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Show 0F \VOUNDLD ARTERIEL , III. 'I‘ns next inquiry which the intelligent young surgeon would naturally make, respects the necessity of tying arteries of the third class, when wounded by a splinter or by a knife. The first question is not so easily answered as the'seCond ; let us for example take the following case :-In Lord Duncan's victory John Niel was stationed at a gun, when a shot struck a bulk-head, and drove it in splinters, so as to throw down and wound all the men at. the gun; Niel was out about the breast and throat with splinters, but not deeply. He went to the next gun and wrought at it; when as he carried a fort y-two pound shot betwixt his hands, a shot passed through the ship, and a very large splinter struck his arm and made him quit his hold. While he was looking at his arm two men were dashed against him, and all three tumbled down the hatchway. Niel was much sprained and bruised in the back by his falli‘v". When he could, he crawled into the cock pit, and found his arm bleeding very profusely. There were OE wounnnn ARTERIES. 245 the flesh, though not to be felt with the finger when it was pushed deep into the wound. Both wounds now bled profu'Sely; the surgeon crammed them with flour, and laid a compress and a tight bandage over them. During two nights and two days the bleeding was so profuse as to indicate a wound of the ulnar artery; but partly because the bleeding was in some degree commanded by the compresses, and partly from want of assistance, the surgeon did not undo the bandage. Niel was by this bleeding reduced very low. IVhen the bandages were undone on the third day the bleeding had stopped. In this case we have a wound in the same arteries, but in circumstances materially different. The splinter of wood, although driven with the force of a bullet, yet wedged and cut its way no doubt; and while a ball, being round and obtuse, bruises as it passes, this splinter cut the artery. Tbe bleeding was however stopped; but if the artery had been cut by a knife, it might have been more difficult: to shew which, I subjoin the following note of a case of wound of the radial artery, proving that a man may die from it :- two wounds on the outside of the elbow joint, through the .7‘ ("w-"w? -wm-w .. "a i_. .. belly of the supinat or muscle. In one of them a large splin‘ ter was sticking, which Niel, while he waited his turn to be dressed, endeavoured to pull away but could not. It was from this wound the bleeding proceeded : it was like a bali wound, and admitted the point of the finger, and was very deep. When the firing ceased the surgeon set this poor fellow in a great chair, while he took his arm and tugged at the great splinter ineffectually. He therefore, at last, out the wound open on one side, so as to free it, and it came out easily. If he had carried his knife into the other wound, which was close by it, he would have done good, for it afterwards ap- IV. A em'rLi-zsmn was wounded in the fore arm by a pistol» shot. The arm swelled prodigiously; abscesses formed in the fore arm; and it was thought necessary to open them freely, and to rip up the fascia: in doing this, unfortunately, the radial artery was touched. The bleeding was profuse; and from the weakness of the patient, critical: my peared that there were many splinters in it, buried deep in reader may conceive from what has been described, that no thing would be so easy as to compress this artery; but let him considér things as he will find them in practice. The man's arm is swoln to half the size of the body; great ab- " The reason I transcribe these Circumstances is to bring my reader ac quainted with the very different kind of wounds aboard ship, from those 10 which the soldier is exposed from grape and musket shot. The case was communicated to me by my brother. foot in the room, or the lifting of the thumb of the patient, gives excruciating pain. It is evident that the wound cannot be efl'ectually stuffed and compressed when in this state scesses are in it; it is inflamed and so painful, that a heavy 7, W, .7..-‘ ". W .4195", |
