30. Apoplexy.-a. This is a sudden loss of consciousness caused by the bursting of a blood vessel in the brain that permits a clot to form that causes pressure upon the brain and interference with the brain function. Associated with this condition is a certain amount of paralysis of some parts of the body, usually one side, such as the right hand and right leg. Such a condition is ordinarily known as a "stroke of paralysis." The persons usually afflicted are those advanced in years-persons over 50 years of age, as a rule.

b. The person usually falls to the ground very suddenly, as if he had been shot, becomes unconscious immediately and can not be aroused. The face is flushed and the pupils are usually widely dilated, or one may be dilated and the other contracted. The breathing is slow, irregular, and sometimes snoring, and the cheeks puff out with each expiration. Convulsions sometimes occur. There is usually paralysis of one side of the body, which may be ascertained by lifting up the hands and legs and allowing them to 1a!! slowly to the side. The one that is paralyzed will be cold and lifeless and drop like a dead weight, while the other will be normal.

Send for a physician at once. Place the patient in a horizontal position, keep him absolutely quiet and warm, and loosen all tight clothing. In fact, treat the case the same as a case of nervous shock or collapse following accident. Do not give any kind of stimulating liquors, as that would only tend to increase the hemorrhage of the brain and produce a larger clot.

c. Apoplexy is frequently mistaken for intoxication, and it often happens that a person suffering from apoplexy is sent to the police station as a case of intoxication, put in a cell, and left to die for want of correct diagnosis and proper treatment.

d. Intoxication differs from apoplexy in that paralysis occurs in apoplexy and does not occur in intoxication. In intoxication the pulse is rapid and the odor of alcohol is always present and sometimes the cause of the trouble may be found in the hip pocket. Alcoholics can usually be aroused, answer questions and then fall asleep again, but in apoplexy it is impossible to arouse the person.

31. Intoxication.-Intoxication is a condition of more or less unconsciousness following the use of too much alcoholic liquids. The person unconscious as the result of intoxication is simply "dead drunk."

The face is flushed and bloated, the eyes reddened, bloodshot, and glassy, the pupils are usually dilated and fixed, breathing slow and regular, and the breath loaded with the odor of alcohol. The patient can be aroused and will answer questions but readily returns to a state of unconsciousness.

An ordinary case of intoxication does not require any particular treatment. Always be careful to remember the possibility that a person may be suffering from apoplexy. It is generally a good scheme to remove the alcohol from the stomach and this can be done by producing vomiting by the use of a tablespoon of salt or mustard in a cup of warm water. Aromatics spirits of ammonia is very useful to help sober a drunken person-one-half to one teaspoonful in a cup of water. Afterwards put the person to bed and let him sleep it off.

32. Wood alcohol poisoning.-The extensive use of this substance as a combustible solvent for shellac, etc., and as an adulterant for alcoholic beverages and medicines has given rise to numerous cases of poisoning. Since refined wood alcohol may not be readily recognized, except upon care

ful examination, it is to be expected that it will be used frequently by the unscrupulous in beverages offered for sale. Cases of wood alcohol poisoning recently have become more numerous and poisoning may be encountered in the future among military personnel. The poisonous properties of wood alcohol may be increased by impurities. However, the wood alcohol itself is poisonous and is the agent usually responsible for the symptoms which occur after the drinking of anything containing it in poisonous quantities. Wood alcohol should never be applied to the body externally or internally. Its presence in foods and drugs is prohibited by law. If required to handle anything containing wood alcohol precautionary measures should be taken not to inhale its vapors.

Shortly after drinking wood alcohol there will be pain in the abdomen, general weakness, nausea, vomiting, and even vertigo and headache. The symptoms of ordinary alcoholic poisoning, namely, delirium, restlessness, unconsciousness, and coma are also present. Occasionally convulsions occur. The pupils are usually dilated. Loss of vision may also occur. Not infrequently this symptom does not manifest itself until from two to four days after the patient has apparently recovered from the acute symptoms. Total blindness may occur. When you know that a patient has taken wood alcohol, send for a doctor immediately. Meanwhile, keep the patient warm, and, if possible, cause him to vomit, if you have any of the ordinary means at hand. 33. Freezing. The part frozen, which looks white or bluish white, and is cold, should be very slowly raised in temperature by careful rubbing with snow or ice and water in a cool place and never near a fire. Stimulants are to be given cautiously, when the patient can swallow, and followed by small amounts of warm liquid nourishment. The object is to restore the circulation of the blood and the natural warmth gradually and not violently. Care and patience are necessary to do this.

34. Transportation.-The carriage of patients for moderate distances on or from the field is best done with the service litter, and when that can not be procured by some improvised substitute which secures the comfort and safety of the person disabled. These methods and those by one or more bearers are fully described in the preceding paragraphs and are not repeated here.

35. Improvisation of litters.-Many things can be used for this purpose: Camp cots, window shutters, doors, benches, ladders, etc., properly padded.

a. Litters may be made with sacks or bags of any description, if large and strong enough, by ripping the bottoms and passing two poles through them and tying crosspieces to the poles to keep them apart. Two, or even three, sacks placed end to end on the same poles may be necessary to make a safe and comfortable litter.

b. Bedticks are used in the same way by slipping the poles through holes made by snipping off the four corners.

c. Pieces of matting, rug, or carpet trimmed into shape may be fastened to poles by tacks or twine.

d. Straw mats, leafy twigs, weeds, hay, straw, etc., covered or not with a blanket, will make a good bottom over a framework of poles and cross sticks.

e. Better still is a litter with bottom of ropes or rawhide strips whose turns cross each other at close intervals.

f. Litters may also be improvised by lashing two short poles about 2 feet long across two long poles with bandages or other materials and securely lashing a blanket, shelter half, or poncho over this; or rope, wire, or other similar material may be woven between the poles and this network covered with a blanket.

g. The usual military improvisation is with blankets or shelter tents and poles about 7 feet long. The blanket is spread upon the ground, one pole is laid across the center of the folded blanket, which is folded back over to the first pole. Should it be desirable, the following methods may be used:

(1) One-half of the blanket is rolled lengthwise into a cylinder, which is placed along the back of the patient, who has been turned carefully on his side. The patient is then turned over upon the blanket and the cylinder unrolled on the other side. The poles are then laid down and rolled tightly in the blanket, each a like number of turns, until the side of the body of the patient is reached.

(2) A litter may also be prepared with two poles and two or three blouses by turning the blouse lining out and buttoning them up, sleeves in, when the poles are passed through the sleeves, the backs of the blouses forming the bed.

36. Methods of removing wounded without litters.-a. By the rifle seat.— A good seat may be made by running the barrels of two rifles through the sleeves of an overcoat, turned inside out and buttoned up, sleeves in so that the coat lies back up, collar to the rear. The front bearer rolls the tail tightly around the barrels and takes his grasp over them; the rear bearer holds by the butts, trigger guards up.

b. A stronger seat is secured in the following manner.-A blanket being folded once from side to side, a rifle is laid transversely upon it across its center, so that the butt and muzzle project beyond the edges; one end of the blanket is folded upon the other end and a second rifle laid upon the new center in the same manner as before. The free end of the blanket is folded upon the end containing the first rifle, so as to project a couple of inches beyond the first rifle. The litter is raised from the ground with trigger guards up.

c. By one bearer.-A single bearer may carry a patient in his arms or on his back. (Pls. 18 and 19.)

(1) The bearer, turning patient on his face, steps astride his body, facing toward the patient's head, and with hands under his armpits lifts him to his knees; then, clasping hands over abdomen, lifts him to his feet; he then, with his left hand, seizes the patient by the left wrist and draws left arm around his (the bearer's) neck and holds it against his left chest, the patient's left side resting against his body, and supports him, with his right arm about the waist.

From this position the bearer, with his right arm upon the patient's back, passes his left under thighs and lifts him into position, carrying him well up.

The patient is first lifted erect, as described in previous paragraphs, when the bearer with his left hand seizes the right wrist of the patient and draws the arm over the head and down upon his left shoulder, then shifting himself in front, stoops and clasps the right thigh with his right arm passed between the legs, his right hand seizing the patient's right wrist; lastly, the bearer with his left hand grasps the patient's left and steadies it against his side, when he rises. (Pl. 20.)

The patient is lifted erect (as described), when the bearer shifts himself to the front of the patient, back to the patient, stoops, and grasping his thighs brings him well upon his back.

As the patient must help himself by placing his arms around the bearer's neck, this method is impracticable with an unconscious man. (Pl. 21.)

(2) In lowering the patient from these positions the motions are reversed. Should the patient be wounded in such a manner as to require these motions

to be conducted from the right side instead of left, as laid down, the change is simply one of hands-the motions proceed as directed, substituting right for left and vice versa.

d. By two bearers.-Besides the methods (already. described) for carrying patient to litter. By the extremities:

The bearers take position at patient, one man between the patient's legs and one at his head, both facing toward his feet. (Pl. 22.)

The rear bearer, having raised the patient to a sitting posture, clasps him from behind around the body under the arms, while the front bearer, standing between the legs, passes his hands from the outside under the flexed knee, both rise together.

This method requires no effort on the part of the patient, but is not applicable to severe injuries of the extremities.

e. To place a patient on horseback.-The help required to mount a disabled man will depend upon the site and nature of his injury; in many cases he is able to help himself materially. The horse, blindfolded if necessary, is to be held by an attendant.