WOUNDS. 



» ptirt of the food fometimes efcapes. Two cafes of wounds 

 of the ilomach are recorded by Dr. Thomfon, in his Obf. 

 on the Mihtary Hofpitals in Belgium. One was from a 

 muflcet-ball ; the other from a pike. They were treated on 

 the mild, unimtating plan, adapted for wounds of the intef- 

 tines, and both ended well. " The hiftories of the Bohe- 

 mian, Pruflian, and Englifh ' cultrivores,' from fome of 

 whom the knives have been cut out, and from others dif- 

 charged fpontaneoufly, through the coats of the flo.Tiach 

 and parietes of the abdomen, as well as many other inftances 

 on record, are (as Mr. Hennen o^jfarves) very encouraging 

 in cafes of injuries of this organ." M. Hevin, in the Mem. 

 de I'Acad. de Chir. tom. i. p. 144. has coUedted a number 

 of interefting inftances of recovery, both from incifed and 

 gun-lhot wounds. But (fays Mr. Hennen) the induftrious 

 Ploucquet, in the articles " Ventriculus" and " Panto- 

 phagi," has exceeded all others for the vaft number of cafes 

 he has amaffed. In our own Philofophical Tranf., Low- 

 thorpe's Abridgment, vol. vi. p. 192. or in the modern one, 

 by Drs. Hutton, Shaw, and Pearlon, vol. iv. p. 66. an in- 

 llance is given, where the ftomach of a horfe was wounded 

 and fewed up, and a fimilar inftance in the human fpecies : 

 both recovered. More recently futures have been applied 

 to its wounds in Holland and France, as may be feen in the 

 *' Annales de Litterature," &c. by Kluyflcens, vol. 2. and 

 in the " Traumalogia" of Schlichting, &c. Notwithftand- 

 ing thefe narratives, however, we have no doubt of the 

 rafhnefs of fuch praftice, and all that can be faid about it is, 

 that the patients had to overcome both the injury and the 

 bad treatment of it. Not unfrequently a wound of the fto- 

 mach has become fiftulous. Richerand gives a very curious 

 cafe of this kind, where the opening remained for nine years ; 

 EtmuUer, in the 5th vol. of Haller's " Difputationes Chi- 

 rurgicae," gives an inftance, where it continued open for ten 

 years ; and Wenker, in the fame volume, relates a cafe where 

 a wound of the ftomach continued open twenty-feven years. 

 (See Hennen on Military Surgery, p. 481, &c.) Copious 

 bleeding, abftinence, and reft, are the beft remedies in the 

 early ftage of all fuch cafes. 



Wounds of the fpleen moftly prove fatal by the profufe 

 hemorrhage arifing from them. Mr. Hennen, however, 

 aflures us, that he has feen fome flight wounds of this vifcus 

 terminate favourably. It has fometimes been cut out of 

 brutes, without any fatal or even any bad confequences ; 

 and there is a recent inftance recorded, in which it protruded 

 from an incifed wound, the furgeon removed it, and the 

 patient got well. (See Medico- Chirurg. Journal, vol. i. 

 1816.) It has alfo been tied and cut out in fome other 

 inftances with fuccefs. See cafes in Gooch's Chir. Works, 

 vol. i. p. 97 ; Leveille's Doftrine Chir. tom. i. p. 400 ; 

 alfo fome references in Thomx Barthohni Anatome, p. 158. 

 8vo. Lugd. Bat. 1686, &c. 



Wounds of the fpleen have fcarcely any fymptom which 

 is peculiar to them. According to Celfus, however, there 

 is great pain in the fhoulder, as in wounds of the liver. The 

 loofe ftrufture of the fpleen, and the magnitude of its veffels, 

 mnft always render its injuries highly dangerous. 



Wounds of the pancreas, according to CaUifcn, are not 

 charafterized by any peculiar fymptom, except the efFufion 

 of a fluid analogous to the fahva. The pancreas, like the 

 duodenum, can hardly be wounded, without the weapon 

 having at the fame time injured other vifcera. ( Syft. Chir. 

 Hodiernae, tom. i. p. 719.) Gooch fets down wounds of the 

 pancreas as mortal, if its duct or blood-veffels be injured. 

 Chir. Works, vol. i. p. 99. 



Wounds of the kidneys and ureters are always dangerous, 

 on account of the hemorrhage and efFufion of urine. When 

 Vol. XXXVIII. 



the latter fluid infmuates itfelf within the peritone urn, or 

 into the cellular membrane, the patient has but a very dif- 

 couraging chance of prefervation. Small wounds of the kid- 

 ney, however, may be cured, though a fiftula will fometimw 

 remain. The danger of wounds of the kidney is well 

 pointed out in M. Hevin's EfTay on Nephrotomy, in the 

 Mem. de I'Acad. de Chir., and a great mafs of evidence is 

 produced on the fubjed. The recoveries which Mr. Hen- 

 nen has feen, after wounds of the kidneys, he obferves, are 

 very few indeed. "If the patient has furvived the firft he- 

 morrhage, the fever and peritoneal inflammation, with in- 

 ccuant hiccough and vomiting from fympathy of the dia- 

 phragm and ftomach, have generally cut him off ; and if he 

 has for a time efcaped, excruciating pains, profufe fuppura- 

 tion from fiftulous fores, heAic, and emaciation, have ter- 

 minated his exiftence. Where the cure has been eft'efted, 

 there is reafon to think that the ureter has been but flightly 

 brulhed, and the body of the kidney itfelf left untouched. 

 The remedies confift in venefeftion, mild purgatives, as 

 manna, oil, Sec. frequent emollient enemas, the warm bath 

 generally, and local fomentations, &c. with a diet of the 

 iiiiideft kind, but much reftrifted in fluids, the indulgence 

 in which, even in fmall quantity, ftiould be avoided." The 

 fame author properly condemns all ftimulants, blifters, and 

 dmretics ; and he recommends light dreflings, fo as to allow 

 the urine to efcape freely. The integuments near the 

 wound hs alfo advifes to be greafed, fo as to prevent the 

 irritation of the urine from making them inflame and ulcer- 

 ate. See Obf. on Military Surgery, p. 454. 



The fubjeft of wounds is one of infinite length, and this 

 muft apologize for the extent of the prcfent article, in which 

 a great deal is ftill omitted. Had we introduced a full 

 account of the wounds of every part of the body, our ob- 

 fervations would have formed a produftion more than twice 

 as long as that which we have now finifhed ; but we thought 

 that fo minute and elaborate a paper would hardly be de- 

 firable in a work not exprefsly allotted to the confideration 

 of furgery. 



Wounds in Horfes. The moft terrible wounds thefe 

 creatures are fubjeft to are thofe got in the field of battle. 

 The farriers that attend camps have a coarfe way of curing 

 thefe ; but it is a very expeditious and efFeftual one. If 

 the bullet be within reach, they take it out with a pair of 

 forceps ; but if it lie too deep to be come at, they leave it 

 behind, and drefs up the wound in the fame manner as if it 

 were not there. 



They firft drop in fome varnifh from the end of a feather, 

 and when the bottom is thus wetted with it, they dip a 

 pledget of tow in the fame varnifh, which they put into the 

 wound, and then cover the whole with the following charge : 

 Take a quarter of a pound of powder of bole armenic, half a 

 pound of hnfeed-oil, and three eggs, (hells and all ; add to 

 thefe four ounces of bean-flour, a quart of vinegar, and 

 five ounces of turpentine ; this is all to be mixed over the 

 fire, and the wound covered with it. This application is 

 to be continued four or five days, then the tent put into the 

 wound is to be dipped in a mixture of turpentine and hog's- 

 lard ; by this means a laudable matter will be difcharged, 

 inftead of the thin fliarp water that was at firft. Then tlie 

 cure is to be completed by drefling it with an ointment 

 made of turpentine, firft well wafhed, and then diflblved in 

 yolks of eggs, and a Lttle fafFron added to it. 



This is the pradlice in deep wounds that do not go 

 through the part ; but in cafes where the bullet has gone 

 quite through, they take a few weavers' linen thrmnbs, 

 made very knotty ; thefe they make up into a kind of link, 

 and dipping it in varnilh, they draw it through the wound, 

 5 E leaving 



