| [p. 195] one has formed
in the course of treatment, owing to the pressure of the splints occasioned
by the bandages, or from any other cause. In such cases it is ascertained
that there is an ulcer, by the pain and the throbbing; and the swelling
in the extremities becomes harder than usual, and if you apply your
finger the redness disappears, but speedily returns. If you suspect
anything of the kind you must loose the dressing, if there be any
itching below the under-bandages, or in any other part that is bandaged,
and used a pitched cerate instead of the other. If there be nothing
of that, but if the ulcer be found in an irritable state, being very
black and foul, and the fleshy parts about to suppurate, and the tendons
to slough away, in these cases no part is to be exposed to the air,
nor is anything to be apprehended from these suppurations, but the
treatment is to be conducted in the same manner as in those cases
in which there was an external wound at first. You must begin to apply
the bandages loosely at the swelling in the extremities, and then
gradually proceed upward with the bandaging, so that it may be tight
at no place, but particularly firm at the sore, and less so elsewhere.
The first bandages should be clean and not narrow, and the number
of bandages should be as great as in those cases in which the splints
were used, or somewhat fewer. To the sore itself a compress, anointed
with white cerate, will be sufficient, for if a piece of flesh or
nerve (tendon?) become black, it will fall off; for such sores are
not to be treated with acrid, but with emollient applications, like
burns. The bandages are to be renewed every third day, and no splints
are to be applied, but rest is to be more rigidly maintained than
in the former cases, along with a restricted diet. It should be known,
that if any piece of flesh or tendon be to come away, the mischief
will spread much less, and the parts will much more speedily drop
off, and the swelling in the surrounding parts will much more completely
subside, under this treatment, than if any of the cleansing applications
be put upon the sore. And if any part that is to come away shall fall
off, the part will incarnate sooner when thus treated than otherwise,
and will more speedily cicatrize. Such are the good effects of knowing
how a bandage can be well and moderately applied.
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