FLESH WOUNDS. 291 



During the healing process, serum is very apt to collect in cavities in 

 the wound. Though punctured, the sacs are apt to fill and refill, and 

 sometimes there is a great deal of trouble in getting rid of them. They 

 are best treated by being freely laid open, and injected with a one per 

 cent solution of carbolic acid. 



In the special treatment of punctured wounds, if the puncture does 

 not extend into a joint or through the sheath of a tendon, the best plan 

 is to lay open and convert them into ordinary incised wounds. Inject 

 with one per cent solution of carbolic acid. 



Unless this course is taken, much pain will ensue, because the deeper 

 tissues, which have been injured and which will become inflamed, have 

 otherwise no room to swell. Again, unless a free opening is made, the 

 matter, which is sure to arise from the inflammatory action, will burrow 

 and form abscesses and sinuses. When this has been done, apply warm 

 fomentations frequently, or, if possible to keep them in place, poultices 

 of boiled turnips or linseed meal are preferable. Subsequently dress the 

 surface of the wound with white lotion: 



Sulphate of zinc, 



Acetate of lead aa 3 ij. 



Water 1 pint. 



If there is good reason to think that the puncture has penetrated a 

 joint or the sheath of a tendon, the case must be treated as one of open 

 joint. 



Wounds of the Abdomen, 

 On account of the structures which they involve, and the danger of 

 intestinal protrusion, require a specialty of management, more particu- 

 larly when situated in the inferior portion of the abdominal walls. 



1st. Shallow punctures, involving the muscles, but not penetrating 

 through the whole thickness of the floor of the belly, are very apt to 

 cause multiple abscesses. The pus formed in the wound, being unable to 

 find exit on account of the smallness of the opening, burrows between 

 the abdominal fascia and muscles, separates them from each other, caus- 

 ing pain and swelling; at the same time small abscesses form in various 

 parts, which are difficult to heal. 



2d. Deeper punctures, penetrating almost or completely through the 

 walls, the peritoneum being divided or not as the case may be, are apt to 



