As to treatment, after the infliction of an injury, the scalp ought to
be shaved, and the wound cleansed of coagula and foreign substances.
If a large flap of integument is detached, it should be replaced,
and retained as nearly as possible in its natural situation; and
if, for this latter purpose, slips of uninitiating adhesive plaster
and methodical compression prove insufficient, it will be necessary
to employ a very few points of interrupted suture: these, however,
must be removed at an early period, that is, when either adhesion or
suppuration has commenced, and ought, if possible, to be altogether
dispensed with, being apt in this situation to produce injurious
effects by their irritation. Light dressing is afterwards applied.
On the accession of swelling, heat, and pain, the parts are to be
well fomented with a hot decoction of chamomile flowers, or hops, and
afterwards covered with a warm and soft poultice; and should these
symptoms continue, the fomentation ought to be frequently repeated.
Fomentation and poultice are also the best applications when a
day or two has elapsed between the receipt of the injury and the
patient’s application for cure. The constitutional symptoms are to be
moderated, and may in many instances be averted, by the exhibition of
antimonials and purgatives; and by general bloodletting, when demanded
and authorised by the symptoms, and the state of the constitution.
Punctures or incisions are to be employed according to circumstances,
in order to lessen the vascular congestion of the part, and prevent
the formation of matter, to evacuate it if already secreted, or to
relieve inflammatory tension and promote the formation of pus at the
incised parts, where erysipelatous inflammation is threatened, healthy
suppuration in such circumstances often appearing to be critical. In
many unpromising cases of lacerated scalp, when a great part of the
cranium has been exposed, and partially deprived of its periosteum, a
rapid cure has taken place without the formation of much matter. The
detached scalp, though much torn and bruised, ought not at first to be
removed, it being more prudent to leave nature to determine how much
must be destroyed. After the sloughs, if any, have separated, and
granulation has commenced, the loss of substance is rapidly repaired
in this region, more especially when the patient is young and healthy.
General or partial support, by bandaging, is required in many cases, as
by a handkerchief, split cloths, or a roller applied in various forms.
Public-domain text, read in full here on John Shaqi.
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