PATHOLOGY. 41 



On Punctured Wounds. 



PUNCTURED WOUNDS are much more dif- 

 ficult of cure than incised wounds, from the many 

 different parts liable to be wounded, as skin, cellu- 

 lar membrane, muscles, nerves, tendon, &c. ; the 

 external opening being small, if suppuration takes 

 place, it is almost impofsible for the matter to be 

 evacuated ; hence fistulous ulcers arise. 



If any extraneous body is lodged in the wound, 

 and there is great difficulty in getting at it without 

 dilating the wound, or if matter should work its 

 "way to any of the surrounding parts, and we are 

 not likely to do mischief, from the division of 

 nerves, or large-blood-vefsels, we may cut down 

 upon it, and extract it ; but if danger is to be ap- 

 prehended from the division of either of the above, 

 ve must wait for suppuration. 



If there should be matter lodged under the 

 fascia, we should open it directly, and reduce it to 

 a fresh incised wound. 



If a puncture should be superficial ; that is, if 

 it should run under the skin and cellular membrane 

 only, it will then be best to lay it open to its full 

 extent. 



