The purposes of a bandage are either to afford means of retaining splints and dressings, to exert pressure, or to afford physiological rest. After every operation of importance it is necessary to apply and retain an occlusive and aseptic dressing, under which the wound may heal or into which wound discharges may be received; but the ideal dressing affords more than this--it furnishes _support and rest._ [Illustration: FIG. 33 FIG. 34 Spica bandage of shoulder.] [Illustration: FIG. 35 FIG. 36 Third roller of Desault’s bandage.] There is danger in the injudicious use of any bandage, as by the exertion of undue pressure it may interfere with wound healing, or may even lead to gangrene. If applied loosely at the extremity and too tightly above it will lead to venous obstruction and possibly secondary hemorrhage. Moreover a bandage which seems properly arranged may become so tight as to be painful and even unbearable after swelling has occurred. There is but one safe rule, and that is to take note of the appearance of the part as well as of the sensations of the patient. An abdominal bandage may have been placed with a proper degree of snugness at the conclusion of an operation, and yet be altogether too tight when the abdomen becomes distended with a little gas. There is then always room for discretion and good judgment in the matter of bandaging. It may be necessary to apply a bandage quite firmly at first in order to repress hemorrhage, with the intention to relax it after a few hours. A splint may be a necessary feature in a surgical dressing; after amputating at the lower part of the leg it is advisable to bind the limb upon a splint in order that the necessary physiological rest may be thus afforded. The first requisite of a bandage is not its appearance but its effectiveness; a due regard for the esthetic in surgery will, however, dictate that it be made as presentable as possible. [Illustration: FIG. 37 T-bandage.] [Illustration: FIG. 38 Kelly’s bandage with perineal straps.] For the roller bandages of cotton cloth, universally in use twenty-five years ago, there have been substituted bandages of thin gauze or crinoline, which have scarcely body enough to be applied, as was the roller, or else of flannel, made wider and necessarily thicker, which are more flexible, comfortable, and applicable. [Illustration: FIG. 39 Barton’s head bandage as employed for suspension in applying plaster-of-Paris bandage.] Crinoline impregnated with starch is also in general use and makes a serviceable bandage for head injuries. When prepared with plaster of Paris it is capable of affording absolute support and even rigidity. CHAPTER XX. ANESTHESIA AND ANESTHETICS, GENERAL AND LOCAL.