BRUISE (OF. bruiser, Fr. briser, AS. brFsan, to break, bruise), or CONTUSION. An injury in flicted by a blow or sudden pressure. in which the skin is not necessarily wounded. Both and especially the latter, are employed in sur gery to include such injuries in their widest range, from a black eye to a thoroughly crushed mass of muscle. In the slighter forms of this injury, as in ordinary simple bruises. there is no tearing, but only a concussion of the textures, the damage done being the rupture of a few small blood-vessels, which occasions the dis coloration that is always observed in these eases. In More severe contusions, the subjacent struc tures—muscles, connective tissue, vessels, ete.— are more or less ruptured, and in extreme cases are thoroughly crushed. and 'usually become gangrenous. The quantity of blood that is ex travasated mainly depends upon the size and number of the ruptured blood-vessels, but partly also on the nature of the tissues injured. Thus, a lax tissue, as that of the eyelids. favors the escape of blood into the surrounding parts. The most charaete•istie SigTI`A of a recent are more or less shock (q.v.), pain, swelling. and discoloration of the surface from effused blood. (See Eeemmiosts.) There is nothing special in the character of the shock, but it is worthy of notice that it is most severely felt in injuries of Special parts—as the testes, the breasts. and the larger joints, which are often followed by remarkable general depression, faint ness, loss of muscular power. and nausea. The immediate pain following the blow is succeeded by a feeling of numbness. which, after a varying time, unless the part is killed. gives place to a heavy, aching pain. Although sonic depression may usually be observed immediately after the infliction of the blow, swelling of the parts rapidly follows. as may be well seen in the case
of a child receiving a blow on the head, or of the wheal that rises after the lash of a whip. In lax parts, such as the eyelids, the swelling is i‘ften considerable, and may remain for a week or more: lint in other parts it usually subsides in two or three days. The discoloration passes suceessively through the variations of red, pur ple, black, green, and yellow. It is due In the effused blood ;mil the changes which subsequently take place in it. The fluid part of the blood and the colorless eorpus•les are reabsorbed in the process of repair. but the red eorlais•les are left behind, and it is the transformation of their Inemog,lobin into Inematoidin NV II jell brings about the characteristic •olor-ehanges.
As a result of contusion we may have a lla•a toma, blood.tuninr, sloughing of a part, septic. infection of the extravasated blood or abscess, in flammation of special structures, as nerve-trunks, synovial membranes of joints. tendon-sheaths, the periostemn of bone, etc. It. seems fairly recognized that certain tumors, malignant and benign, may be stimulated to growth from a con tusion. The treatment of contusion consists in stimulating measures to combat shock when present; locally rest and elevation of the parts are indicated, together with moist and cold or hot applications in the first stage to allay pain and inflammation. hen inflammation has sub sided, massage and stimulating applications should he employed to hasten absorption of the effused blood-prodnets.