402 HEALTH AND DISEASE 



Prevention. — In regard to prevention, this must take the form of pro- 

 tecting the limb, and giving an altered form and bearing to the oflFending 

 foot. The former may be effected by the application of a suitable boot. 

 The latter will require that the inner quarter of the crust be rasped down 

 and the shoe fitted close in. Three-quarter shoes (fig. 408) or the Charlier 

 system (fig. 409) may be tried where the other methods fail, and the 

 feather-edged shoe will in some instances have the desired effect. Speedy 

 cutters should not be allowed to wear their shoes too long. 



21. WOUroS AND THEIR TREATMENT 



WOUNDS 



A wound is a division or rent in the soft parts of the body, the result 

 of violence. 



Wounds diff"er in kind according to the manner of their production, and 

 are classed as follows: — 



1. Incised Wounds. 



2. Lacerated AVounds. 



3. Contused Wounds. 



4. Punctured Wounds. 



There is also a fifth kind — poisoned wounds — which includes all wounds 

 into which poisonous matter or virus has entered. 



Incised wounds are such as are produced by a sharp-cutting instru- 

 ment, as a razor or knife. Here the divided surfaces are smooth and 

 regular, and lend themselves most readily to readjustment. Moreover, 

 the healing process in this description of wound is greatly favoured by 

 the absence of any bruising or tearing of the flesh. The liability to 

 haemorrhage is much greater, however, than in the other varieties. This 

 is referable to the fact that the vessels, instead of being torn and frayed 

 out at their broken ends, are cut clean through, so that the blood, besides 

 Ihaving a free and open passage, meets with no broken shreds of tissue 

 about which to coagulate. 



Lacerated wounds result when hooks or blunt instruments enter 

 the fiesh and are forcibly torn out. In this case the broken surface is 

 more or less rough and irregular, and loose shreds of tissue sometimes 

 hang from the divided parts. Bleeding is much less considerable than in 

 incised wounds, as in the breaking of the torn vessels their coats become 

 detached from each other, and the inner ones are retracted within the 



