41 



If the wound is a large one, •with the skin and tissues badly 

 torn and lacerated, and it will not admit of the use of sutures, 

 the torn and ragged edges, espscially if the lower part of the 

 wound should hang down, should be removed with the knife or 

 scissors and the wound dressed as above directed. When the 

 wound begins to granulate (fill with new tissue) care should be 

 taken that the granulations are not allowed to grow out higher 

 than the skin; in case they do so we will then have the condition 

 known as proud flesh. 



The treatment of proud flesh consists in the removal of the un- 

 healthy tissue by the use of the knife or the application of the red- 

 hot iron; or burnt alum or salicylic acid dusted upon the surface 

 of the wound will destroy the unhealthy granules. 



If hemorrhage is profuse the first step to be taken is to arrest 

 the flow of blood by ligating (tying) the blood vessels or vessel 

 with a piece of silk, or if none is at hand, a clean piece of string 

 will do; if unable to tie the blood vessels a thick pad made of cot- 

 ton or several layers of gatize or clean cloth, folded so as to cover 

 the wound and held firmly in place by one or more cotton ban- 

 dages will check the flow of blood. Before applying the com- 

 press and bandages, the edges of the wound should be brought in 

 contact by the aid of sutures if possible. The compress should 

 be left on until the hemorrhage ceases, and the wound treated as 

 before mentioned. 



Punctured wounds should be explored with a probe to ascer- 

 tain if any foreign bodies are in the channel; if so, they should be 

 removed, and if necessary a dependent opening be made to allow 

 perfect drainage, and the parts syringed out thoroughly with a 

 solution of creolin, 3 per cent; carbolic acid, 3 to 5 per cent; 

 or, bichloride of mercury, 1 to 1,000, and the outside opening 

 sprinkled with iodoform. This treatment should be applied twice 

 daily. 



An excellent antiseptic solution for the treatment of wounds, 

 especially during fly time, is made by dissolving eight ounces of 

 gum camphor in three ounces of carbolic acid. Apply with a 

 clean swab several times daily. 



PUNCTURED WOUNDS AROUND JOINTS. 



Open joint is a wound situated on a joint and extending through 

 the capsular ligament and allowing the joint oil to escape. The 



