74 



THE ALUMNI JOURNAL. 



dition the faculties of the mind and body 

 are in abeyance. This state is due to so 

 many different causes that in many cases 

 even the most experienced medical prac- 

 titioners are at a loss to determine its 

 origin. It may be due, for example, to 

 trouble within the brain or an injury of 

 the skull, to apoplexy or epilepsy, to 

 heat-stroke or intoxication, to suffoca- 

 tion or to simple fainting, to blood poi- 

 soning (as in ursemic coma) or to one of 

 the numerous narcotic poisons. How- 

 ever, there are usually certain indications 

 which ought, at any rate, to prevent the 

 making of grave mistakes, and in most 

 cases point to the nature of the trouble. 

 If a person is brought to you in such a 

 condition how should you act ? In the 

 first place, you can make no mistake by 

 sending at once for medical assistance ; 

 then place the patient in a comfortable 

 position on his back, and loosen the cloth- 

 ing about his neck and waist ; make 

 the crowd stand back, and give him 

 plenty of air. Do not lose your head, 

 but proceed in a careful, systematic man- 

 ner. If the face is red or flushed, raise 

 the head somewhat, and lay cloths dip- 

 ped in cold water upon it. 



A good rule, when in doubt, is to give 

 no stimulant when the face is flushed. 

 If the face is pale, it is better to lay the 

 head on a level with the body, sometimes 

 even lower. In any case, turn the head 

 a little to one side, so as to prevent the 

 reflux of the contents of the stomach into 

 the lungs in case of vomiting. If the 

 patient stops breathing, resort to artifi- 

 cial respiration, which I will explain 

 later along. In the mean time, learn 

 whatever you can about the case — 

 whether the patient has had a fall or a 

 blow, has been indulging in alcohol or 

 asphyxiated by gas ; whether or not he 

 is subjert to such attacks, how it came 

 on ; whether he fell suddenly, had a con- 

 vulsion or complained of feeling ill, etc. 



Kxamine the surface of the body, espe- 

 cially the head, for signs of injury or 

 fracture ; see whether or not the pupils 

 are of the same size or whether they 

 contract when exposed to light. Count 

 the pulse, and notice the respiration — 

 whether difficult, easy or snoring ; notice 

 the odor of the breath, and whether the 

 skin is hot or cold. 



This investigation may lead you to a 

 knowledge of the cause of the uncon- 

 sciousness, and will at any rate be. of 

 great service to the doctor w^ho takes 

 charge of the case, as the symptoms may 

 be greatly changed before his arrival. 



Fainting .—"Tins, occurs with far greater 

 frequency in females than in males. The 

 face is pale and the lips colorless, indi- 

 cating the bloodless state of the brain to 

 which the condition is due. The patient 

 is unconscious, the action of the heart 

 weakened, and the pulse perhaps imper- 

 ceptible. Treatment : Lay the person 

 down at once. Raise the front of the 

 bed, table or sofa so that the head will 

 be lower than the body, thus facilitating 

 the return of the blood to the brain. 

 Sprinkle the face with cold water, and 

 hold ammonia or smelling-salts to the 

 nose. These simple measures are almost 

 always effective, but if the faint con- 

 tinues, hot baths may be applied to the 

 feet and a hot water bag to the stomach. 



Shock, Collapse or Prostration. — This 

 is a very common condition in all in- 

 juries, and may vary in degree from a 

 slight nervous start to complete insensi- 

 bility, ending in death. In severe cases 

 the patient is breathing feebly, the face 

 is pale, pinched and anxious, the eyelids 

 are drooping, and the eyes dull and the 

 pupils dilated. The pulse is feeble and 

 often absent at the wrist; the skin is cold, 

 and there may be shivering. In most 

 cases reaction will take place sooner or 

 later — sometimes in a few minutes, some- 

 times after hours or days; in others there 



