ILLUSTRATED BY 122 ENGRAVINGS ON WOOD. BY BERKELEY HILL, M.B. Lond. , F.R.C.S., Instructor in Bandaging, &c., in University College, Assistant Surgeon to University College Hospital, and Surgeon to Out-patients at the Lock Hospital. SECOND EDITION, REVISED AND ENLARGED. LONDON: JAMES WALTON, BOOKSELLER AND PUBLISHER TO UNIVERSITY COLLEGE, 137, GOWER STREET. 1869. LONDON: BRADBURY, EVANS, AND CO., PRINTERS, WHITEFRIARS....

In laying a Second Edition before the public, I have decided not to alter the scope of this little work, but simply to endeavour to increase its usefulness, by remedying omissions, and by adding new instructions where such appeared desirable. I have ventured to insert, as an Appendix, lists of the preparations requisite for the sick room and for the operating room before the ordinary operations of surgery are performed; also, lists of the instruments and appliances requisite, or possibly useful,

The descriptions and directions for using surgical apparatus in the following pages, are those originally prepared for oral delivery in a short course of practical lessons in bandaging and the application of surgical apparatus, given by me in University College Hospital. No attempt is made to include all efficient modes of treating surgical injuries: it is merely proposed to supply the student or practitioner with instructions by which he may refresh his memory when about to employ the ordinary

General Rules. —Ordinary bandages are strips of unbleached calico 6 or 8 yards long, having a breadth of ¾ inch for the fingers and toes, 2¼ inches for the head and upper limb, 3 inches for the lower limb, and 6 inches for the body. These, when tightly rolled for use, are termed rollers. Besides these rollers for general use there are special bandages, such as rollers of muslin for using with plaster of paris, of stocking-webbing when elasticity is needed; four- and many-tailed bandages for part

Bandages for the Head. —A roller is commonly applied in three different ways to the head. 1st. For keeping simple dressings in place. Apparatus. —1. A roller 2 inches wide, and of the usual length. 2. Some pins. A turn is first carried round the head, over the brows and below the occipital protuberance, and fastened by a pin; this being done, the roller is carried across the dressing, and getting into the line of the first turn, is passed round the head again, then across the dressing, and round

To bandage the Breast. Apparatus. —1. A roller 3 inches wide and 8 yards long. The roller is first carried once round the body below the breast, beginning in front and passing towards the sound side. When the bandage is fixed, the roller ascends over the lower part of the diseased breast, to the opposite shoulder, and comes back by the arm-pit to the horizontal turn; it is then passed round the chest to fix the oblique turn. Having done this, it again is carried up over the breast and shoulder,

Bandage for the Fingers and Thumb. Apparatus. —A ¾-inch wide roller. The fingers are bandaged to prevent œdema when splints are tightly attached to the fore or upper arm. A roller ¾ inch wide is passed once round the wrist and then carried over the back of the hand to the little finger; then wound in spirals round it to the tip and returned up the finger, completed by a figure of 8 round the wrist and the root of the finger, and returned to the wrist before being brought across the back of the h

For adults the most useful width for the rollers is 3 inches, and the length the ordinary one of 8 yards. The Foot is usually bandaged without covering the heel, and the bandage is begun as follows:— The roller being held in the right hand for the right foot, or in the left hand for the left foot; the unoccupied hand takes the end, and passing it under the sole, brings it up on the back of the foot just behind the toes, where it is made fast by carrying the roller outwards over the back. When on

Strapping is a method of supporting weak or swollen joints and other parts. Sheets of calico, wash-leather, or white buckskin, spread with lead or soap plaster, are prepared for this purpose. A sheet should be rubbed with a dry cloth before using, to remove adherent dust, &c. It is then cut into strips varying in width between ¾ inch and 2 inches, according to the evenness of the surface to be covered: narrow strips fit best over joints and irregular surfaces. When applied to a limb, the

Fracture of the lower Jaw.—The External Splint and Bandage. —A method requiring the lower jaw to be firmly fixed against the upper one while the broken bone knits. Apparatus .—1. One and a half yards of bandage four inches wide. 2. A piece of gutta-percha, sole leather, or binder’s millboard. 3. Dentists’ silk or wire. 4. Boiling hot, and cold water. Step 1. The fracture is first reduced. While the apparatus is being fitted, the recurrence of the displacement is prevented by the hands of an assi

Fracture of the Metacarpal Bones. Apparatus. —1. A piece of gutta-percha. 2. A roller 2 inches wide. In treating this fracture it is important to keep the broken bone in place without confining the wrist or fingers. A pattern of the palm and dorsum of the hand is cut out of paper, which is doubled round the radial side, letting the thumb out through a hole of convenient size to clear it (see fig. 27). The piece of paper is then laid on a sheet of gutta-percha ¼ inch thick, and the requisite quan

Ruptured tendo Achillis is treated by extending the foot and flexing the knee; for this purpose the patient wears a high-heeled slipper. A band is sewn to the heel, drawn tight, and fastened to a buckle and strap round the thigh, just above the knee. The patient should not walk for a month unless he will use a wooden leg on which he can kneel, with the knee bent. Separation of the Epiphysis of the Calcaneum , which sometimes occurs instead of rupture of the tendo Achillis, is treated in the same

The main obstacles in reducing dislocations are entanglement together of the displaced bones and contraction of the muscles; the entanglement of the bones determines the direction in which extension must be made, and also of the counter extension , or point at which the body is fixed to resist the traction practised on the limb; this should be exactly opposite the direction in which the limb will be drawn. The muscles can always be relaxed by chloroform, hence it is better when they are powerful

Having a good Light and Windows that open readily, and a Fire in Winter....

Before a room is occupied by a patient who has been operated on, it should be thoroughly cleaned; the walls and ceiling should be well brushed, the carpet taken away and the floor thoroughly scrubbed with soda. All curtains and chintz furniture should be removed, old window-blinds replaced by new green ones, and the window made to open readily at the top and bottom. A fire or oil-lamp should be lighted in the fireplace to maintain a circulation of air. If the season require a fire, the iron fend

(See List for the Ligature of Arteries.)...

The same....

(See also the List for the Operating Room)....

( Syme’s and Chopart’s Operations. )...