BRUISES.
When the contused part is seen immediately after injury before extra vasation has occurred, this may be sometimes prevented by firm pressure over a pad of cotton-wool or by the application of ice or an evaporating lotion. A cold saturated, recently prepared, solution of Chloride of Ammonium is a good application to orbital contusion where a " black eye " is dreaded. The juice of the fresh root of Convallaria and Solomon's Seal is reputed to be of value for the same purpose. Arnica is of little or no benefit, and often produces dangerous erythematous rashes, which may spread from the site of application over the entire body.
When ecchymosis already has taken place, warm Spirit Lotion, covered with oiled silk, and padded over with thick layers of cotton-wool, and bandaged moderately tightly, is the best practice. Absorption is always hastened by massage. The surgeon should be very slow to incise the skin when even extensive extravasations of blood have occurred; these as a rule, if let alone, will become absorbed in a short time, while the admission of air is fraught with great danger. The aspirator may, however, be safely
used where the removal is absolutely necessary. Large hcematomas may be incised under aseptic conditions; bullw should be snipped and an anti septic dressing or dusting powder applied. Where large doughy extrava sations remain under impervious skin, their absorption may be hastened by mild counter-irritants as Camphor Liniment, &c., combined with massage and pressure. Pain should be relieved by local anodynes like Aconite or Belladonna Liniment. Leeching should be avoided owing to the danger of sepsis through the punctures, as the damaged tissue has its resisting powers much weakened.