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Treatment of Wounds

cold, inflamed, hand, rest, bandage and bath

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TREATMENT OF WOUNDS, p. 530, Vol.

Keep the inflamed part at rest is the next most vital injunction. In the case, for instance, of the inflamed hand, the continued use of the hand can only help to maintain and aggravate the inflammation with its attendant throbbing of pain. Keeping the part at rest may, in many cases, imply the application of 'a 'bandage, or a splint and bandage, or a plaster bandage. Nothing so effectually relieves an in flamed joint in many cases as rest secured in such a way.

Elevate the inflamed part is the next direction. For instance, it would be profitless to put a bandage on an inflamed band and go about with the arm hanging ; the hand should be kept raised in a sling. If the inflamed part be below the level of the heart, gravitation will tend to make the rush of blood to the part even greater than it would be otherwise. Raising the part, on the other hand, brings gravity to the aid of the inflamed area, doing something to help in the emptying of the en gorged vessels, and the diminution of the swell ing. Wherever inflammation attacks a de pendent part, the foot, for instance, swelling is likely to become very great, unless the foot is kept raised.

These directions, one may say, are of universal application, and are worth summarizing, thus: (1) remove the cause of the inflammation, (2) cleanse and keep the part clean, (3) keep the part absolutely at rest, (4) raise the part somewhat above the level of the heart.

If these directions are followed at the outset it will frequently happen that little else is needed.

External applications are, however, fre quently valuable aids in the relief of inflamma tion. Now it is not difficult to explain in general terms what purpose these external ap plications should serve.

Cold may be employed to diminish the flow of blood to the irritated area, and contract the blood-vessels. Cold applications are also, when rightly applied, very soothing to the irritated nerves, by their action on the vessels causing a lessening of the swelling, as well as by a directly soothing effect. Cold may be employed

in the form of a local bath, cold cloth, cold drip or cold coil, or ice-bag.

In the use of cold, care must be taken not to lower the vitality of the tissue by (1) too great a degree of cold or (2) too prolonged an action.

It is only in the early stages of inflamma tion that cold is likely to be suitable. If the inflamed area is the least dusky in colour, cold is almost certain to be injurious.

Cold in the form of a local bath would be suitable for hand, or hand and forearm, or foot, or foot and part of leg. It must be noted, however, that, except in the case of the hand, it would be impossible to keep the part raised during the bath, and this is a disadvantage. The water employed should be GO° Fahr. and the duration not more than half an hour. The part should then be gently dried and lightly covered, and the local bath repeated in an hour or two, it comfort has been produced by it.

Cold Compress is made of a piece of linen, old and thin, two-fold, and of appropriate size. The person lying in bed should have the clothes so arranged that the inflamed part only is ex posed, the surrounding clothes being protected from wetting. A thick folded towel should be placed beneath the part to receive any drip, and it would be well also that this towel should rest on a layer of waterproof.

The linen should be clipped in water at 55° Fahr. and closely applied to the inflamed sur face, and it should be so steadily and regularly renewed that it has not time to get warmed. If this is not carefully attended to, the cold cloth becomes converted into a warm fomen tation, and the inflamed area becomes irritated rather than soothed. Two pieces of linen shoUld be prepared, therefore, one lying in the basin of water while the other is applied, and with absolute regularity one is replaced by the other. The water in the basin can be kept at the proper temperature by means of a piece of ice.

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