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February 16, 2019

Which part of the body would you rather receive a slap?

Suppose someone came up to you and insisted that they must inflict some physical pain, which part of the body would you choose to have the pain inflicted?

Such choices were common and legal in yesteryear when corporal punishment was allowed in schools. There are many adults who have fond memories of a teacher who smacked them repeatedly for a variety of offences that today they find amusing and nostalgic.

The idea of corporal punishment was that deliberately inflicting pain by methodically striking a wrong doer they would be disciplined and deterred from whatever unacceptable attitude or behaviour they were exhibiting.

Schools were not alone in such thinking as until the new constitution outlawed it, corporal punishment was allowed as judicial punishment and in the home.

So today if you are asked such a question it means that you are probably involved in something illegal either as a victim or a deal gone wrong or you have injured yourself and are wondering if there was another bit of you that could have been less painful given the pain you are now feeling.

The common behaviour that binds these different causes is that often you cannot really express the pain you are feeling, freely.

When a sudden physical force such as; a blow, slap, punch or even own bodyweight in a fall; is applied to the body several reactions can occur depending on the amount of force used, the manner in which the force is applied and the part of the body where the force is applied.

For example there are men who greet each other with a great big slapping motion of the hands then pull each the arm half bent at the elbow with such force to bring the other person, a long lost and apparently good friend, close to them into the male African shoulder hug greeting pose.

Great force and energy is used but because it is the palm of the hand and the shoulder that bear the greatest force in either person the sensation felt is one of a stinging palm and the single tear that might appear is taken to be one of joy at seeing the other person.

On the other hand a slap on the cheek may sting in the same way but instead of just a tear the area of where the slap is most felt may begin to darken and even swell, a sign that just under the topmost layer of the skin the tiny blood vessels, called capillaries have been injured.

When this happens blood seeps through into the surrounding tissues causing swellings in medical terms, a hematoma, with the overall injury a bruise or contusion. Unlike a cut or an abrasion the skin is not broken and one does not see blood.

However a bruise can still be painful because of the mechanical pressure due to collection of blood in surrounding tissue and to signal to the body that there is an injury.

In a light skinned person it is easy to spot a bruise, but in a typical sun-tanned African it may require careful inspection to not overlook one. This is important because a bruise today means that the person has had an accident or is engaged in some illegal activity.

Bruising occurs more easily where the tissue is loose for example around the eye or where there is a lot of subcutaneous fat so women and babies bruise easier than men because they have more fat.

A bruise in a baby or a woman should never be taken lightly. The elderly are also at greater risk because with advancing age the skin becomes thinner.

So an elderly person with a bruise on the shin requires careful questioning to establish if they are having problems seeing, walking, or was it a reaction to some unbelievable football result that made them kick out and miss the coffee table?

There are other causes of bleeding besides a physical blow. High blood pressure and bleeding disorders can cause spontaneous bleeds. Extreme muscular weightlifters can also have microscopic tears in blood vessels as they strain to lift heavier weights. In children, falls, riding a bicycle for example, are the most likely causes.

Initial treatment consists of first aid by applying a cold compress to the bruise to help relieve pain and swelling. A compress can be made by soaking a cloth in cold water or wrapping ice in a towel.

Applying heat for example some menthol compound often people’s first instinct because they think the injury is muscular makes the situation worse. If it is possible the affected area should be elevated so that blood flow is reduced and a painkiller (not aspirin which can prolong bleeding) taken reduce pain.

If the swelling persists or there is a possibility that there is further damage a fracture for example then a doctor should be seen. One should never try to drain blood from a bruise, as it should fade away in a few days.

So the best way to avoid having to answer such a question was to not have been a naughty child in school before 2010. Having survived those days a clutter free living room can save many shins and toes.

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