2d. Perforating Wounds — In the event of a stab of the
abdomen ^a^sing through its walls, either the intestines, or
some other organ, may be wounded. Which of these may be
injured, it may be difficult even for a surgeon to determine
exactly. As, however, this treatise will be of more service to
those who are beyond the reach of surgical aid, we shall
endeaver to assist their diagnosis by referring to the positions
of the principal internal organs relatively one to the other. A
perforating wound, reaching to any one of the organs in the
abdomen cavity, is attended with symptoms of alarming pros-
tration. Means should be taken to stanch the bleeding of the
external wound, and the patient must be supported by stimu-
lants and light diet. Opium must be given freely to relieve
pain. It acts beneficially also by moderating the muscular
movements of the intestines. If there be vomiting of blood, it
may be feared that the stomach is wounded. There is every
inducement and hope that by rigidly enforcing rest and quiet-
ness, with the above rneans, life may be saved. Wounds even
of the liver and spleen have been known to heal.
The next most serious effects of stabs in the abdomen, and
those which give rise to great fear for the 'results, are those
attended with protrusion of the intestines. If, however, the
latter be not wounded, it may be returned, and the wound
closed as directed above. Wounds of the walls of the abdo-
men, through which the intestines protrude, and are themselves
wounded, call for particular treatment.
The wounds in the intestines should first be attended to.
The edges of these should be united by means of a continuous
or glover's stitch, similar to the stitch used in hemming. It
should be so done that the exterior surface of the bowel, on
either side of the cut, shall be in contact; and then the bowel
having been carefully washed in luke-warm water, should be
returned, stitches and all. If all goes on well, the silk will be
removed by the bowel when the wound is healed. The after
treatment is to be conducted as for a simple punctured wound.
The general treatment of the perforated wound of the intes-
tines will be the same as that of wounds of other organs in the
abdomen — viz., rest of the parts secured by opiates, and sup-
port of the system by stimulants and light food.
Gunshot Wounds are perforated, bruised wounds, compli-
MEDICINAL. 381^
cated with nervous shock. These wounds do not bleed so
much as cuts, but they are more troublesome to heal on
account of the large amount of destruction of tissue they occa-
sion. This varies on account of the size of bullet. Another
cause for their being more dangerous than cuts is that it some-
times happens a piece of the wad becomes lodged in the
wound, and being difficult to detect, is sometimes left behind
when the bullet is extracted, causing mischief by its presence
until removed or thrown off in the sloughing of the wound.
Inflammation generally sets in about the wound within twenty-
four hours. The external parts become swollen and fed, the
patient complains of pain in the wound. After another day or
so a discharge of pus and matter appears.
Page 280
Presented as published in 1883. Historical recipes may not meet modern food-safety standards. Cook from the modern interpretation, not the original instructions.
AI-modernized reading of the original text
2d. Perforating Wounds — In the event of a stab of the abdomen passing through its walls, either the intestines, or some other organ, may be wounded. Which of these may be injured, it may be difficult even for a surgeon to determine exactly. As, however, this treatise will be of more service to those who are beyond the reach of surgical aid, we shall endeavor to assist their diagnosis by referring to the positions of the principal internal organs relatively one to the other. A perforating wound, reaching to any one of the organs in the abdominal cavity, is attended with symptoms of alarming prostration. Means should be taken to stanch the bleeding of the external wound, and the patient must be supported by stimulants and light diet. Opium must be given freely to relieve pain. It acts beneficially also by moderating the muscular movements of the intestines. If there be vomiting of blood, it may be feared that the stomach is wounded. There is every inducement and hope that by rigidly enforcing rest and quietness, with the above means, life may be saved. Wounds even of the liver and spleen have been known to heal.
The next most serious effects of stabs in the abdomen, and those which give rise to great fear for the 'results, are those attended with protrusion of the intestines. If, however, the latter be not wounded, it may be returned, and the wound closed as directed above. Wounds of the walls of the abdomen, through which the intestines protrude, and are themselves wounded, call for particular treatment.
The wounds in the intestines should first be attended to. The edges of these should be united by means of a continuous or glover's stitch, similar to the stitch used in hemming. It should be so done that the exterior surface of the bowel, on either side of the cut, shall be in contact; and then the bowel having been carefully washed in luke-warm water, should be returned, stitches and all. If all goes on well, the silk will be removed by the bowel when the wound is healed. The after treatment is to be conducted as for a simple punctured wound. The general treatment of the perforated wound of the intestines will be the same as that of wounds of other organs in the abdomen — viz., rest of the parts secured by opiates, and support of the system by stimulants and light food.
Gunshot Wounds are perforated, bruised wounds, compli-
cated with nervous shock. These wounds do not bleed so much as cuts, but they are more troublesome to heal on account of the large amount of destruction of tissue they occasion. This varies on account of the size of bullet. Another cause for their being more dangerous than cuts is that it sometimes happens a piece of the wad becomes lodged in the wound, and being difficult to detect, is sometimes left behind when the bullet is extracted, causing mischief by its presence until removed or thrown off in the sloughing of the wound. Inflammation generally sets in about the wound within twentyfour hours. The external parts become swollen and fed, the patient complains of pain in the wound. After another day or so a discharge of pus and matter appears.