to read over these directions occasionally
, —to regard it as a duty to do so at least three or four times a year, so as to be prepared for emergencies whenever they may arise. When accidents occur, people are too excited to acquire immediately a knowledge of what they should do; and many lives have been lost for want of this knowledge.
Study, therefore, at moderate intervals, the
Domestic Surgery
,
Treatment of Poisons
,
Rules for the Prevention of Accidents
,
How to Escape from Fires
,
the Domestic Pharmacopœia
,
&c.
, which will he found in various pages of
Enquire Within
.
And let it be impressed upon your mind that
The Index
will enable you to refer to
anything
you may require
In A Moment
. Don't trouble to hunt through the pages; but when you wish to
Enquire Within
, remember that the
Index
is the knocker, by which the door of knowledge may be opened.
To-morrow, Cries Too Late to be Forgiven.
797. Dressings
These are substances usually applied to parts for the purpose of soothing, promoting their reunion when divided, protecting them from external injuries, absorbing discharges, protecting the surrounding parts, insuring cleanliness, and as a means of applying various medicines.
798. Certain Instruments
Certain Instruments are required for the application of dressings in domestic surgery, viz.—scissors, a pair of tweezers or simple forceps, a knife, needles and thread, a razor, a lancet, a piece of lunar caustic in a quill, and a sponge.
799. Materials for dressings
These consist of lint, scraped linen, carded cotton, tow, ointment spread on calico, adhesive plaster, compresses, pads, bandages, poultices, old rags of linen or calico, and water.
800. Rules
The following rules should be attended to in applying dressings:
801. Lint, how made
Lint, how made. This may be quickly made by nailing a piece of old linen on a board, and scraping its surface with a knife. It is used either alone or spread with ointment. Scraped lint is the fine filaments from ordinary lint, and is used to stimulate ulcers and absorb discharges; it is what the French call
charpie
.
802. Uses of Scraped Lint
This is made into various shapes for particular purposes. When it is screwed up into a conical or wedge-like shape, it is called a
tent
, and is used to dilate fistulous openings, so as to allow the matter to escape freely; and to plug wounds, so as to promote the formation of a clot of blood, and thus arrest bleeding. When rolled into little balls, called
boulettes
, it is used for absorbing matter in cavities, or blood in wounds. Another useful form is made by rolling a mass of scraped lint into a long roll, and then tying it in the middle with a piece of thread; the middle is then doubled and pushed into a deep-seated wound, so as to press upon the bleeding vessel, while the ends remain loose and assist in forming a clot; or it is used in deep-seated ulcers to absorb the matter and keep the edges apart. This form is called the
bourdonnet
. Another form is called the
pelote
, which is merely a ball of scraped lint tied up in a piece of linen rag, commonly called a dabber. This is used in the treatment of protrusion of the navel in children.
803. Carded Cotton
Carded cotton is used as a dressing for superficial burns, and care should be taken to free it from specks, as flies are apt to lay their eggs there, and generate maggots.
804. Tow
Tow is chiefly employed as a padding for splints, as a compress, and also as an outer dressing where there is much discharge from a surface.
805. Ointments
Ointments are spread on calicoes, lint, or even thin layers of tow, by means of a knife; they should not be spread too thick. Sometimes ointment is applied to discharging surfaces on a piece of linen, folded over on itself several times, and then cut at the corners with scissors, in order to make small holes in it. The matter discharged passes out freely through these holes, and is received in a layer of tow spread over the linen.
806. Adhesive Plaster
Adhesive plaster is cut into strips, ranging in width, according to the nature of the wound, &c., but the usual width is about three-quarters of an inch. Isinglass plaster is not so irritating as diachylon, and is more easily removed.
807. Compresses
Compresses are made of pieces of linen, calico, lint, or tow, doubled or cut into various shapes, according to the purposes for which they are required. They are used to confine dressings in their places, and to apply an equal pressure on parts. They should be free from darns, hems, and knots. Ordinary compresses are square, oblong, and triangular. Compresses are also graduated by placing square pieces of folded cloth on one another, so arranged that they decrease in size each time. They are used for keeping up pressure upon certain parts.
808. Pads
Pads are made by sewing tow inside pieces of linen, or folding linen and sewing the pieces together. They are used to keep off pressure from parts such as that caused by splints in fractures.
809. Poultices
Poultices are usually made of linseed meal, oatmeal, or bread, either combined with water or other fluids; sometimes they are made of carrots, charcoal, potatoes, yeast, and linseed meal, mustard, &c., but the best and most economical kind of poultice is a fabric made of sponge and wool felted together, and backed by Indian rubber, called "spongio piline."
The method of using this poultice is as follows:— A piece of the material of the required form and size is cut off, and the edges are pared or bevelled off with a pair of scissors, so that the caoutchouc may come in contact with the surrounding skin, in order to prevent evaporation of the fluid used; for, as it only forms the vehicle, the various poultices generally used can be employed with much less expenditure of time and money, and increased cleanliness.
For example,—a
vinegar
poultice is made by moistening the fabric with distilled vinegar; an
alum
poultice, by using a strong solution of alum; a
charcoal
poultice, by sprinkling powdered charcoal on the moistened surface of the material; a
yeast
poultice, by using warmed yeast, and moistening the fabric with hot water, which is to be well squeezed out previous to the absorption of the yeast; a
beer
poultice, by employing warm porter-dregs or strong beer as the fluid; and a
carrot
poultice, by using the expressed and evaporated liquor of boiled carrots.
Spongio-piline costs about one farthing a square inch, and may be obtained of the chemist. As a fomentation it is most invaluable, and by moistening the material with compound camphor liniment or hartshorn, it acts the same as a mustard poultice.
To-morrow, Dies in Anguish and Despair.
810. Mustard Poultices
These may be made of the mustard powder alone, or in combination with bread crumbs, or linseed meal. When mustard only is used, the powder should be moistened with water, and the paste thus produced spread on a piece of linen, and covered with muslin to intervene between the mustard and the skin. When mixed with linseed the powder and the meal may be incorporated before water is added, or the meal may be moistened and spread on linen for application, and the mustard be then strewn on the surface, more or less thickly according to the age of the patient. Rigollot's Mustard leaves, which can be procured from any chemist, are now much used in the place of mustard poultices. They only require wetting before application, and are both clean and economical.
811. Bandages
Bandages are strips of calico, linen, flannel, muslin, elastic webbing, bunting, or some other substance, of various lengths, and from one to six inches wide, free from hems or darns, soft and unglazed. They are better after they have been washed. Their uses are to retain dressings, apparatus, or parts of the body in their proper positions, support the soft parts, and maintain equal pressure.
812. Simple and Compound Bandages
Bandages are simple and compound; the former are simple slips rolled up tightly like a roll of ribbon. There is also another simple kind, which is rolled from both ends—this is called a double-headed bandage. The compound bandages are formed of many pieces.
813. Bandages for Different Parts of the Body
Bandages for the head should be two inches wide and five yards long; for the neck, two inches wide, and three yards long; for the arm, two inches wide, and seven yards long; for the leg, two inches and a half wide and seven yards long; for the thigh three inches wide, and eight yards long; and for the body, four or six inches wide and ten or twelve yards long.
814. To Apply a Single-Headed Bandage
To apply a single-headed bandage, lay the
outside of the end
near to the part to be bandaged, and hold the roll between the little, ring and middle fingers, and the palm of the left hand, using the thumb and forefinger of the same hand to guide it, and the right hand to keep it firm, and pass the bandage partly round the leg towards the left hand. It is sometimes necessary to reverse this order, and therefore it is well to be able to use both hands.
Particular parts require a different method of applying bandages, and therefore it is necessary to describe the most useful separately; and there are different ways of putting on the same bandage, which consist in the manner the folds or turns are made. For example, the
circular
bandage is formed by horizontal turns, each of which overlaps the one made before it; the
spiral
consists of spiral turns; the
oblique
follows a course oblique or slanting to the centre of the limb; and the
recurrent
folds back again to the part whence it started.
815. Circular Bandages
Circular bandages are used for the
neck
, to retain dressings on any part of it, or for blisters, setons, &c.; for the
head
, to keep dressings on the forehead or any part contained within a circle passing round the head; for the
arm
, previous to bleeding; for the
leg
, above the knee; and for the
fingers
, &c.
816. To Confine the Ends of Bandages
To confine the ends of bandages some persons use pins, others slit the end for a short distance, and tie the two strips into a knot, and some use a strip of adhesive plaster. Always place the point of a pin in such a position that it cannot prick the patient, or the person dressing the limb, or be liable to be drawn out by using the limb; therefore, as a general rule, turn the head of the pin from the free end of the bandage, of towards the upper part of the limb. The best mode is to
sew
the bandage on. A few stitches will hold it more securely than pins can.
Little Deeds are Like Little Seeds.
817. The Oblique Bandage
The oblique bandage is generally used for arms and legs, to retain dressings.
818. The Spiral Bandage
The spiral bandage is generally applied to the trunk and extremities, but is apt to fall off even when very carefully applied; therefore the recurrent bandage, which folds back again, is generally used.
819. The Recurrent Bandage
The recurrent bandage is the best kind of bandage that we can employ for general purposes. The method of putting it on the leg is as follows: —Apply the end of the bandage that is free, with the outside of it next the skin, and hold this end with the finger and thumb of the left hand, while some one supports the heel of the patient; then with the right hand pass the bandage over the piece you are holding, and keep it crossed thus, until you can place your right forefinger upon the spot where it crosses the other bandage, where it must be kept firm. Now hold the roll of the bandage in your left hand, with the palm turned upwards, and
taking care to keep that part of the bandage between your right forefinger, and the roll in your left hand, quite slack
; turn your left hand over, and bring the bandage down upon the leg; then pass the roll under the leg towards your right hand, and repeat this until the leg is bandaged up to the knee, taking care
not to drag
the bandage at any time during the process of bandaging. When you arrive at the knee, pass the bandage round the leg in circles just below the knee, and pin it as usual.
Bandaging is very easy, and if you once see any one apply a bandage properly, and attend to these rules, there will not be any difficulty; but bear one thing in mind, without which you will never put on a bandage even decently; and that is,
never to drag
or pull at a bandage, but make the turns while it is slack, and you have your right forefinger placed upon the point where it is to be folded down. When a limb is properly bandaged, the folds should run in a line corresponding to the shin-bone. Use, to retain dressings, and for varicose veins.
820. A Bandage for the Chest
A bandage for the chest is always placed upon the patient in a sitting posture; and it may be put on in circles, or spirally. Use, in fractures of the ribs, to retain dressings, and after severe contusions.
821. A Bandage for the Belly
A bandage for the belly is placed on the patient as directed for the chest, carrying it spirally from above downwards. Use, to compress belly after dropsy, or retain dressings.
822. Bandaging the Hand
The hand is bandaged by crossing the bandage over the back of the hand Use, to retain dressings.
823. Different Bandages for the Head
For the head, a bandage may be circular, or spiral, or both; in the latter case, commence by placing one circular turn just over the ears; then bring down from left to right, and round the head again, so as to alternate a spiral with a circular turn. Use, to retain dressings on the head or over the eye; but this form soon gets slack. The circular bandage is the best, crossing it over both eyes.
824. For the Foot
Place the end just above the outer ankle, and make two circular turns, to prevent its slipping: then bring it down from the inside of the foot over the instep towards the outer part; pass it under the sole of the foot, and upwards and inward over the instep towards the inner ankle, then round the ankle and repeat again. Use, to retain dressings to the instep, heel, or ankle.
825. For the Leg and Foot
For the leg and foot, commence and proceed as directed in the preceding paragraph; then continue if up the leg as ordered in the
Recurrent Bandage
.
826. Substitutes
As it sometimes happens that it is necessary to apply a bandage at once, and the materials are not at hand it is desirable to know how to substitute something else
that any one may apply with ease
. This can be readily done with handkerchiefs.
They Grow to Flowers, or to Weeds.
827. Handkerchiefs
Any ordinary handkerchief will do; but a square of linen folded into various shapes answers better. The shapes generally required are as follows:—The triangle, the long square, the cravat, and the cord.
828. The Triangular Handkerchief
The triangular handkerchief is made by folding it from corner to corner. Use, as a bandage for the head.
Application
.—Place the base round the head, and the short part hanging down behind, then tie the long ends over it.
829. The Long Square
The long square is made by folding the handkerchief in three. Use, as a bandage to the ribs, belly, &c. If one handkerchief is not long enough, sew two together.
830. The Cravat
The cravat is folded as usual with cravats. Use, as a bandage for the head, arms, legs, feet, neck, &c.
831. The Cord
The cord is used to compress vessels, when a knot is made in it, and placed over the vessel to be compressed. It is merely a handkerchief twisted in its diagonal.
832. Multiple Handkerchiefs
Two or more handkerchiefs must sometimes be applied, as in a broken collar-bone, or when it is necessary to keep dressings under the arm. The bandage is applied by knotting the opposite comers of one handkerchief together, and passing the left arm through it, then passing another handkerchief under the right arm, and tying it. By this means we can brace the shoulders well back, and the handkerchief will press firmly over the broken collar-bone: besides, this form of bandage does not readily slip or get slack, but it requires to be combined with the sling, in order to keep the arm steady.
833. For an Inflamed Breast
For an inflamed breast that requires support, or dressings to be kept to it, pass one corner over the shoulder, bring the body of it over the breast, and pass it upwards and backwards under the arm of that side, and tie the opposite corners together.
834. An Excellent Sling
An excellent sling is formed by placing one handkerchief around the neck, and knotting opposite corners ever the breast bone, then placing the other in triangle under the arm, to be supported with the base near to the hand; tie the ends over the handkerchief, and pin the top to the other part, after passing it around the elbow.
835. Apparatus