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On The Surgery   


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

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