364 
DEPARTMENT OF SURGERY. 
to that of all the structures that compose the walls but the 
peritoneum. These wounds are usually the result of accidents, 
such as have already been mentioned, and as a rule require surgi¬ 
cal attention in order to obviate undesirable results which 
usually follow as a consequence of negligence on the part of 
the surgeon or the client. These wounds may be divided 
into two classes, viz. : (<?) Simple Wounds, and (£) Complicated 
Wounds. 
(a) Simple Wounds. —The simple non-penetrating wounds 
are those that consist of a division of the soft structures with¬ 
out the introduction of foreign bodies which may be introduced 
into it, either by the interception of substances, such as part of 
the harness, vehicle, blanket or any object that may accidentally 
come between the patient thus injured and the object which in¬ 
flicted the wound, or by the retention of part of the object 
which may be broken off by the force of the blow as it entered 
the abdominal walls or while ejecting it from the walls. Simple 
wounds may have septic products introduced into them, but do 
not contain other foreign substances. 
(b) Complicated Wounds. —The complicated non-penetrating 
wounds of the abciomen include all wounds that contain for¬ 
eign substances which may be introduced as mentioned above. 
Considerable attention must be given to these wounds in order 
to ascertain the true condition ; the object that produced it 
must be carefully examined ; the position of the patient when 
injured should be ascertained ; and the condition that sur¬ 
rounded him at the time of the accident should be obtained 
from the coachman, driver or attendant ; to all of which the 
surgeon should add his own deductions to the information thus 
obtained, and “ govern himself accordingly.” 
Treatment. —In treating these wounds the chief object in 
view should be to make it an aseptic wound that will heal as 
readily as a surgical wound, and the following course of treat¬ 
ment should be adopted, viz. : 
1. x\rrest all haemorrhage. 
2. Cut away all tissues that are likely to become necrotic. 
3. Clip the hair, and clean the part surrounding the wound. 
4. Ascertain whether simple or complicated. 
5. Treat according to indications. 
6. Apply sutures, dressings and bandages required. 
Always arrest all hsemorrhage before attempting to do any¬ 
thing else ; to attempt to treat a wound while wading in blood 
is unsurgical, and should never be done under any circum- 
