on the surgery-第3章

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should　say　that　he　feels　the　compression　particularly　at　the　seat　of

the　injury；　but　very　little　at　the　extremities；　the　parts　should　be

adjusted　but　not　pressed　together；　and　that　rather　by　the　number　of

the　bandages　than　by　the　force　of　the　constriction；　and　the

tightness　should　rather　be　on　the　increase　during　the　first　day　and

night；　but　on　the　next　it　should　be　less；　and　on　the　third　the

bandages　should　be　loose。　On　the　next　day　a　soft　swelling　should　be

observed　in　the　extremities；　and　on　the　third　day；　when　the

bandaging　is　loosed；　the　swelling　should　be　found　diminished　in

size；　and　this　should　be　the　case　every　time　the　bandages　are　removed。

At　the　second　application　of　the　bandage；　it　should　be　ascertained

whether　the　dressing　has　been　properly　done；　and　then　greater

compression　should　be　made；　and　with　more　bandages；　and　on　the

third；　still　greater；　and　still　more。　On　the　seventh　day　from　the

first　dressing；　when　the　bandages　are　loosed；　the　limb　should　be　found

slender　and　the　bones　mobile。　We　must　then　have　recourse　to　the

splints；　provided　the　limb　be　free　of　swelling；　pruritus；　and

ulceration；　and　allow　them　to　remain　until　twenty　days　after　the

accident；　but　if　any　suspicions　arise；　the　bandages　must　be　loosed

in　the　interval。　The　splints　should　be　tightened　every　third　day。

　　19。　The　suspending　of　a　fractured　limb　in　a　sling；　the　disposition

of　it；　and　the　bandaging；　all　have　for　their　object　to　preserve　it

in　position。　The　principal　considerations　with　regard　to　the

position　are　the　habits　and　the　peculiar　nature　of　each　of　the

limbs：　the　varieties　are　shown　in　running；　walking；　standing；　lying；

action；　repose。

　　20。　It　should　be　kept　in　mind　that　exercise　strengthens；　and

inactivity　wastes。

　　21。　Compression　should　be　produced　by　the　number　of　bandages；　rather

than　by　the　force　of　the　constriction。

　　22。　In　cases　of　ecchymosis；　contusions；　sprains；　or　swellings　not

attended　with　inflammations；　blood　is　to　be　expelled　from　the　wound；

in　greatest　quantity　to　the　upper　part；　and　in　smallest　to　the

inferior；　neither　the　arm　nor　the　leg　should　be　placed　in　a

declining　position：　the　head　of　the　bandage　should　be　placed　on　the

wound；　and　there　the　greatest　pressure　should　be　made；　the　least　at

the　extremities；　and　intermediately　in　the　middle；　the　last　fold　of

the　bandage　should　be　at　the　upper　part　of　the　body。　As　to　binding　and

compression；　these　objects　are　to　be　attained　rather　by　the　number

of　the　bandages　than　the　force　of　the　constriction；　and　moreover；　in

these　cases　the　bandages　should　be　thin；　light；　soft；　clean；　broad；

sound；　so　that　they　may　effect　their　purpose；　even　without　splints。

And　we　must　use　affusions。

　　23。　Dislocations；　sprains；　diastases　of　bones；　violent　separation；

abruption　of　the　extremities　of　bones；　and　distrainings；　so　as　to

induce　varus　or　valgus；　in　these　cases　we　must　apply　the　bandages　so

as　not　to　compress　the　part　whence　the　displacement　took　place；　and

that　we　may　render　them　tight　at　the　side　to　which　the　displacement

was；　and　give　the　limb　an　inclination　in　the　opposite　direction；　and

that　in　an　excessive　degree。　We　employ　bandages；　compresses；

suspension　of　the　limb　in　a　sling；　attitude；　extension；　friction；

rectification；　and　along　with　these　the　affusion　of　much　water。

　　24。　In　treating　parts　which　are　atrophied；　we　must　comprehend　a

considerable　part　of　the　sound　limb　with　the　bandage；　so　that　by　the

influx　thereby　produced；　the　wasted　part　may　acquire　a　supply

greater　than　its　loss；　and　may　be　thus　disposed　to　growth　and

restoration　of　its　fleshy　parts。　It　is　better　also　to　bandage　the

parts　above；　as　the　thigh　in　the　case　of　the　leg；　and　also　the　thigh

and　leg　of　the　opposite　side；　so　that　they　may　be　placed　in　similar

circumstances；　and　may　both　equally　be　deprived　of　motion；　and　that

the　supply　of　nourishment　may　be　alike　curtailed　and　open　to　both。　The

compression　should　be　the　effect　rather　of　the　number　of　the

bandages　than　of　their　tightness。　We　relax　first　the　part　most

requiring　it；　and　have　recourse　to　that　kind　of　friction　which　will

promote　the　growth　of　flesh；　and　to　affusion。　No　splints。

　　25。　Those　things　which　are　for　the　purpose　of　giving　support　and

strength　to　the　part；　as　to　the　breast；　side；　head；　and　so　forth；

are　used　in　such　cases　as　the　following：　for　pulsations；　that　there

may　be　no　motion　in　the　part；　and　in　separation　at　the　sutures　of

the　skull；　in　order　to　give　support；　and　in　order　to　strengthen　the

chest　and　head；　in　coughs；　sneezings；　and　other　movements。　In　all

these　cases　the　same　measure　of　bandaging　is　to　be　observed；　for　where

the　injury　is；　there　the　bandage　should　compress　most；　and　something

soft　is　to　be　placed　below　that　suits　with　the　complaint；　and　we

must　not　apply　the　bandages　tighter　than　just　to　stop　the　pulsations

from　creating　disturbance；　and　that　the　separated　parts　at　the　sutures

may　be　brought　into　contact；　they　must　not　be　such　as　absolutely　to

stop　the　coughs　and　sneezings；　but　so　as　to　give　support；　and；　without

occasioning　uneasiness；　prevent　the　parts　from　being　shaken。





　　　　　　　　　　　　　　　　　　　　　　　　　　…THE　END…

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