Wounds 159 



they may be caused by violent internal muscular ex- 

 ertion. They are classified according to their nature. 

 Clean-out, or incised wounds, are such as would be 

 made with a knife. Other things being equal, incised 

 wounds are the easiest to treat. Lacerated, or torn, 

 wounds are usually made by barbed wire. Contused 

 wounds are those in which the parts are bruised, 

 as well as cut. These wounds are serious, for if the 

 tissues are badly bruised there may be considerable 

 sloughing of the injured parts, leaving a large sore. 

 Punctured wounds are made by more or less pointed 

 bodies penetrating the flesh. Considering their size, 

 punctured wounds are the most serious. They are 

 likely to be deep, and to injure vital parts, or the 

 foreign body that caused the wound is liable to break 

 off and a part of it to be left in the tissues. It is 

 difficult to reach the deeper parts of punctured wounds 

 to clear them of foreign substances and to treat them 

 satisfactorily. Gunshot and poisoned wounds are some- 

 times classified with punctured wounds, but they are so 

 rare that they do not need special consideration here. 



Treatment of Wounds 



The first step in the treatment of wounds is to stop 

 hemorrhage, or excessive flow of blood. While a hemor- 

 rhage is seldom dangerous unless a large artery or vein 

 is cut, yet it is best to stop it at once. Bleeding from 

 an artery is more serious than from a vein. Arteries 

 carry blood from the heart to the different parts of the 

 body, while veins gather the blood and carry it back to 



