to, and care must be taken that fresh ice is supplied as often as is necessary. The sprained parts generally become hot and inflamed, and the ice soon melts. The success of the ice treatment depends on a regular and constant temperature. Sometimes, however, the cold is disagreeable to the patient, and cannot be tolerated; then apply hot fomentations or hot poultices; the sprain will get better under either plan of treatment, provided it have been well carried out; with absolute rest in bed, and such other measures as may seem indicated for instance, a dose of purgative medicine. In the later stages, the limb must be cautiously but regularly used in order to overcome the stiffness, which will generally be in proportion to the length of time during which its movements have been suppressed.

In reference to the poultice, a better and more cleanly remedy is the water dressing, which consists in passing a piece of lint or rag twice or thrice round the injured part, and saturating it with tepid water, and then carefully covering the whole with oiled silk; this prevents evaporation, and thus the whole part is kept in a continual soothing vapour-bath. This application is a much less troublesome one than the poultice, and answers equally well.

Although the accident in the first instance may have been thought slight, yet if after the application of the fomentations for an hour or two the child complain of much pain, it is always wise to send for medical aid; leeches or other treatment may now be necessary, and delay in the use of such measures might be mischievous.

Sect. 7.-Foreign Bodies in the Ears and Nose.

A foreign body occasionally gets into the ear or up the nostril of the child. If it be a hard substance, such as a glass bead or a shell, its remaining in a few days will not be of much consequence, and it may probably drop out, unless indeed it has been forced in; but if it be a pea, or bean, or seed, indeed anything of a kind that can imbibe the moisture of the part, and so become swollen, the sooner it is removed the better, for the longer it remains, the firmer, from its increasing size, will it be fixed, the greater suffering will it give, and the more difficult will be its removal.

'If the pea or shell be in the nostril,' says Mr. South, 'the child should be made to draw his breath in deeply, and then, closing the other nostril with the finger, and closing the mouth firmly, to snort forcibly through that side of the nose in which the substance is lodged. If this be done soon after the accident, two or three efforts usually shoot the unwelcome lodger out. But if this do not succeed, the nose might be tightly nipped with the finger and thumb above the pea or shell, so as to prevent it getting further in, and then the eyed end of a bodkin or probe, having been a little bent, must be gently insinuated between the bottom of the nose and the substance, and when introduced sufficiently far, must be gently used as a hook to bring it down. Pushing it back into the throat should not be tried, as not unfrequently so doing only fixes it the more firmly. If a doctor be within reach, it is better at once, if the substance cannot be snorted out, to take the child to him, as he will be able to manage the matter better and more readily the earlier he is applied to.

'It is of much greater consequence when anything has been pushed into the ear, as, though the passage is short, its nearly circular form and smooth surface more readily permit its being quickly thrust almost to, or even quite down to the drum of the ear. The passage is also so narrow that it is difficult to get in either the end of a bodkin or eyed probe between the substance and the ear-passage, and not unfrequently, indeed, it is pushed farther in. If it were advisable to attempt the early removal of any swellable body from the nose, it is ten times more so when such is lodged in the eartube, nearly the whole of which being unyielding, the agony which the swelling body produces by its enlargement is extreme. The doctor therefore should be immediately sought for. No syringing with water or any other fluid should be resorted to, as it will excite the pea to swell, and increase the mischief; and dry heat alone must be employed.

'If, however, a hard body, as a shell or button, or bead, be pushed into the ear, syringing with water may be used with advantage, as if the water pass in any way between the hard body and the ear-drum, it will not unfrequently force it out. The head should be laid down, so that the ear in which the hard body is, should be undermost, and in this position the water should be thrown up with the syringe, the nozzle of which, however, must be held at some little distance, and not put into the pipe of the ear, or it will prevent the hard body dropping out. Whilst the head is thus laid on its side, I have known the offender ousted by a smart box on the other ear.' 1

1 Hints on Emergencies, p. 299.

Sect. 8.-Choking.

Some children eat much too fast; they bolt their food rather than eat it; and now and then a large portion sticks by the way; sometimes a fish bone or other bone is swallowed, and is similarly placed;-sometimes a metallic body, as money. Now any one of these substances may stick at the back of the throat— in the gullet itself, higher or lower-or may at once pass down into the stomach.

If the first take place whilst the child is eating, and he appears choking, it is always advisable immediately to thrust the finger and thumb as far back into the throat as possible, and if there be anything there, to attempt to pull it out at once; whilst you are doing this sometimes a fit of coughing will take place and expel it.

If the second occur, a child for instance eating hastily and carelessly, and bolting a large piece of meat, it sticks in the gullet, make the child take large draughts of water, and at the same time make powerful efforts to swallow; the water will frequently dislodge the food, and both pass down into the stomach together; but if this happy result does not take place, medical aid must be obtained forthwith. If it be a piece of bone or a pin that is swallowed, and it lodges by the way, there need be no alarm, but instead of water, first give the child a crust of bread, see that he chews it coarsely, and then make him swallow it, taking at the same time a gulp or two of water, and the chances are in favour of the bone or pin being carried down into the stomach.

Of the treatment of things that pass down at once

into the stomach, such as pieces of money, buttons, and many articles of a like kind which children, playing with, frequently put into the mouth, and sometimes swallow, little need be said, for they are seldom followed by any serious consequences. Sooner or later the foreign body passes through the alimentary canal with the food, and is thus got rid of. I may add, however, that in this case it is a very common practice -and a very foolish one-to give repeated doses of aperient medicine; now unless the bowels should become confined, such a measure is rather injurious than useful.

Of substances getting into the windpipe it would be useless to say anything to the unprofessional reader, except-Send for the doctor.

Sect. 9.-Stings of Insects.

Children are perhaps more frequently stung by bees and wasps than adults. The first thing to be done is to examine the wound with a lens, and if the sting is still in, to extract it with a pair of fine forceps or tweezers. If only part is left, this will be attended with difficulty; but by gently squeezing the sides of the wound, it may sometimes be pressed out. Then the best remedies to apply to the part are, either turpentine, hot vinegar, spirits of wine, eau de Cologne, or olive oil. If none of these are at hand, cold water simply will give great relief if used continuously. If the wound should look very angry or become very painful, a bread-and-water poultice or water dressing will be the best application. Subsequently if any oedematous swelling remains, a piece of soft linen soaked in soap liniment may be used.