Abdomen-Injuries to.-May arise from rupture of some internal organ. In some cases collapse follows, and internal bleeding may prove fatal. Brandy for extreme collapse. Empty the bladder, and if micturition is suspended use a catheter. Put patient in bed. Apply ice to abdomen.

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Ague or intermittent fever. This disease is usually accompanied by an enlarged spleen. During the cold stage of an attack, give warm diluent drinks, apply warm blankets and bottles to feet, hot-air baths, &c. During hot stage, give cooling drinks, sponge the body with tepid water. In sweating stage, rest, and the free use of tepid diluent drinks. Removal from the district is advisable.

Apoplexy-Symptoms: Pain in head.


tient suddenly falls down, face flushed, is insensible, pulse full and rather slow, sometimes sickness and vomiting come on, оссаsionally paralysis. Cold sweats, stertorous breathing, involuntary micturition.


-Take to a cool well-ventilated room, oosen clothes. Cold to head, stimulating and purgative enemata. Blisters to scalp. Mustard foot baths. Emetics if stomach overloaded. If face be very turgid, bleed, but this with caution.

Asthma. During the paroxysm relief may be obtained by inhaling the fumes of "Himrod,' or some preparation containing the leaves of datura tatula mixed with nitre. Severe cases are relieved by inhaling a few drops of chloroform. An antispasmodic draught containing spirit of æther, sumbul, ammonia, and dilute hydrocyanic acid will often relieve.

Bites-and stings-poisonous.-DOG BITES. -It is some satisfaction to know that all "mad " dogs are not hydrophobically so, and that distemper madness makes dogs more frantic than does rabies pure and simple. If you have reason to believe that the dog that has bitten is suffering from rabies, tightly bandage or ligature above and below the bite; the wounded part should then be entirely excised, taking care to cut out every part that has come in contact with the animal's teeth, expose the wound to a stream of cold water, and thoroughly cauterize the edges with lunar caustic. It is well after this to be inoculated after the method of M. Pasteur; the earlier this is done the better. (See also Snake Bites.)

STINGS may be treated with a strong solution of liquid ammonia in water; the sting must be extracted if the insect has left it in. A good hot poultice will relieve the inflammation. A sting on the tongue from a wasp concealed in fruit is a dangerous form of sting, and medical advice should at once be obtained.

Bleeding-To arrest.- Severe bleeding coming in jerks from a wound shows that it is in relation to a severed artery. Tightly bandage the limb between the wound and the heart, apply cold, and get a surgeon to ligature the artery as soon as possible. Amongst styptics may be mentioned lunar caustic, blue vitriol, tannin, alum, and all astringents.

BLEEDING FROM THE LUNGS.-Lay the patient down. Let him suck ice freely (a doubtful remedy), give two grains of gallic acid, and a drachm of liquor of ergot of rye in an ounce of water every hour or half-hour. Keep the room cool and free from visitors, keep the patient as quiet as possible,

BLEEDING FROM THE NOSE.-Stuff up tannin, put ice up the nostril, inject a strong solution of alum up the nostril, apply cold to the spine. In severe cases plug the nostril from behind, this requires the skill of a surgeon to be a successful operation.

BLEEDING FROM THE BOWELS. - Astringent injections or suppositories.

Breathing suppressed. This occurs in so many cases that under its heading would come Drowning, Asphyxia from poisonous gases or drugs, Hanging, Apoplexy, Syncope, Sunstroke, &c. It is sufficient therefore to bring under this heading the operation known as "artificial respiration," which is resorted to in all cases where the patient's life is in danger from his inability to breathe.

1. Strip the body, rub it dry, wrap it in warm blankets and keep in a fairly warm room in the recumbent posture with the head slightly raised.

2. See the nostrils and mouth are free for breathing purposes, remove artificial teeth.

3. Apply heat by bladder or hot-water bottles to the pit of the stomach, armpits, between the thighs, and to the soles of the feet.

4. Rub the body with the hand to encourage circulation.

5. Raise the patient's arms above the head, pulling upon them to raise the walls of the chest, at the same time rotating the body on to the right side.

6. At the same time bend both knees, and make pressure on the back and front below the lungs.

7. Now roll the body on to the back or a little to the left side, at the same time bringing both arms to the side, and pressing them against the ribs and straightening the knees. 8. Remember that rules Nos. 5, 6, and 7 should take exactly five seconds, not less, and then be repeated. To work quicker than this is attended with danger, the idea being to bring about artificially what the patient is unable to accomplish.

9. As soon as the patient commences to breathe stop the operation.

Many recommend the application of a strong smelling bottle to the nose, some inflate the lungs through a nostril with a pair of bellows, others inject warm brandy and water into the stomach, but the great idea is to restore (a) animal heat, (b) the power to breathe, and (c) the circulation of the blood. Above all things do not give up trying to restore life simply because no good results appear to be forthcoming, for individuals occasionally take as long as four hours to be brought to.

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Bruises. Apply a lotion of spirits and water or tincture of arnica and water, or use ice. To allay the pain paint the bruised part (if no broken skin) with equal parts of aconite, belladonna and opium liniments.

Burns and Scalds.-If patient collapse give 25 drops of laudanum with some warm brandy and water internally. Keep air from surface, do not disturb the burnt skin. Apply a lotion to the part, made of two parts of linseed oil, one part of lime water, and about one part in two hundred of carbolic acid-on cotton wool covered with gutta-percha tissue or oil-silk. Prick any vesicles containing water. Some prefer dusting the affected part with flour, chalk, starch, or car

bonate of lead, if this plan is adopted do not interfere with the crust formed by the powder.

Catalepsy is suddenly suppressed power of will and consciousness, and is best exemplified in mesmerism; it is usually met with in hysterical females. (See Hysteria.)

Cauterize-how to.-In case of a bite or poisonous wound chemical or actual cauteries may be used. The former include nitrate of silver, chromic acid, and the mineral acids. The latter simply means the application of a red-hot iron (e.g. the poker) to the affected part.

Cold-When overcome by the effects of-The patient goes giddy, blind, weak and stiff in his limbs, his pulse falls, his respiration grows weak, he has an intense desire to sleep, and eventually dies from coma (see Coma). Employ friction to the body. Do not place him too rapidly under the influence of heat, give him a stimulating enema, and try to get him to swallow warm milk, coffee, or beef tea, with brandy.

Coma-is the result of cold as above, inflammation of the brain, apoplexy, epilepsy, blood poisoned by urine diabetes, opium taking, alcohol drinking, or direct injury. It is a state of stupor with loss of consciousness. Each form of coma has symptoms peculiar to the exciting cause of the attack.

Concussion of the Brain-is the result of some act of violence to the head, and results in collapse, sickness, and loss of all muscular power. Apply cold to the head, give a strong purgative, empty the bladder, keep the extremities warm, and if no signs of rallying come on, give stimulants.

Convulsions are involuntary contractions of the whole muscular system, usually accompanied by unconsciousness, are due to some internal cause affecting the nervous system. Under this head come Epilepsy, Hysteria, Lock-jaw, &c., which see.

Cough Mixture.-For an irritating cough (for adults) use oxymel of squills one ounce, tincture of tolu three drachms, white poppy syrup six drachms, ipecacuanha wine two drachms, mucilage one ounce, ammoniacum mixture up to eight ounces a teaspoonful or more for a dose.

Croup.-Immediately the child is seized with the attack give from two to five drops of antimonial wine in water every ten or fifteen minutes, place it in a warm bath near a fire, and keep off all draught with a screen; after faintness comes on remove the child from the bath and place it on a hard bed where steam from a steam kettle can be freely admitted, to keep in which it is advisable to curtain the bed in. Generally speaking, after faintness and vomiting has been induced the attack goes off, but bad cases are relieved by the judicious inhalation of chloroform. (See also Emetics.")

Death Tests.-Hold mirror to mouth. If living, moisture will gather. Push pin into flesh. dead the hole will remain, if alive it will close up. Place fingers in front of a strong light. If alive, they will appear red; if dead, black or dark.

Delirium Tremens.-Sleeplessness, a busy and non-violent delirium, trembling of hands, patient sees all kinds of horrid animals, &c., loss of appetite, pale and moist skin, &c. Give ice internally, induce the patient to eat any kind of nutrient and easily digested food. Fifteen grains of chloral may be given four times a day, or half a grain of morphia may be injected occasionally. Do not suddenly stop all stimulants, and keep patient quiet and well watched.


Diphtheria. No specific known, anti-toxin reatment recommended by some practitioners. External applications to the throat are useless, but a strong solution of perchloride of iron with

glycerine was tried with very good results during an epidemic of a virulent form of the disease to paint the throat with after the pellicles had formed.

Dislocations-of many of our joints require surgical skill to reduce, especially those of the thigh, the ankle, the wrist, and the elbow; they are usually reduced by firmly pulling the distorted joint in the long axis of the limb, and at the same time using lateral pressure to force the bones into their places. One of the commonest and one of the easiest dislocations to reduce is the shoulder joint. Place the patient on a chair, place another chair by his side, and let the operator place his foot upon it, raise the arm, let the knee go into the armpit, and pull the arm outwards and downwards forcibly, the operator's knee acting as the fulcrum, and the patient's elbow as the lever. Remember that all dislocations become more difficult to reduce as time lapses, therefore it is necessary to be prompt.


Drowning.-I. Loosen clothing, if any. Empty lungs of water by laying body on its stomach, and lifting it by the middle so that the head hangs down. Jerk the body a few times. 3. Pull tongue forward, using handkerchief, or pin with string, if necessary; 4. Imitate motion of respiration by alternately compressing and expanding the lower ribs, about twenty times a minute. Alternately raising and lowering the arms from the sides up above the head will stimulate the action of the lungs. Let it be done gently but persistently. 5. Apply warmth and friction to extremities. 6. By holding tongue forward, closing the nostrils, and pressing the "Adam's apple" back (so as to close entrance to stomach), direct inflation may be tried. Take a deep breath and breathe it forcibly into the mouth of patient, compress the chest to expel the air, and repeat the operation. 7. DON'T GIVE UP! People have been saved after HOURS of patient, vigorous effort. 8. When breathing begins, get patient into a warm bed, give WARM drinks, or spirits in teaspoonfuls, fresh air and quiet.

Remember that you have (a) to restore animal heat, (b) to restore the circulation, (c) to induce breathing. On no account use violence, do not place the patient with his head down, nor roll the body about, nor rub it with salt, spirits, &c., and do not inject tobacco smoke. Electricity may often be resorted to with advantage. (See also Breathing.")

Ear-foreign bodies in it.--If the substance is solid and not likely to swell by water being used (such as a pea or a bean) forcibly inject lukewarm water into the ear. If this fails, and no forceps are at hand, the foreign body can often be removed by using a very finely pointed pair of scissors, or a loop made of fine wire.

Emetics. In giving emetics remember that antimonial wine is a depressant of the heart's action; the dose of it is one or two drachms in water followed by plenty of warm water. Ipecacuanha wine (half to one ounce), or sulphate of zinc (ten grains in water), followed by plenty of tepid water taken internally are far better remedies to use when the object is merely the prompt evacuation of the contents of the stomach. The readiest form of domestic emetic is mustardflour and warm water, plenty of it, followed by copious draughts of warm water. As a remedy for the spasms of croup (the idea being to make a child feel sick without being so), give it a teaspoonful every hour or two of a mixture made of two drachms of ipecacuanha wine, three drachms of syrup of Hemidesmus, half an ounce of glycerine, and water up to two ounces.

Enemas.-The best purgative enema is made by placing in a small basin of hot water, 1 ozs. of castor oil, then use ordinary soap in the water as though you were washing your hands; this thoroughly incorporates the oil with the water. To allay pain use one syringe full of warm water, with fifteen drops of Battley's sedative of opium extract. But enemas for nutrition and as anodynes are now cast aside for the nutrient and opiate suppositories, which are on sale at all chemists, although it is doubtful if the latter act as rapidly as do fluid enemata.

Epilepsy-or falling sickness.-Treatment of a fit of Lay patient on a hard bed or on the floor; plenty of air; raise head; warm clothes; keep something between jaws to prevent biting of tongue; remove false teeth; if face blue, cold water to head; give snuff to induce sneezing; there is little to be done during an attack, and epileptics should always be attended by someone, for they fall so suddenly, and are so insensible to what takes place after they have fallen, that they may, if left alone, do themselves severe bodily harm.

Eyes-Foreign bodies in.-Get the patient's head bent well backwards, drop a drop or two of olive oil between the upper eyelid and the eye, then seize the upper eyelashes, and pull the upper eyelid well forward and in front of the lower one, press it against the latter as it returns to its original position, and if the offending substance is beneath the upper eyelid (as it usually is), you will see it deposited on the lower lid. If this plan fails to remove it, pull the upper eyelid forward and look beneath it, where may probably be seen the minute substance causing the pain, which can be removed with a paper "spill," or a sharpened wooden match, or a camel hair pencil. If, however, the foreign body is embedded in the front of the eye (the cornea) it must be "dug out" with a needle. For lime in the eye, use a weak lotion of vinegar and water to which a few drops of laudanum have been added.

Fainting.-A fit of.-Patient is pale, and unconscious, skin clammy, pupils dilated, limbs loose, and he looks deadly. Lay him down, dash cold water on his face; loosen his neck; open window and door and place in a draught, and use a strong smelling bottle.

Fevers. To produce perspiration take ten grains of Dover's powder on going to bed, and an aperient on the following morning, as the opium contained in the powder may produce constipation. Fits. These are of four kinds, Epileptic, Apoplectic, Hysterical, and Fainting; all treated of under their respective heads, and all differing from each other in a way that makes diagnosis comparatively easy.

Fractures. That a bone is fractured may be seen by the distortion of the limb, and the sound caused by the broken bones. Prior to the arrival of a surgeon place the limb on pillows in as restful position, and as much as possible in its natural state. An ordinary chip band-box with the bottom out is useful to put over a limb to prevent the pressure of bedclothes, &c.

Gargle. The best form of gargle for an ordinary sore throat is made thus:-Mulberry juice two ounces, chlorate of potash, alum, and nitrate of potash of each ninety grains, syrup of tolu two ounces, acid infusion of roses up to eight ounces, add more alum if not astringent enough.

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Gunshot Wounds-are contused and lacerated. There is little bleeding unless a large vessel is divided or a vascular part injured such

as the lungs. Patient suffers from "shock." A bone may be splintered. Extract the bullet or foreign body with bullet forceps, and without enlarging the aperture of the wound, if possible. At first apply cold to the wound; but circumstances may afterwards suggest poultices. When the sloughs have separated, and suppuration has commenced to cease, it is well to apply stimulating lotion, and a bandage to support the parts. Constitutionally, it is necessary to allay the fever which is the outcome of the suppuration, and support the strength of the patient.

Hanging. The patient should be treated for suspended respiration or for apoplexy, the result of pressure on the jugular veins. (See "Breathing.") Galvanism may be used.

Hysteria. Be firm and do not sympathise with the patient, throw cold water on her face, apply ammonia to the nose, and give the following anti-spasmodic draught: Aromatic spirits of ammonia, tincture of sumbul, tincture of valerian, and spirits of sulphuric æther, of each fifteen drops. Infusion of quassia an ounce and a half.

Lockjaw-or Tetanus.-Crampy pain about the neck, the jaw, and the throat, twitching of the muscles of the face, cramp ultimately seizes the whole body which is stiff (especially the muscles of the back). Treatment in pronounced and acute cases is of but little use. Ice may be applied to the spine, and opium and Indian hemp given as a medicine, but the inhalation of chloroform is the only form of relief known. The symptoms are identical with those of poisoning by strychnia.

Mother's Milk.-Infants should not be fed on Cow's milk, which is far too strong in some respects for them to digest and too weak in others. A very good substitute for Mother's milk is made thus: Fresh milk, pint; hot water, pint; sugar of milk, I oz.; carbonate of potash, 4 grs.

Obstruction of the Bowels-causes sickness sudden and violent pains, constipation, collapse, and discharges of blood and mucus posteriorly. Give opium freely, and large injections of warm water.

Pills. The best form of dinner pill is made by mixing together a grain of powdered capsicum, a grain of Barbadoes aloes extract, a quarter of a drop each of oil of cloves and pure carbolic acid, and two grains of maltopepsin. The best form of liver pill is made of half a grain of podophyllin resin, two grains of compound scamony powder, one grain of powdered capsicum, and two grains of extract of taraxacum, one or two for a dose.

Poultices and Plasters.-The best and cleanest method of making a mustard plaster is to spread mustard such as is used for the table on rough brown paper with a knife, like butter on bread, let it remain for a minute, and then wipe it all off and apply the damp paper.

Poultices are now manufactured, and it saves trouble to buy them in the dry state and make them ready for use by placing them in boiling water. The best way to make them is to sew in a muslin bag the oatmeal or linseed meal to be used, and place the bag in boiling water, or boil it. It can be used over and over again. spongiopiline and hot water make an excellent moist hot application for all practical purposes.


Prolapsus ani-and protruding piles.-Carefully sponge the protruding part quite clean, let the patient sit over some hot water, then anoint the part with ointment of galls, opium and Hamamelis, and, with a warm soft towel, make continuous pressure, which if persevered in will result in returning the part,

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be reduced, place the patient in a warm bath, the knees bent, let him inhale a little chloroform, or give him a full dose of laudanum. Some practitioners give antimonial wine cause nausea, others invert the patient with a view of emptying the sac of fluid, others apply ice to the tumour. After the patient under the influence of the remedy, the tumour must be grasped fully and dexterously (but harshly), and manipulated with a view to reduction. Do not use force; never give purgatives; and do not delay summoning a medical



Snake Bites.-Ligature the part and excise around it as for a dog bite, encourage bleeding, and inject with a hypodermic syringe a five per cent. solution of carbolic acid, permanganate of potash, or nitro-hydrochloric acid. Give full doses of sal-volatile frequently, or strong hot brandy and water. If difficulty of breathing sets in, place strong mustard plasters on the chest. If collapse threatens resort to artificial respiration. (See "Breathing.")

Sore Throats (Infant's).-For infants who have sore mouths, take 3 drachms of glycerine of borax, a teaspoonful of warmed honey, and 10 grains of nitrate of potash (saltpetre). Mix well together, and apply to the inside of the mouth with the little finger.

Scalds. See "Burns." Stings. See "Bites."

Soothing Syrup.-Tincture of opium, 15 drops; nitrate of potash, 40 grains; syrup of saffron,


Mix well together, a little to be placed on the finger and rubbed into the child's gums Occasionally.

Strangulation.-See " Hanging."

Sudden Death.-As soon as Our arterial blood ceases to circulate, we die. There are two forms of death associated with the stoppage of arterial circulation (a) Anemia, when there is an insufficient supply of blood to the heart, and (b) Asthenia, when there is failure of the heart's muscular action. There is a form of death called syncope, which may be a combination of the two, and is really death by fainting. Death may be caused by circulation of venous blood instead of arterial, as in (a) Apnea, where no air goes to the lungs-as in drowning-and (b) by Coma, when the patient has not the power to use his chest muscles to breathe with.

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imparting a tone to some of the tissues or component parts of the body, and improving some particular function thereby.

The best and simplest tonic to use for loss of tone and appetite is a quassia cup, which when filled with water, turns the latter into a bitter infusion of quassia. If the blood requires tone,

administer iron in the form of the ammonia citrate-5 to 10 grains in a wineglassful of water; or the tincture of steel 5 to 10 drops in the same quantity of water. Sometimes the nerves lose their tone, in this case give the compound tincture of quinine, one teaspoonful in water occasionally. Where it is necessary to impart tone to the blood and the nervous system simultaneously give 5 to 10 grains of the citrate of iron and quinine, or 5 grains of the citrate of iron and strychnine, or perhaps a more elegant remedy is found in Easton's Syrup, which may be given in doses of from 40 to 60 drops in a small wineglassful of water.

Vomiting -to arrest.-The drugs specially used for this purpose are the carbonate of bismuth, the oxalate of cerium, and opiates. A very good ready-made preparation is "Seller's Compound Bismuth (or Cerium) Mixture,' twenty drops for a dose in an ounce of water. Amongst other remedies are ice, or mustard plasters to the pit of the stomach, lime water, soda water, champagne, and hydrocyanic acid.

Vomiting Blood. - Always remember that blood vomited from the stomach is nearly black, whilst blood (apparently) vomited from the lungs is of a bright red colour. Blood vomiting is associated principally with ulcerated stomach. Give large doses of astringents, such as the acid infusion of roses, alum, &c., also opium and ice, and keep the patient in the recumbent posture in a cool atmosphere.


Wounds are of six kinds.-Incised, lacerated, contused, punctured, poisoned, and gunshot. Generally speaking, it is necessary to keep all wounds disinfected, for which purpose a one or two per cent. solution of carbolic acid in water may be used. Try to induce union in simple wounds by "the first intention" by cleanliness, and approximation and support of the parts, and in contused and lacerated wounds to replace the tissues in the most favourable positions, and to keep up the vitality of the injured parts, In punctured wounds don't close them up too prematurely or before ascertaining the exact amount of the lesion, and in poisoned wounds excise the part or apply the actual or chemical cautery (see Bites).

ANTIDOTES FOR POISONS. Aconite.-See "Monks Hood."

Ammonia.-Fumes from.-Inhale the fumes of boiling vinegar or acetic or hydrochloric acid. Arsenic. Induce vomiting, and give an emetic of sulphate of zinc.

Belladonna.-Give stimulants, such as brandy and opium which antagonises the action of this drug.

Cantharides. Avoid giving anything oily, and give emetics and demulcents."

Carbonic Acid Gas.-Artificial respiration and bleeding.

Charcoal.-Artificial respiration and bleeding. Chloroform vapour of.-Fresh air, draw tongue forward, artificial respiration, ammonia to the nose, loosen the neck, encourage breathing to return.

Colchicum.-Stimulants, warmth, emetics and external friction,


Form of Proposal for Insurance Against Burglary and Housebreaking.

Subscribed Capital and Reserves exceed £370,000.

Established 1885.

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6. State the amount for which the contents are insured against Fire


1. Household Goods and Personal Effects, including Furniture, Wearing
Apparel, Linen, Books, Cutlery, Clocks, China, Glass, Wines and Cigars,
Articles of Vertu, Bric-a-Brac, Musical Instruments, Cycles, Pictures,
Prints and Drawings, and the like Articles,

2. On Jewellery, Personal Ornaments, Watches and Trinkets, Gold, Silver, and Electro-Plate,

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No one article included under headings Nos. 1 and 2 (Pianos and Organs excepted) shall be deemed to be of greater value than £25, unless specially mentioned hereunder :


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I DO HEREBY DECLARE that the whole of the answers in this Proposal are true; and I undertake to exercise all ordinary and reasonable precautions for the safety of the said property. I agree that this Declaration, and the answers annexed, shall be the basis of the contract between me and the Corporation.

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Registered Number..

be sent on application.

M.B.—If it is desired to insure for a larger amount, particulars as to premium charged will Three months' non-occupancy annually is allowed free of charge. An additional premium of 20% will be charged for each month or part of a month in excess of this period.

No Insurance is effected until the Premium is paid in full. All Claims and correspondence in reference to this Insurance to be addressed to

London Offices: 115-117, CANNON STREET, E.C.

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