92 SUEGICAL THERAPEUTICS. 



the finger-nails must by no means be used for such a purpose, 

 for the twofold reason that it is both filthy and dangerous. 

 Handle the wound only as much as is necessary; all needless 

 taxis irritates — the inference is obvious. If the wound is deep, 

 injections can be combined with the lotions in cleansing it. 



With the first dressing, there is probably only blood to wash 

 away, and that should be done thoroughly, not overlooking any 

 portion that may have dried in the haii- and on the skin. The 

 essential condition of cleanliness applies not only to the wound, 

 but also to the material used for the dressing, and soiled cloths 

 or bandages, and dii'ty tow or oakum must be rigorously rejected. 

 And, while insisting on strict cleanhness in the instruments and 

 dressing material, it will hardly be decorous to the surgeon to 

 omit him from the category, and to remind him of the propriety 

 of looking to his own condition, and especially to that of his 

 hands. 



In all his manipulations it should be a matter of conscience 

 with the surgeon to treat his patient kindly. Rough handling, 

 loud scolding, threatening or jerking, with a restless animal, to 

 pimish him for an instinctive and natural attempt to move under 

 the infliction of pain, will not only be of no service, but, on the 

 contrary, will increase his fright and render him all the less docile 

 and willing to submit in quietness. 



In applying the various parts of the dressings, unnecessary 

 pressure should be avoided, esjpeciaUy on soft tissues ; and when 

 it is indicated, it should be apphed by slow degrees, and as imi- 

 formly as possible, packing the wound upon its entire surface, 

 and completed only as the dressing is nearly ended. Assistants 

 should be enjoined to observe the same rules. The dressing 

 should be apphed, not hastily, but rapidly; not with the idea of 

 saving time, simply with a view to lose none. The fact of avoid- 

 ing any waste of time, by working without needless pause, has, 

 moreover, the excellent effect of curtailing the sufferings of the 

 patient, and sparing him much needless j)ain. 



It is always important to watch the effect of the various arti- 

 cles of dressing as they are apphed, in order to be certain that 

 they cause no pain either at the time, or at a later period by their 

 shape, the roughness of their surface, or their unskillful apjolica- 

 tion ; and above aU, that they cause no interference with any of 

 the essential functions of the economy, as the respii-ation or cu-- 



