SECT. II.
Of Wounds
A Wound is an unnatural separation of any part of our body, whereby the order of circulation is hindered, the solids divided, and the fluids let out; suddenly caused by some violent means or other. But when such a separation becomes ulcerated, it loses the apellation of wound, and is called a sore, or ulcer.—This distinction is requisite to be taken notice of; for wounds and sores are often confounded, which shews not only ignorance, but as their nature is materially different, their method of treatment is not less so; and ought therefore previously to be understood.
Wounds are best distinguished into three different kinds; cut wounds, bruised wounds, and gun-shot wounds. I shall briefly shew how to treat each in particular.
Cut Wounds.
A Cut wound is barely a separation of parts; and the sharper the instrument with which the wound was made, the easier will the wound be to heal up again.
It is however a natural thing to observe what parts of the body is wounded, for tho’ nature is kind in uniting the parts, yet some parts are more easier healed than others.——Observe therefore
The different Methods.
If an artery is wounded (which is known by the blood being of a florid colour and spinning out by starts) care should be taken to have it stopt to prevent bleeding to death. But in this you should not be too scrupulous. Two or three ounces from a wound makes a great shew; and very often a little blood lost is of great benefit to the healing. Should, however, the blood gush from the wound violently, especially from an artery, make a compress of lint, strewed with Powder’d Allum, (17) which secure well on the parts with a roller, laying over it a compress, with Spirit of Wine and Camphor; (A) if that should not be yet sufficient, put a piece of money in a compress, and secure it on the wound, that is, provided the part of the body will admit of it, such as the arms or the legs, &c.
Let the ligature, or the first dressing, lie on for two or three days, and, if no hindrance to the patient, longer. If all these things are not sufficient, recourse must be had to the needle.
In every other kind of cut wounds, care should be taken to have it first cleaned with some water; (a small matter of vinegar, and brandy may be mixed with it) next, let the lips of the wound be well closed, dressed with dry lint, and Turlington’s Balsam (W), and over which, a compress with Camphor Spirits (A).
Plaisters, salves, &c. in green cut wounds, are altogether needless. All that is required to healing, is to keep the wound clean, to give it rest, and not to aggravate it with any thing acrimonious. Turlington’s Balsam (W) is admirable, but yet it suits small wounds better than large ones.
As a finger is very liable to be cut, and sometimes gives a great deal of trouble, I will here give a simple and expeditious remedy:—If you have cut your finger, wash it in a little salt or fresh water; tie it round with a good long thread, not too tight,—take care that your wooling may keep on without being removed; and a day or two will heal it up, without any farther plaistering. If inflammation attends the wound, methods should be taken accordingly, by bleeding, fever powders, &c.
Of Bruised Wounds.
These kinds of wounds are of a worse nature, and are not so kind to heal as the former; for here the parts seem to be torn to pieces, so that there is not only a separation of parts, but a destruction of a great many tender fibres all round the wound.
Hence we see in such cases a great deal of swelling, inflammation, and pain attend it; for the blood being hindered, the circulation naturally swells up the parts; and the nerves being lacerated also, must occasion great pain. Hence it must follow, that nature must first get rid of the obnoxious and torn part before she will consent to unite the wound again; and this must be performed by suppuration.
In small cases, nothing is more beneficial than Diachylon Plaister, (20) which assuages the inflammation, corrects the acrimony, and brings the wound to a good state.
Broken shins often occur on board a ship, which is of that species of wounds. And as from such a case, (though in general slighted) many evils have arisen, I would caution the mariner to apply immediately Diachylon Plaister (20) to a broken shin; by which he will prevent having an ulcerated leg; a thing very troublesome.
If the bruised wound is on other parts, and the parts all round are bruised, care should be taken that it is cleaned as before directed, and a pledget of lint, with Yellow Basilicon, (F) will be necessary; over which a compress with Spirits of Wine and Camphor, (A) or rum, may be applied; and afterwards, when it begins to heal, it may be dressed with dry lint.
As these kind of wounds are liable of becoming ulcers, great care should be taken in the beginning to treat them properly.—Wounds in general should not be dress’d or look’d to too often; in general it aggravates the parts, and retards healing. A wound should not be opened the first three days after the first dressing: nature is very kind, and requires care only to replenish what is deficient.
When an ulcer has commenced, see the treatment under that head.
Gun-shot Wounds.
These are the most terrible of all sorts of wounds; for it is not only the contusion that attends them, but frequently the ball forces strange things, as cloaths, &c. into the wound with it.
Gun-shot wounds at best are tedious in their healing, but very often, from their nature, liable to mortification, and thence become dangerous. Besides, it is seldom that the fleshy parts alone are wounded, but they frequently penetrate into the very bones themselves.
The first care in gun-shot wounds, is to extract the ball, or whatever is forced into the wound; in the next place, the wound should be dressed with Yellow Basilicon, (F) mixed with fine Precipitate (O).
No. I
Take Basilicon one ounce, fine Precipitate one scruple, and mix them.
The parts all round should be well fomented with warm claret, intermixed with Spirits of Wine and Camphor.
If the patient is full-bloody, and no blood lost by the wound, he should be blooded, and immediately treated as a patient in a fever.
If the pain in the parts become violent, eight or ten drops of liquid laudanum (T), together with thirty or forty drops of sweet spirit of nitre (D), should be given once, twice, or thrice a day. If the wound begins to discharge plenty of matter, it should be dressed with the same dressing often. But if the parts become black, very fœtid, the patient in great pain, and grows faint, a mortification is to be feared; which I shall treat of in its proper place.
When the suppuration is unkind, and the parts are much inflamed, a poultice will be very proper.
No. II
Take oatmeal (15) or (if that is not on board) biscuit pounded about three spoonfuls, honey one spoonful, water a sufficient quantity to boil it into soft poultice; in which put of sweet oil about half a spoonful. This poultice should be renewed twice a day at least, and put on as warm as possible it can be borne.
As gun-shot wounds are apt to degenerate into malignant ulcers, I shall refer the reader to the treatment of ulcers in general.