THE UP-OOUNTRY MEDICINE CHEST AND HOW TO USE IT . 



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Whenever possible, see that your own hands are thoroughly cleaned before 

 touching a fresh wound, using for the purpose soap and water and a nail-brush, with 

 subsequent immersion in solution "B." The area of skin surrounding the wound should 

 be similarly purified. The washing of the wound itself will be best done by trickling 

 the solution "A" or "B" on its surface from a pledget of salicylic cotton, or by simply 

 pouring it on from a wineglass or cup. In washing wound use pledgets of absorbent 

 or salicylic cotton rather than sponges ; a sponge in ordinary use contains impurities 

 which ought not to be brought in contact with fresh wounds. A really dirty wound 

 should be cleaned with solution "A," and the surface may need to be wiped clean 

 with pieces of cotton wrung out of the solution, followed by free irrigation with the 

 same or a weaker solution. Punctured wounds, especially those into which earth has 

 entered, need extra care, and the cleaning should be very thoroughly done before 

 they are bound up. The edges of gaping wounds should be brought together by a 

 suitable arrangement of pads of salicylic cotton wrung out of solution "B" and 

 secured in position by a bandage ; if the wound is large and the edges cannot be 

 kept together in this way, one or two stitches had better be inserted ; these can be 

 made with an ordinary sewing needle and thread of white cotton, but both needle 

 and thread should be immersed in solution "A" for at least ten minutes before they 

 are used, 



I give now briefly the method of dressing an ordinary wound on board the boat 

 where boracic ointment, salicylic cotton and a solution of carbolic acid are all to be 

 found in the medicine chest. Wash your hands. Take a piece of lint or clean rag 

 large enough completely to cover the wound ; spread over its whole surface the 

 "universal" or plain boracic ointment, using a clean knife to do this, cleaned by 

 immersion in solution "A." Now wash the wound and the surrounding skin, using 

 the weak or strong solution as you judge best in the particular case under treatment. 

 To dress the wound: — Take the piece of lint spread with the ointment, dip it in 

 solution "A" to purify it thoroughly and lay it over the wound ; above this lay a pad 

 of salicylic cotton wrung out of solution "B," cover the wet pad with a larger pad of 

 dry salicylic cotton, and a clean handkerchief above all to keep the cotton together ; 

 secure the whole with a bandage. In this arrangement the ointment prevents the 

 dressing from sticking to the wound and protects the surrounding skin from the 

 irritating effect of the carbolic acid, while the pads of cotton form a suitable anti- 

 septic covering, and will enable you to apply properly distributed pressure with the 

 bandage, should pressure be needed to stop bleeding. If no pain is complained of 

 a dressing of this kind need only be changed every second day. Before changing 

 a dressing see that the materials necessary for the next one are all at hand and the 

 dressing itself prepared as far as possible ; by doing this you avoid unnecessary 

 exposure of the wound. 



To Stop Bleeding from a Wound. — Unless you possess a surgical instrument case and 

 understand the use of artery forceps and how to apply a ligature directly to the 

 bleeding point you must depend on pressure ; and pressure should always in the first 

 instance be applied over or in the wound itself. The fingers of the operator will 



