A handbook of local therapeutics / edited by Harrison Allen.

Date:
1893
Catalogue details

Licence: Public Domain Mark

Credit: A handbook of local therapeutics / edited by Harrison Allen. Source: Wellcome Collection.

    104/554 (page 92)
    A piece of rubber cloth, fashioned into a gutter so as to convey the redundant flu.d into a vessel at the side of the bed, and to p event bed and patient from becoming wet, is placed beneath the affLt pan 71 I ''''^ '^'^ ^^l^^^^d dressing. The fluid wi 1 find Its way by capillary attraction along the lint and diffuse i seIf th ough the dressing, and run off, when this has been surcharged, on th rubber cloth. Another method is to have a suitable vessel provided with a stop-cock, which will permit the water to escape in a small stream, or by drops, as the attendant may desire. It is important that the water should not fall from a height as the constant dropping often causes distress. Cold water was extensively used m Gunshot Wounds during the late war between the States, and as a primary dressing, answered a good purpose. If too long continued however, it produces a depressing influence on the part, the granulations become pale and flabby, and exhibit an indisposition to heal It is difficult to state positively what should be the temperature of the water to be employed. As a rule the feelings of the patient are to be consulted ■ if cold water causes a sense of chilliness and discomfort, it should at once be changed for warm water, or be discontinued. Cold water is usually preferable in the early stage of inflammation, when it will assist in pro- motmg resolution, but is not desirable when suppuration is impending, or when danger of gangrene is imminent. Warm water is of service in the early treatment of severe Lacerated and Contused Wounds, where the vitality of the part is threatened. It is here best applied by irrigation; care will be required to keep it at the desired temperature. Some practitioners prefer to irrigation that the tissues involved be immersed in a bath of warm water. The effect of either heat or cold may be obtained indirectly by the use of a Petitgand or Leiter's coil, by a rubber bag filled with water, or, if cold be desired, one filled with broken ice. The latter method' is extensively used in the treatment of Concussions or Threatened Inflammation of the Brain, in order to reduce as much as possible the vascularity of the meninges. In temporary, non-reducible Hernia, which if left to itself may soon become strangulated, the ice bag, or in its absence, cold water on a lint dressing, will in many cases prove a' satisfactory application. Not infrequently a scrotal hernia thus treated will spontaneously disap- pear after an application to the scrotum for two or three hours. In all cases of strangulated hernia, when it is necessary to wait for the arrival of the surgeon it is well to apply cold to the tumor, as a means of pre- venting inflammation. In severe Sprains and Contusions of the Articulations there may