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SOME TROPICAL TRAUMATISMS 



first toe is only compressed. The weight of the body is then 

 supported by the posterior aspect of the os calcis and by the distal 

 end of the first metatarsal, and the plantar aspect of the great toe, 

 while the dorsal aspect of the other toes may assist a little. The 

 distance from the end of the os calcis to the big toe may be only 

 three inches. 



Such a compressed, deformed, stunted foot may easily become 

 the site of disease. In the first instance, there is danger of gan- 

 grene, necrosis (especially of the phalanges), and synovitis of the 

 knee-joint during the active bandaging, while the immediate result 

 may be total lameness. As a later complication, tuberculosis of 

 the bones of the deformed foot is liable to occur. 



Fortunatety this horrible proceeding, like many other horrible 

 fashions, is dying a natural death under the influence of increased 

 feminine education and common sense first produced among Euro- 

 pean women, and by them introduced into China. Naturally no 

 cure can be effected in a foot which has become fully deformed. 



Heavy Fruits. — The fruits of the coconut {Cocos nucifera Linnaeus) and of 

 the jak-tree {Artocarpus integrifolia Linnaeus) are heavy and fairly hard, 

 and injuries may be caused by the fall of one of these fruits from the tree 

 on to the head or other part of the body. When the blow is received by the 

 head, the symptoms produced may be those of concussion or compression, 

 or there may be signs of fracture of the vault or base of the skull. 



Electrical Fans. — -In the more civilized tropical towns it is common to 

 use small, movable, quickly running electric fans in order to obtain a cooling 

 breeze. These are brought into use specially in the bedroom and dressing- 

 room, but are also frequently seen in the dining-room, and sometimes in the 

 office. Being easily movable, they are apt to have their position slightly- 

 altered when running at full speed, and in doing this quite a number of acci- 

 dents have taken place. Sometimes during the condition between sleeping 

 and waking, people, stretching out their arms while still in bed, catch their 

 fingers in the fans. The most common traumatism is for the fingers to be 

 caught by the blades, and to sustain contused and lacerated wounds, the 

 danger of which is tetanus, as the blades of the fan are generally thickly 

 covered with the dust brought by the current of air. 



Another and far less serious but most awkward accident somxctimes happens 

 in a lady's dressing-room. The fan is placed on or near the dressing-table, 

 and is so arranged that the back of the fan is towards the person at the dressing- 

 table. The current of air passes from the person towards the back of the fan. 

 If the lady has long hair and is dressing it, the current of air may carry it into 

 the back of the fan and between the blades, which, still revolving, causes the 

 hair to be twisted into a tangle. Usually the lady or her attendant has suffi- 

 cient nerve to switch off the fan, and no very serious injury is done, but it is 

 difficult to extract the hair from the tangle in the fan. 



Powdered Glass. — In certain parts of the tropics, especially in the 

 East, powdered glass is used for suicidal and homicidal purposes. 

 The injury caused is, of course, purely mechanical, and the more 

 finely it is powdered, the less likely it is to cause serious injury, 

 owing to mucus surrounding the particles. The glass is administered 

 in food — e.g., bread, spinach, sweetmeat, etc. The symptoms are 

 those of irritant poisoning — retching, violent vomiting, spasms, 

 convulsions, and racking pain. The most evident post-mortem 

 feature is acute gastritis. The mucosa is covered with a layer of 



