GUNSHOT WOUNDS. 29 



The consequences may be a simple pustule, inflammation of the 

 lymphatics, and typhoid lever, with diffuse abscesses. 



The pustule has not much elevation, is surrounded by redness, 

 and attended with burning and itching. When opened, it discharges 

 a little thin pus, and is soon refilled, the excavation gradually in- 

 creasing. This may not be followed by constitutional symptoms, 

 unless the health is very bad. 



The inflammation of the lymphatics is more apt to follow a small 

 scratch or wound from examining recent subjects, especially those 

 dying with peritonitis or any disease of serous membranes. The 

 pain and swelling extend up the arm to the axilla, and there is fever 

 and depression of spirits. The course of the inflammation can be 

 traced along the lymphatics to the axillary glands, which often 

 suppurate. 



Extensive abscesses and typhoid fever take place when the poison 

 is very violent, and the system much prostrated. 



Treatment. — The pustule will be managed best by a lye poultice, 

 and then removing the coverings and touching the surface with lunar 

 caustic. A simple incision or puncture for an ordinary pustule will 

 not prevent the renewal of the matter. 



When the lymphatics are inflamed, the original wound is not 

 always the most tender spot, nor is there, the appearance of a pus- 

 tule. Leeches, cold applications, poultices of Indian meal and rye, 

 nitrate of silver, and tincture of iodine are useful local applications. 

 Bleeding may be necessary when the inflammation and fever are very 

 high. Free incisions prevent the formation of abscesses, by evacu- 

 ating the serum and depleting the part. Spreading abscess of the 

 cellular tissue is attended with typhoid fever, and very dangerous. 

 The system must be supported by stimulants and tonics, such as 

 brandy and bark ; opium will allay pain and restlessness, and the 

 local dressing will resemble that for abscess in general. 



Fresh air, clean clothes, healthy skin, good diet, and regular 

 habits will be found to be the best prophylactics. 



GUNSHOT WOUNDS. 



These include all injuries by fire-£^rnis, and partake of the nature 

 of lacerated and contused wounds. There is usually but little he- 

 morrhage, unless a large yessel is injured. The nature and extent 

 of the injury will vary with the distance, force, and character of the 

 shot or slug producing it, and the part affected ; fracture, contusions, 

 and perforations, niay require amputation. The aperture made by 

 the entrance of the bullet often appears smaller than the bullet, and 

 resembles an incised wound with inverted" edges ; the aperture of its 

 exit is larger, and has ragged and everted edges. The pain of a 

 flesh wound is often so slight that it does not attract attention ; but 

 when a bone is broken or a nerve torn, the pain is severe. The 



