8. Lunar caustic.
Step 1. First apply the tourniquet to the brachial artery, to control the hæmorrhage while the apparatus is being adjusted.
Step 2. Make a graduated compress by folding a sixpence or slip of a cork in two or three thicknesses of lint, trim the lint into circular disks and prepare a dozen similar disks of increasing size; lay these one on each other to form a round cone about one inch high with the piece of cork at the apex, and fasten them together by a thread.
Step 3. Clean and dry the wound, then rub its surface carefully with nitrate of silver, to lessen the suppuration.
Step 4. Bandage the fingers and thumb, and prepare the splint, which should be straight, as broad as the forearm, and long enough to reach from the elbow to the tips of the fingers; it should be lightly padded.
Step 5. Envelope the wrist with a little wool; next lay the graduated compress on the wound, the small end downwards, and press it firmly in with the left thumb, while the splint is applied to the back of the hand and forearm. These are then fixed by a roller carried in figures of 8 round the hand and wrist across the compress until that is tightly pressed into the wound and the splint fixed to the limb. The roller is then carried along the forearm, a fold of wool laid in front of the elbow, the tourniquet removed and the roller carried to the axilla while the forearm is raised, flexed across the chest, and fastened to the side.
This apparatus is worn without being disturbed for three or four days if bleeding do not return; but at the end of this time it should be examined; if painful or if discharge ooze out at the wound, the bandage should be removed and readjusted less firmly than before, a piece of wet lint replacing the graduated compress.
Venæsection.—Bandage and bleeding at the bend of the elbow.
Apparatus.—1. Lancet.
2. Tape.