gangrene Ammon. Mur., Arnica, Calendula, Hypericum, Lachesis. He also recommends Bromium for hospital gangrene.
 Bubbling of gas is one of the symptoms of the disease. Kent mentions medicines such as Ambra Grisea, Antim. Crudum, Asafoetida, Belladonna, Berberis, Colchicum, Ipecac., Lycopodium, Nux Vomica, Pulsatilla, Rheum, Squilla, Spigelia and Taraxacum.
 Various kinds of injuries are sustained in war and treatment of these injuries has already been described under various heads elsewhere in this book.
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Materia medica of injury medicines
 Angustura vera
 It causes drawing, tension and stiffness of the muscles and joints, with a bruised, sore feeling, as if after a blow. This tension is marked enough in the temporal and masseter muscles to suggest trismus. The drug also affects the bones. It is very possible that injury with incipient muscular contractions needs this remedy.
 Arnica montana
 Arnica is applicable to both acute and chronic effects of injuries. The acute injuries are : simple bruises, in which there are well marked ecchymosis, concussions of the brain or spine or both. Compression of the brain comes within the range of Arnica. When this compression is as a result of a displacement of bone in cranial fracture, operation will be demanded in order to obtain permanent relief.
 Arnica is also used in injuries of the muscles from a strain or from a sudden wrench, as in case of heavy lifting and haemorrhages of mechanical origin. Fractures of bones may call for its use both externally and internally to relieve the swelling and tumefaction of the limb and also to relieve the twitching of muscles – a reflex symptom of the fracture.
 In chronic effects of injury, we may use Arnica when disease may be traced to a traumatic origin. No matter what that disease may be, whether of brain, eyes, lungs of nerves, if the injury is the exciting cause, the administration of Arnica is proper.
 Dr. Kent says that Arnica is very important remedy in injuries, bruises and shocks, injuries of joints, injury of the back with lameness and soreness. In such conditions Arnica becomes one of the first remedies and unless there are general decided symptoms calling for other remedies it should be the first remedy. Persons who have gone through a rail road accident or suffered a mental shock or who are bruised or covered with wounds and sores, wake up often in the night with fear of sudden death, with an expression of terror. The horrors they have gone through are repeated. They experience dreadful anguish before they come to themselves. This is repeated night after night in persons who have escaped death by drowning in a river or an automobile or fire accident, etc. There is no substance in their complaint except that the mind is in a state of shock and needs to be soothed back to a state of calm. Arnica is a best specific here.
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 In bruises Arnica is most satisfactory in high potency and when no decided contra indicated it is the first remedy but for the weakness of tendons that follows such a condition Arnica is not always sufficient and Rhus Tox. is its natural follower. If the weakness and tenderness remain in the joints, follow the Rhus with Calcarea. One should not give these remedies all on the same day but should wait until all the good has been gotten out of Arnica before following Rhus.
 Arnica is also a remedy in cases where pain occurs and swelling results from a blow or injury. For pain, only a single dose of Arnica 200 is quite sufficient. If these is much swelling with blue or black spots, Arnica 1000 will eliminate the swelling and pain within twenty four hours.
 Arnica will very often take all the soreness out of a sprained ankle and permit him in a few days to go walking about. The blue and black appearance of sprained joints will go away in a surprising short time, the soreness will disappear. It also removes lumps on heads of children caused by injury.
 Hahnemann says of Arnica, “Hence it is very beneficial” (not only in “injuries caused by severe contusions and lacerations of fibres”) “but also in the most severe wounds by bullets and blunt weapons : in the pains and other ailments consequent on extracting the teeth, and other surgical operations, whereby sensitive parts have been violently stretched : as also after dislocations of joints, after setting fractures of bones, etc.”.
 For internal use he recommends the 30th potency. For external use the parts are to be kept moistened for 24 hours with wine, or brandy and water, in which, 5 to 10 drops of Arnica (not the ¨ but 1C) has been well mixed (5 to 10 drops to the pint).
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 Arnica has a role in insect stings. The strong tincture applied to a wasp sting, prevents the pain and swelling, and in a couple of hours the sting is forgotten.
 Arnica is useful for injuries sustained in sports, for instance, a footballer gets kicked on the knee, or when generally knocked about in a rough game.
 Black letter symptoms
 Mechanical injuries : especially with stupor from concussion, fractures of skull, or even compression (apply externally warm cloths saturated with dilute tincture from the root; give also internally).
 Meningitis after mechanical or traumatic injuries, such as concussions, bruises, falling, concussion of brain, etc., when suspecting exudation of blood, fibrine or pus. In such cases we find great sopor and partial paralysis of tongue, oculmotors, iris or limbs.
 Inflammation of eyes, with suggillations after mechanical injuries.
 Diplopia after injuring the eye.
 Loss of sight after violent blow.
 Hard hearing from concussions.
 Nose bleed; preceded by tingling, from mechanical causes.
 Vomiting of dark red coagula, mouth bitter, general soreness after injury.
 Hematemesis from injuries (stomach).
 Bladder affections after mechanical injuries.
 Penis and testes swollen purple red; after injuries.
 Haemorrhage after mechanical injuries.
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 Pleurisy after mechanical injuries.
 Pneumothorax from external injuries.
 Concussions and contusions.
 Stings of bees or wasps.
 Caution : - Arnica can bring out a very nasty dermatitis, when used externally too long or too strong – even a cellulitis when applied to wounds where the skin is broken; and here it is better always to use Hypericum. Probably Hahnemann’s 1st centesimal potency (1C) would be an improvement; always on the mother tincture (¨) commonly used.
 Bellis perennis
 Bellis Perennis is our common daisy. It acts very much like Arnica. In old workmen, labourers, and the overworked and fagged, it is princely remedy. It is a grand friend to commercial travellers and in railway spine of moderate severity.
 It is the first remedy in injuries to the deeper tissues, after major surgical work. Results of injuries to nerves with intense soreness and intolerance of cold bathing. It is an excellent remedy for traumatism of the pelvic organs. It is also recommended in haemorrhage, dysentery, as a ‘herrliches wund kraut’, internally and externally, e.g. , as a vulnerary, for the effects of falls, blows, bruises and like pains in the joints, rheumatism. A battered bruised uterus yields quickly to anti traumatics such as Bellis and Arnica.
 It acts on the muscular fibres of the blood vessels, and upon the tissues, and this clears the line of mechanical obstructions.
 An ordinary commendation of Arnica reads almost in the same term but this drug is useful to such as have partaken of a too cold draught of something, for it possesses a peculiar quality of being useful in all those terrible and dangerous accidents that arise from having drunk something very cold when the body is in a heated condition.
 Like Arnica it affects blood vessels; and like Hypericum nerves.
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 It is also precious for its effects on the mammae, when induration persists after blows.
 Calcarea phosphorica
 One looks upon this powerful medicinal agent as one of Schuessler’s Tissue Remedies. In injuries it has an action on joints, e.g.  in treatment of fractures. Whenever bones form a joint or suture there Calcarea Phos. has an action. Again where the sacrum unites with the iliac bones, forming the sacro-iliac symphysis there, Calcarea Phos. produces pain. Now, when there is a sort of artificial suture, as there is at the point of co-aptation of broken bones, there also Calcarea Phos. has an action. In some cases fractured ends will fail to unite, here give this medicine repeatedly in low potency to stimulate the formation of callus. Nash says that it is an excellent remedy for broken bones, where the bones refuse to knit.
 Compare Calcarea Phos. with Symphytum for non union of fractures. Symphytum is more useful when the trouble is of nervous origin. Calcarea Phos. is very useful in cases where the place of old injury becomes the seat of new affections. (Hering).
 Calendula officinalis
 For open lacerations and cuts, study Calendula. The condition that comes from the external ought to be remedied to a great extent by external means. A solution of Calendula is excellent in conditions that come from the external and should be applied externally. When you have lacerated wounds and cuts with knives or other sharp instruments apply Calendula because the injury is external without internal effects. Always protect surfaces that are exposed, and raw, and bleeding with something of a bland and superficial character. Wounds must be dressed with as simple a means as possible and there is no simpler dressing than Calendula, one part to four or six of water.
 Calendula is to be thought of when the injury causes a torn or ragged wound, possibly with loss of substance. Calendula removes the inflammatory condition of the part, and so permits of healthy granulation. Where wounds and ulcers due to wounds do not heal, Calendula checks suppuration, helps union of severed parts or broken skin. It is a remarkable healing agent and acts as a wonderful antiseptic wash.
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 Calendula is very useful in pains which are in excessive and out of all proportions to injury. Injuries to eyes which tend to suppurate after operations are healed by Calendula.
 Calendula tincture, diluted with one half or more with water, applied on cloths, kept constantly saturated with solution, works wonders as a dressing for wounds – contusions – crush injuries – lacerations – amputations – gangrenous conditions – unhealthy or excessive suppuration – sore ulcerated nipples.
 Conium maculatum
 Ill effects of bruises and shocks to spine. After injuries especially in the lumbar region pains and filling up the veins of lower limbs.
 Stony hard lumps in breast after contusions.
 Paraplegia after concussion of spine.
 Euphrasia officinalis
 It is indicated in conjunctivitis of traumatic origin when little blisters or phlyctenulae form on or near the cornea. The discharges from the eyes are acrid and purulent. Arnica which is more a remedy for bruises, has no application to this acrid discharge or to the formation of these little blisters. So, when these form after an injury Euphrasia is the preferable drug.
 Glonoinum
 It has been found excellent remedy for pains and abnormal sensations, following sometimes after local injuries. Long after the reception of an injury, the part pains or feels sore or an old scar breaks out again, then Glonoine seems to relieve.
 Helleborus niger
 Allen’s handbook of Materia Medica clinical section says, “Effects of concussion after Arnica has failed”. Farrington relates a case where Arnica has failed “and the patient became drowsy, one pupil was large than the other, the patient answered questions slowly as comprehension was imperfect, one leg was dragged in walking, the pulse was scarcely 50 per minute and the patient in general was worse from 4 to 8 p.m. , Helleborus cures the case”. Helmuth suggests Helleborus with Arnica, Belladonna, Cuprum or Zincum when there is effusion within the cranium. Hering recommended in sensitiveness of the external head from a blow, concussion on brain. In Kent’s Repertory, Helleborus is not noted under injuries in the head section, but is found in the second degree under the rubric ‘concussion’.
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 Hypericum perforatum
 “When the ends of the fingers or toes are lacerated or bruised by a blow from a hammer and the pain can be traced up along the nerve towards the body, stitching and darting, coming and going, then by all means use Hypericum. It is the remedy that will prevent lock-jaw for which your patient is headed.” (Charles C. Waltenbough).
 It is an excellent vulnerary plant…………outwardly of great service in bruises, contusions and wounds, especially in the nervous parts……… The ointment open obstructions, dissolves swellings, and closes up the lips of wounds…..
 Hypericum has a healing touch on injured nerves, and for injuries especially to parts rich in nerves. Farrington says that Hypericum is to be substituted for Arnica when the nerves have been injured along with other soft parts. Nothing equals Hypericum in cases of mashed finger. It relieves the pain and heals. It often follows Arnica in concussion of the spine.
 Hypericum is only a minor remedy for bruised and strained tendons and muscles. It goes into a different class of complaints. Hypericum and Ledum run close together. Hypericum and Ledum come together for consideration when an injury to a nerve has taken on inflammatory action. Instead of the muscles and bones and blood vessels as in Arnica, Rhus and Calcarea, the nerves are the sphere for these two remedies. When the finger ends or toes have been bruised or lacerated, or a nail has been torn off, or when a nerve has become pinched between a hammer and bone in a blow, and that nerve becomes inflamed and the pain can be traced up along the nerve, and it is gradually extending towards the body from the injured part with stitching, darting pains, coming and going, or shooting up from the region of injury towards the body, a dangerous condition is coming on. In these conditions Hypericum is above all the remedies to be thought of.
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 A vicious dog will take hold through the thumb, or the hand or the wrist, and run one of his teeth through the radial or some of its branches in the hand, causing a lacerated wound……or a wound may yawn, swell up, no tendency to heal, look dry and shiny on its edges, red inflamed, burning stinging, tearing pains, no healing process. That wound needs Hypericum. It prevents tetanus.
 A shoe maker may stick his awl into the end of his thumb or a carpenter may stick his finger with a brass tack, and he does not think much of it, but next night shooting pains extend up the arm with great violence. When these pains come on, Hypericum will stop them and from this stage to advanced states or tetanus with opisthotonos and lockjaw, Hypericum is the remedy. (Kent).
 Punctured wounds, rat bites, cat bites, etc., are made safe by Ledum, but if the pain shoots from the wound up the nerve of the arm, it is more like Hypericum.
 Injuries of Spine and Coccyx : - Many a woman sustains an injury of the coccyx during labour and here Hypericum be used. Sometimes while a man going upstairs falls backward, his feet to slip from under him and he strikes his back upon one of the steps and undergoes a sharp injury. Hypericum here will do miracle. Do not waste time by giving Arnica or any other. A sudden lurch of the ear caused by a man who was standing on the rear end of the car to be hurled back on his coccyx, Hypericum when given cured him fully.
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 Hering in his Guiding Symptoms gives cases of cure by Hypericum of concussion of spine. Man thrown from wagon who stuck his back violently against a kerb stone and had shooting pains down both legs, with partial paralysis. Boy with traumatic meningitis after a fall on the head recovered under Hypericum. Woman with headache after a fall on occiput, with sensation of being lifted high into the air; tormented by the greatest anxiety that the slightest touch or motion would make her fall down from this height; and so on. All these cases were cured by Hypericum.
 Hypericum is useful to close up the lips of wounds. A girl had fallen through glass, and among other cuts had a nasty one on lip, a little bit of which was missing. Merely a compress of Hypericum that night left the lip healed by morning. In another case when a piece of barbed wire penetrated and made a rather deep puncture, with a large deep scratch on the skin. The wound was dressed with Hypericum and healed up.
 Ledum palustre
 This is a great remedy for the surgeon, closely associated in traumatism with Arnica and Hypericum; especially for injuries for stepping on tacks, puncturing with needles; wound that bleed scanty, but are followed by pain, puffiness and coldness of the parts. Splinters under the nail; if such wounded parts become cold, then pale, paralysed and mottled, think of Ledum. A horse steps on a nail, it goes through and strikes the margin in the coffin bone, with tetanus to follow and death, put Ledum on the tongue of that horse and there will not be any trouble.
 A Resident Casualty Officer reports that he prescribed Ledum for puncture wounds, or wounds very sensitive to touch, abscess and septic conditions, very tender, relieved by cold. If the patient was not sure of effect of heat and cold, he used to get him to ‘put it under the cold tap’ and if this was grateful, he was sure of his drug e.g. , Ledum.
 Ledum has a special action on the capillary system in parts where cellular tissue is wanting, and there dry resisting texture is present, as in the fingers and toes. It is perhaps for that reason that it acts better on the small than on the large joints.
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 Nash points out that Ledum has its action in ecchymosis. Ledum sometimes comes in to finish up an Arnica case where Arnica was best a first, Ledum often removes the ecchymosis and discolouration more rapidly and perfectly.
 For black eye from a blow or contusion there is no remedy equal to Ledum in 200th potency. But if there is great pain in the eye balls itself, Symphytum may have to be used. (Nash).
 Farrington says that Ledum is useful after Arnica when the latter remedy fails to relieve the soreness. Hering brings out its usefulness in missteps which cause the sensation of concussion of the brain.
 Black letter symptoms
 Sprains of ankles and feet.
 Punctured wounds, from sharp pointed instruments as awls, nails, etc., particularly if wounded parts feel cold to touch, and to patient.
 Punctured wounds, stings of insects, ill effects of mosquito bites or bites of some other poisonous insects or animals, intolerable pain, tetanus.
 Hypericum perforatum
 Hypericum and Ledum are two remedies which come for consideration in injuries f fingers, soles, toes, etc. When the finger end or the toe has been bruised or lacerated, or a nail has been torn off, or when a nerve has become pinched between a hammer and the bone in blow, while stretching a nail into the wall, etc., the finger tip experiences excruciating pain. The pain can be traced along the nerve and gradually extend towards the body from the injured part. Stitching and darting pains coming and going, or shooting up from the region of the injury towards the body, here no remedy other than Hypericum will be helpful.
 Ledum comes in very often as a preventive medicine. It is a preventive medicine when an injury occurs to the ends of the fingers (punctured wounds). Hypericum is for crushed finger tips. If a person steps on a nail tack or sticks a splinter under a finger nail or into the foot, pull it out and give him a dose of Ledum. It will prevent lockjaw. These punctured wounds, rat bites, cat bites, etc., are made safe by Ledum.
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 Ledum prevents the shooting pains that naturally come, and the nerves are never involved. Again, if the pain is a dull aching in the part that was injured, still Ledum is the remedy.
 Remember Hypericum is for crushed finger tips and Ledum for punctured wounds. Ledum acts a preventive but if the pain continues Hypericum is to be used. If a dose of Ledum is given before the tetanus comes on, it can save from tetanus but when the jerking comes on, Ledum will not do, Hypericum must be used.
 When the tenderness of a perforating wound is worse than the appearance would suggest, think of Hypericum rather than Ledum.
 Ledum palustre
 Hypericum and Ledum are two remedies which come for consideration in injuries f fingers, soles, toes, etc. When the finger end or the toe has been bruised or lacerated, or a nail has been torn off, or when a nerve has become pinched between a hammer and the bone in blow, while stretching a nail into the wall, etc., the finger tip experiences excruciating pain. The pain can be traced along the nerve and gradually extend towards the body from the injured part. Stitching and darting pains coming and going, or shooting up from the region of the injury towards the body, here no remedy other than Hypericum will be helpful.
 Ledum comes in very often as a preventive medicine. It is a preventive medicine when an injury occurs to the ends of the fingers (punctured wounds). Hypericum is for crushed finger tips. If a person steps on a nail tack or sticks a splinter under a finger nail or into the foot, pull it out and give him a dose of Ledum. It will prevent lockjaw. These punctured wounds, rat bites, cat bites, etc., are made safe by Ledum.
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 Ledum prevents the shooting pains that naturally come, and the nerves are never involved. Again, if the pain is a dull aching in the part that was injured, still Ledum is the remedy.
 Remember Hypericum is for crushed finger tips and Ledum for punctured wounds. Ledum acts a preventive but if the pain continues Hypericum is to be used. If a dose of Ledum is given before the tetanus comes on, it can save from tetanus but when the jerking comes on, Ledum will not do, Hypericum must be used.
 When the tenderness of a perforating wound is worse than the appearance would suggest, think of Hypericum rather than Ledum.
 Rhus toxicodendron
 For the strains of muscles and tendons Arnica proves insufficient and here Rhus will show that remedy is suitable for the resultant weakness of tendons and muscles. Rhus is preferable to Arnica when the ligaments of a joint, rather than the soft parts are involved in an injury. It acts on the fibrous structures. Arnica is suited more to tumefaction of the other tissues . Arnica has not the strained feeling of Rhus.
 Rhus is the great remedy of over exertion. Ill effects of over exertion as may frequently happen in athletes and in machinists who wield heavy tools. A player of wind instruments gets pulmonary haemorrhage : Rhus will be the remedy. If from violent exertion a patient is seized with paralysis, his trouble may yield to Rhus. In sprains, Calcarea Carb. follows, when Rhus has relieved, but failed to cure.
 In periproctitis, Rhus Tox. may be needed if the inflammation is of traumatic origin; Lachesis, if an abscess forms and fails to point, the surrounding tissues presenting a purplish hue.
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 Rhus may also be used in iritis, either of rheumatic or traumatic origin. The inflammation may extend to and involve the choroid, and still a Rhus will be the remedy. Pains shoot through the eyes to the back of the head, and are worse at night. On opening the eye there is profuse flow of hot tears. In some cases the inflammation may go on to suppuration.
 Rheumatic pain after sprain, or lifting heavy weight or from continued stretching of one’s self high up to reach a thing or things. Erysipelas following wounds; traumatic paralysis without destruction of nervous tissues.
 Trousseau says that he had often used RHUS RADICANS for paralysis of the lower extremities succeeding on a concussion of the spinal marrow, or a lesion of that great organ, which do not destroy its tissues.
 Ruta graveolens
 It was proved by Hahnemann. It has a very definite sphere of action – a s we well see : viz., eyes, anus, ganglia and such like injuries to periosteum – sprains, especially of wrist and ankle. It is one of the great vulneraries (with Arnica), helping in injuries not only of soft parts, but of bones and periosteum – and as said – sprains (with Rhus) – and skin even to erysipelas.
 Lameness and other complaints after sprains, after over strain, circumscribed pain from traumatic cause, from missing a step when descending or putting feet on the floor with some force or sudden pressure.
 After Arnica it hastens the curative process in the joints; after Symphytum in injuries to bone.
 Black letter symptoms
 Injuries to periosteum suggests Ruta.
 Phthisis after mechanical injuries to chest.
 Bruises and other mechanical injuries to bones and periosteum; sprains; periostitis.
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 Ankles pain as after a sprain or dislocation.
 Eyes feel as if strained by too much reading.
 Weak, pressive like pain in right eye, with dimness of surrounding objects as if from having looked too long at an object that was fatiguing to the eyes.
 Bruised sensation all over, as from fall or blow : with soreness of parts on which he lies (Arnica).
 Staphysagria
 This is the remedy for smooth, clean cuts from sharp pointed instruments or form surgeon’s knife. Stinging and smarting pains. It is mostly called for in symptoms which are traceable to surgical operations. Colic after lithotomy or ovariotomy or attending abdominal section will be relieved by its application.
 Sulphuricum acidum
 Sulphuric acid is also useful as a traumatic remedy. It may be used for bruises of soft parts after Arnica, in bruises of glands after Conium, and in injuries of bones after Ruta. Contusions and suggillations, pains increase gradually and then cease suddenly in different parts of body; excoriating surfaces with threatening suppuration; crampy paralytic pains and shocks in arms and fingers when writing. Particularly it may be used when there are long lasting black and blue spots with soreness and stiffness.
 Symphytum officinale
 It is specific for injuries caused, not by sharp stabbing instruments but by blows from blunt masses that damage but fail to penetrate.
 Pain in eyes after a blow of an obtuse body, snow ball strikes the eye; infant thrusts its fist into its mother’s eye. In traumatic injuries of eyes no remedy equals this. Symphytum * is especially useful for blows on the eye balls.
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 Symphytum is our very great remedy for fractures and of fractures that fail to unite. It facilitates union of fractured bones and lessens peculiar pricking pain. Non union of fracture particularly when the trouble is of nervous origin respond well to Symphytum.
 Black letter symptoms
 It favours production of callus.
 It has a special mission in regard to periosteum (Ruta) and bones. Peculiar pain in periosteum after wounds have healed.
 It may also be administered in case of irritable stump after amputation, and also for irritability of bone at the point of fracture.

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