burn is extensive, or if it is not so when situated on certain parts of the body, that it may give rise to the most serious deformity, and that no efforts whatever of the surgeon can possibly prevent this. It is just to all parties to bear this fact in mind.

Sect. 2.-Swallowing Boiling Water.

Death from the accidental swallowing of boiling water, from the mouth of a tea-kettle or tea-pot, is by no means uncommon among young children. It occurs, however, chiefly among the children of the poorer classes, and is due to the pernicious habit of allowing children to drink water or cold tea from the spout of the tea-pot. I would earnestly caution parents against such a practice. In the majority of instances the child is too quickly alarmed by the pain to complete the deglutition of the boiling water, and it is no sooner in the mouth than it is immediately got rid of. But yet the tongue,

mouth, and the parts at the back of the throat are scalded by the steam, even though no water be sucked in, and the delicate mucous membrane of the pharynx (the hinder part of the mouth), and the entrance to the air passages immediately swells up, and gives rise to the most dangerous and distressing symptoms. In such cases, at once seek the aid of your medical adviser, and if possible, in an interval procure some ice, let the child suck pieces, and let everything-milk, water, or tea, be iced: apply a cold compress of ice to the neck. Such a compress is most easily made, by wringing an old soft pocket-handkerchief out of iced water and frequently renewing. If you cannot directly obtain help, you may in addition to the above measures apply ૨

a couple of leeches, one

on each side of the windpipe

Let the child be put to bed,

close beneath the chin.

and be kept as quiet as possible. Such measures will sometimes be followed by the best effects.

Sect. 3.-Bruises.

A simple, uncomplicated bruise (the appearance of which everybody is familiar with) requires very simple treatment. If more severe, the medical man must be sent for. However, until his arrival, both may be treated alike. Apply then cold water to the part, and you may put some nitre into the water, if you have any in the house to make it colder. Dip into the water a piece of linen rag, folded once or twice, and proportioned to the size of the bruise, and lay it upon it, and renew this application sufficiently often to maintain its coldness. Or you may substitute for this, if you can procure it, ice, which must be broken into small pieces, put into a bladder, and applied.

It is important to give this caution: in case the blow occur to the head of a young child, do not think too lightly of the circumstance. Its health should be watched for some time afterwards, and the medical man consulted as to its management; for want of such care, I have again and again seen serious results. One of the worst cases of convulsions that I was ever called to, was clearly traceable to a blow on the back of the head, received from a fall out of the nurse's arms two or three weeks previously, which had been all but forgotten, and thought of no consequence. If the fall or blow is followed by paleness and vomiting, never delay to place the child under medical

care.

Sect. 4.-Wounds.

These will either be clean, as when made by some sharp-cutting instrument, as by a knife, or torn, as by a broken plate, or such as would be produced by a fall on the ground and occasioned by rough gravel. In either case, if the accident be severe, medical aid must be sought; a few plain directions, however, for the management of the lesser forms of accident may be useful.

And first, of what you are not to do. Do not apply the favourite and very popular remedies, Tincture of Benjamin or Friar's Balsam; they do no good, but positive harm, by hindering the subsequent healing of the wound. Applications of this description have, in delicate children, caused a trifling cut to become a dangerous sore.

Take then a soft sponge and some cold water, and bathe the wound so as to arrest the slight bleeding which may be going on; or if you have reason to believe from the way in which the accident happened that any foreign substances are lodged in the wound, such as gravel, dirt, or glass, take tepid water and freely sponge the part until the wound is clean; but if you find that the foreign matters cannot be easily extracted, apply a bread-and-water poultice; suppuration will ensue, and the particles readily discharge themselves. Such a case, however, demands the surgeon's care, and ought to have it if possible. Having then cleaned the wound, bring the edges together, and keep them in apposition by means of strips of adhesive plaister laid across the wound. The plaister must, of course, be cut of convenient length and width to the

size of the wound: long and wide, or short and narrow, as the wound may be large or small. So dressed, it may remain for three, four, or more days, in fact so long as the dressing continues firmly attached and gives no pain: but it will generally become loose about the fourth or fifth day, and, if removed, the chances are that the wound will be found healed, or at all events the greater part of it, and to the remainder fresh dressing may be applied.

The most important point of all is to know what to do in a case of severe bleeding before the arrival of the surgeon. Pressure well applied is the remedy. For this purpose, if the wound is in the trunk, take a piece of lint or rag, double it three or four times, and keep it pressed firmly upon the part until professional assistance is obtained. In the case where the finger or any part of either extremity is wounded, a bandage should be applied over the lint, and tied tightly round the limb, so as to keep up firm and continued pressure. This advice is frequently misapplied— rag after rag is heaped upon the part, and pressure is no longer made.

Sect. 5.-Broken Limbs.

When a child meets with an accident, and it is suspected that a bone is broken from the nature of the complaint he makes and the deformity of the limb, such as its being bent, shortened, or twisted, much immediate additional suffering to the patient, and increased mischief to the injured part, may often be saved by a little care and management. In lifting the child from the place where the accident happens, and carrying him to a couch or bed, let it be one person's

business to take charge of the broken limb, and, instead of allowing it to dangle loosely, carefully place it upon a soft pillow, and tie it up firmly, so as to protect it from all jar and shaking. In this way a child or an adult may travel some distance without any fear, and with very little inconvenience. Do not attempt to undress the patient, but wait for the surgeon's arrival. In the meanwhile, the bed could be prepared; the most proper for such a patient is a firm, but not hard, mattress, with two or three under blankets for the sake of warmth.

Sect. 6.-Sprains.

If a severe sprain should occur, it ought not to be trifled with, but the surgeon consulted, for the consequences are sometimes more lasting than of a broken bone. This observation particularly applies to the sprains of the knee or ankle-joint. Even slight sprains, neglected, occasionally terminate in the establishment of serious disease, a result which a little care and prudence would have altogether prevented. Again, the cure of these accidents demands not only much care, but much patience also, for their consequences, as a stiff wrist, for instance, will require perhaps many weeks before perfect freedom of motion and use are regained.

If the knee or ankle-joint is sprained, put the child to bed; if an upper extremity, this is not necessary ; but in either case, it is rest, freedom from all motion of the injured part, that you are to aim at; place the limb therefore in that position which secures this object most completely. The best application in such a case is the ice-bag; but it must be regularly attended