SPRAIN, the partial displacement or twisting of a joint with stretching, and more or less injury to the articulating apparatus; the ligaments, tendons and their sheaths being all involved in the injury, while sometimes even small portions of the articulating processes of bones are separated. All joints are liable to this accident, but the wrist and ankle are most frequently the seat of this injury; their lia bility arising from their immobility, compared with such a joint as the shoulder, which is more liable to dislocation. A sprain is attended with violent pain, and the sufferer feels sick and faint. Swelling and discoloration rapidly take place from extravasation of blood into the sheaths of the tendons and the other surround ing tissues, through laceration of the smaller blood-vessels. Subsequently the swelling is kept up in consequence of the effusion of serum from the incited action which occurs. Thus the joint is much deformed, and great care is required in examining the parts to guard against mistakes and to gain an exact knowledge of the nature of the injury so as to ascertain decidedly and at once whether it be a simple sprain, or whether there be fracture or dislocation. For this purpose the radiograph has been most valuable. If it is a simple sprain the part af fected should be laid in an easy position on a pillow and confined in that position by broad slips of bandage crossing the limb and pinned at each end of the sides of the pillow. The
part should at first be fomented for an hour or two with cloths wrung out of warm water; afterward it is to be wrapped in cloths wetted with a warm lotion, say of sugar of lead, one dram; opium, one dram; and boiling water, one quart. These cloths, when applied, should be covered with oiled sik or cotton to prevent evaporation. Absolute rest is the principal point to be attended to. To secure this, when there is much restlessness, it sometimes be comes necessary to use splints. In case of in flammation, a purgative may assist. After the pain abates and the swelling disappears, gentle rubbing with a soap and opium liniment is well, and a light flannel bandage should be applied. If the joint remains weak and stiff, stimulat ing frictions will be found useful, also the pouring of water on the part from a height, beginning with warm water, and after a time gradually reducing the temperature till the patient can bear it cold. After each applica tion the part should be well rubbed, as other wise it may become rheumatic; rheumatism is a very common occurrence in parts injured by sprains and fractures. Too great caution can not be applied in bringing a joint which has been sprained into use, as many diseases of joints are brought on by mismanagement.