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Show £20 or GUN-SHOT wounm. anrrc mvnn accompanies the formation of abscess, and is increased upon its being opened. It has been supposed to pron ceed from the absorption of the matter ; but it corresponds better with a more extensive review of the effects of disease, to say that it is the constitutional sympathy, with a continued low degree of local irritation. Hence painful affections of the tion and hardening of such channels, by habitual discharge, bones and joints, where there is no matter formed, produce av 7.. 4‘ = «Na-"4. ARV-12 -v» - :. "2-5". ""1." '-.a'\-E.' .1 -- 1' "wry- . a." :«ufviw‘ #5 .:~_‘ *0): .«I 'sbuvy, mm : lithium", 21 or sures AND risrurii. hectic. In hectic fever there is a small, sharp, quick pulse, with pale skin and loss of appetite, with frequent debilitating per" spiration. There is no regular intermission, but there are exacerbations, preceded by a slight degree of cold stage. The fever is increased about noon ; but especially towards the evening there is an increase of symptoms, and towards the morning they abate. As the disease advances, the nightsweats become profuse and debilitating, and a diarrhoea comes on, with a rapid increase of debility. Although the system be thus irritated, so as to produce the greatest degree of debility, yet, as it is a symptom and consent quencc of a local affection, it might be supposed that, on the removal of the diseased part, the local irritation would in ev» ery case be succeeded by an immediate change, and restoration of healthy action. It would, but that often (as by operation), to remove the cause of the disease, we substitute another 5- l urce of irritation. SINUS .‘iIiD FISTCLA. tbrrncrross of matter, when deepwseated and neglected, or improperly treated, instead of filling only one cavity, spread irregularly where the connecting membrane yields most easily to the action. If the abscess burst outwardly, the opening is small at first, and having discharged the matter, the orifice contracts, becomes hard around its edges, continues to drain off the secreted fluids of the cavities, which cavities and sinu~ ses acquiring an habitual action, become hard or fistulous. The sinus, then, is the abscess taking a course under the Sim: or amongst the (1091' PaFtS- The fistula is the consolida and becoming a. deep, narrow, callous sinus, with a sanious, often an acrid discharge. This is a change most generally produced by neglect. or bad management in the dressing, oftener by intemperance and dcbauchery, or a debilitated or distempcred constitution. "'e in the first place turn our attention to the confined, impure air, bad clothing, and filth and bad diet ; to the palid countenance of the patient, and his nightly feverish condition, and the state of his bowels, Sec. before we think of the knife. If improper dressing has made of an abscess or sinus, a fistulous sore, the lips will be hard and inflamed on the edges, or tumid and inverted ; the discharge great in quantity, and thin and ichorous ; the pulse will be hard and quick ; there will be thirst and sleepless nights. Then there must be no stuffing with precipitate and dressings, but soft slips of dressing, with milder ointment introduced upon the lips of the sore, and covered with a softening poultice. CHARACTER 0F GUN-SHOT WOUNDS- A GUN-SHOT wound difl‘ers in its character from any of the wounds which we have already delineated, and yet partakes occasionally of them all. The parts may be bruised, as by great shot; they may be cut and torn up by splinters, and the parts pricked by the spiculae of bone, so as to partake of the na« ture of a punctured wound ; they may be simple, as in fleshy parts, or compound, as having fractured bones and bleeding arteries, or the great cavities laid open. OF A \VOUND BY A BULLET. '1. Tue transit of a bullet through a limb is made with a rapidity so foreign to our usual course of sensation, that no pain, or even distinct sensation, is conveyed. The blood does not follow, as in another wound, because the vessels and nerves are paralysed by the concussion of the bullet in its passage, and |
