Internal use of Arnica and Comfrey root would appear to be justified in serious chest injuries.
Internal use of Arnica and Comfrey root would appear to be justified in serious chest injuries.
Contents The trachea divides into right and left main bronchi which go to the two LUNGS. The left lung is slightly smaller than the right. The right has three lobes (upper, middle and lower) and the left lung has two lobes (upper and lower). Each lung is covered by two thin membranes lubricated by a thin layer of ?uid. These are the pleura; similar structures cover the heart (pericardium). The heart lies in the middle, displaced slightly to the left. The oesophagus passes right through the chest to enter the stomach just below the diaphragm. Various nerves, blood vessels and lymph channels run through the thorax. The thoracic duct is the main lymphatic drainage channel emptying into a vein on the left side of the root of the neck. (For diseases affecting the chest and its contents, see HEART, DISEASES OF; LUNGS, DISEASES OF; CHEST, DEFORMITIES OF.)... chest
Blunt injuries These may cause haemorrhage inside the eye, cataract, retinal detachment or even rupture of the eye (see also EYE, DISORDERS OF). Injuries from large blunt objects – for example, a squash ball – may also cause a ‘blow-out fracture’ of the orbital ?oor resulting in double vision. Surgical treatment may be required depending on the patient’s speci?c problems.
Chemical burns Most chemical splashes cause conjunctivitis and super?cial keratitis in the victim (see EYE, DISORDERS OF); both conditions are self-limiting. Alkalis are, however, more likely to penetrate deeper into the eye and cause permanent damage, particularly to the cornea. Prompt irrigation is important. Further treatment may involve testing the pH of the tears, topical antibiotics and CORTICOSTEROIDS, and vitamin C (drops or tablets – see APPENDIX 5: VITAMINS), depending on the nature of the injury.
Corneal abrasion Loss of corneal epithelium (outermost layer). Almost any sort of injury to the eye may cause this. The affected eye is usually very painful. In the absence of other problems, the epithelium heals rapidly: small defects may close within 24 hours. Treatment conventionally consists of antibiotic ointment and sometimes a pad over the injured eye.
Foreign bodies Most foreign bodies which hit the eye are small and are found in the conjunctival sac or on the cornea; most are super?cial and can be easily removed. A few foreign bodies penetrate deeper and may cause infection, cataract, retinal detachment or haemorrhage within the eye. The foreign body is usually removed and the damage repaired; nevertheless the victim’s sight may have been permanently damaged. Particularly dangerous activities include hammering or chiselling on metal or stone; people carrying out these activities (and others, such as hedge-cutting and grass-strimming) should wear protective goggles.... eye injuries
Emergency treatment consists of turning the person on to the affected side or supporting the flail segment by firm strapping.
In severe cases, artificial ventilation is needed until the chest wall is stable.... flail chest
13.
The ?rst type of damage occurs as an acute episode in which one or more severe blows leads to loss of consciousness and occasionally to death. Death in the acute phase is usually due to intracranial haemorrhage and this carries a mortality of 45 per cent even with the sophisticated surgical techniques currently available. The second type of damage develops over a much longer period and is cumulative, leading to the atrophy of the cerebral cortex and brain stem. The repair processes of the brain are very limited and even after mild concussion it may suffer a small amount of permanent structural damage. Brain-scanning techniques now enable brain damage to be detected during life, and brain damage of the type previously associated with the punch-drunk syndrome is now being detected before obvious clinical signs have developed. Evidence of cerebral atrophy has been found in relatively young boxers including amateurs and those whose careers have been considered successful. The tragedy is that brain damage can only be detected after it has occurred. Many doctors are opposed to boxing, even with the present, more stringent medical precautions taken by those responsible for running the sport. Since the Royal College’s survey in 1969, the British Medical Association and other UK medical organisations have declared their opposition to boxing on medical grounds, as have medical organisations in several other countries.
In 1998, the Dutch Health Council recommended that professional boxing should be banned unless the rules are tightened. It claimed that chronic brain damage is seen in 40–80 per cent of boxers and that one in eight amateur bouts end with a concussed participant.
There is currently no legal basis on which to ban boxing in the UK, although it has been suggested that an injured boxer might one day sue a promoter. One correspondent to the British Medical Journal in 1998 suggested that since medical cover is a legal requirement at boxing promotions, the profession should consider if its members should withdraw participation.... boxing injuries
Severe head injuries cause unconsciousness for hours or many days, followed by loss of memory before and after that period of unconsciousness. The skull may be fractured; there may be ?ts in the ?rst week; and there may develop a blood clot in the brain (intracerebral haematoma) or within the membranes covering the brain (extradural and subdural haematomata). These clots compress the brain, and the pressure inside the skull – intracranial pressure – rises with urgent, life-threatening consequences. They are identi?ed by neurologists and neurosurgeons, con?rmed by brain scans (see COMPUTED TOMOGRAPHY; MRI), and require urgent surgical removal. Recovery may be complete, or in very severe cases can be marred by physical disabilities, EPILEPSY, and by changes in intelligence, rational judgement and behaviour. Symptoms generally improve in the ?rst two years.
A minority of those with minor head injuries have complaints and disabilities which seem disproportionate to the injury sustained. Referred to as the post-traumatic syndrome, this is not a diagnostic entity. The complaints are headaches, forgetfulness, irritability, slowness, poor concentration, fatigue, dizziness (usually not vertigo), intolerance of alcohol, light and noise, loss of interests and initiative, DEPRESSION, anxiety, and impaired LIBIDO. Reassurance and return to light work help these symptoms to disappear, in most cases within three months. Psychological illness and unresolved compensation-claims feature in many with implacable complaints.
People who have had brain injuries, and their relatives, can obtain help and advice from Headwat and from www.neuro.pmr.vcu.edu and www.biausa.org... brain injuries
Before the doctor comes: 3 drops each or any one: Tinctures Arnica, Calendula and Hypericum; hourly. ... abdomen, injuries
Barrel chest is found in long-standing ASTHMA or chronic BRONCHITIS and EMPHYSEMA, when the lungs are chronically enlarged. The anterio-posterior dimension of the chest is increased and the ribs are near horizontal. In this position they can produce little further expansion of the chest, and breathing often relies on accessory muscles in the neck lifting up the whole thoracic cage on inspiration.
Pigeon chest is one in which the cross-section of the chest becomes triangular with the sternum forming a sort of keel in front. It may be related to breathing problems in early life.
Rickety chest is uncommon now and is caused by RICKETS in early life. There is a hollow down each side caused by the pull of muscles on the softer ribs in childhood. The line of knobs produced on each side where the ribs join their costal cartilages is known as the rickety rosary.
Pectus excavatum, or funnel chest, is quite a common abnormality where the central tendon of the diaphragm seems to be too short so that the lower part of the sternum is displaced inwards and the lower ribs are prominent. When severe, it may displace the heart further to the left side.
Local abnormalities in the shape of the chest occur when there is a deformity in the spine such as scoliosis which alters the angles of the ribs. The chest wall may be locally ?attened when the underlying lung is reduced in size locally over a prolonged period. (See SPINE AND SPINAL CORD, DISEASES AND INJURIES OF.) This may be seen over a scarred area of lung such as that observed in pulmonary TUBERCULOSIS.... chest, deformities of
In Britain there are an average of 110 deaths a year from electrocution, half of these occurring in the home.
Treatment No electrical apparatus or switch should be touched by anyone who is in metallic contact with the ground, such as through a metal pipe, especially, for example, from a bath. The ?rst action is to break the current. This can sometimes be done by turning o? a switch. If the victim is grasping or in contact with a live wire, the contact may be severed with safety only by someone wearing rubber gloves or rubber boots; but as these are not likely to be immediately available, the rescuer’s hands may be protected by a thick wrapping of dry cloth, or the live wire may be hooked or pushed out of the way with a long wooden stick such as a broom-handle. If the injured person is unconscious, and especially if breathing has stopped, arti?cial respiration should be applied as described in APPENDIX 1: BASIC FIRST AID – Electrocution. When the patient begins to breathe again, he or she must be treated for shock and professional help obtained urgently.... electrical injuries
Alternatives. Teas. Boneset, Yarrow, Angelica. White Horehound, Hyssop.
Irish Moss. 1 teaspoon to 2 cups water gently simmered 20 minutes. Do not strain but eat with a spoon, sweetened with honey.
Tablets/capsules. Lobelia. Iceland Moss.
Foot-bath. Immerse feet in hot infusion of Chamomile or Mustard to divert blood to lower extremities. Supplementation: Vitamin C, 2-3 grams daily. ... cold – on the chest
Symptoms When a sensory nerve is injured or diseased, sensation is immediately more or less impaired in the part supplied by the nerve. Ulceration or death of the tissue supplied by the defective nerve may occur. When the nerve in question is a motor one, the muscles governed through it are instantly paralysed. In the latter case, the portion of nerve beyond the injury degenerates and the muscles gradually waste, losing their power of contraction in response to electrical applications. Finally, deformities result and the joints become ?xed. This is particularly noticeable when the ulnar nerve is injured, the hand and ?ngers taking up a claw-like position. The skin may also be affected.
Treatment Damaged or severed (peripheral) nerve ?bres should be sewn together, using microsurgery. Careful realignment of the nerve endings gives the ?bres an excellent chance of regenerating along the right channels. Full recovery is rare but, with regular physiotherapy to keep paralysed muscles in good shape and to prevent their shortening, the patient can expect to obtain a reasonable return of function after a few weeks, with improvement continuing over several months.... nerves, injuries to
An immediate surgical repair may be necessary. However, there are ways in which healing can be speeded and body defences sustained. The following promote healing: Fringe Tree being most relevant. To prevent infection it should be combined with Echinacea (anti-microbial).
Alternatives. Teas. Comfrey, Horsetail, Marigold, St John’s Wort, Plantain.
Decoction. Equal parts: Fringe Tree bark; Echinacea root. 1 heaped teaspoon to each large cup water simmered gently 20 minutes. Half-1 cup or as much as tolerated, every 2 hours.
Tinctures. Equal parts: Milk Thistle, Echinacea root. 20-60 drops in water every 2 hours.
Castor oil packs. Applied over liver area. ... liver – injuries
wall. In Tietze’s syndrome, inflammation at the junctions of the rib cartilages causes pain on the front of the chest wall.
Pain within the chest may be caused by pleurisy, as a result of bronchitis, pneumonia, or, rarely, pulmonary embolism. Cancerous tumours of the lung (see lung cancer; mesothelioma) may cause pain as they grow and press on the pleura and ribs. Acid reflux may lead to heartburn, a burning pain behind the sternum. The common heart disorder angina pectoris causes pain in the centre of the chest that may spread outwards to the throat, jaw, or arms. Myocardial infarction (heart attack) and acute pericarditis both also produce severe pain in the centre of the chest. Mitral valve prolapse may cause sharp chest pain, usually on the left side. Chest pain may also be a result of anxiety and emotional stress (see hyperventilation; panic attack).... chest pain
chest X-ray One of the most frequently performed medical tests, usually carried out to examine the heart or lungs to confirm diagnoses of heart disorders and lung diseases. (See also X-rays.)... chest thrust
Kyphosis is a backward curvature of the spine causing a hump back. It may be postural and reversible in obese people and tall adolescent girls who stoop, but it may also be ?xed. Scheuermann’s disease is the term applied to adolescent kyphosis. It is more common in girls. Senile kyphosis occurs in elderly people who probably have osteoporosis (bone weakening) and vertebral collapse.
Disc degeneration is a normal consequence of AGEING. The disc loses its resiliance and becomes unable to withstand pressure. Rupture (prolapse) of the disc may occur with physical stress. The disc between the fourth and ?fth lumbar vertebrae is most commonly involved. The jelly-like central nucleus pulposus is usually pushed out backwards, forcing the annulus ?brosus to put pressure on the nerves as they leave the spinal canal. (See PROLAPSED INTERVERTEBRAL DISC.)
Ankylosing spondylitis is an arthritic disorder of the spine in young adults, mostly men. It is a familial condition which starts with lumbar pain and sti?ness which progresses to involve the whole spine. The discs and ligaments are replaced by ?brous tissue, making the spine rigid. Treatment is physiotherapy and anti-in?ammatory drugs to try to keep the spine supple for as long as possible.
A National Association for Ankylosing Spondylitis has been formed which is open to those with the disease, their families, friends and doctors.
Spondylosis is a term which covers disc degeneration and joint degeneration in the back. OSTEOARTHRITIS is usually implicated. Pain is commonly felt in the neck and lumbar regions and in these areas the joints may become unstable. This may put pressure on the nerves leaving the spinal canal, and in the lumbar region, pain is generally felt in the distribution of the sciatic nerve – down the back of the leg. In the neck the pain may be felt down the arm. Treatment is physiotherapy; often a neck collar or lumbar support helps. Rarely surgery is needed to remove the pressure from the nerves.
Spondylolisthesis means that the spine is shifted forward. This is nearly always in the lower lumbar region and may be familial, or due to degeneration in the joints. Pressure may be put on the cauda equina. The usual complaint is of pain after exercise. Treatment is bed rest in a bad attack with surgery indicated only if there are worrying signs of cord compression.
Spinal stenosis is due to a narrowing of the spinal canal which means that the nerves become squashed together. This causes numbness with pins and needles (paraesthia) in the legs. COMPUTED TOMOGRAPHY and nuclear magnetic resonance imaging scans can show the amount of cord compression. If improving posture does not help, surgical decompression may be needed.
Whiplash injuries occur to the neck, usually as the result of a car accident when the head and neck are thrown backwards and then forwards rapidly. This causes pain and sti?ness in the neck; the arm and shoulder may feel numb. Often a support collar relieves the pain but recovery commonly takes between 18 months to three years.
Transection of the cord occurs usually as a result of trauma when the vertebral column protecting the spinal cord is fractured and becomes unstable. The cord may be concussed or it may have become sheared by the trauma and not recover (transected). Spinal concussion usually recovers after 12 hours. If the cord is transected the patient remains paralysed. (See PARALYSIS.)... spine and spinal cord, diseases and injuries of
Common injuries include tendinitis, stress fractures, plantar fasciitis, torn hamstring muscles, back pain, tibial compartment syndrome, and shin splints.... running injuries
Typical sports injuries include fractures, head injury (including concussion), muscle strain or compartment syndrome, ligament sprain, tendinitis or tendon rupture, and joint dislocation or subluxation.
Some so-called sports injuries, such as tennis elbow, are in fact a type of overuse injury.... sports injuries
Severe breathlessness and a life-threatening lack of oxygen result.... sucking chest wound
Avoid overstocking; some herbs lose their potency on the shelf in time, especially if exposed. Do not keep on a high shelf out of the way. Experts suggest a large box with a lid to protect its contents, kept in a cool dry place away from foods and other household items. Store mixtures containing Camphor separately elsewhere. Camphor is well-known as a strong antidote to medicinal substances. Keep all home-made ointments in a refrigerator. However harmless, keep all remedies out of reach of children. Be sure that all tablet containers have child-resistant tops.
Keep a separate box, with duplicates, permanently in the car. Check periodically. Replace all tablets when crumbled, medicines with changed colour or consistency. Always carry a large plastic bottle of water in the car for cleansing dirty wounds and to form a vehicle to Witch Hazel and other remedies. Label all containers clearly.
Health care items: Adhesive bandages of all sizes, sterile gauze, absorbant cotton wool, adhesive tape, elastic bandage, stitch scissors, forceps (boiled before use), clinical thermometer, assorted safety pins, eye-bath for use as a douche for eye troubles, medicine glass for correct dosage.
Herbal and other items: Comfrey or Chickweed ointment (or cream) for sprains and bruises. Marshmallow and Slippery Elm (drawing) ointment for boils, abscesses, etc. Calendula (Marigold) ointment or lotion for bleeding wounds where the skin is broken. An alternative is Calendula tincture (30 drops) to cupful of boiled water allowed to cool; use externally, as a mouth rinse after dental extractions, and sipped for shock. Arnica tincture: for bathing bruises and swellings where the skin is unbroken (30 drops in a cup of boiled water allowed to cool). Honey for burns and scalds. Lobelia tablets for irritating cough and respiratory distress. Powdered Ginger for adding to hot water for indigestion, vomiting, etc. Tincture Myrrh, 5-10 drops in a glass of water for sore throats, tonsillitis, mouth ulcers and externally, for cleansing infected or dirty wounds. Tincture Capsicum (3-10 drops) in a cup of tea for shock, or in eggcup Olive oil for use as a liniment for pains of rheumatism. Cider vinegar (or bicarbonate of Soda) for insect bites. Oil Citronella, insect repellent. Vitamin E capsules for burns; pierce capsule and wipe contents over burnt area. Friar’s balsam to inhale for congestion of nose and throat. Oil of Cloves for toothache. Olbas oil for general purposes. Castor oil to assist removal of foreign bodies from the eye. Slippery Elm powder as a gruel for looseness of bowels. Potter’s Composition Essence for weakness or collapse. Antispasmodic drops for pain.
Distilled extract of Witch Hazel deserves special mention for bleeding wounds, sunburn, animal bites, stings, or swabbed over the forehead to freshen and revive during an exhausting journey. See: WITCH HAZEL.
Stings of nettles or other plants are usually rendered painless by a dock leaf. Oils of Tea Tree, Jojoba and Evening Primrose are also excellent for first aid to allay infection. For punctured wounds, as a shoemaker piercing his thumb with an awl or injury from brass tacks, or for shooting pains radiating from the seat of injury, tincture or oil of St John’s Wort (Hypericum) is the remedy. ... first aid and medicine chest