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
COLI BACILLUS. Infections. Freshly-grated Horseradish root steeped in cup cold water for 2 hours.
Remove root. 1 cupful freely, as tolerated. Papaya fruit.
COLIC. Spasm of the bowels, particularly the colon. Severe pain under the navel with nausea, vomiting.
Patient writhes from side to side. Cause may be wind, acid bile, worms, constipation, food; aluminium, lead or other metal poisoning, strangulated hernia, appendicitis, adhesions.
Differential diagnosis: gallstones, menstrual difficulties, kidney stone.
Alternatives. Teas, any one. Roman Chamomile, Catmint, Fennel, Lovage, Caraway, Betony, Avens, Wormwood, Holy Thistle, Peppermint leaves, Aniseed, Tormentil.
Decoction, any one. Angelica root, Boldo, Calamus, Cardamom, Condurango, Coriander, Cramp bark, Ginger root, Liquorice, Wild Yam.
Tablets/capsules. Dandelion, Capsicum, Valerian, Wild Yam, Cramp bark, Blue Flag root.
Powders. Alternatives. (1) Calamus 2; Marshmallow root 1. Add pinch Cayenne. (2) Turkey Rhubarb plus pinch of Cayenne. (3) Wild Yam plus pinch of Cayenne. Dose: 500mg (one-third teaspoon or two 00 capsules) every 2 hours.
Tinctures. Formulae. Alternatives: (1) Angelica root 1; Wild Yam 1; Ginger half. Mix. (2) Dandelion 2; Wild Yam 1; few drops Tincture Capsicum. Mix. (3) Wild Yam 1; Galangal root half; Ginger half. Mix. Dose: 1 teaspoon in hot water every 2 hours.
Traditional German combination. Ginger, Gentian, Turkey Rhubarb.
Topical. Apply hot bran, oats, hops or Slippery Elm poultice, or Castor oil packs to abdomen. Aromatherapy. Any one oil: Aniseed, Fennel, Mint, Garlic, Bergamot. Adult: 6 drops to 2 teaspoons Almond oil: child, 2 drops in 1 teaspoon Almond oil, for abdominal massage.
Enema. 1oz Catmint, Boneset or Chamomile in 2 pints boiling water. Strain, inject warm.
Diet. 3-day fast, with fruit juices and herb teas.
See: RENAL COLIC, COLIC OF PREGNANCY, CHILDREN. Gripe water. ... cold sore
Also called acute coryza or upper respiratory infection, the common cold is characterised by in?ammation of any or all of the airways – NOSE, sinuses (see SINUS), THROAT, LARYNX, TRACHEA and bronchi (see BRONCHUS). Most common, however, is the ‘head cold’, which is con?ned to the nose and throat, with initial symptoms presenting as a sore throat, runny nose and sneezing. The nasal discharge may become thick and yellow – a sign of secondary bacterial infection – while the patient often develops watery eyes, aching muscles, a cough, headache, listlessness and the shivers. PYREXIA (raised temperature) is usual. Colds can also result in a ?are-up of pre-existing conditions, such as asthma, bronchitis or ear infections. Most colds are self-limiting, resolving in a week or ten days, but some patients develop secondary bacterial infections of the sinuses, middle ear (see EAR), trachea, or LUNGS.
Treatment Symptomatic treatment with ANTIPYRETICS and ANALGESICS is usually su?cient; ANTIBIOTICS should not be taken unless there is de?nite secondary infection or unless the patient has an existing chest condition which could be worsened by a cold. Cold victims should consult a doctor only if symptoms persist or if they have a pre-existing condition, such as asthma which could be exacerbated by a cold.
Most colds result from breathing-in virus-containing droplets that have been coughed or sneezed into the atmosphere, though the virus can also be picked up from hand-to-hand contact or from articles such as hand towels. Prevention is, therefore, di?cult, given the high infectivity of the viruses. No scienti?cally proven, generally applicable preventive measures have yet been devised, but the incidence of the infection falls from about seven to eight years – schoolchildren may catch as many as eight colds annually – to old age, the elderly having few colds. So far, despite much research, no e?ective vaccines have been produced.... cold, common
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
Internal use of Arnica and Comfrey root would appear to be justified in serious chest injuries. ... chest 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
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
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
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
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
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
In frostbite, an area of skin and flesh becomes frozen, hard, and white as a result of exposure to very cold, dry air.
Sometimes there is restriction of the blood supply to the affected area.
Another type of cold injury, immersion foot, occurs when the legs and feet are kept cold and damp for hours or days.
The main risk of both conditions is that blood flow will be slowed so much that the tissues will die, leading to gangrene.
Less serious forms of cold injury include chilblains and chapped skin.... cold injury