Wounds

This medical information is great for writing historicals because of the concise information.

Of Wounds.
Wounds are of three kinds, viz., incised, punctured, and contused: among the latter are included gun-shot wounds. The first step in all wounds, is

To Stop the Bleeding.
If the flow of blood is but trifling, draw the edges of the wound together with your hand, and hold them in that position some time, when it will frequently Btop. If, on the contrary, it is large, of a bright red color, flowing in spirts or with a jerk, clap your finger on the spot it springs from, and hold it there with a firm pressure, while you direct some one to pass a handkerchief round the limb (supposing the wound to be in one) above the cut, and to tie its two ends together in a hard knot. A cane, whip-handle, or stick of any kind, must now be passed under the knot (between the upper surface of the limb and the handkerchief), and turned round and round until the stick is brought down to the thigh, so as to make the handkerchief encircle it with considerable tightness. You may then take off your finger; if the blood still flows, tighten the handkerchief by a turn or two of the stick, until it ceases. The patient may now be removed (taking care to secure the stick in its position) without running any risk of bleeding to death by the way.
As this apparatus cannot bo left on for any length of time, without destroying the life of the parts, endeavor as soon as possible to secure the bleeding vessels, and take it off. Having waxed together three or four threads of a sufficient length, out the ligature they form into as many pieces as you think there are vessels to be taken up, each piece being about a foot long. Wash the parts with warm water, and then with a sharp hook, or a slender pair of pincers in your hand, fix your eye steadfastly upon the wound, and direct the handkerchief to be relaxed by a turn or two of the stick; you will now see the mouth of the artery from which the blood springs, seize it with your hook or pincers, draw it a little out, while some one passes a ligature round it, and ties it uptight with a double knot. In this way take up in succession every bleeding vessel you can see or get hold of.
If the wound is too high up in a limb to apply the handkerchief, don't lose your presence of mind, the bleeding can still be commanded. If it is tho thigh, press firmly in the groin; if in the arm, with the hand end or ring of a common door key, make pressure above the collar bone, and about its middle against the first rib which lies under it. The pressure is to be continued until assistance is procured, and the vessel tied up.
If the wound is on the head, press your finger firmly on it, until a compress can be brought, which must be bound firmly over the artery by a bandage. If the wound is in the face, or so situated that pressure canuut be effectually made, or you cannot get hold of (he vessel, and the blood flows
fast, place a piece of ice directly over the wound, and let it remain there till the blood coagulate*, when it may be removed, and a compress and bandage be applied.

Incised Wounds.

By an incised wound is meant a clean cut. Having stopped the bleeding, wash away all dirt, etc, that may be in it with a sponge and warm water, then draw the sides of the wound together, and keep tbem in that position by narrow strips of sticking plaster, placed on at regular distances, or from one to two inches apart A soft compress of old linen or lint may be laid over the whole.
Should much inflammation follow, remove the strips, and purge the patient (who should live very low, and be kept perfectly quiet) ae^rding to the exigency of the case. If it is plain, that matter must form before the wound will heal, apply a soft poultice or wet lint (water dressing) until that event takes place, when dressing of some simple ointment may be substituted for it.
Although narrow strips of linen, spread with sticking-plaster, form the best means of keeping the sides of a wound together, when they can be applied, yet in the ear, nose, tongue, lips, and eye-lids, it is necessary to use stitches, which are made in the following manner: Having armed a common needle with a double waxed thread, pass the point of it through the skin, at a little distance from the edge of the cut, and bring it out of the opposite one at the same distance. If more than one stitch is required, out off the needle, thread it again, and proceed as before, until a sufficient number are taken, leaving the threads loose until all the stitches are passed, when the respective ends of each thread must be tied in a bard double knot, drawn in such a way that it bears a little on the side of the cut. When the edges of the wound are partly united, cut the knots carefully, and withdraw the threads.
From what has been said, it must be evident that in all wounds, after arresting the flow of blood and cleansing the parts, if necessary, the great indication is to bring their sides into contact throughout their whole depth, in order that they may grow together as quickly as possible, and without the intervention of matter. To obtain this very desirable result, in addition to the means already mentioned, there are two things to be attended to, the position of the patient and the application of the bandage. The position of the patient should be such as will relax the skin and muscles of the part woanded, thereby diminishing tbeir tendency to separate.
A common bandage of a proper width, passed over the compresses moderately tight, not only serves to keep them in their place, but also tends by its pressure to forward the great object already mentioned. If, however, the wound is so extensive and painful that the limb or body of the patient cannot be raised for the purpose of applying or removing it, the best way is to spread the two ends of one or two strips of linen or leather with sticking-plaster, which may be applied in place of the bandage, as follows: Attach one end of a strip to the sound skin, at a short distance front the edge of the compress, over which it is to be drawn with moderate firmness, and secured in a similar manner on its opposite side. A second or third may, if necessary, be added in the same way.
In all wounds, if violent inflammation come on, reduce it by bleeding, purging, etc., but if there if reason to fear lock-jaw, give wine, porter, brandy, opium, and a generous diet.

Punctured Wounds.
These are caused by sharp pointed instruments,
Mb needles, awl s, nails, etc. Having stopped the bleeding, withdraw any foreign body, as part of a needle, splinters, bit of glass, etc., that may be in it. pro Tided it can be done easily; and if enlarging the wound a little will enable you to succeed in this, do so. Though it is not always necessary to enlarge wounds of this nature, yet in hot weather it is a mark of precaution which should never be omitted. As soon as this is done, apply wet lint or soft linen, covered with oiled silk, or cover the wound with a poultice, moistened with laudanum. This practice may prevent lock-jaw, which is but too frequent a consequence of wounds of this description. When matter forms, cover the part with mild dressings, as a common sore. Laudanum may be given in large doses to relieve pain, and should the inflammation be excessive, bleed and purge. In hot weather, however, or in feeble persons, bleeding should be avoided. Contused Wound*.
Wounds of this nature are caused by round or blunt bodies, as musket-balls, clubs, stones, etc. They are in general attended by but little bleeding; if, however, there should be any, it must be stopped. If it arises from a ball which can be easily found and withdrawn, it is proper to do so, as well as any piece of the clothing, etc., that may be in it; or if the ball can be distinctly felt directly under the skin, make an incision across it, and take it out, but never allow of any poking in the wound to search for such things; the best extractor of them, as well as the first and best application in contused wounds, proceed from what they may, being a soft bread and milk poultice.
Should the inflammation be great, bleed and purge. Pain may be relieved by laudanum, and if the parts assume a dark look, threatening a mortification, cover them with a carrot poultice.
If the wound is much torn, wash the parts very nicely with warm water, and then (having secured every bleeding vessel) lay them all down in as natural a position as you can, drawing their edges gently together, or as much so as possible, by strips of sticking-plaster, or stitcnas if necessary. A soft poultice or water dressing is to be applied over the whole.

Poisoned Wounds from bites of Mad Dogs, Battle snakes etc.
The instant a person is bitten either by a mad dog, rattlesnake, or any rabid animal or reptile, he should apply a ligature by means of the stick, above the wound, as tightly as he can well bear it, -and without hesitation or delay, cut out the parts bitten, taking along with them a portion of the surrounding sound flesh. The wound should then be freely touched with caustic, or have turpentine poured into it. A decoction of Spanish flies in turpentine may also be applied to the skin surrounding the wound. By those means inflammation will be excited, and suppuration follow, which may prevent the usual dreadful consequences of each accidents. As soon as the parts are cut out take off the ligature.
Should the patient be too timid to allow the use of the knife apply a cupping-glass, and then burn the wound very freely with caustic, and place in it a tuft of tow or cotton, well moistened with the above decoction. The discharge of matter that follows should be kept up for some time. The only reasonable chance for safety is found in the above plan, all the vegetable and mineral productions that have been hitherto recommended as internal remedies, being of very doubtful, if of any, efficacy.
It is asserted, however, that not more than one in ten persons bitten by mad dogs have the
hydrophobia. When it occurs it is incurable; but nervous symptoms produced by fear are sometimes mistaken for it. Rattlesnake bites are now commonly treated by giving the sufferer intoxicating doses of whiskey. Ammonia, locally applied immediately after the bite, may be of some use; and the same has been said of iodine and bromine. (Bibron's Antidote.) Sting* of Bees and Wa*p*t Bites of Mu*qvitoes, etc.
Nothing relieves the pain arising from the sting of a hornet, bee, or wasp so soon as plunging the part in extremely cold water, and holding it there for some time. Water of ammonia may antagonize the poison. A cold lead-water poultice is also a very soothing application. If a number of these insects have attacked you at once, and the parts stung are much swollen, lose some blood, and take a dose of salts.
Musquito-bitesmay be treated in the same manner, although I have found a solution of common salt and water, made very strong, speedy and effectual in relieving the pain. Camphorated spirits, vinegar, etc., may also be used for the same purpose. A solution of Prussian blue in soft water, with whioh the parts are to be kept constantly moist, is a highly celebrated remedy for the stings of bees, wasps, etc., etc.

Wounds of the Ear, Nose etc.
Wash the parts clean, and draw the edges of the wound together by as many stitches as are necessary. If the part is even completely separated, and has been trodden under feet, by washing it in warm water, and putting it accurately in the proper place, by the same means, it may still adhere ; and so may teeth that have been knocked out, if replaced.

Wounds of the Scalp.
In all wounds of the scalp it is necessary to shave off the hair. When this is done, wash the parts well, and draw the edges of the wound together with sticking-plaster. If it has been violently torn up in several pieces, wash and lay them all down on the skull again, drawing their edges as nearly together as possible by stickingplaster, or, if necessary, by stitches. Cover the whole with a soft compress, smeared with simple cerate, or with water dressing.

Wounds of the Throat.
Scire and tie up every bleeding vessel you can get hold of. If the windpipe is cut only partly through, secure it with sticking-plaster. If it is completely divided, bring its edges together by stitches, taking care to pass the needle through the loose membrane that covers the windpipe, and not through the windpipe itself. The head should be bent on the breast, and secured by bolsters and bandages in that position, to favor the approximation of the edges of the wound.

Wound* of the Chest.
If it is a simple incised wound, draw the edges of it together by sticking-plaster, cover it with a compress of wet linen, and pass a bandage round the chest. The patient is to be confined to his bed, kept on a very low diet, and to be bled and purged in order to prevent inflammation. If the latter comes on, reduce it by bleeding.
Should the wound be occasioned by a bullet, extract it and any pieces of cloth, etc., that may be lodged in it, if possible, and cover tho part with a piece of linen smeared with some simple ointment, taking care that it is not drawn into the chest. If a portion of the lung protrudes, return it without any delay, but as gently as possible.

Wounds of the Belly.
Close the wound by strips of sticking-plaster, and stitches passed through the skin, about half an inch from its edges, and cover the whole with a soft compress, secured by a bandage. Any inflammation that may arise is to be reduced by bleeding, purging, and a blister over the whole belly.
Should any part of the bowels come oat at the wound, if clean and uninjured, return it as quickly as possible; if covered with dirt, clots of blood, etc., wash it carefully in warm water previous to so doing. If the gut is wounded, and only cut partly through, draw the two edges of it together by a stitch, and return it; if completely divided, connect the edges by four stitches at equal distance*, and replace it in the belly, always leaving the end of the ligature to project from the external wound, which must be closed by sticking-plaster. In five or six days, if the threads are loose, withdraw them gently and carefully.

Wounds of Joints,
Bring the edges of the wound together by stick ing-plaster, without any delay, keep the part perfectly at rest, bleed, purge, and live very low, to prevent inflammation. Should it come on, it must be met at its first approach by bleeding or leeching to as great an extent as the condition of the patient will warrant. If a permanent stiffening of the joint seems likely to ensue, keep the limb in that position which will prove most useful, that is, the leg should be extended, and the arm bent at the elbow. Wounds of joints are always highly dangerous, and frequently terminate in death.

Wounds of Tendons.
Tendons or sinews are frequently wounded and ruptured. They are to be treated precisely like any other wound, by keeping their divided parts together. The tendon which connects the great muscle forming the calf of the leg, with the heel, •ailed the tendon of Achilles, is frequently cut with the adze, or ruptured in jumping from heights. This accident is to be remedied by drawing up the heel, extending the foot, and placing a splint on the fore part of the leg, extending from the knee to beyond the toes, which being secured in that position by a bandage, keep the foot in the position just mentioned. The hollows under the splint must be filled up with tow or cotton. If the skin falls into the space between the ends of the tendon, apply a piece of sticking-plaster, so as to draw it out of the way. It takes five or six weeks to unite, but no weight should be laid on the limb for several months.
Source: Mackenzie's Ten Thousand Receipts ©1867