SECTION X. 
SURGICAL AFFECTIONS. 
CHAPTER I. 
WOUNDS. 
Ir goes without saying that in cases of fractured bones, severe wounds, etc., 
surgical assistance is very generally necessary, but it is not, by any means, always 
at hand, even in cities; hence at least a little knowledge of such injuries and 
the essential treatment in ordinary emergencies should be possessed by all; and 
by its prompt application the worst effects of many accidents can be prevented. 
Wounds are divided into certain classes, namely, the incised or clean cut, 
the lacerated or torn, the contused or bruised, the punctured or penetrating, 
and the crushed. To these may be added poisoned wounds, bites, stings, and 
scratches. 
Incised wounds, usually made by sharp-edged tools or instruments, or glass, 
are generally produced with only little violence and admit of repair most easily. 
They are, however, often dangerous at first through bleeding; while torn, bruised, 
and crushed wounds, as a rule, bleed but very little. If only small vessels, the 
so-called capillaries, are divided, the blood flows steadily, and is of an ordinary 
red color, it being a mixture of arterial and venous blood. If a vein be cut, the 
flow is also steady, but the color of the blood is dark-red — almost blue-black or 
dark purple. When an artery has been cut, bright red blood comes from the 
wound in jets or spurts, which are in unison with the pulsations of the heart. 
All cut wounds should be promptly washed out by a stream of water — either 
warm or cold — poured from a pitcher or other convenient vessel, and dirt and 
all foreign bodies or particles with absolute certainty removed. The edges 
should then be brought together, and kept in place if possible. 
When pressure can be applied and persisted in, even arterial bleeding, the 
most difficult to control, can always be checked. This will be practicable over 
a bone of considerable size, the same furnishing a solid foundation on or against 
which the cut vessel can be forced and held by a compress; which is made by 
folding a fragment of cloth into a thick pad, an inch or more square, as required. 
Laid on the wound, the edges of which have been brought together, it may be 
kept in place by a bandage firmly applied. 
273 
