A universal formulary : containing the methods of preparing and administering officinal and other medicines the whole adapted to physicians and pharmaceutists / by R. Eglesfeld Griffith.
- Robert Eglesfeld Griffith
- Date:
- [1854]
Licence: Public Domain Mark
Credit: A universal formulary : containing the methods of preparing and administering officinal and other medicines the whole adapted to physicians and pharmaceutists / by R. Eglesfeld Griffith. Source: Wellcome Collection.
555/696 page 549
![to apply compress, wliicb should be broad, to keep the skin*better together, and thick, to make the compression more certain. When blood-letting is ordered, everything required for the operation should be at hand. The ligature for tying the arm, so as to obstruct the flow of blood in the veins below it, should be a soft old ribbon; and the same may be employed for securing the pledget over the orifice, when the flow of the blood is to be stopped. The pledget, or compress, should be a piece of linen, folded into^ a squai’e form, about an inch in diameter, and compi’ehending three or four thicknesses of the material. It is always proper to use a graduated basin for receiving the blood, that the exact quantity drawn may be ascertained. If the invalid be bled in bed, he should sit erect; if he be up, he should be placed erect in a chair. When the operator is dexterous, there is little or no necessity for guarding either the bed or the clothes of the patient from the blood; as the pressure of the thumb of the operator, placed below the point where the vein is to be punctured, should not be relaxed until the utensil for receiving the blood be conveniently placed for that purpose. A basin with a little tepid water, and a clean, soft towel, should be ready for washing and drying the arm, before the compresses and the bandage for pre- venting the further escape of the blood be applied. When a nurse or an attendant is not fully instructed in her duty, there is always considerable anxiety displayed to provide smelling salts and other means to obviate fainting. But, in many cases, much of the benefit of blood-letting depends on the fainting which it causes; and the propriety of checking that effect should be left entirely to the physician. No person should be present at this operation, nor should any one attempt to hold the basin for receiving the blood who is liable to become sick or faint at the sight of blood. The arm should not be used for some hours after a vein has been opened in it ; but, if everything has gone on well, the bandage may be removed at the end of two days. When this has been applied too tightly, the forearm and hand are apt to swell and become painful, in which case the bandage is to be loosened. If, on removing the bandage, it is found that the orifice, instead of being closed, presents an inflamed appearance, with its lips swelled and red, the arm is to be kept per- fectly quiet, the edges of the wound brought in contact, and some cool application made to the part, to relieve the inflammation. In those cases where the inflam- mation extends beyond the orifice, and assumes an erysipelatous appearance, with a hard and painful tumor around the wound, a compress is to be applied upon the vein at the inflamed part, to make the two sides adhere together; if they do not adhere, simple contact will still be sufficient to prevent suppuration in this part; or, if inflammation has gone so far as to make the surgeon suspect that suppuration has taken place, then the compress must be put upon that part of the vein just above the suppuration. The remedy for inflammation of the veins consequent on venesection, which answers best, is the application of a blister over the inflamed part. As soon as the inflammation commences, a small plaster of simple cerate, spread on linen, should be applied on the orifice, and over this, a blister large enough to cover the whole in- flamed part, extending three or four inches from the orifice in every direction. This remedy was first proposed, and made use of, by Dr. Physick, and has been employed by many physicians with great success, even after extensive inflammation of the vein has taken place. Sometimes it becomes expedient to open the external jugular vein. To do this the head should be laid on one side, and the vein compressed by the operator’s thumb near the clavicle, and the opening made in that part of the vein which lies over the sterno-cleido-mastoid muscle.* The blood soon ceases to escape after the pressure is removed, but a small strip of adhesive plaster is necessary. • jug'ilar vein, it is generally advisable to compress both of the external jugmars. this IS easily done by placing the thumb of the Ictl hand upon one jugular vein, and me lore mgerof the same hand upon the other. If this point is not attended to, the operation may taU, m consequence of the free anastomosis across the neck, and the passage of the blood downwards upon the opposite side.] ^](https://iiif.wellcomecollection.org/image/b28125678_0555.jp2/full/800%2C/0/default.jpg)
