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.
When a person receives a severe contusion of the leg or foot, or
breaks his leg, or has painful ulcers over the leg, or is unable from
some cause to bear the pressure of the bedclothes, it is advisable to
know how to keep them from hurting the leg. This may be done by
bending up a fire-guard, or placing a chair, resting upon the edge of
its back and front of the seat, over the leg, or putting a box on each
side of it, and placing a plank ever them; but the best way is to make
a _cradle_, as it is called. This is done by getting three pieces of
wood, and three pieces of iron wire, and passing the wire or hoop
through the wood. This can be placed to any height, and is very useful
in all cases where pressure cannot be borne. Wooden hoops cut in
halves answer better than the wire.
836. When a Person Breaks his Leg
When a person breaks his leg, and _splints_ cannot he had directly,
get bunches of straw or twigs, roll them up in handkerchiefs, and
placing one on each side of the leg or arm, bind another handkerchief
firmly around them; or make a long bag about three inches in diameter,
or even more, of coarse linen duck, or carpet, and stuff this full of
bran, sawdust, or sand, sew up the end, and use this the same as the
twigs. It forms an excellent extemporaneous splint. Another good plan
is to get a hat-box made of chip, and cut it into suitable lengths; or
for want of all these, take some bones out of a pair of stays, and run
them through a stout piece of rug, protecting the leg with a fold of
rug, linen, &c. A still better splint or set of splints can be
extemporized by cutting a sheet of thick pasteboard into proper sized
slips, then passing each piece through a basin of hot water to soften
it. It is then applied to the fractured limb like an ordinary splint,
when it hardens as it dries, taking the exact shape of the part to
which it is applied.
[GOOD-NATURE COLLECTS HONEY FROM EVERY HERB.]
837. Applying Dry Warmth.
When dry warmth is required to be applied to any part of the body, fry
a flour pancake and lay it over the part; or warm some sand and place
in the patient's socks, and lay it to the part; salt put into a paper
bag does as well; or warm water put into a stone jar, and rolled up in
flannel.
838. Minor Operations.
839. Bleeding
Bleeding is sometimes necessary at once in certain accidents, such as
concussion, and therefore it is well to know how to do this. First of
all, bind up the arm above the elbow with a piece of bandage or a
handkerchief pretty firmly, then place your finger over one of the
veins at the bend of the arm, and feel if there is any pulsation; if
there is, try another vein, and if it does not pulsate or beat, choose
that one. Now rub the arm from the wrist towards the elbow, place the
left thumb upon the vein, and hold the lancet as you would a pen, and
nearly at right angles to the vein, taking care to prevent its going
in too far, by keeping the thumb near to the point, and resting the
hand upon the little finger. Now place the point of the lancet on the
vein, push it suddenly inwards, depress the elbow, and raise the hand
upwards and outwards, so as to _cut obliquely across_ the vein.
When sufficient blood is drawn off, which is known by feeling the
pulse at the wrist, and near the thumb, bandage the arm. If the pulse
feel like a piece of cord, more blood should be taken away, but if it
is soft, and can be easily pressed, the bleeding should be stopped.
When you bandage the arm, place a piece of lint over the opening made
by the lancet, and pass a bandage lightly but firmly around the arm,
so as to cross it over the bend of the elbow, in form of a figure 8.
840. Dry Cupping
Dry cupping is performed by throwing a piece of paper dipped into
spirit of wine, and ignited, into a wineglass, and placing it over the
part, such as the neck, temples, &c. It thus draws the flesh into the
glass, and causes a determination of blood to the part, which is
useful in headache, and many other complaints. This is an excellent
method of extracting the poison from wounds made by adders, mad dogs,
fish, &c.
841. Ordinary Cupping
Ordinary Cupping is performed the same as dry cupping, with this
exception, that the part is scarified or scratched with a lancet, so
as to cause the blood to flow; or by the application of a
scarificator, which makes by one action from seven to twenty-one light
superficial cuts. Then the glass is placed over it again with the
lighted paper in it, and when sufficient blood has been taken away,
the parts are then sponged, and a piece of sticking plaster placed
over them.
842. Leeches and their Application.
The leech used for medical purposes is called the _hirudo medicinalis_
to distinguish it from other varieties, such as the horse-leech and
the Lisbon leech. It varies from two to four inches in length, and is
of a blackish brown colour, marked on the back with six yellow spots,
and edged with a yellow line on each side. Formerly leeches were
supplied by Lincolnshire, Yorkshire, and other fenny countries, but
latterly most of the leeches are procured from France, where they are
now becoming scarce.
843. When Leeches are Applied
When leeches are applied to a part, it should be thoroughly freed from
down or hair by shaving, and all liniments, &c., carefully and
effectually cleaned away by washing. If the leech is hungry it will
soon bite, but sometimes great difficulty is experienced in getting
them to fasten. When this is the case, roll the leech into a little
porter, or moisten the surface with a little blood, or milk, or sugar
and water. Leeches may be applied by holding them over the part with a
piece of linen cloth, or by means of an inverted glass, under which
they must be placed.
844. When applied to the Gums
When applied to the gums, care should be taken to use a leech glass,
as they are apt to creep down the patient's throat: a large swan's
quill will answer the purpose of a leech glass. When leeches are
gorged they will drop off themselves; never _tear_ them off from a
person, but just dip the point of a moistened finger into some salt
and touch them with it.
[ILL-NATURE SUCKS POISON FROM THE SWEETEST FLOWER.]
845. Quantity Removed.
Leeches are supposed to abstract about two drachms of blood, or six
leeches draw about an ounce; but this is independent of the bleeding
after they have come off, and more blood generally flows then than
during the time they are sucking. The total amount of blood drawn and
subsequently lost by each leech-bite, is nearly half an ounce.
846. After Leeches Come Away,
After leeches come away, encourage the bleeding by flannels dipped in
hot water and wrung out dry, and then apply a warm spongiopiline
poultice. If the bleeding is not to be encouraged, cover the bites
with a rag dipped in olive oil, or spread with spermaceti ointment,
having previously sponged the parts clean.
847. When Bleeding Continues
When bleeding continues from leech-bites, and it is desirable to stop
it, apply pressure with the fingers over the part, or dip a rag in a
strong solution of alum and lay over them, or use the tincture of
sesquichloride of iron, or apply a leaf of matico to them, placing the
under surface of the leaf next to the skin, or touch each bite with a
finely-pointed piece of lunar caustic, or lay a piece of lint soaked
in the extract of lead over the bites; and if all these tried in
succession fail, pass a fine needle through a fold of the skin so as
to include the bite, and twist a piece of thread round it. Be sure
never to allow any one to go to sleep with leech-bites bleeding,
without watching them carefully; and never apply too many to children;
or place them where their bites can be compressed if necessary. In
other words, _never apply leeches to children except over a bone_.
848. After Leeches have been Used
After leeches have been used they should be placed in water containing
sixteen per cent. of salt, which facilitates the removal of the blood
they contain; and they should afterwards be placed one by one in warm
water, and the blood forced out by _gentle_ pressure. The leeches
should then be thrown into fresh water, which is to be renewed every
twenty-four hours: they may then be re-applied after an interval of
eight or ten days, and be disgorged a second time. The best plan,
however, is to empty the leech by drawing the thumb and forefinger of
the right hand along its body from the tail to the mouth, the leech
being firmly held at the sucker extremity by the fingers of the left
hand. By this means, with a few minutes' rest between each
application, the same leech may be used four or five times in
succession.
849. If a Leech be Accidentally Swallowed,
If a leech be accidentally swallowed, or by any means should get into
the body, employ an emetic, or enema of salt and water.
850. Scarification
Scarification is useful in severe contusions, and inflammation of
parts. It is performed by scratching or slightly cutting through the
skin with a lancet, holding the lancet as you would a pen when you are
ruling lines on paper.
851. Terms used to express the Properties of Medicines.
852. Absorbents
Absorbents are medicines which destroy acidity in the stomach and
bowels, such as magnesia, prepared chalk, &c.
853. Alteratives
Alteratives are medicines which restore health to the constitution,
without producing any sensible effect, such as sarsaparilla, sulphur,
&c.
854. Analeptics
Analeptics are medicines that restore the strength which has been lost
by sickness, such as gentian, bark, &c.
855. Anodynes
Anodynes are medicines which relieve pain, and they are divided into
three kinds, _sedatives, hypnotics,_ and _narcotics_ (see these
terms); camphor is anodyne as well as narcotic.
856. Antacids
Antacids are medicines which destroy acidity, such as lime, magnesia,
soda, &c.
[ONE WATCH SET RIGHT WILL DO TO SET MANY BY.]
857. Antalkalies
Antalkalies are medicines given to neutralize alkalies in the system,
such as citric, nitric, and sulphuric, acids, &c.