What is to be observ'd in Wounds of the Breast?
Two things, viz. whether they penetrate into the Cavity of the Thorax or not, which may be discover'd by the Probe, and by a Wax-Candle lighted, and apply'd to the Entrance of the Wound, obliging the Patient to return to the same Posture wherein he receiv'd the Hurt, as also to keep his Nose and Mouth shut: For then the Flame may be perceiv'd to be wavering, the Orifice of the Opening being full of
Bubbles; a Judgment may be also made from the running out of the Blood.
What is to be done when it is certainly known that the Wound penetrates into the Cavity of the Breast?
It is necessary to examine what Part may be hurt, by considering the situation of the Wound, and its Symptoms: If the Lungs are pierc'd, a spitting of froathy Vermilion-colour'd Blood ensues, with difficulty of Respiration, and a Cough. If any of the great Vessels are open'd, the wounded Person feels a Weight at the bottom of his Breast, is seiz'd with cold Sweats, being scarce able to fetch his Breath, and Vomits Blood, some Portion whereof issueth out of the Wound. If the Diaphragm or Midriff be cut in its Tendinous Part, he is suddenly hurry'd into Convulsions: And if the Heart be wounded either in its Basis or Ventricles, he falls into a Swoon, and dies incontinently.
But if the Probe doth not enter, and none of the above-mentiond Symptoms appear, it may be taken for granted that the Wound is of no great Consequence.
What is to be done when the Wound penetrates into the Chest, yet none of the Parts are hurt, only there is an Effusion of Blood over the Diaphragm?
It is necessary to make an Empyema, or otherwise the diffus'd Blood in corrupting, wou'd inevitably cause an Inflammation, Gangrene, and Death it self.
What is an Empyema?
It is an Operation whereby any sorts of Matter are discharg'd with which the Diaphragm is over-spread, by making a Puncture or Opening in the Breast.