Venous Hæmorrhage.-In bleeding from varicose veins the direction of the flow of blood in these vessels towards the heart is to be remembered in the treatment. Elevate the limb and apply pressure with a pad and bandage on both sides of the wound, and remove any restriction to the circulation. on the heart side, such as garters or tight clothing. There are two things that should be borne in mind by people who suffer from swollen veins; the limbs should be raised and kept in the horizontal position as often as practicable; also the first thing in getting out of bed in the morning, before the legs have time to swell, get a friend to apply a roller bandage smoothly and evenly, beginning at the lowest extremity and working upwards, and let the bandage be put on firmly at first. Internal Hæmorrhage may be treated by placing the patient in an easy semi-recumbent position, perfectly at rest; apply cold applications as near as possible to the part affected. Sucking ice is useful in

bleeding from the mouth, stomach, or air-passages; the patient should be kept quiet and not allowed to talk.

Bleeding may be recognised as coming from the lungs, when it is coughed up and of a bright red colour.

In hæmorrhage from the stomach, dark-coloured blood is vomited up without effort, and it is sometimes mixed with particles of food.

A little bleeding from the nose often relieves head

ache, and does good, but should it become very severe a surgeon must be called in. It can often be stopped by applying a sponge to the nose and forehead, wrung out in cold or iced water, or a little tannin powder used as snuff; alum and water may be To blow the nose will only

squirted up the nose.

increase the trouble.

(86)

CHAPTER VII.

Bandaging-Roller and triangular bandages-The clove hitch, and reef knot.

Bandages are used as a means of applying pressure, for support, to fix splints and dressings, to ensure rest, and to allay muscular action.

They are usually made of unbleached coarse linen, webbing, or flannel. If calico or linen be used, it should be first washed, to get rid of the glaze and stiffening with which it is got up for sale, and the selvage removed; the bandage should be torn off from one whole piece, to avoid cross ridges from the joining of short lengths. Roller and triangular bandages are the ones in most common use; their application is best learnt by a practical lesson. Roller bandages must be cut in certain convenient sizes, according to the part of the body for which they are required.

For the arm or head of an adult the bandage should be made about two inches wide and six yards long; a broader and longer bandage will be necessary for the chest or leg. Before commencing, see that the bandage is firmly and evenly rolled, for unless this is

done it is impossible to apply it to a limb neatly. The operator should stand in front of his patient, grasp the roll in one hand, and taking the loose end in the other, apply it to the limb so that the outer surface may be against the skin. After fixing your bandage with a couple of turns round the limb, begin from below and work upwards, bandaging from within outwards.

Be careful that the pressure is uniformly and evenly applied; leave no gaps, and avoid wrinkles.

Fig. 6.

A common fault with beginners is either to put on the bandage too tightly, and so cause constriction and hindrance to the circulation of the blood, or too loosely, which renders the bandage practically useless; a happy medium must be struck between these extremes by great care and practice.

Where the limb is of uniform thickness use the simple spiral, when it thickens reverse the spiral, and at joints use the figure of eight. The spiral consists

in covering a limb by a series of spiral turns, each turn overlapping the one below by exactly one-third of its width. A reverse or turn in the bandage is made when the limb thickens so as better to accommodate the shape; these turns must be made from above downwards, and on the outer fleshy side of a limb, never over a prominence of bone. Care must be taken

Fig. 7.

not to unroll more bandage than is actually required for the performance of this turn; however tightly the bandage may have been drawn before, at the moment of making the turn it should be held quite loosely; the applied part of the bandage may be prevented from slipping by pressure with the fingers of the manipulator's other hand. The figure-of-eight bandage is used generally for joints, and can be applied in the