Blaker Family of Sussex - Reminiscences



IN former days, in the treatment of surgical cases, especially fractures and amputations, nothing was more common or more dis-appointing than the occurrences of bed-sores. Bed-sores in those days were not simple abrasions of the skin, such as we see now, but were formed not infrequently by the separation of sloughs three or four inches in diameter, composed of skin, areolar tissue, and sometimes even of the periosteum of the sacrum; indeed, I have occasionally seen exfoliation of a thin lamella of that bone. These sloughs left a still larger wound, with edges under-mined for an inch or more. The management of these bed-sores was extremely difficult. We had not water-beds or air-cushions then such as we now have, but the Hospital possessed, as far as my recollection serves me, two water-beds of the type then in use. Each of these consisted of a large wooden receptacle for the water, about seven feet long by three or four wide and two deep, in form something like a brewer's vat. It was lined with a thin sheeting of lead and had a tap at the bottom by which it could be emptied, and a short pipe in one corner by which it could be filled, and to the inside of the rim of this, all round, a large piece of India-rubber sheeting was nailed. It was supported on four legs with castors. The quantity of water required to fill this was enormous and, owing to its low temperature, many thick-nesses of blanket had to be spread over the mackin-tosh sheeting to protect the patient from the cold. It was only with great difficulty that a patient, when once placed on one of these beds, could be moved, and the sheeting being, of course impervious to moisture, these blankets became saturated with emanations from the patients, and became con-verted into a really putrid mass, although they were changed at comparatively short intervals. It is difficult in these days of cleanliness and sanitation to imagine how a patient could possibly have done well. Still this sometimes happened. I remember a man, with a badly fractured thigh and a bed-sore almost as large as a plate, being on one of these beds for many weeks and eventually getting well, and though still somewhat lame, he survived for more than forty years.

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