AlA?g?srt,  iSb!™*}     Treatment  of  Contusions  and  Wounds.  387 
Contusions  or  bruises  are  injuries  generally  caused  by  some  blunt 
instrument,  e.g.,  a  stone,  club  or  fist.  There  is  more  or  less  destruc- 
tion of  tissue  followed  by  swelling,  subcutaneous  hemorrhage  and 
frequently  discoloration.  The  treatment  is,  first,  to  prevent  any 
further  escape  of  blood  in  the  tissues;  this  may  be  effected  either  by 
cold  or  hot  applications,  both  of  which  ultimately  reduce  the  calibre 
of  the  bloodvessels.  If  ice  is  used  it  should  not  be  applied  for  too 
great  a  length  of  time,  as  the  circulation  may  be  interfered  with  to 
so  great  an  extent  as  to  injure  the  vitality  of  the  part.  Secondly, 
to  antagonize  the  pain,  shock  or  inflammation.  This  may  be  done 
by  rest,  elevation  and  cold,  as  already  alluded  to.  In  severe  cases 
warmth  would  probably  be  more  agreeable  and  safer.  After  the  in- 
flammatory stage,  absorption  may  be  promoted  by  massage  or  friction 
with  liniments.  It  may  be  said  in  passing  that  the  best  methods  of 
treating  a  sprain  is  to  keep  the  injured  part  (which  is  generally  an 
ankle)  immersed  in  water  as  hot  as  it  can  possibly  be  borne  for 
some  three  hours.  Ammonium  chloride  (8  ounces  to  a  bucketful  of 
water)  is  a  valuable  adjunct. 
The  wounds  that  the  apothecary  will  be  most  apt  to  see  are  the 
incised,  generally  caused  by  some  sharp  instrument,  such  as  a  knife 
•or  razor ;  the  lacerated,  in  which  the  tissues  are  more  or  less  torn, 
as  a  scalp  wound;  and  wounds  produced  by  animals,  usually  dogs. 
In  the  case  of  incised  wounds,  if  they  are  properly  treated  and 
the  edges  of  the  wounds  closely  approximated,  healing  always  takes 
place  by  what  is  called  "  union  by  first  intention,"  frequently  in 
seventy-two  hours.  In  the  case  of  lacerated  wounds,  healing  takes 
place  more  slowly  by  granulation ;  that  is,  the  formation  of  new 
material  from  the  bottom  of  the  wound  called  "  union  by  second 
intention." 
It  is  hardly  necessary  at  this  late  day  to  argue  in  favor  of  the 
antiseptic  treatment  of  wounds,  but  it  should  be  said,  and  said  as 
strongly  as  possible,  that  any  apothecary  who  is  not  willing  to  go  to 
the  trouble  to  treat  wounds  in  this  way  should  not  treat  them  at  all. 
The  following  articles  will  be  needed  for  the  antiseptic  treatment 
of  wounds,  unless  they  are  of  a  very  trivial  nature  :  Solution  cor- 
rosive sublimate,  1 :  1000  or  1, 12000.  In  deeprseated  or  extensive 
wounds  weaker  solutions  must  be  used,  or  there  will  be  danger  of 
poisoning;  but  it  must  be  borne  in  mind  that  in  the  drug  store 
where  perfect  antisepsis  cannot  be  attained,  fairly  strong  solutions 
