WOUNDS, in Surgery, are solutions of the continuity of the soft parts of the body effected by some external agent. and attended with a greater or less amount of bleeding. Wounds vary in their character according to the kind of instrument by which they have been pro duced, as well as the greater or less amount of force with which it has been applied. In order to facilitate the description of treatment, surgi cal writers have divided wounds into several kinds. Thus they are spoken of generally under the terms incised, punctured, contused, lacerated, poisoned, and gunshot wounds. Wounds of particular parts, requiring peculiar treatment, are also described, as of the head, throat, chest, &e.
Incised wounds, cuts, or incisions are produced by cutting instru ments, and are free from contusion and laceration. Punctured wounds, or stubs, are caused by pointed weapons, as bayonets, lances, nails, thorns, &c.. penetrating deep into the flesh. Contused and lacerated wounds are produced by the violent application of bard blunt and obtuse bodies to the soft parts ; and under this head might be included gunshot wounds. Poisoned wounds are those which are complicated with the introduction of a poison into the wounded part. Wounds are more or less dangerous according to the extent of soft parts they involve, the parts they occur in, and the state of health of the indi vidual wounded. In small wounds, unless poisoned, the system gene rally suffers little in consequence ; but when a large amount of soft parte is injured, symptoms of fever come on from twenty to thirty hours after the receipt of the wound, which require attention on the part of the surgeon, as, according to the coostitution and circumstances of the patient, the fever may vary greatly, and require opposite moles of treatment. The fever is called symptomatic, and in most caeca is infiaminato7.
/seised 11 ounds.—The elect of a cut on any part of the body is to produce a gaping space, from which blood In most asses issues, and pain is felt. The blood arises from the blood-vessels of the part having been cut through or wounded, and the pain is caused by a similar injury to the nerves. The amount of blood that issues from a wound,
as well as the pain, will always depend upon the nature of the part which is injured. Some parts of the body are very copiously supplied with blood-vessels which have few nerves, and vice rend; ; so that neither pain nor bleeding is constant according to the size of the wound. The immediate danger of iucised wounds does not so much arise from the extent of parts divided as upon the kind and size of the blood-vessels which are injured. Thus extensive wounds may occur on the back and other parts of the body without producing sufficient inemorrhage to endanger life, whilst a small puncture of the jugular vein or femoral artery might speedily occasion death. The integrity also of some parts of the nervous system is so essential to life, that the slightest wound will produce an immediate cessation of the functions of the body. Thus n small puncture of some parts of the brain, cere bellum, and spinal cord will cause immediate death. The remote con sequences of wounds also vary in some measure with the kind of tissues and the organs wounded. Wounds situated near moving parts some times never heal. Wounds of tendinous and ligamentous structures do not heal so rapidly as those of muscular and other tissues ; and thus it is that wounds of the joints are frequently healed with great difficulty.
The amount of gaping of a wound depends on the kind of tissues cut through. The skin is elastic ; and thus, whenever it is cut through, the wound gapes by reason of its elasticity. Where there is much cellular tissue the wound does not gape so much, as this tissue is not elastic. Wounds of muscles differ : if the cut is in the directiou of their fibres, then the wound gapes but little ; but if it be across the fibres, then, owing to their contractile nature, the wound gapes very considerably. Wounds may be also made to gape or to close their edges, according to the state of flexion or extension of the muscles under the part iu which they are situated.