first way, it covered only one; but, in this case, the strip must be
longer, as it must fairly cross the ulcer on each side, and be retained
by sticking to the adjacent skin. When the ulcer is deep, the strip
will press only on the margins; and, therefore, it will be useful to
fill up the surface with a fold of soft lint. A thin cotton roller is
now to be wound firmly round the limb, beginning at the extremity, and
continuing the bandage to the next joint above the sore.
By this contrivance, we obtain a firm covering to the granulations, and
bring a substance in contact with each individual. We then restore,
as it were, the natural state of the parts, each granulation having a
substance in contact with it; and a slight interstice is left between
each, owing to their pointed structure. They become, therefore,
similar, in this respect, to the organic particles of internal parts;
on which account, healing goes on more quickly, and the organic
particles, or granulations, are deposited in greater perfection, and
with greater powers of action; for the unusual and morbid condition of
exposure and want of contact is now removed. The same circumstances
promote cicatrization, when the granulations have risen to a proper
height. This is more evidently seen in the cure which is effected of
the smaller ulcers, by dusting them with chalk, &c. or dressing them
with an ointment made thick with some mild powder, by which a scab, or
covering, is formed, which operates clearly independently of pressure.
Pressure, applied with this view, ought to be moderate and permanent,
and may be used with utility in almost every case of solution of
continuity, however healthy the action may be. But, besides being
of use in this way, pressure also produces a second set of effects,
by mechanically exciting action in the part to which it is applied.
Applied to the skin, it increases the cuticular action, and the skin is
formed thicker. Applied to a weakened part, it increases the natural
action of that part, and strengthens it: This is seen in the instance
of debilitated muscles, &c. But, if the pressure be too great, then a
morbid increase of action takes place, which even goes the length of
inflammation, if the pressure be considerable; and this inflammation
is either strong or weak, according as the pressure has operated;
for, if many vessels be obstructed, as is commonly the case, then the
power of the part is injured, and the action is weak; or, the same
happens if pressure be applied in any manner to a weak part, or if the
constitution be weak; as, for instance, from previous disease.
Public-domain text, read in full here on John Shaqi.
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