Perhaps at no period in our Nation's history has the pursuit of athletics been more popular that at the present. Nor is the practice confined to any particular class of society. For the peasant boy who plays at cricket of football on the village green and for the nobleman who enters into a polo competition at Hurlingham the spirit of keenness is the same. The competitive idea pervades all ranks. At the public schools athletics enter largely into the daily life, for each boy is expected and encouraged to take part in the games; and at the old Universities the average undergraduate, even if he is not a competitor himself, treats the true athlete or "blue" with as much respect as he does the scholar, and in some in- stances with even more. It is not surprising, therefore, considering the many thousands who are daily engaged in these pleasant yet serious pastimes, that various accidents and injuries are from time to time i met with amongst those so employed.
It is with these injuries, unavoidable as they would seem to be, that the writer of this thesis is concerned. He would enquire especially into the causation of these accidents to discover some means
whereby they may in some measure be prevented or minimised; ' and failing prevention, he would discuss the remedial measures most helpful to early and complete restoration to functional activity. All such methods of treatment to be efficacious must be at the same time rational, and systematically carried out, and be dependent entirely upon a full knowledge of the exact pathology. That many of the means employed in the past have been empirical no one will gainsay, any more than it can be denied that in certain directions there is still room for improvement. An attempt will be made in the succeeding chapters to introduce into the discussion the opinions held by the opposite schools with a view to criticism in so far as they are for or against the method adopted by the writer.
For the last 14 years it has been his privilege to be professionally connected with many of the athletes injured at one of the old Universities in England and with those at a large public school for boys. Ample opportunities have been afforded him for not only seeing many of the well known injuries that have been recorded and of dealing with them soon after their occurrence, but also of meeting with others seldom if ever to be found mentioned in current literature. While many of the injuries are the result of direct: violence such as from blows or falls, the vast majority are occasioned by indirect violence such as strains. For the convenience of classification the injuries may be divided into (a) those in which there is an open wound in the skin and (b) those without a wound; or again into those affecting (1) the various viscera or internal organs, (brain, spinal cord, abdominal organs), and (2) those concerned with the various connective tissues of the body, such as the nerves, bones, muscles, ligaments, subcutaneous tissues, vèssels etc.
Injuries to the viscera are fortunately, uncommon, while those affecting the various connective tissues are of everyday occurrence. Yet, relatively to the ¡enormous number of players, it may be stated generally that accidents are not as frequent as one would Ibe inclined to think at first. Exact statistics however, are wanting.
Almost every organ or tissue in the body is liable to injury. The extent of the particular injury varies with the amount and nature of the violence. Thus a slight violence may be productive of a minor injury (contusion) when applied to one of the ordinary tissues of the body, yet may give rise to disastrous con- sequences (large haemorrhage) when applied to one of the more delicate internal organs.
Perhaps of the various p games, football may be said to be the most fertile in injuries, and the reason for this probably in a measure lies in its almost universal popularity. While the Rugby game accounts for the greater number of accidents, that played under the Association rules perhaps occasions the more serious injuries. But even these are less grave than the mishaps that may occur in the hunting field or in point-to-point races, or in the game of polo. Injuries of every degree may be met with from the slightest bruising of the skin to the fractured skull or injured spine.