GUNSHOT WOUNDS. 
relieve immediately any epee part, or the conititution, 
then you gain nothing by i iaeeg ——— but only 
increafe the inflammation ; and, in cafes, the inflamma- 
tion arifing from the accident and Lapciieas together may be 
Under this lait circumitance, it 
oat by which means, the patient will ftand a much better 
‘chance of a cure, the inflammations eer divided. It is 
offible, n may arife from fome 
or 
artery, » nerve, or vital 
d the fee is 
c co weak, 
the veffel ought undoubtedly to be tied, and, moft probably, 
i e done without previoufly opening the external 
parts, 2 often freely. 
ly, in a wound of the-head, when there is reafon 
to fafpeet a fiadbure of the fkull, it may be neceffary to 
open the fcalp. 
Fourthly, ae there are in any part of the .body frac- 
tured bones, which can be immediately extra¢ted with ad- 
vantage, and which would do much mifchief if left, the 
cafe is to be regarded as a compound fraéture whenever it is. 
It makes no isteaee | in the treatment, whether the wound 
in the fkin was made by a ball or the bone itfelf, at leaft where 
the compound fraéture is allowed to fuppurate ; for there is 
oftena poffibility of treating a compou ure as a fim 
ple oe athing which gun-(hot fractures will feldom detect 
of, cafes, however, are very fimilar, when fuppuration 
cannot %y avoided. -Inftances, indeed, fays Mr. — 
eee sis diiptatsan 
ome internal part is mifplaced, and can be 
put at once fats its natural pofition again, it may be proper 
to dilate the wound, as in wounds of the belly, 
with a protrufion of “ Homé-of the vifcera, where it is nece{- 
fary to perform gaftroraphe. In ‘ ion 
tobe done in the fame manner as if the accident arofe from 
any other caufe ; but Mr. Hunter obferves, the treat- . 
ment fhould be different ; for 2 cannot heal by 
the firft intention, on account the flough which is to enfue. ' 
ily, when fi Sit tg: is preffed, fo that its 
en happen in 
fkull, fractures of the ribs, fternum, &c. 
a es or much impaired, as will often 
an er 
the fkin is requifite, fince the operation can do no good to 
the reft of es und, whic hes canal, 
At prefent, Fungeon ns do vit give themfelyes fo much 
trouble about the balls, nor often dilate the wound on 
account. When the wound is dilated, they do not fearch 
much after them, which fhews that the opening is not necef- 
fary, or at leait, that it is not made on account of extrene- 
ous 
Such pradtice, obferves Mr. Hunter, has arifen from ex- 
perience’; for it has been found, that balls, when obli cs) 
be left, have e feldom or never done any _s when 
apt “2 promo ote 
matio ne : ¥ 
he ball os readily be found at firft, becaufe the parts 
are oaly torn and —_ get ot lofs of fubftance be- 
fore the flough come e the parts collapfe and 
fall into their places ein fo as 6 paisks it difficult to pafs 
any thing in the dire€tion of the ball, or even to know its 
direction. ‘T'his difficulty is increafed by the winding courfe 
which a ball takes, in confequence of being t turned by 
ome refifting body. 
The courle of a tba however, pe eafily be traced whea 
it is not perpendicular, but ruus quely, and not more 
deeply than an inch or fo; for the len over the paflage of 
the fhot is em marked by a reddith line. See Hunter™ 
on Guntfho rt S. 
bh 14 ‘ff «4 
After 
tial reader, that the sdentge of — eee ‘shojanlle 
ihef mvt Oke Seep a urdity oe —* 
teguments part of which ik 
itruck by the ay igh he driven into the wound, 
ftill Segre, fo pd, fot 6 
ftances, can find a 
forcing ale foreign bodies often 
m wounded part, and that 
tly em ot be extrted pent » OWing to 
