98 SURGICAL THERAPEUTICS. 



which compose it being often impregnated with blood and glued 

 together by concreted pus, causing, if removed carelessly, the 

 laceration of tissues, tearing of granulations, hemorrhages, etc. 

 It must especially be ascertained whether adhesions exist between 

 the material of the dressing, and if they are present they must 

 be thoroughly soaked by means of compresses wet with tepid 

 water, or a warm water bath, if the dressing is upon a region 

 which allows it, as, for instance, one of the extremities. When 

 this is done, the various constituents of the dressings may easily 

 be removed, one by one, but care and deliberation will still be 

 necessary. The smaller particles should be removed with the 

 forceps, not the fingers. If the location allows it we even prefer 

 to wash these away by irrigation, with a stream of luke-warm 

 water, or by soaking thoroughly in a foot bath. The wound is to 

 be cleaned out carefully, by soaking or sopping away the pus with 

 fine sponges, avoiding all rubbing upon the granulations or caus- 

 ing them to bleed. Then studying all the indications, to be dis- 

 covered in the condition of the wound, and avoiding aU unneces- 

 sary manipulations, and attentively removing all causes likely to 

 interfere with the repairing processes, the di'essing is to be re- 

 placed with all the original precautions. As little time as possi- 

 ble, consistent with thoroughness, should be occupied in this 

 process. The wound should be uncovered only as long as 

 necessity requires, the materials for the dressing being all easily 

 accessible without delay or hindrance, being prepared in advance 

 and carefu^Uy inspected. 



The effects looked for in the application of dressings can be 

 divided into general and special, these varying in their natin'e, 

 according to the object which the surgeon has in view. The 

 first and principal object is to protect the wound from exposure 

 to the action of the atmosphere, and also against contact with 

 foreign bodies, thus to relieve the pain, diminish the inflammatory 

 irritation, and accelerate the cicatrization. It also prevents the 

 retention, by their absorption of the suppuration and serosity 

 which form on the surface. They also expedite recovery b}' 

 maintaining the natural warmth of the body in the region. 

 The sp>ecial effects of dressing, vary according to the special 

 action produced by their application, and these may be considered 

 under several heads. 



{a) Retentive dressing. — This is designed to keep parts in their 



