Ordinarily, Accidents are not Serious. Accidents will happen—even in the best regulated families! While taking all reasonable care to avoid them, it is not best to worry too anxiously about the possibility of accidents; for a nervous, fearful state of mind is almost as likely to give rise to them as is a reckless and indifferent one. Fortunately, most accidents, especially with growing boys and girls, are comparatively trifling in their results, and to a considerable extent must simply be reckoned as part of the price that has to be paid for experience, self-control, and skill. To have keen senses, vigorous and elastic muscles, and a clear head, is better protection against accidents than too much caution; it is also the best kind of insurance that can be taken out against their proving serious. The real problem is not so much to avoid accidents as to be ready to meet them promptly, skillfully, and with good judgment when they occur, as they inevitably will. As the old masters of swordsmanship used to teach, "Attack is the best defense."

Luckily, healthy children are as quick as a cat and as tough as sole-leather—if they weren't, the race would have been wiped out centuries ago. Children in their play, on errands, going to and from school, and in excursions through the woods and the fields, run, of course, a great many risks. But in spite of all these dangers, the number of children killed, or even seriously injured, in these "natural" accidents, is not half of one per cent of those who die from disease or bad air or poor food or overwork.

Another cheering thing about accidents is that ninety-nine out of every hundred of them are not serious; and if you are only wise enough to know what to do—and still more what not to do—in taking care of them, you can recover from them safely and quickly. The bodies of healthy children have an astonishing power of repairing themselves. Their bones are not so brittle as those of "grown-ups"; and even when one of them is broken, if properly splinted and dressed, it will heal up in a little more than half the time required by the adult. And wounds and scratches and bruises, if kept perfectly clean, will heal very rapidly.

Probably the commonest of all accidents are cuts and scratches. So common is it for us to "bark" our knuckles, or our shins, or scratch ourselves on nails and splinters and drive pins into ourselves, or let our pocket knives slip and cut our fingers, that, if the human skin had not the most wonderful power of repairing itself,—not merely closing up the cut or the scratch, but making the place "as good as new,"—we should be seamed and lined all over our hands, arms, faces, and limbs like a city map, or scarred and pitted like a tattooed man, before we were fifteen years old. But of course, as you know, the vast majority of cuts and scratches and tears heal perfectly. They hurt when they happen; and they burn, or smart, for a few hours, or hurt, if bumped, for a few days afterward; but they heal soon and are forgotten.

On the other hand, some cuts and scratches will fester and throb and turn to "matter" (pus) and even give you fever and headache and blood poisoning. What makes the difference? It is never the size, or depth, of the scratch or cut itself, but simply the dirt that gets into it afterward. If a cut, or scratch, no matter how deep or ragged, be made with a clean knife-blade or sliver and kept clean afterward, it will never "matter" (suppurate) or cause blood poisoning. So if you know how to keep dirt out of cuts and scratches, you know how to prevent ninety-nine per cent of all the dangers and damage that may come from this sort of accident.

Not more than one cut or scratch in a thousand is deep enough to go down to an artery, so as to cause dangerous bleeding, or to injure an important nerve trunk. So, though no one would by any means advise you to be reckless about getting cut and scratched, yet it is better and safer to run some risk of cuts and scratches in healthy play when young, and learn how to keep them clean, than to grow up pale and flabby-muscled and cowardly.

How to Prevent Infection in Wounds. It is not just dirt that is dangerous,—although dirt of any sort is a bad thing to get into wounds and should be kept out in every possible way,—but dirt that contains those little vegetable bacteria that we call germs. The dirt most likely to contain these germs—called pus germs, because they cause pus, or "matter" in a wound—is dirt containing decaying animal or vegetable substances (particularly horse manure, which may contain the tetanus, or lock-jaw germ) and the discharges from wounds, or anything that has come near decayed meat or unhealthy gums or noses or teeth. This is why a cut or scratch made by a knife that has been used for cutting meat, or by a dirty finger-nail, or by the claw of a cat, or by the tooth of a rat, is often likely to fester and "run." Animals like rats and dogs and cats often feed upon badly decayed meat; and hence their teeth, or claws, are quite likely to be smeared with the germs that cause decay, and these will make trouble if they get into a wound.

Fortunately, the care of a cut or scratch is very simple and practically the same in all cases. Just make the wound thoroughly clean and keep it so until it is healed. For a slight clean cut or scratch, a good cleanser is pure water. Hold the hand or foot under the faucet or pump, and let the cool water wash it out thoroughly. If you are sure that the thing you cut it with was clean, let the blood dry on the cut and form a scab over it. If the wound is large, or there is any danger of the water of the well, or tap, having sewage in it (see chapter IX), it is better to boil the water before using it. Unless the blood is spurting in jerks from a cut artery, or bleeding very freely indeed, it is better to let the wound bleed, as this helps to wash out any dirt or germs that have got into it. When the bleeding has stopped, do not put on sticking plaster, because this keeps out the air and keeps in the sweat of the skin surrounding the wound, which is not healthful for the wound, and may also contain some weak pus germs.

If the wound is small, the old-fashioned clean white rag that has been boiled and washed is as good as anything that can be used for a dressing. Tear off a narrow strip from one to two inches wide and as many feet long, according to the position of the wound, roll it round the finger or limb three or four times, and then take a turn round the wrist or nearest joint, to keep the bandage from slipping off. If the wound be likely to keep on oozing blood, put on first a thickness of surgeon's cotton, or prepared cotton-batting, an ounce of which can be purchased for ten cents at any drugstore. This is an excellent dressing, because it not only sucks up, or absorbs any oozing from the wound, but is a perfect filter-protection against germs of all sorts from the outside. Ninety-nine simple wounds out of a hundred dressed in this way will heal promptly and safely without danger of pus, or "matter."

If the wound happens to have been made with a knife or tool that you are not absolutely sure was perfectly clean, or if the wound gets manure or road-dirt or other filth rubbed into it, then it is best to go at once to a doctor and let him give it a thorough antiseptic dressing, which consists of cleaning it out thoroughly with strong remedies, called antiseptics,—which kill the germs, but do not injure living tissues,—and then putting on a germ-proof dressing as before. This is one of the "stitches in time" which will save not only nine, but ninety-nine.

If you have a wound with dirt in it, and cannot reach a doctor, one of the best and safest antiseptics to use is peroxide of hydrogen. This is non-poisonous, and can be poured right into the wound. It will smart and foam, but will clean out and kill most of the germs that are there. Another safe antiseptic is pure alcohol. It is a good thing to have a bottle of one of these in the medicine-closet, or in your "war-bag" when camping out. A package of surgeon's cotton and two or three rolled bandages of old cotton, linen, or gauze also should be on hand.

Dog-bites, rat-bites, or cat-bites should always be dressed by a doctor, or made thoroughly antiseptic, mainly on account of the germs that swarm round the roots of the teeth of these animals, and also because treatment of this sort will prevent hydrophobia—although this danger is a rare and remote one, not more than a few score of deaths from mad-dog bites occurring in the whole United States in a year.

The wonderful progress made by surgery within the last twenty or thirty years has been almost entirely due to two things: first, the discovery of chloroform and ether, which will put patients to sleep, so that they do not feel the pain of even the severest and longest operation; and, second, but even more important, keeping germs of all kinds out of the wound before, during, and after the operation. That sounds simple, but it really takes an immense amount of trouble and pains in the way of baking the dressings; boiling the instruments, and scrubbing with soap, alcohol, hot water, and two or three kinds of antiseptics, or germ-killers, the hands of the surgeon and of the nurse and the body of the patient. How enormous a difference this keeping of the germs out of the wound has made may be gathered from the fact that, while in earlier days, before Lister showed us how to avoid this danger, surgeons used to lose seventy-five per cent of their amputations of the thigh, from pus infection, or blood poisoning, now they can perform a hundred operations of this sort and not lose a single case. We can open into the skull and remove tumors from the brain; open into the chest and remove bullets from the lungs, and even from the heart itself; operate in fact upon any part, or any organ, of the body with almost perfect safety and wonderful success. Whereas, before, two-thirds of the patients so operated upon would die, probably of blood poisoning.

How to Treat Bruises. Bruises are best treated either by holding the injured part under the faucet, or pump, if convenient, or by plunging it into very hot water and holding it there for ten or twelve minutes. Then if the bruise still continues to throb or ache, wrap it up lightly with a bandage of soft, loose cotton or linen cloth, and pour over it a lotion of water containing about one-fourth alcohol until the bandage is soaked, moistening it again as fast as it dries. This is also a useful treatment for wounds that have been made by a fall, or by something blunt and heavy, so that there is bruising as well as cutting. Most of the household applications for wounds or bruises, such as arnica, camphor, witch-hazel, etc., owe their virtues to the five or ten per cent of alcohol they contain, which, by evaporating, cools the wound and relieves inflammation, kills germs and so acts as an antiseptic, and cleans the wound and the skin around it very thoroughly and effectively.

Bruises of all sorts, however, unless very severe, are much safer than cuts or scratches, because they do not break the skin, and consequently no germs can get into the tissues of the blood. Our skin, as you remember, is one of the most wonderful water-proof, germ-proof, hot-and-cold-proof coatings in the world; and as long as it remains unbroken, none but a few of the most virulent disease-germs can get through it into the body.

Boils and Carbuncles, their Cause and their Cure. Boils and carbuncles are almost the only instances in which pus germs can get into the body without some actual cut, tear, or breaking of the skin. They come always from other boils or ulcers or discharging wounds and are caused by the pus germs in these either being rubbed into the skin until it is almost chafed through, or else being driven down into the mouth of one of the hair follicles, or "pores." Here they proceed to grow and form a little gathering, which soon turns to pus; and this stretches the skin and presses upon the sensitive nerves in it so as to cause much pain. The best way to treat them in the beginning is to give a thorough scrubbing with hot water and soap, and then to drop right over the point, or "head," of the gathering two or three drops of a strong antiseptic, like formalin or peroxide or carbolic acid. If this does not check them, then they had better be opened up freely with a sharp knife that has been held in boiling water, or a needle that has been held in a flame until it is red hot and allowed to cool. Then pour peroxide into the opening, put on a light dressing, and keep soaked with alcohol and water, as for a bruise. This evaporating dressing is far superior to the dirty, sticky, germ-breeding poultice. If this does not clear it up within twenty-four hours, go to a doctor and have him treat it antiseptically.

How to Stop Bleeding. If a cut should go deep enough to reach an artery the size of a knitting needle, or larger, then the blood will spurt out in jets. There is then some danger of so much blood being lost as to weaken one. Our blood, however, has a wonderful power of clotting, or clogging, round the mouth of the cut artery, so that the risk of bleeding to death, except from quite a large artery, like that of the thigh, or the armpit, is not very great.

For a wound in the hand or foot, that spurts in this way, it will usually be sufficient to grasp the arm firmly above the wrist or the elbow, or the ankle, as the case may be, with the thumb over the artery, or even to press directly over the wound, until the bleeding stops and the blood is thus given a chance to clot. If the wound is small and deep, like that made by the stab of a knife, or the slip of a chisel, then firm pressure directly over the wound itself with a thumb, or both thumbs, will usually be sufficient to stop the bleeding.

Should, however, the spurting be from an artery like that of the pulse, or from that at the bend of the elbow or the knee, then the best thing to do is to tie quickly a handkerchief or strip of tough cloth loosely around the limb above the wound and, slipping a short stick or bar into the loop, twist upon it, as shown in the picture, until the blood ceases to flow from the wound. It is much better to use a handkerchief or piece of cloth than a cord, because the latter may cut into and damage the tissues, when drawn as tight as is needed to stop the circulation. It is not best to allow a bandage twisted tight enough to stop the circulation—called a tourniquet—to remain tight for more than half an hour at a time, as this may give rise to very dangerous congestion, or serious "blood starvation" of the tissues below it. It should be gently untwisted every half hour until the arm, or limb, below it reddens up again, and then, if the spurting begins, should be tightened as before. There is, however, a good chance that if the cut artery is not too large, the blood will have clotted firmly enough in this time to stop the bleeding; though the tourniquet had better be left on the arm, ready to be tightened at a moment's notice, until the doctor comes.

The Treatment of Burns. Burns require more careful treatment on account of the wide surface of the skin usually destroyed. The layer of the skin that is most alive and most active in the process of repair is the outer layer (the epithelial, or epidermis). A burn, or scald, if at all severe, is likely to destroy almost the entire thickness of this, over its whole extent. This gives both a wide surface for the absorption of pus germs and a long delay in "skinning over," or healing. As the same heat that made the burn has usually destroyed any germs that may be present, it is not necessary to wash or clean a burn, like a wound, unless dirt has been rubbed or sprinkled into it after it has been made. The first thing to be done is to coat it over so as to shut out the air; and this, for a slight burn, can be very well done by dusting it over with baking soda or clean flour or with one of the many dusting, or talc, powders on the market, containing boracic acid, or by laying over the burn a clean cloth soaked in perfectly clean olive oil or vaseline. If the oil or vaseline is not perfectly clean, put it on the top of a stove and heat it thoroughly before using. Dress with soft, clean cotton rag or lint as before, keeping wet with the alcohol lotion (one part of alcohol to eight of water) if there be much pain, or throbbing.

If the burn is deep or the pain at all severe, it is best to call in a doctor, as bad burns are not only agonizingly painful, but also very dangerous on account of the wide, raw surface that they leave open to entrance of pus germs for days and even weeks. Until a doctor can be secured, coat it over with some non-irritating powder or oil, as for lighter burns, or hold it in warm water to exclude the air. Do not try to clean a burn. You only increase the pain of it and probably add to the risk of infection.

If your clothing ever catches fire, wrap yourself up at once in a blanket or rug to smother the flame. Remember that running will supply more air to the flame and cause it to do more damage. If you have nothing at hand in which to wrap yourself, lie down on the floor, or ground, and roll over and over until you have smothered the flame.

What should be Done in the Case of Broken Bones, or Fractures. Broken bones, or fractures, as they are called, are more serious, but fortunately not very common. They should, of course, always be treated by a doctor, to prevent shortening of the limb, or to prevent the bones from growing together at an angle, or in a bad position, so as to interfere with the use of it. Where a doctor cannot readily be had, or the patient has to be taken to him,—as, for instance, where the accident occurs out in the woods,—take two light pieces of board, or two bundles of straight twigs, or two pieces of heavy paper folded fifteen or twenty times—two folded newspapers, for instance—and, wrapping them in cloth or paper, place one on each side of the broken limb, at the same time gently pulling it straight. Then take strips of cloth, or bandage, and bind these splints gently, but firmly and snugly, the length of the limb, so that it cannot be bent in such a way as to make the ends of the bone grate against each other. The patient can then be lifted, or carried, with comparative comfort. Most fractures, or broken bones, in children or young boys or girls, heal very rapidly; and if the limb be properly straightened and splinted by competent hands, it will be practically as good and as strong as before the accident.

Sprains. Sprains are twists or wrenches, of a joint, not severe enough to "put it out," or dislocate it, or to break a bone. A mild sprain is a very trifling affair, but a severe one is exceedingly painful and very slow in healing. The best home treatment for sprains is to hold the injured joint under a stream of cold water for ten or fifteen minutes and then to bandage it firmly and thoroughly, but gently, with a long "figure-of-eight" bandage, wound many times, and to keep this moist with an alcohol lotion. Then keep the limb at rest. If the cold water does not relieve the pain, plunge the joint into water as hot as you can comfortably bear it and keep it there for ten or fifteen minutes, adding fresh hot water to keep up the temperature; then bandage as before.

If the pain should not go down under either of these treatments within six or eight, certainly within ten or twelve, hours, it is far wisest to call a doctor, because severe sprains very often mean the tearing of some important tendon or ligament, and the partial fracture of one of the bones of the joint. Unless these conditions are promptly corrected, you may be laid up for weeks, and even months, and left with a permanently damaged—that is, stiffened—joint. You will often hear it said that a sprain is harder to heal than a fracture; but that kind of sprain usually includes a fracture of some small portion of a bone, which has escaped notice and proper treatment. If the sprain is mild, so that it does not pain you when at rest, then the bandage should be removed every day, and the joint gently rubbed and massaged, and the bandage replaced again. Should there be any one in reach who understands massage, a thorough massaging right after the accident is quite helpful; but no amateur had better attempt it, as unskilled rubbing and stretching are likely to do more harm than good.

What to Do in Case of Poisoning. Poisoning is, fortunately, a rare accident; and the best thing to be done first is practically the same, no matter what poison—whether arsenic, corrosive sublimate, or carbolic acid—has been swallowed. This is to dilute the poison by filling the stomach with warm water and then to bring about vomiting as quickly as possible. This can usually be done by adding a tablespoonful of mustard to each glass of warm water drunk. If this cannot be had, or does not act within a few minutes, then thrusting the finger as far down the throat as it will go, and moving it about so as to tickle the throat, will usually start gagging; or a long feather may be dipped in oil and used in the same way. It is also a good thing to add milk or white of egg or soap to the water, or to mix a little oil or plaster scraped off the wall with it, as these tend to combine with the poison and prevent its being absorbed. If the poison happens to be an acid, like vitriol, then add a tablespoonful or more of baking soda to the hot water; if an alkali, like lye or ammonia, give half a glass of weak vinegar. The main thing, however, is to set up vomiting as quickly as possible.

It may be distinguished from woodbine by its leaves in groups of three (not five), glossy and smooth-edged (not dull and saw-toothed); its berries greenish-white (not blue).