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Show 3 or mrnsnmanos, AS AFFECTED BY THE NATURE OF THE INJURY. ing and laceration which injures also the surrounding parts, merit of the vascular action of the part. This excited state of the vascular system of the part produces an increased sensibi- lity of the nerves. The effect of wounds, therefore, in a healthy body, is an increased action of vessels; an unusual sen- sibility and increase of lieati"; with swelling, pain, redness, and throbbinv. This is the PHLEGMONOUS INFLAMMATION. Resolution is the subsiding of inflammation, andthe return of the action of the part to the usual relations. It is of course preceded by subsiding of the inflammatory swelling, and diminution of pain and heat. ' In a debilitated and diseased state of the system, this healthy action (healthy, as being natural to a healthy body) is interrupted. Instead of a due degree of this phlegmonous tume» faction, heat, and redness, the parts are at first pale and flabby, and there runs a creeping dark-coloured and diffused inflam- and leaves not a fibre, vessel, or nerve uninjured for some ex- tent around. The nerves are injured, and the sensation be- comes duli; the arteries are paralysed, and do not contract upno the impulse of the blood ; so that, as in dead parts, the blood settles and stagnates in them. The same ellect is pro‘ duced in open wounds, where an exposed surface is bruise . Both these kinds of wounds are on this account apt to resist a. healthy action, and in that case the swelling is slight and general; the edges of the wound loose ; the patient restless, and l. . Miami" . 0W" 'iN‘oiA disturbed with slight delirium ; and the parts, instead of suppuraiing, become black and dry. Now there is a daneer of gangrene, spasm, and locked jaw. The tearing and exposure of tendons and tendinous sheaths is almost peculiar to lacerated wounds. Where these parts are cut, they shrink and are buried; but in lacerations they are often torn out, and lie relaxed. In the wounds and exposure of tendons and tendinous sheaths, there is some peculiarity. They neither bleed nor suppurate readily ; and therefore prer bahly it is that they produce dry and irritable wounds. Not being dead, and yet not prone to that degree of inflammatory action which is thenatural eonseque ce of the wound of a vast: eular part in a healthy body, their exposure is followed by unr tmi‘ard symptoms. The edges of the wound are hard and irritable -, the discharge is gleety; and a dangerous spasmodic 1' state 01 the system is apt to prevaiias. or i::i>i.:.3i.ir_\.'rio_\: s it. {ECARDS run ronncoixc Disriyc 'i'loHS lN \YUL'NDS. 'y p .u , . mation over the skin, which destroys the cellular membrane, and undermines the integuments, and is attended with a small, quick, and sometimes irregular pulse, and erysipelatous inflam~ mation (erethismusfi. This is most apt to follow laceration MlnI‘ C k and punctures, and is not unfrequently a precursor of gangrene. This kind of erysipelas, is very apt to occur from punctured rounds of the head, especially when the constitution is bad, or the patient is laid in a crowded hospital. This inflammation is preceded by pain and a dillused swelling; of the integrimerits around the wound; sometimes the pain is dull, sometimes there. is an acute and prickling pain. There is nausea, loss of appetite, and foul tor gue, which when present is a de= monstration that this is not a local affection. The inflammation and slight swelling of the integuments sometimes extends over all the head and face, and even spreads . . . ' , » in me constdntion ol. a living nod-g, all wounds are attend- ,. coup. ...._...».l. .rg-xc..--;-~-*'w' -' ' ed with an irritation of the nerves, and a consequent excite .\ liail:il:;:ci' of more violent and universal state of convulsion, is the ition of the tendons in the wound. liven a 1m» imposed this to be a proof ot‘Sensibilitv in these tendinom has spasm begins with the tendons. But I should l';tiil( :‘.:rely the alert ofthc commencing agitation oi 9 * This increase ofheat seems to the patient, from'the increase ofsensihilily, to be much greater than the degree ol'temperature appears to the sen= sation ofthe surgeon. f \Ve are to endeavour in this case to restore a healdiy inflammatory ae‘ Lion and suppuration, by warm cataplasms and spiritous fomentation. "'6 must attend to the general state of the system ; check this approaching den hility by an emetic ; free the. bowels, as in fever ; and then support the: strength as much as possible. i \ UT . l. .- |