Sprains

It is commonly said thafc a sprained joint is worse thaii a broken bone, and tMs is of ten true, for in a severe sprain the injury is really greater than in a simple fracturo. The ankle is perhaps the most froqnently sprained of all the joints, thcragh the knee, elbow aud wrist are also very liable to be injured, in falls especially. A sprain of a joint varies greatly in severity. It may consist of a simple wrench, without the tearing of auy of the ligaruents, or it may be a more extensive injury, stopping just short of a dislocation. In a moderately severe case onn or more of the ligaments of the joint -vt ill be torn slightly, or possibly oompletuly across. The membrane beneath the llgainents, which retains the lubricatiug fluid of the joint, will be ruptured, permitting the escape of more or lens of this fluid into the parts about, aud giving rise soruetimes to a considerable swelling. Thisswelling may be increased also by au eft'usion of fluid into the joint, especially if inflammation sets in, and finally there is usually a sligut or even sometimes a quite pronouaaed escape of blood into the tissues, and this, gradnally working to the surface, appears as a black and blue stain. In more severe cases thetendons passing over the joint and attaching the muscles which moveit to the bones may suffer considerable damage, or one of them may be brokeu or torn from its attachment, bringing with it a sliver of bone. Where so much harm has bten done to all the parts - bones, ligaments, leudons and muscles - it is easy to understaud that muoh pain will result and that the cure will be tedious. Iu tbe treatmeut of a sprain the first thiug to be aimed at is to relieve pain and prevent inflauiujatiou, then to favor healuig of tbe toru structures, and after that to restore tbe use of the limb. Tbe flrst of these objects is aecomplished by absolute ret of the iujured part, tbe liuib being raUed, aud by lead and opium wasb, a spirit lotion, or such other local applieatious as tbe pbysician may prescribe. Swelliug isprevented iú a weasure and paiu is sometinies relieved by firni baudaging witb a flannel bandage. Wbeu the swelling, beat aud pain are gone, the limb should not be used too soou, out sbould be brought gradually back to bealtb by cold douching, dry rubbiug in a directiou toward the body aud passive motiou. It is sornetimes uecessary in very severe cases to treat the sprain by means of splints, exactly as if it were a fracture or tiou.-