BACKWOODS SURGERY

BACKWOODS
SURGERY &
MEDICINE

By
CHARLES STUART MOODY, M. D.

MCMX
OUTING PUBLISHING COMPANY
NEW YORK

Copyright, 1910, by
OUTING PUBLISHING COMPANY
Entered at Stationer's Hall, London, Eng.
All rights reserved

CONTENTS

HOW TO TREAT FRACTURES,
SPRAINS AND DISLOCATIONS

Backwoods Surgery and Medicine

CHAPTER I
HOW TO TREAT FRACTURES, SPRAINS AND DISLOCATIONS

Several years ago I stood beside a cot in a hunter's cabin in the heart of the Bitter Root Mountains in Idaho, after a three days' ride, and watched a valuable young life go out as the result of an unattended compound fracture of the thigh. At another time I amputated a leg to prevent the spread of gangrene from a simple cut across the instep while the camper was splitting wood, an accident which, properly treated, would have resulted at most only in a slight inconvenience. Once again, I transformed my boat into a funeral barge and conveyed a young man who had only been in the water three minutes back to his sorrowing parents dead, because his companions were ignorant of how to resuscitate him.

These and many other instances that have come under my observation of the sacrifice of lives from trivial causes, owing to a lack of knowledge, have impressed me with the value of a few suggestions on how to treat the commoner injuries and diseases that may befall those who seek recreation in the remote wilds.

The rules will necessarily be brief and from the nature of things easily followed. The woods loafer should learn them and be prepared whenever the occasion arises. Works on first aid, written ostensibly for the guidance of the laymen, are apt to presuppose a far greater supply of surgical necessities than the hunter cares to burden himself with. It is one thing to apply surgical measures, having at hand a well-filled emergency bag, and quite another to render the same assistance with nothing to depend upon but your native adaptability. My intention is to tell in the plainest and simplest manner possible how to render intelligent assistance to an injured comrade, using only the fewest appliances and those of the most primitive character. These hints are the result of over twenty years of life in the West, in mining camps, cow camps, logging camps, and in the heart of the mountains, where people did not have forethought enough to provide themselves with even a bandage, many times hundreds of miles from where such things could be obtained.

The most appalling accident that can befall a man isolated from skilled surgical aid is the fracture of a limb, especially of the leg, and yet this is one of the commonest of all woods misfortunes.

Before proceeding to the discussion of individual fractures, a brief consideration of the classification and detection of fractures in general is necessary. Surgeons divide fractures into: simple, those where there is a simple separation of the bone without injury to the flesh; compound, where in addition to the separation of the bone there is laceration of the flesh and one or both ends of the bone are driven out through the skin; and comminuted, where the bone is in several fragments. A comminuted fracture may be either simple or compound, according as it does or does not penetrate the flesh.

The symptoms of fracture are pain, loss of motion, change of position, change of contour of the fleshy parts, and most important of all, a light crackling sound when the limb is moved—crepitation the surgeons call it.

Pain following an injury that might produce a fracture is not necessarily proof positive of the existence of a fracture. Pain may and often does follow a bruise, sprain, or dislocation, in a greater degree than that following a fracture. Loss of motion, too, is quite as marked in dislocations and severe sprains as in fractures. Change of contour, unless in the locality of prominent joints, is quite a valuable sign. The fractured limb, except in certain rare cases, will show a change in the appearance of its general outline.

By crepitation is meant that characteristic grating sound produced by rubbing the two ends of the fractured bone together. It is the one absolute sign of a fracture, and once heard can never be forgotten. It may be likened to the sound produced by rubbing two or three coarse hairs between the finger and thumb.

If a fracture is suspected let the patient himself, or some one for him, grasp the limb above and below the site of the suspected fracture and turn it in opposite directions. If a fracture is present it will be manifested by a distinct grating sound, also by a jarring sensation as the uneven fragments pass over each other.

A description of all the fractures of the different bones of the body would be manifestly out of place in a book of this character, so I shall confine myself to those most liable to be encountered in the woods—that is, fractures of the leg, thigh, forearm, and arm. Fractures of the leg or thigh will entail an enforced stay of from four to six weeks in the woods, or the devising of some means to transport the patient to a place where he can have proper care, an arduous task in a country where there are no roads and the trails are difficult. If a personal experience may be allowed, I will tell how I once treated a man with fractured thigh and conveyed him with comparatively little discomfort over sixteen miles of rugged mountain trail and some forty miles of equally rugged mountain road.

I found the man in a mining camp in the very heart of the higher mountains, lying in his bunk with a badly fractured thigh. The bone was separated between the upper and middle third—that