A Sprain, or subluxatio, happens most frequently in the wrists, knees, and ankles; and is usually occasioned by a slip, or some sudden effort or violent exertion.

Sprains of the tendons and ligaments are usually productive of an immediate painful and inflammatory swelling. In severe sprains there is often not only an increased action of the arteries in the inflamed part, but there is likewise an instantaneous effusion from the rupture of some of the small vessels. In general, we may suppose the effusion to be of the serous kind, as the skin is not altered in colour for some time after the accident; but it sometimes happens that the tumid parts are either of a deep red or leaden colour from the very first, owing to blood being extravasated from the ruptured vessels.

In the treatment of sprains, two circumstances are very properly attended to by the faculty: the first, to prevent, by all possible means, the swelling from arising at any considerable magnitude; the second, to employ those remedies that are known to be powerful in removing inflammation.

To answer the first of these intentions, restringent applications, such as vinegar, ardent spirits, and the lees of red wine, are made use of. It is recommended to immerse the injured part in any of these immediately on receiving the injury; the effusion will be rendered much less than it otherwise would be, and perhaps prevented altogether. Cold water is also used soon after the accident, and is, doubtless, as a preliminary step to other applications, often attended with the best effects.

Local bleeding, leeches, and where fever is concomitant, as it sometimes is, in violent cases, opiates, together with refrigerants, and the remedies which prove useful in other inflammations producing fever, are administered. Proper rest is absolutely necessary for the limb, which never should be kept in a pendent position.

This is the usual method of treatment by the faculty; in all instances of sprain I have effected the most complete and permanent cures.

Case I

Brighton, Charles-street, April 25, 1820.

Sir, - It is with the greatest pleasure that I have to inform you of the benefits I have derived from the use of your Indian Shampooing Baths, after I had almost despaired of finding any restorative. I think I should be acting ungratefully and unjustly to the character of the Bath, if I did not make my case known as much as possible, for the service of others labouring under a similar complaint.

Mv lameness in the hip arose from over exertion or a sprain in riding, having travelled nearly four hundred miles in the course of a few days; I was taken ill the day after I had completed the journey (about the 21st of February, 1819,) accompanied with the most extreme pain in my right leg; in the course of a fortnight, by the constant application of Bathing Spirits, I found myself much better, when I walked from London to Chelsea, which increased my lameness very much, I was attended by a surgeon at Chelsea for some time, and then applied to Mr. Astley Cooper, who advised warm bathing and sea air. I left Chelsea for Brighton in April 1819, when I took the warm water and Vapour Bath, and continued them for four months with blisters on the hip; at the time of bathing I was electrified and cupped several times, without receiving any benefit; at this time I was not able to walk without my two crutches and a sling. I was lifted in and out of bed by two people, and attended during my stay at Brighton by four medical gentlemen:-- finding no relief from them, or the bathing, I returned to town in September 1819, and continued to get much worse; my health and strength daily decreased, and the flesh on my hip, thigh, and leg, was wasting fast away; my doctors thinking me in a decline, advised my return again to Brighton for the benefit of the bathing, at which time I had two large places open on my hip, sufficient to contain sixty peas.

I returned to Brighton in 1820, when hearing of your Baths, and the Wonderful cures you had performed, I sent for you, and after stating my case, you told me frankly, you could make the cure in two months - I consented, and after having taken your Bath every day for nearly four weeks, I relinquished my crutches for two sticks. I now bear great weights on the leg I could not before put to the ground, my health and strength greatly improved, and my pains entirely abated, my cure may be considered as secured.

I am, Sir, Your obedient servant,

I. H. Godwin.