Mechanical therapeutics. A practical treatise on surgical apparatus, appliances, and elementary operations ...

Front matter

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Preface

In offering to the profession the present volume on mechanical therapeutics, the author would state that his design is to place in the hands of students and practitioners of medicine a systematized and condensed description of surgical dressings, apparatus, and elementary operations, drawn from the writings and teaching of the ablest surgeons in America and Europe. In its preparation care has been taken to adapt it also to the necessities of those wishing to enter the public service, inasmuch as the rigid and thorough examinations of our Military and Naval Medical Boards require more minute and extended information upon these subjects than can be obtained from the ordinary text-books.

The author has availed himself of the advantages offered him in hospital and private practice, and has submitted to actual trial most of the plans of treatment described in the work, noting at the time their advantages and disadvantages in the cases in which they have been recommended by their authors. All embarrassing generalities have been avoided as far as possible in the descriptions, each step in the preparation and application of apparatus being minutely detailed.

In a work of this nature it was indispensable for the easy understanding of the subjects treated that it should be fully illustrated. Many engravings introduced throughout the volume have been drawn from the well-known works of Yelpeau, Gross, Miller, Erichsen, Fergusson, Druitt, Skey, Pirrie, and Sargent; while the author would also acknowledge special indebtedness to the elaborate treatises of Hamilton, Malgaigne, and E. E. Smith, on fractures and dislocations ;

IV PKEFACE.

to Goffres' " Precis des Bandages, Pansements et Appareils," Jamain's " Manuel de Petite Chirurgie," and to Bigg's Orthopraxy.

The skilful surgical mechanicians, Mr. Kolbe and Mr. Gemrig, of Philadelphia, have been courteous enough to place at his disposal models and drawings of the latest surgical apparatus and appliances.

Philadelphia, Nov. 1867.

Chapter I. Of The Instruments Of Dressing

PARE

PAfiE

The Pocket-Case . . . .33

Porte-meche ..... 42

Scalpels

Directors

. 42

Bistouries

Spatulas .

Scissors .

Porte-caustic .

Razor

Surgical Needles

Forceps .

Trocars .

Tenaculum

Catheters

Lancets .

Ivory winder for suture threads

Probes .

Chapter II. Of The First Pieces Of Dressing

Lint

.

Sawdust .

. 51

Charpie .

Metallic Plates

Different Forms of C

'harpie

Compresses

Sponge Tent .

Simple

Cotton .

.

Splint .

Oakum .

.

Folded

Tow-

.

Knots

Wool

Adhesive Plaster

Raw Silk

Isinglass Plaster

Sponge . .

.

Collodion

Moss

Styptic Colloid

Cat's-Tail

The Surgical Tray

Amadou .

.

The Surgical Wallet

Bran

Chapter III. On The Use Of Some Topical Remedies

Cerates .

. 62

Lotions . .

. 72

Ointments

. 64

Collyria

. 74

Plasters .

. 67

Gargles

. 77

Liniments

. . . 69

Collutories ....

. 73

Glycerine

. 70

Poultices ....

. 79

VI

Chapter IV

ON THE USE OF WATER IN SURGICAL DISEASES AND INJURIES. Sect. I. Water as a Surgical Dressing

Cold Water-dressings Warm Water-dressings .

Medicated Water-dressings Dry Fomentation Immersion Irrigation

Cold ....

Irrigation —

Of the Nasal Fossse Of the Bladder ....

Of the Uterus and Vagina .

The Application of Water by Means of India-rubber Sacks

Sect. II. The Use of Water Generally — Bathing General Baths . . . 98 I Local Baths

93 94 94

98 98

Chapter V Injections

Injection ....

. 106

Injection of the Vagina .

. 110

Of the Lachrymal Duct

. 107

Of the Uterus

. Ill

Of the Ear .

. 107

Of the Rectum

. 112

Of the Urethra .

. 109

Of the Cellular Tissue

. 115

Of the Bladder .

. 110

Of Abnormal Canals .

. 116

CHAPTER YI.

ON THE USE OF GASES AND VAPORS.

Sect. I. Purification of the Air of Hospitals and Chambers, or Disinfection 117 Sect. II. The Application of Vapors and Gases to the Skin, or Fumigation . 123 Sect. III. The Application of Gases, Vapors, and Atomized Liquids to the Interior Cavities

Chapter VII. The "second Pieces" Op Dressing, Or Bandages Properly So Called

Sect. I. General Rules for the Preparation and Application of Bandages . 131

Sect. II. Special Systems of Bandaging 137

Mayor's 137 1 Rigal's 137

Sect. III. The Indications Answered by Bandages . - 139

Sect. IV. Classification of Bandages 158

Chapter VIII. Special Or Regional Bandaging

Sect. I. Bandages for the Head .....

Simple Bandages Circular Bandages

Of the Forehead and Eyes

160 160 160

Simple Bandages — Crossed Bandages The Monocle

162 162

CONTENTS.

Vll

PAGE

PAGE

The Binocle ....

Sling Bandages ....

Single Crossed Bandage for the

Six-Tailed Bandage of the Head

Lower Jaw ....

Four-Tailed Bandage of the Chin

Double Crossed Bandage for the

Mask

Lower Jaw ....

Sheath Bandages ....

Crossed Bandage of the Head .

Sheath Bandage of the Nose .

Crossed Bandage of the Head

Sheath Bandage of the Tongue .

and Neck ....

Knotted Bandages

Mayor's Bandages . .

Knotted Bandage of the Head .

Circular Cravat ....

Occipito-Frontal Triangle

Recurrent Bandage of the Head

Fronto-Occipital Triangle

Handkerchief Bandages

Fronto-Oculo-Occipital Triangle .

Triangular Bandage of the Head

Bis-Oculo-Occipital Triangle

Quadrilateral Bandage of the

Occipito-Mental Triangle

Head

Fronto-Cervico- Labial Triangle .

Invaginated Bandages

Facial Triangle ....

Invaginated Bandage of the Lips

Occipito-Auricular Triangle

Rigal's Bandages ....

T Bandages

Cap .

.

.

T Bandage of the Head and Ears

Half-Cap .

.

.

Double T Bandage of the Nose .

Simple Capeline

.

T Bandage of the Head .

Fixed Capeline

.

.

Double T Bandage of the Head .

Arabic Capeline

.

.

T Bandage of the Mouth .

Shepherd's Sling

.

.

Crucial Bandages

Ocular Triangle

.

Crucial Bandage of the Head .

Sect. II. Bandages of the Neck and

Trun

K

Simple Bandages ....

The Spica or Figure of 8 of the

Circular of the Neck

Shoulder and Opposite Axilla

Circular of the Chest and Abdo-

Anterior Figure of 8 of the men

Shoulders ....

Oblique Bandages

Posterior Figure of 8 of the

Oblique Bandages of the Neck

Shoulders ....

and Axilla ....

Crossed Bandage of the Chest .

Spiral Bandages ....

Of One Breast

Spiral Bandages of the Body .

Of Both Breasts .

Crossed Bandages

Of One Oroin

Posterior Figure of 8 of the Head

Of Both Groins .

and Axillas ....

Anterior Figure of 8 of the Head and Axillas ....

T Bandages ....

Figure of 8 of the Head and One

Double T of the Chest and Ab-

Axilla .....

domen .....

Figure of 8 of the Neck and

Anterior Double T of the Head

Axilla and Chest

.

.

Vlll

CONTENTS,

Posterior Double T of the Head

and Chest . . . .184 Double T of the Pelvis . . 184 T Bandage of the Groin . .184

The Crossed Bandage of the Trunk 185

Sling Bandages .... 185 Of the Shoulder . . .185 Of the Breast . . . .185 Of the Hip ... 186

Suspensory Bandages . . . 186 Of the Breast . . . .186 Of the Testicle . . .187

Of the Penis . . . .187

Mayor's Bandages for the Neck and

Trunk 187

Cravat of the Neck . . .187 Occipito-Thoracic Triangle . . 187 Fronto-Thoracic Triangle . . 188 Parieto-Axillary Triangle . .188 Thoracico-Scapular Triangle . 188

Simple Bis-Axillary Cravat . . 188 Compound Bis-Axillary Cravat . 188

Simple Dorso-Bis-Axillary Cravat 189 Compound Dorso-Bis-Axillary Cravat 189

Cravat, Triangle, and Squares . 189 Triangular Cap of the Breast . 189 Cervico-Thoracic Cravat . . 189 Cervico-Dorso-Sternal Cravat . 189 Sacro-Pubic Triangle . . . 189 Intercrural Cravat . . . 190 Cruro-Pelvic Triangle . . .190 Cruro-Pelvic Cravat . . .190 Sacro-Bi-Crural Cravats . . 190 Sacro-Lumbar Triangle . . 190

Coxo-Pelvic Triangle . . .190

Rigal's Bandages for the Neck and

Trunk 191

Cervico- Axillary Cravat . .191 Lateral Thoracic Bandage . .191 Sternal Triangle . . . .191 Dorsal Triangle . . . .192 Thoracico-Abdominal Bandage . 192 Girdle 192

Sect. III. Bandages for the Upper Extremities

Circular Bandages . . .194 Of a Finger . . . .194 Of the Forearm . . .194 Of the Arm . . . .194

Spiral Bandages .... 195 Of a Finger . . . .195 Of all the Fingers (Gauntlet) . 195 Of the Hand and Fingers . .196 Of the Forearm . . .196 Of the Arm . . . .196 Of the Whole Arm . . .197

Figure of 8 Bandages . . . 197 Of the Thumb and Wrist . 198 Posterior, of the Hand and Wrist 198 Anterior, of the Hand and Wrist 198 Of the Elbow . . . .198 Extensor, of the Hand and Forearm 199

Flexor, of the Hand and Forearm 199

Recurrent Bandages . . . 199 Of a Stump of the Arm and

Forearm .... 199 After Disarticulation at the Shoulder . . . .199

.... 193

Handkerchief Bandages . . 200 Large Quadrilateral Scarf of the

Arm and Chest . . .200 Oblique Quadrilateral Scarf of

the Arm and Chest . . 200 Scarf of the Arm and Neck . 201 Scarf of the Hand and Forearm 201

T Bandages 201

Simple T Bandage of the Hand . 201 Double T Bandage of the Hand . 201 Perforated T Bandage of the Hand 202

Sling Bandages . . . .202 Of the Hand . . . .202 Anterior, of the Elbow . . 202 Posterior, of the Elbow . . 202

Sheath Bandages . . . .202 Of the Fingers . . . .202

Laced and Buckle Bandages . 202

Laced Bandage of the Arm . 202 Laced Bandage of the Body (Strait-Jacket) . . .202

CONTENTS.

IX

Mayor's Bandages of the Upper Ex-

TREMITIES .

.

. 203!

Cervico-Brachial Triangle

Cravats, Triangles, and Squares . 203 |

Triangular Cap of the Shoulder .

Carpo-Digito Dorsal Triangle

. 203

Triangular Cap of Stumps .

Interdigital Triangle .

. 204

Palmo-Digito-Brachial Triangle . 204

Rigal's Bandages of the Upper Ex-

Carpo-Olecranon Cravat

. 204 tremities .....

Carpo-Cervical Triangle

. 205

Deltoid Bandage ....

Sect. IV. Bandages for the Lower Extremities .......

. 207

. 207

Of a Toe .

. 207

. 207

Laced Bandages ....

Spiral Bandages .

. 207

Of the Lower Extremity .

Of a Toe .

. 207

. 208

Mayor's Bandages for the Lower

Of the Thigh .

. 208

Extremities ....

Of the Lower Extremity

. 208

Cravats, Triangles, and Squares of

Figure of 8 Bandages .

. 209 the Toes, Foot, Leg, and Thigh .

Of a Toe .

. 209

Imbricated Squares and Cravats .

Of the Foot and Leg

. 210

Tibial Triangle ....

Posterior, of the Knee

. 210

Popliteal Cravat ....

Anterior, of the Knee

. 210

Tarso-Patellar Cravat .

Of both Knees .

. 210

Compound Metatarso-Patellar Cra-

. 211 vat

. 211

Tarso-Pelvic and Tarso-Crural Cra-

Of the Thigh .

. 211 vats

Of the Hip

. 211

Triangular Cap for Stumps .

Invaginated Bandages

. 211

Triangular Cap for the Heel .

For Longitudinal "Wounds

. 211

Metatarso-Malleolar Cravat .

For Transverse Wounds

. 212

Malleolar-Phalangeal Triangle

Tibio-Cervical Cravat .

. 213

Uniting Cord for Longitudinal

T Bandages .

. 213

Wounds

Single, of the Foot

. 213

Double, of the Foot

. 213

Rigal's Bandages for the Lower Ex-

Sling Bandages .

. 214 tremities

Of the Instep .

. 214

Triangle of the Trochanter Major

Of the Heel

. 214

Bandage for the Leg-

Of the Knee .

. 214

Bandage for the Foot .

CONTENTS.

Chapter I. Apparatus For Remedying Loss Op Parts

Sect. I. Loss of Parts of the Head and Neck

219 219

Deficiency of the Cheeks and Lips Of the Palate Of the Chin

Deficiency of the Cranial Walls Of the Integuments Of the Nose Of the Eye ....

Sect. II. Apparatus for Remedying Deficiencies of the Trunk Deficiency of the Thoracic Walls . 227 I Deficiency of the Spinal Canal

Sect. III. Apparatus for Remedying Deficiencies of the Upper Extremities Deficiency of the Arm

Sect. IV. Apparatus for Remedying Deficiencies of the Lower Extremities Deficiency of the Leg ..........

PAGE

219 223

223 226

227 228

228 228

237 237

CHAPTER IT.

APPARATUS FOR REMEDYING LOSS OF FUNCTION OF PARTS OF THE BODY.

Sect. I. Apparatus for Remedying Loss of Function of the Muscles of the

Head and Neck 252

Loss of Function of the Cervical Muscles 252

Sect. II. Apparatus for Remedying Loss of Function of Muscles of the Trunk 253

Loss of Function of the Erector Muscles of the Spine . . . 253 Of the Abdominal Muscles — Hernia 254

Loss of Function —

Of the Sphincter Ani .

Of the Uterine Ligaments — Prolapsus Uteri ....

Sect. III. Apparatus for Remedying Loss of Function of Parts of the Upper Extremities ............

Loss of Function of the Muscles of

the Fingers .... 274 Of the Interossei Muscles . . 276 Of the Extensor Communis Digitorum 277

Loss of Function —

Of the Extensors of the Hand

Of the Biceps

Of the Scapular Muscles

Sect. IV. Apparatus for Remedying the Loss of Function of Parts of the Lower Extremities ...........

Loss of Function of the Tibialis An-

ticus 281

Of the Peronei Muscle . . .281 Of the Extensor Muscles of the Leg 282

Loss of Function —

Of the Ligament of the Knee-Joint — Knock-Knee ....

Of the Ligament of the Hip

267 268

278 279 279

284 289

CONTENTS.

XI

Chapter III

APPARATUS FOR REMEDYING LOSS OF SYMMETRY OF PARTS. Sect. I. Apparatus for Remedying Loss of Symmetry of the Head and Neck

Deformity of the Nose . . .289

Immobility of the Lower Jaw . . 290

Projection of the Chin . . .291

Distortion of the Lips from Burns . 291

Deformity of the Chin and Neck from

Burns

Posterior Curvature of the Neck Angular Cervical Curvature .

Torticollis

Sect. II. Apparatus for Remedying Loss of Symmetry of the Trunk Lateral Curvature of the Spine . 297 Angular Curvature of the Spine Posterior Curvature of the Spine . 309 Loss of Symmetry of the Pelvis

Sect. III. Apparatus for Remedying Loss of Symmetry of the Upper Extremities

Deformity of the Fingers . . 315 I Deformity of the Elbow .

Deformity of the Wrist . . 317 |

Sect. IV. Apparatus for Remedying Loss of Symmetry of the Lower Extremities

Deformities of the Toes .

Bunions .....

Deformity of the Foot and Ankle

320 I Bowed or Bandied Legs .

321 j Contraction of the Knee-Joint .

322 Contraction of the Hip .

PAGE

291 292

293 294

297 310 314

315 318

320 331 333 336

Chapter I. General Consideration Of Fractures

Classification .

. 346

Mode of Repair

. 350

Frequency

. 347

Ununited Fracture .

. 352

Causes

. 347

Treatment of Ununited Fracture

. 352

Symptoms

. 348

Compound Fracture

. 354

Diagnosis

. 350

Complicated Fracture

. 355

Prognosis

. 350

. 355