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on the surgery-第2章

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downwards; in the case of the leg。 The turns of the bandage should

be made from right to left; and from left to right; except on the

head; where it should be in a straight direction。 When opposite

parts are to be bandaged together; we must use a bandage with two

heads; or if we make use of a bandage with one head; we must attach it

in like manner at some fixed point: such; for example; as the middle

of the head; and so in other cases。 Those parts which are much exposed

to motion; such as the joints; where there is a flexion; should have

few and slight bandages applied to them; as at the ham; but where

there is much extension; the bandage should be single and broad; as at

the kneepan; and for the maintenance of the bandage in its proper

place; some turns should be carried to those parts which are not

much moved; and are lank; such as the parts above and below the

knee。 In the case of the shoulder; a fold should be carried round by

the other armpit; in that of the groin; by the flanks of the

opposite side; and of the leg; to above the calf of the leg。 When

the bandage has a tendency to escape above; it should be secured

below; and vice versa; and where there is no means of doing this; as

in the case of the head; the turns are to be made mostly on the most

level part of the head; and the folds are to be done with as little

obliquity as possible; so that the firmest part being last applied may

secure the portions which are more movable。 When we cannot secure

the bandaging by means of folds of the cloth; nor by suspending them

from the opposite side; we must have recourse to stitching it with

ligatures; either passed circularly or in the form of a seam。

  10。 The bandages should be clean; light; soft; and thin。 One

should practice rolling with both hands together; and with either

separately。 One should also choose a suitable one; according to the

breadth and thickness of the parts。 The heads of the bandages should

be hard; smooth; and neatly put on。 That sort of bandaging is the

worst which quickly falls off; but those are bad bandages which

neither compress nor yet come off。

  11。 The following are the object which the upper bandage; the

under bandage; or both aim at: The object of the under bandage is

either to bring together parts that are separated; or to compress such

as are expanded; or to separate what are contracted; or to restore

to shape what are distorted; or the contrary。 It is necessary to

prepare pieces of linen cloth; which are light; thin; soft; clean;

having no seams nor protuberances on them; but sound; and able to bear

some stretching; or even a little more than required; not dry; but

wetted with a juice suitable to the purpose required。 We must deal

with parts separated (in a sinus?) in such wise; that the parts

which are raised may touch the bottom without producing pressure; we

must begin on the sound part; and terminate at the wound; so that

whatever humor is in it may be expelled; and that it may be

prevented from collecting more。 And straight parts are to be

bandaged in a straight direction; and oblique obliquely; in such a

position as to create no pain; and so that there may be no

constriction nor falling off on a change of position; either for the

purpose of taking hold of anything; or laying the limb; and that

muscles; veins; nerves; and bones may be properly placed and

adjusted to one another。 It should be raised or laid in a natural

position; so as not to occasion pain。 In those cases in which an

abscess is formed; we must act in a contrary way。 When our object is

to bring together parts which have become expanded; in other

respects we must proceed on the same plain; and we must commence the

bringing together from some considerable distance; and after their

approach; we must apply compression; at first slight; and afterwards

stronger; the limit of it being the actual contact of the parts。 In

order to separate parts which are drawn together; when attended with

inflammation; we must proceed on the opposite plan; but when without

inflammation; we must use the same preparations; but bandage in the

opposite direction。 In order to rectify distorted parts; we must

proceed otherwise on the same principles; but the parts which are

separated must be brought together by an underbandage; by

agglutinants; and by suspending it (the limb?) in its natural

position。 And when the deformities are the contrary; this is to be

done on the contrary plan。

  12。 In fractures we must attend to the length; breadth; thickness;

and number of the compresses。 The length should be that of the

bandaging; the breadth; three or four fingers; thickness; three or

fourfold; number so as to encircle the limb; neither more nor less;

those applied for the purpose of rectifying a deformity; should be

of such a length as to encircle it; the breadth and thickness being

determined by the vacuity; which is not to be filled up at once。 The

upper bandages are two; the first of which is to be carried from the

seat of the injury upwards; and the second from the seat of the injury

downwards; and from below upwards; the parts about the seat of the

injury being most compressed; the extremities least; and the rest in

proportion。 The upper bandages should take in a considerable portion

of the sound parts。 We must attend to the number; length; and

breadth of the bandages; the number must be such as not to be inferior

to what the injury requires; nor occasion compression with the

splints; nor prove cumbersome; nor occasion any slipping of them;

nor render them inefficient。 As to length and breadth; they should

be three; four; five; or six cubits in length; and as many fingers

broad。 The folds of the strings (selvages?) should be such as not to

occasion pressure; they are to be soft and not thick; and all these

things are to be proportionate to the length; breadth; and thickness

of the part affected。 The splints are to be smooth; even; and

rounded at the extremities; somewhat less all along than the upper

bandaging; and thickest at the part to which fracture inclines。

Those parts where there are tuberosities; and which are devoid of

flesh; such as the ankles or fingers; we must guard from the splints

which are placed over them; either by position; or by their shortness。

They are to be secured by the strings in such a manner as not to

occasion pressure at first。 A soft; consistent; and clean cerate

should be rubbed into the folds of the bandage。

  13。 As to the temperature and quantity of the water used; its heat

should be just such as the hand can bear; and it ought to be known

that a large quantity is best for producing relaxation and

attenuation; whereas a moderate quantity is best for incarnating and

softening。 The limit to the affusion is; to stop when the parts become

swelled up; and before the swelling subsides; for the parts swell up

at first; and fall afterward。

  14。 The object on which to (the limb?) is laid should be soft;

smooth; and sloping upwards toward the protuberant parts of the

body; such as the heel or hips; so that there may be no p
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