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Show SABRE WO'U bill. PUNCTUBED WOUND. If the excitement of the vessels be continued after this exudation of serum, the secretion from them changes to purulent matter, and the centre of the cellular membrane, with the skin above it, is absorbed. This stage is marked by the swelling, heat, redness, throbbing, fever, and pointing 0r rising of the centre of the absecssd". Sometimes the shreds of cellular membrane are deadened by the bruise, or the high inflammatory action terminates in the death of some part of it. Then a slough is seen in the centre of the abscess when it bursts. This slough is not to be at~ ken away, unless it confines the matter, or is likely to become putrid : the living parts will be excited by the contact of the dead. The living part will consolidate, ulcerate, and forming granulations, push oil." the slouga. When the skin is bruised, and the blood axtravasated under l m, niacin, it, the parts will sometimes mortiiy: but this mortiflcation i‘: of a less dangerous kind than that kind of gangrene which i UW .. "Will but... shall presently explain. n» 5" :.,‘.,,‘<~.....s.~ OF A CUT. Tiii: sabre around forms a good distinction in wounds; for this kind of wound necessarily, from the curve of the sword, takes a peculiar form. This wound is what a surgeon would call a fair incision, deep in the middle only, and becoming .< - __"., 50.53.. "-3" .. __ .igg-.,., kn... :. -. gradually shallower towards the extremities. It bleeds freely but openly; what is injured is seen, and when the swelling and inflammation arise, and the suppuration forms, there is: no OI" A PENETRATING \VOUND. A WOUND by a small sword or bayonet is the proper exam-- ple. It is a wound which runs deep, but makes no large outw ward openinw. These are generally the most complicated wounds, from taking their course among blood-vessels, entering the cavities or wounding the bowels. But even considered, independently of these risks, they are the most troublesome and dangerous in their eli‘ects, and the most difficult to be mam aged ; for as they run under the fascia without cutting it, they produce deep and of course general swelling of the limb, which, from the binding of the fascia, occasions great pain, with ten sion, and contraction of the joints. ture, or may be stopped by the mere drching-whcther the oozing will subside when the parts are bound up, or the hrcmorrhagy will return when the faintness has gone ofl". He will no doubt be prepared with his needles to stitch the wound ; but this is very seldom necessary where there is no loss of substance ; and ligatures are always, when it is possible, to be dispensed with. Adhesive straps are better, with compresses laid longitudi~ nally on the sides ofthe wound, so as to make the bandage act as a compress to the bottom ofthe wound. The young surgeon must study to place the parts in such a manner that the muscles which are cut will be relaxed. lfligatures be necessary, they mustbe supported from cutting and irritat. ing, by adhesive straps in the interstices ; over these dry lint is placed, and a general roller is then applied to support the limb. But observe, that, though the inflammation be moderate, this firm bandage is oi‘ advantage : ii, on the other hand, the limb be unyielding and tight, and the part s conti- nuing to swell, it is highly dangerous. In the same way, the ligatures must be. watched, if the inflammation should rise above what necessarily cccom~ panics the. action ofadhesion,tlmt the swelling pulls upon the iig‘aturcs, and binding of the flesh, and no internal mischief; the parts open they cut the flesh, and become anew source of irritation. cutn ai'dly, and the matter is freely dischargedi‘. redness, he at, and pain, force us to undo all that we have been (10' 57 before, so as to allow ofperi'ect freedom for this process. surface by some acid ingredient. When a regular suppurating cavity is formed, and the disease is concentrating, open it ; but ifit be opened before The increased By and bye the hill: motion and swelling; of the parts subside; suppuration is established ; this stage, the natural quiet action is interrupted. Such abscesses , therefore, are only to be opened early when we fear that the matter may lodge to the injury of some internal part, as for example, on the surface of a bone. mile compresses, with proper bandages, procure the adhesion of the granm luring surface, by what is called the second intention. bupposc that :1 wound is indicted, or an operation performed, on a man with an ill-Conditioned habit of body, the \a'i‘iund does not iuiiaiuc nor be- " The nature ot'thc pain is changed ; with the throbbing from the pill.de "‘iid, the. pulse is hard and Frequent, accompanied u iili thirst, 1c»:- tiou otthc vessels, there is a sharp pricking pain. T In the treatment ot'this wound, the only difficulty of the young surgeon is to determine whether the Vessels which are laid open require tilt: 135'1‘ ilanguor evidentin the countenance. ' .nind remains lax, ilabln'. :znd (cl-3. , ., . i, i ther. i p:l...‘-..11\.ku.:‘ Some days alter the arch 1 were is no snppuratior, the ‘4sz \Mn 3?». , l |
