_Of Wounds_
A Wound is an unnatural separation of any part of our body, whereby the
order of circulation is hindered, the solids divided, and the fluids let
out; suddenly caused by some violent means or other. But when such a
separation becomes ulcerated, it loses the apellation of wound, and is
called a sore, or ulcer.—This distinction is requisite to be taken
notice of; for wounds and sores are often confounded, which shews not
only ignorance, but as their nature is materially different, their
method of treatment is not less so; and ought therefore previously to be
understood.
Wounds are best distinguished into three different kinds; cut wounds,
bruised wounds, and gun-shot wounds. I shall briefly shew how to treat
each in particular.
_Cut Wounds._
A Cut wound is barely a separation of parts; and the sharper the
instrument with which the wound was made, the easier will the wound be
to heal up again.
It is however a natural thing to observe what parts of the body is
wounded, for tho’ nature is kind in uniting the parts, yet some parts
are more easier healed than others.——Observe therefore
_The different Methods._
If an artery is wounded (which is known by the blood being of a florid
colour and spinning out by starts) care should be taken to have it stopt
to prevent bleeding to death. But in this you should not be too
scrupulous. Two or three ounces from a wound makes a great shew; and
very often a little blood lost is of great benefit to the healing.
Should, however, the blood gush from the wound violently, especially
from an artery, make a compress of lint, strewed with _Powder’d Allum_,
(17) which secure well on the parts with a roller, laying over it a
compress, with _Spirit of Wine and Camphor_; (A) if that should not be
yet sufficient, put a piece of money in a compress, and secure it on the
wound, that is, provided the part of the body will admit of it, such as
the arms or the legs, &c.
Let the ligature, or the first dressing, lie on for two or three days,
and, if no hindrance to the patient, longer. If all these things are not
sufficient, recourse must be had to the needle.
In every other kind of cut wounds, care should be taken to have it first
cleaned with some water; (a small matter of vinegar, and brandy may be
mixed with it) next, let the lips of the wound be well closed, dressed
with dry lint, and _Turlington’s Balsam_ (W), and over which, a compress
with _Camphor Spirits_ (A).
Plaisters, salves, &c. in green cut wounds, are altogether needless. All
that is required to healing, is to keep the wound clean, to give it
rest, and not to aggravate it with any thing acrimonious. _Turlington’s
Balsam_ (W) is admirable, but yet it suits small wounds better than
large ones.
As a finger is very liable to be cut, and sometimes gives a great deal
of trouble, I will here give a simple and expeditious remedy:—If you
have cut your finger, wash it in a little salt or fresh water; tie it
round with a good long thread, not too tight,—take care that your
wooling may keep on without being removed; and a day or two will heal it
up, without any farther plaistering. If inflammation attends the wound,
methods should be taken accordingly, by bleeding, fever powders, &c.
_Of Bruised Wounds._
These kinds of wounds are of a worse nature, and are not so kind to heal
as the former; for here the parts seem to be torn to pieces, so that
there is not only a separation of parts, but a destruction of a great
many tender fibres all round the wound.
Hence we see in such cases a great deal of swelling, inflammation, and
pain attend it; for the blood being hindered, the circulation naturally
swells up the parts; and the nerves being lacerated also, must occasion
great pain. Hence it must follow, that nature must first get rid of the
obnoxious and torn part before she will consent to unite the wound
again; and this must be performed by suppuration.
In small cases, nothing is more beneficial than _Diachylon Plaister_,
(20) which assuages the inflammation, corrects the acrimony, and brings
the wound to a good state.
Broken shins often occur on board a ship, which is of that species of
wounds. And as from such a case, (though in general slighted) many evils
have arisen, I would caution the mariner to apply immediately _Diachylon
Plaister_ (20) to a broken shin; by which he will prevent having an
ulcerated leg; a thing very troublesome.
If the bruised wound is on other parts, and the parts all round are
bruised, care should be taken that it is cleaned as before directed, and
a pledget of lint, with _Yellow Basilicon_, (F) will be necessary; over
which a compress with _Spirits of Wine and Camphor_, (A) or rum, may be
applied; and afterwards, when it begins to heal, it may be dressed with
dry lint.
As these kind of wounds are liable of becoming ulcers, great care should
be taken in the beginning to treat them properly.—Wounds in general
should not be dress’d or look’d to too often; in general it aggravates
the parts, and retards healing. A wound should not be opened the first
three days after the first dressing: nature is very kind, and requires
care only to replenish what is deficient.
When an ulcer has commenced, see the treatment under that head.
_Gun-shot Wounds._
These are the most terrible of all sorts of wounds; for it is not only
the contusion that attends them, but frequently the ball forces strange
things, as cloaths, &c. into the wound with it.
Gun-shot wounds at best are tedious in their healing, but very often,
from their nature, liable to mortification, and thence become dangerous.
Besides, it is seldom that the fleshy parts alone are wounded, but they
frequently penetrate into the very bones themselves.
The first care in gun-shot wounds, is to extract the ball, or whatever
is forced into the wound; in the next place, the wound should be dressed
with _Yellow Basilicon_, (F) mixed with fine _Precipitate_ (O).