ON THE SURGERY

第4章

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第4章

ON THE SURGERY American Medical Association S

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ON THE SURGERY
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  18.Thefollowingshouldbethestateofmattersonthefirstapplicationofthebandage.Thepersontowhomithasbeenappliedshouldsaythathefeelsthecompressionparticularlyattheseatoftheinjury,butverylittleattheextremities;thepartsshouldbeadjustedbutnotpressedtogether,andthatratherbythenumberofthebandagesthanbytheforceoftheconstriction;andthetightnessshouldratherbeontheincreaseduringthefirstdayandnight;butonthenextitshouldbeless,andonthethirdthebandagesshouldbeloose.Onthenextdayasoftswellingshouldbeobservedintheextremities;andonthethirdday,whenthebandagingisloosed,theswellingshouldbefounddiminishedinsize,andthisshouldbethecaseeverytimethebandagesareremoved.

  Atthesecondapplicationofthebandage,itshouldbeascertainedwhetherthedressinghasbeenproperlydone,andthengreatercompressionshouldbemade,andwithmorebandages;andonthethird,stillgreater,andstillmore.Ontheseventhdayfromthefirstdressing,whenthebandagesareloosed,thelimbshouldbefoundslenderandthebonesmobile.Wemustthenhaverecoursetothesplints,providedthelimbbefreeofswelling,pruritus,andulceration,andallowthemtoremainuntiltwentydaysaftertheaccident;butifanysuspicionsarise,thebandagesmustbeloosedintheinterval.Thesplintsshouldbetightenedeverythirdday.

  19.Thesuspendingofafracturedlimbinasling,thedispositionofit,andthebandaging,allhavefortheirobjecttopreserveitinposition.Theprincipalconsiderationswithregardtothepositionarethehabitsandthepeculiarnatureofeachofthelimbs:thevarietiesareshowninrunning,walking,standing,lying,action,repose.

  20.Itshouldbekeptinmindthatexercisestrengthens,andinactivitywastes.

  21.Compressionshouldbeproducedbythenumberofbandages,ratherthanbytheforceoftheconstriction.

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