may
be of any degree, from the tearing of a few fibers of the membrane
enwrapping the joint to its complete rupture, together with that of
the ligaments, so that the bones are no longer in place, the joint
loses its natural shape and appearance, and we have a condition known
as dislocation. In a sprain then, the twist of the joint produces only
a temporary displacement of the bones forming the joint, sufficient to
damage the soft structures around it, but not sufficient to cause
lasting displacement of the bones or dislocation.

It will be seen that whether a sprain or dislocation results, depends
upon the amount of injury sustained. Since it often happens that the
bone entering into the joint is broken, it follows that whenever what
appears to be a severe sprain occurs, with inability to move the joint
and great swelling, it is important to secure surgical aid promptly.
Since the discovery of the X-ray many injuries of the smaller bones of
the wrist and ankle joint, formerly diagnosed as sprains by the most
skillful surgeons, have, by its use, been discovered to be breaks of
the bones which were impossible of detection by the older methods of
examination.

=Symptoms.=--The symptoms of sprain are sudden, severe pain, often
accompanied by faintness and nausea, swelling, tenderness, and heat of
the injured parts. The sprained joint can be only moved with pain and
difficulty. The swelling is due not so much to leaking of blood from
broken blood vessels as to filling up of the joint with fluid caused
by the inflammation, although in a few days after a severe sprain the
skin a little distance below the injury becomes "black and blue" from
escape of blood caused by the injury.

=Treatment.=--Since the treatment of severe sprains means first the
discrimination between dislocation, a break of bone, and a rupture of
muscle, ligament, or tendon, it follows that the methods herein
described for treatment should only be employed in slight
unmistakable sprains, or until a surgeon can be secured, or when one
is unavailable. Nothing is better than immediate immersion of the
sprained joint in as hot water as the hand can bear for half an hour.
Following this, an elastic bandage of flannel cut on the bias about
three and one-half inches wide should be snugly applied to the limb,
beginning at the finger tips or at the toes and carrying the bandage
some distance above the injured joint.

In bandaging a part there is always danger of