Bandages. There is not a more important art connected with household surgery than that of bandaging. To do it well requires much practice and no little judgment ; even hospital dressers are not always perfect in this branch of their operations; and we have known " family doctors " make a sad bungle of bandaging a leg or an arm. On the other hand, we have seen it so deltly performed, that no piece of machinery-work could excel it; so smooth and regular, so compact and firm ; every fold and diagonal turn falling into its exact place, and maintaining its proper relative position; each layer of even texture fading off, as it were, from its fellow, and in turn supporting another, with no undue strain or pressure on any part; the very perfection of close binding. We do not expect many of our readers to accomplish this; hut it will be as well for them to understand how it is done, that they may, when the emergency arises, know how to go about it. First of all let us ask what is a bandage? Something that binds, a fillet, a piece of linen or cloth for binding up a wounded limb. The material employed for this purpose is usually stout unbleached calico, from two or three to nine or ten inches wide, and from six to twelve yards long; the former length and breadth will do best for the leg. If commenced at the ball of the foot, and evenly applied, so that each fold overlaps the other about one-third, it will reach to the knee; the preceding cut will best show the mode of application. The bandage having been first tightly rolled up, is taken in the right hand of the operator; the end is passed under the foot, and held there by the left hand until it is secured by one turn of the bandage over it; an upward direction is then taken, so that a couple of folds bring the bandage up to the front of the leg, over the instep ; the next turn will naturally pass over the heel behind ; and then, if proper care be observed, it will go on fold above fold, each overlapping the other slightly, all up the leg; the bandage is passed from the right to the left hand each time that it goes round the leg, and great care should be taken to hold it firmly, and equalize the pressure, as well as to smooth out any wrinkles that may occur in the process of binding. A firm and even support is thus afforded to the limb, which is not likely to crease, or get displaced by the motion which may be afterwards necessary ; it may be made fast above the calf by a couple of pins, or a needle and thread. Great care should be taken in tins, as in all similar operations, to get the bandage rolled up tightly and smoothly, before commenc-ing; it may thus be grasped in the hand, and kept well under the command of th6 operator, who should on no account let go his hold of the bandage, so as to relax the pressure.
The arm does not require so long or broad a bandage as the leg; about two inches, by three or four yards, being the average size: this limb is rather more difficult, to manage, half turns being necessary to effect a proper envelopment. How this is effected may be seen by the following cut. The bandage is folded back upon itself, so as to take a different direction, and cover the space which would be left exposed by the ordinary method of folding; these half turns, unless they are done tightly and evenly, will be very apt to slip and derange the whole binding. Some operators avoid half turns by letting the roller take its natural course, and then coining back to cover the exposed parts; but this method, besides requiring a larger bandage, does not effect the required purpose so neatly and efficiently. One mode of fastening a bandage is to split it up a short distance, so as to leave two ends, which can be passed round the limb, and tied. It should always be borne in mind that the chief art in applying bandages is to give firm and uniform support, without undue pressure upon any part; and to effect this properly, the strain in winding should be upon the whole roll held in the hand, and not upon the unrolled portion of it; and this strain should not be relaxed during the operation.
The next cut represents the mode of applying what is called a many-tailed bandage, useful to apply over a wound, or wherever it requires frequent, changing, or in cases in which it is desirable not to exhaust the patient by much movement of the limb, This is a strip of calico somewhat longer than the limb to be enveloped; on it are sewn, at right angles, other strips, about one-half longer than the circumference of the limb, each overlapping the other about one-third of its breadth, so that when drawn tightly over in regular succession, each secures the other; the end of the strip parses under the heel, and coming up on the other side, is made fast to the bandage there, and so all is kept firm.
For keeping poultices on the lower part of the back, or in the groin, a cross bandage is used, the fashion of which is this : make a calico band large enough to pass round the loins, and tie a buckle in front; to this is attached another piece, which proceeds from the centre of the back to the anus, where it divides into two, which pass under the thighs, up on either side, and are fastened to the band in front. The bondage used to close a vein after bleeding is commonly Called a figure of eight.
For a sprained ankle, place the end of the bandage upon the instep, then carry it round, and bring it over the same part again, and from thence round the foot two or three times, finishing off with a turn or two round the leg above the ankle.
For a sprained wrist begin by passing the bandage round the hand, across and across, like the figure 8; exclude the thumb, and finish with a turn or two round the wrist.
For a cut finger, pass the bandage, a narrow one, round the finger several times, winding from the top, and splitting the end, fasten by tying round the thick part above the cut; or if it be high up, tie round the wrist.
I he best bandage for the eve Is an old silk handkerchief passed over the forehead, and tied at the back of the head. For the head itself, it is best to have a cross-band-age, or rather two bandages; one passing across the forehead, and round the back of the head, and the other over the top of the head, and below the chin, as in the preceding cut. Or, better than this is, perhaps, a large handkerchief which will extend all over the forehead and crown, two ends of it passing to the back, and after crossing from thence round the neck, then tying the other two beneath the chin.
For a bandage to support a pad or poultice under the armpit, a handkerchief may be used, put on as in the following cut; or a broad piece of calico, arranged in the same way.
For fracture of the ribs, bandages should be about nine inches wide, and drawn round the body very tightly ; in this case, as in that of any other fracture or dislocation, only a properly qualified person should attempt their application.
We have not yet spoken of the T bandage, which is simply a broad band to pass round the body or elsewhere, having attached to it one of the same width, or narrower, like the upright part of the letter after which it is named; or, there may be two stems, if they can be so called, in which case it is a double T bandage, as under.
Starch bandages are those in which the roller, before it is put on, is saturated in a strong solution of starch. Sometimes a covering of brown paper is put over this, and another dry bandage is applied ; this makes a firm and compact case for the limb ; it is useful in cases of fracture, especially if the patient has to be removed to a distance. Sometimes, when it is not desirable to make the covering so thick and durable, the displacement of the bandages is guarded against by brushing a weak solution of starch or gum over the folds.
Bandaging should be performed in nearly all cases from the extremities upwards, or inwards to the heart, except where the injury is situated above the seat of vital action. If they give much pain there is reason to suspect inflammatory swelling beneath, and they should be loosened, if moistening with cold water does not relieve the pain. Flannel for bandages is used where warmth as well as support is required. - Family Doctor.