These may be either Bruised, Crushed, Cut, Lacerated (torn), Penetrating, or Poisoned wounds.

Bruises are familiar to everybody. If the blow or fall has been of such moderate violence as to injure only the surface of the head, body, or limbs, it is not a serious matter. Some blood will be forced out of the small vessels; swelling and discoloration will follow. It will be first red, then almost black and blue, and at last dull yellow or yellowish-brown This is the history of a "black eye," or of a bruise of any other part. Early use of a soothing application will do the most good. There is nothing better for this than cocoa butter, or "camphor ice." Arnica has a reputation for bruises far beyond its desert. When a bruised part becomes painful, a cloth wet with lead-water and laudanum will be suitable. Later, bathing with soap-liniment will hasten the absorption and disappearance of the blood-deposit which causes the discoloration.

Crushed wounds- are much more serious, often endangering life. Such, affecting the head, will cause fracture of the skull. Falling on the chest, ribs may be broken; or, worse, the heart or lungs may be so pressed as to kill at once or shortly. When a limb is crushed in a railroad accident, it may be wholly or partly severed from the body. We might expect great bleeding in such cases; but it does not occur; the arteries are paralyzed, and bleed little or none, even when torn across. The immediate danger then is from shock, going down into fatal collapse. When this is recovered from, the injured limb must be dealt with according to the methods of surgery. Amputation is 546 R Pros often called for; the damage being too great for the limb to be possibly saved.







Shock constitutes the greatest immediate danger in all crushing injuries. Afterwards, there may be inflammation (or perhaps mortification) of internal organs involved; lungs, liver, stomach, kidneys, peritoneum, etc. Such cases will require perfect rest in bed, with treatment which can only be judged of by an experienced practitioner of medicine or surgery. Tetanus (lockjaw) occasionally follows a crushing injury.

Cut wounds are dangerous at first through bleeding. Bruised, crushed, and torn wounds bleed, as a rule, very little. Much difference exists as to what is cut in an incised wound. If only small vessels, the capillaries, are divided, the blood flows steadily, of a moderately red color, being a mixture of arterial and venous blood. If a vein is cut, the flow is steady, and the color of the blood is dark-red, almost blue-black or dark-purp1e . When an artery has been cut, bright red blood comes out in jets, timing with the pulsation of the heart in pumping blood through the arteries. Whatever the source of a flow of blood from a cut wound, we should endeavor (after cleaning out, best with a stream of cold water, any foreign bodies in it) to stop the hemorrhage by putting and holding the edges of the wound together. Pressure may then be added, so far as needful and available. Over a solid bone, as the skull, this will always be practicable. Bleeding even from a divided artery of the scalp can always be checked, by firm pressure on the vessel against the bone. A compress may be made by folding up a fragment of handkerchief, or rag of muslin or linen, into a thick piece an inch square. Laying this right over the source of the bleeding, it may be kept in place by the firm application of a bandage around the head.

To stop bleeding from a vein, large enough to be seen, when pressure at the wound will not do it, the rule is to press just below the wound; that is, on the side farthest from the heart; as the blood flows in the veins from the extremeties towards the heart.

When an artery bleeds, and pressure at the wound fails or cannot be applied, pressure must be applied above the wound; that is, on the side nearer to the heart; the course of the blood in the arteries being from the heart.

Lacerated wounds are those which are torn; as by machinery, or bites of dogs, horses, or other beasts, etc. They are irregular in shape, seldom bleed much, but often inflame, sometimes mortify, and hardly ever heal" by the first intention." Machinery in-juries may be dreadful in character ; a whole limb being torn off at once ; or a hand or a foot torn to pieces. Such may be speedily fatal by shock ; or their results may entail a tedious and uncertain struggle for life; at least when an arm or a leg is badly lacerated. Erysipelas is one of the dangers attending such injuries ; tetanus (lockjaw), another; septicemia (orpyaemia), another.

Besides what may be needful on account of the general shock to the system, lacerated wounds require to be carefully cleared of all fragments of foreign bodies, dirt, etc., and then protected from the air by a proper dressing. To cleanse such a wound, a stream of water should be allowed to flow over it from a clean sponge, dipped in warm water and squeezed above the wound. Water-dressing agrees well with such injuries. Double a piece of lint or soft linen, and squeeze it out of clean tepid water or clear lime-water. Lay this upon the wound, and cover it with a piece of oiled silk, oiled paper, or thin rubber-cloth. Bandage it on the part with just enough firmness to prevent its being displaced. Such a dressing will have to be moistened at least twice a day, and had better be changed 'once in twenty-four hours ; disturbing the wounded surface each time as little as possible. Before the dressing is reapplied, sprinkle iodoform powder lightly over it. This is antiseptic and promotes healing.

Penetrating wounds may vary much; from piercing with a pin to a bayonet, sword, or bullet wound. Even a needle or large pin may be forced into the heart, so as to cause death. Every one receiving a severe penetrating wound, of any part of the body, must be kept in a condition of complete rest, awaiting results which need to receive the best professional attention, to meet the dangers, seen and unseen, belonging inevitably to such injuries.

Poisoned wounds. These are seldom met with, even in war, amongst civilized nations, except by unintended causation. This may happen especially to physicians and surgeons, in their operations, and to medical students in the dissecting-room. Matter from dead bodies, or from diseased living ones, introduced even into the slightest scratch with a knife, needle, or pin, may so taint the blood as to produce a dangerous illness. Not a few physicians have suffered a fatal result from pricking a finger in a post-mortem examination. To prevent such results (besides care to avoid letting an abraded or punctured part come in contact with morbid matters), as soon as such a thing has happened, the part should be immediately washed and sucked, and then kept out of the way of further danger.

In the treatment of poisoned wounds, there is nothing different from that of those which are penetrating or lacerated, unless the wound is made by rabid animals or by venomous serpents. For either of these last, immediate suction is a right precaution; and at the same time a tight cord around the arm or leg, if either extremity has been bitten ; then the end of an iron wire or rod, heated red hot, or a piece of caustic potassa, should be made to burn out the part; or a pinch of gunpowder may be exploded upon it. All these severe measures are designed to prevent the poison from getting, through the blood-vessels, into the system. Although not more, probably, than one in ten of those bitten by mad dogs have hydrophobia, that one will incurably suffer a dreadful death.

Poisons are of several kinds: Animal, as snake-venoms and cantharides; Vegetable, as opium, strychnia, tobacco; Mineral, as arsenic and corrosive sublimate. But a more useful classification of them is according to their effects: as Depressants, Irritants, Neurotics, and Complex poisons.

Depressants are prussic (hydrocyanic) acid, tobacco, lobelia, hemlock, and aconite. It is true, the effects of these, and indeed of almost all poisons, have some complexity; but their chief effect is depression, sinking, prostration ; which, from a certain dose, is fatal.

Irritants are strong acids, as sulphuric, nitric, hydrochloric, oxalic, citric, and tartaric acids; strong alkalies, as potassa, soda, and ammonia ; phosphorus ; corrosive sublimate; tartar emetic; salts of copper and of zinc ; castor-oil seeds ; colchicum ; croton-oil; cantharides; and certain fishes and molluscs (some mussels, etc.).



Neurotic poisons either produce stupor, as do opium, chloroform, ether, chloral, hyoscyamus, and camphor (in excessive doses); or otherwise damage the nervous system, with either delirium, convulsion, tremor, or paralysis, as strychnia (or nux-vomica), belladonna, stramonium, calabar bean, cocculus Indicus.

Complex (Irritant-Neurotic) poisons are such as arsenic, carbolic acid, creosote, digitalis, ergot, fungi (toadstools, etc.), hellebore, iodine, bromine, lead, etc.

Depressant poisons cause prostration, sinking: with paleness, coldness, feeble pulse, gasping breath, with or without nausea and vomiting; all the symptoms of collapse.

Irritant poisons produce burning and pain in the mouth, throat, stomach, and bowels; with nausea, vomiting, and purging ; an artificial cholera-morbus.

Neurotic poisons have just been described as causing either stupor, delirium, convulsions, tremor, or paralysis. Complex poisons may combine several of either of these kinds of effects.

So far, we have been considering poisons as taken into the stomach by the mouth. It must be remembered, however, that they may also enter the system by being breathed into the lungs; injected under the skin ; or even absorbed from the surface of the skin (especially with children; a tobacco leaf has been so fatally used); or inserted into the bowels, etc.

With these general remarks, we may now take up those poisons most likely to be met with, or heard or read about, alphabetically, for ease of reference by the reader.

Acids. As already said, strong acids are generally irritant poisons. Hydrocyanic or prussic acid is a powerful depressant. The antidotes for acids are alkalies and alkaline earths; as soda, limewater, chalk, magnesia, and soap, etc. In like manner, acids of the milder sort, as vinegar, lemon-juice, etc., are antidotes for poisonous doses of strong alkalies or alkaline earths, as caustic potassa, soda, ammonia, or lime.