ON THE SURGERY

第3章

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第3章

ON THE SURGERY American Medical Association S

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ON THE SURGERY
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  12.Infractureswemustattendtothelength,breadth,thickness,andnumberofthecompresses.Thelengthshouldbethatofthebandaging;thebreadth,threeorfourfingers;thickness,threeorfourfold;numbersoastoencirclethelimb,neithermorenorless;

  thoseappliedforthepurposeofrectifyingadeformity,shouldbeofsuchalengthastoencircleit;thebreadthandthicknessbeingdeterminedbythevacuity,whichisnottobefilledupatonce.Theupperbandagesaretwo,thefirstofwhichistobecarriedfromtheseatoftheinjuryupwards,andthesecondfromtheseatoftheinjurydownwards,andfrombelowupwards;thepartsabouttheseatoftheinjurybeingmostcompressed,theextremitiesleast,andtherestinproportion.Theupperbandagesshouldtakeinaconsiderableportionofthesoundparts.Wemustattendtothenumber,length,andbreadthofthebandages;thenumbermustbesuchasnottobeinferiortowhattheinjuryrequires,noroccasioncompressionwiththesplints,norprovecumbersome,noroccasionanyslippingofthem,norrendertheminefficient.Astolengthandbreadth,theyshouldbethree,four,five,orsixcubitsinlength,andasmanyfingersbroad.Thefoldsofthestrings(selvages?)shouldbesuchasnottooccasionpressure;theyaretobesoftandnotthick;andallthesethingsaretobeproportionatetothelength,breadth,andthicknessofthepartaffected.Thesplintsaretobesmooth,even,androundedattheextremities;somewhatlessallalongthantheupperbandaging,andthickestattheparttowhichfractureinclines.

  Thosepartswheretherearetuberosities,andwhicharedevoidofflesh,suchastheanklesorfingers,wemustguardfromthesplintswhichareplacedoverthem,eitherbyposition,orbytheirshortness.

  Theyaretobesecuredbythestringsinsuchamannerasnottooccasionpressureatfirst.Asoft,consistent,andcleancerateshouldberubbedintothefoldsofthebandage.

  13.Astothetemperatureandquantityofthewaterused,itsheatshouldbejustsuchasthehandcanbear,anditoughttobeknownthatalargequantityisbestforproducingrelaxationandattenuation,whereasamoderatequantityisbestforincarnatingandsoftening.Thelimittotheaffusionis,tostopwhenthepartsbecomeswelledup,andbeforetheswellingsubsides;forthepartsswellupatfirst,andfallafterward.

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