178 INJURIES. 



PUNCTURED WOUNDS. 



These differ from other wounds in their dispropor- 

 tionate depth compared with the size of their external 

 opening. Thorns, nails, pitchforks, knives, scissors, and 

 lancets, commonly produce them; they all are more or 

 less dangerous, according to the part pierced, and the 

 depth of the puncture. They are generally attended 

 with more danger than incised wounds, lacerations or con- 

 tusions : in fact, they constitute the most perilous description 

 of injuries which we have to deal with. From the apparent 

 insignificance of the external wound, people are apt to 

 regard punctures as of little importance ; and therefore they 

 often continue using their horses as though nothing had 

 happened. After a time, however, the animal falls dead 

 lame, and is returned to his stable with a foot or leg which 

 will require two or three months to be restored to soundness. 

 On these wounds Mr. Lawrence makes the following prac- 

 tical observations : — '' When inflammation is brought on in 

 consequence of a wound of this kind, it affects the deep- 

 seated textures of the limb ; hence the limb generally swells 

 and becomes hard, the inflamed parts being confined and 

 bound by the fascia which covers them. Under these cir- 

 cumstances, people say, ' Oh ! the fascia is inflamed.' It is 

 necessary, therefore, in the treatment of a wound of this 

 kind, to adopt those measures, in the first place, which are 

 calculated to obviate inflammation of deep-seated parts. 

 Although you may not know the extent to which the punc- 

 ture has gone, you should treat the case as if it were one in 

 which considerable inflammation is likely to arise, and thus 

 you will prevent its occurrence ; for if a case of this kind is 

 neglected, the local inflammation (attended, I would add, 

 by suppuration) often becomes very considerable. '^ 



I shall now consider the injuries to which particidar 

 parts are subject. 



