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30Medical Report On The April 1977 Expedition to Sotano de San AgustinMore injuries due to caving were seen in my four weeks work at Sotanode San Agustin than I have ever seen before on any other expedition or longcaving trip. There were some problems which I consider to have been handledvery poorly. There were some which utilized outside medical assistance.But most problems the crew members took care of themselves. Ilearned from the help I gave and the observations made, and I would like toshare my education with you.A list of the medical problems is fonowed by the drugs and materialsmost commonly used. M!Jst medical care was self-administered. I assistedonly a few cavers.The medical problems include abrasions, cafes, common cold, concussion,cramps, diarrhea, dislocated cottar bone, facial lacerations,broken finger, hand sprain and puctures, headaches, hypothermia, insufficientinsulin, loss of voice, nausea, ribs bruised, sore throats, urinaryinfection, and weariness.A wide variety of antibiotics were taken due to the various types of infectionsdisplayed. Penicillin by injection was taken by one caver once a dayfor several days due to a severe sore throat suspected to be strep. Anothersore throat accompanied by fever took Erythromycin and gargled warm saltwater three times a day. Tetracycline (Achromycin) was taken for a feverand cold in another caver, for a sore throat in another, and by anotherspeleologist to help control a urinary tract infection.The sore throats were all easily acquired due to sloppy kitchen habitssuch as drinking from group water jugs. Weariness after· long cave trips(20 to 30 hours), weakness due to other infections (colds), unaccustomed ,-yelling up and down drops and going without.insulin in the case of the diabeticlowered the bodies' defenses and allowed yet other infections such as sorethroats to begin more easily especially toward the end of the expediton.Two varieties of cold capsules were taken by various cavers. Contacwas taken as a strong, sure symptomatic relief from the common cold.Ornex was taken when the caver planned to go underground because it containedno sedatives and no antihistamines which may cause drowsiness insome people. The obvious remedy - rest - was often ignored because equipmentand tra.sh was still below ground and there wer~ several cavers anxiousto finish de-rigging so that they could head back home. Hence theypushed themselves too hard. This was a skeleton crew; there were no extracavers to help de-rig while the ill ones rested.Lomotil was used by almost all the cavers. Diarrhea hit everyonesooner or later but I only heard of two people wh 0 were nauseated and onlyone of those developed stomach cramps which she suspects may have beendue to the lomotil in the first place. Plain lomotil is best to use for simplediarrhea because its morphine-like action simply shuts down the intestinewall action and allows your insides to grow accustomed to the new bacteriainvasion. Streptomagma, entero-viforma and lomotil with neomycin kill