SURGERY, 
water m the cellular substance, occasioning 
a general swelling of the part, without dis- 
colouration, that pits on pressure, is uneasy 
rather than painful, and increases in a de- 
pending position. It arises from constitu- 
tional, or local weakness. In the latter 
case, which alone belongs to surgery, let 
the cause bd removed ; put the limb in a 
horizontal posture; employ frictions with 
flannel, and camphorated, or other slightly 
stimulating applications, and tlien apply a, 
moderately tight roller. 
Burns are attended with violent inflam- 
mation of the part, severe pain, and fever. 
The cuticle is raised into clear yellow blis- 
ters. The part may be destroyed at once, 
and converted into a dead black substance, 
or it may slough from the subsequent in- 
flammation. If vesications do not form, 
suppuration will probably not take place. 
Where the injury is very extensive, the 
breathing is much affected. 
As burns are violent local inflammations, 
the antiphlogistic treatment, both locally 
and generally, was the usual surgical prac- 
tice, until Dr. Kentish, who then practised 
surgery at Newcastle, introduced the oppo- 
site, but as subsequent experience has 
proved, much more successful plan of ap- 
plying hot oil of turpentine, or alcohol, and 
then covering the part with a liniment 
composed of ung. resin, flav. and ol. tereb. 
on the principle of maintaining the action 
of the part by an adequate stimulus, which 
is to be gradually diminished. The first dress- 
ing remains for twenty-four hours ; and in 
the second, warm proof-spirit, or laudanum, 
may be used before the plaister is applied ; 
which alone suffices for the third. When 
suppuration commences, powdered chalk, 
and a plaister of cerat. lap. calam. Opium 
and good diet are to be allowed at the 
commencement of tlie treatment, with the 
topical stimulus. , 
Effects of cold. When a limb has been 
frozen, beat must be communicated to it 
very gradually. The sudden application of 
considerable warmth w'ill inevitably cause 
mortification. Jliib the part with snow, as 
persons in northern countries do their ears 
or noses when thus affected, or with cold 
w'ater, until motion and sensibility return. 
Then camphorated spirit of wine may be 
used, and ultimately, a moderate approach 
to the fire may be allowed; or else the 
patient may be put in a warm bed, and 
warm flannels may be applied locally ; ge- 
neral perspiration being at the same time 
promoted. The same principles must be 
kept in view when the whole body is affect- 
ed. Volatiles and sternutatories may be 
used when animation has returned; and 
warm wine, or spirits, should be introduced 
into the stomach as speedily as possible. 
Chilblains are caused by exposure of parts 
to the vicissitudes of heat and cold, par- 
ticularly in young persons, females, and 
such as are brought up tenderly. Before 
they are ulcerated ice, cold water, or snow, 
may be applied two or three times a day ; 
and the parts should be kept dry, and in an 
uniform temperature. In some cases, topi- 
cal stimulants seem more beneficial, as spir. 
vin. camph. or tinct. myrrh® rubbed in ; 
also vinegar and alum lotion. Sp. vin. camph. 
and tinct. cantharid. in equal parts, have 
been very useful. 
WOUNDS. 
These vary so much according to their 
extent, the degree of violence employed, 
the powers of the part, its importance to 
life, complication with bleeding, fracture 
of bones. See. that they must be considered 
under various heads. 
The size of the wound is a matter of con- 
sequence ; as a very large cut may produce 
serious consequences, although no important 
parts are injured. The degree of violence 
done to flie fibres is another material con- 
sideration : a wound in which the parts 
have been bruised, stretched, and lacerated, 
as well as divided, will often mortify from 
that cause only ; hence contused and gun- 
shot wounds are particularly dangerous. 
Such injuries too as expose circumscribed 
cavities are alarming, on account of the in- 
flammation which generally follows such 
exposure; hence the danger of even a slight 
wound in the belly, chest, or large joints. 
A slight wound of a part whose timetions 
are intimately connected with life, is often 
fatal. 
Simple incised wounds require only that 
the sides should be brought into a state of 
apposition, and maintained in that condi- 
tion; by means of adhesive plaister, assist- 
ed perhaps by bandage. 
Hemorrhage, which frequently attends 
these injuries, demands particular care, as 
it must be stopped before any thing else is 
done. If the blood flow from an artery, it 
is a florid red, and comes out in jets ; if 
from a vein, the stream is uniform, and the 
colour dark purple. If the vessel be not 
large, the bleeding often stops of itself. 
The divided artery retracts; the surround- 
ing cellular substance, becoming injected 
with blood, presses p, its mouth; andj 
