The surgeon's handbook : a prize essay / by Friedrich von Esmarch ; tr. from the 3rd German ed. by B. Farquhar Curtis.

  • Esmarch, Friedrich von, 1823-1908.
Date:
1888
Catalogue details

Licence: Public Domain Mark

Credit: The surgeon's handbook : a prize essay / by Friedrich von Esmarch ; tr. from the 3rd German ed. by B. Farquhar Curtis. Source: Wellcome Collection.

Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.

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    feres with the healing process, and may cause hemorrhage and in- flammation with their consequences. This is avoided by abundant covering of the wound (protective dressing), careful securing of the dressing, and by changing the latter as seldom as possible (permanent dressing); and also by placing the injured part completely at rest (by bandages, cloths, splints, firm dressings, proper position, cradles, etc.), absolute rest in bed if the injury is severe, undisturbed quiet of the wound, avoidance of unneces- sary examination, probing and squeezing. a) 5. Every hinderance to the return-circulation of blood and lymph (congestion); for this may cause discharge to be effused into the wound from capillaries and lymphatics. This may be prevented by elevation of the injured part, and by the avoidance of every constriction (strangulation), and the remo- val of constricting clothing or dressings. 6. The entrance and settlement of the agents of decom- position during the healing of the wound (septic infection). This can be avoided by antiseptic dressings and by changing the dressing as seldom as possible (permanent dressing). 7 Inflammation of the injured parts, with its consequences. This is to be combatted by abstraction of heat, rest, elevation, elastic pressure; and, in inflammation of a joint, by separating the joint-surfaces by extension (antiphlogosis). CLEANLINESS (ASEPSIS). Since the agents of decomposition (micro-organisms of putrefac- tion) are to be found everywhere, in the air as well as in the water, and attach themselves to every object, they must be removed, destroyed,, or rendered harmless, before and during every operation, and before and during every dressing of a wound. This is accomplished by scrupulous cleansing and disinfection of the wound and its surroundings, as well as of everything which can come in contact with the wound — air, hands, instruments, dressings. CLEANLINESS OF THE SURGEON AND HIS ASSISTANTS. Before touching any wound, before every operation, and before every dressing of a wound-, the hands and forearms of the surgeon, l) Absolute rest, is the ideal treatment of wounds (Optimum remedium quies est — Celsus. To be let alone — Lister.) Although the ideal has not yet been quite attained by Lister's method (Cheyne, Antiseptic Surgery, p. 597), because thS drainage-tubes and sutures have necessitated frequent change of the dressing, we nevertheless owe the immeasurable improvements in the modern treatment of wounds to the great surgeon, Joseph Lister, alone.