I ought now to say something concerning a contusion, or echymosis; I
shall confine my remarks particularly to that kind where there is a
great quantity of extravasated fluid diffused under the skin, such as
we often see, when a ball, without breaking the skin, injures it to
such a degree, that it looks like a mortified eschar, and at the same
time dislocates, fractures, or shatters the bones belonging to the
part. When a surgeon meets with a contusion of this kind, the treatment
is not greatly different from that recommended in a mortification; for
the skin must be treated exactly like a mortified slough, must be laid
open by several deep incisions, dressed with the powder mentioned §
X. covered with a digestive ointment mixed with a little essence of
myrrh, and the part affected, as well as all around it, kept constantly
bathed with emollient fomentations, without any ingredient, either
stimulating or astringent. With regard to the shattered bones, the
same method may be followed as in § XX. If any of them are luxated,
they must be reduced, without, however, confining them by the bandages
used in ordinary luxations, and which, in this case, would make the
necessary incisions uneasy, would prevent the gangrenous sloughs
from casting off, and hinder the formation of pus: It is therefore
sufficient, after having replaced the bone, to let it remain quite
undisturbed; and when the corrupted slough is come off, the sore may be
dressed like wounds of the fleshy parts.