Surgical emergencies and accidents / by J.G. Gilchrist.

  • Gilchrist, J. G.
Date:
1884
Catalogue details

Licence: Public Domain Mark

Credit: Surgical emergencies and accidents / by J.G. Gilchrist. Source: Wellcome Collection.

Provider: This material has been provided by the Harvey Cushing/John Hay Whitney Medical Library at Yale University, through the Medical Heritage Library. The original may be consulted at the Harvey Cushing/John Hay Whitney Medical Library at Yale University.

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    III. CONTUSIONS. DEGREES. A contusion* commonly known as a bruise, is an injury inflicted by a blunt instrument, in which the parts are more or less lacerated with- out rupture of the integument. Physically, it is the result of a squeeze, betweenthe body inflicting the injury on one side, and some resisting body on the other, as a bone. This class of injuries is per- haps the most common of accidents, and is infinitely more serious, apart from the haemorrhage, than wounds of almost any description. The first symptom, depending somewhat upon the extent of the in- jury, is a numbness and tingling of the part, to which is soon added pain, swelling and discoloration. Pain, is rarely acute, oftener aching in character, and not persist- ent or long lasting unless some of the more important nerves are injured. It is due partly to the direct violence inflicted on the periph- eral nerves; and partly to the stretching of these nerves by the subse- quent swelling. Different cases, however, furnish many modifica- tions of pain, both as to quality and intensity, for the most part dependant upon the extent to which deep parts are implicated. Thus in contusions of the abdomen, as will be shown later—when one of the viscera is contused the sensation is of weight: of the chest, dyspnoea; of the head, either cephalalgia, confusion of the mind without pain, or coma. Pain, as a symptom, however, is of little therapeutic or diagnostic value, except as intimated above; when unusually severe an injury to some important nerve trunk may be suspected. Swelling is; perhaps the most characteristic feature of contusions, and is always present to some extent. It is greater, as a matter of course, when the texture of the part is loose, and less in proportion to the density. It is due to several causes, or rather several degrees of intensity in the same condition, viz.. injury to the blood vessels. The effusion of serum, is due to a momentary vaso-motor paresis, inducing dilatation of the vessels, and congestion or stasis, which produces transudation, as in the case of inflammation. Such a swell- ing is Arm, or boggy, but quite colorless, or it may be of a marbled appearance. The tumefaction is not of long duration, and there is little, if any, tendency to suppuration. The hcemorrhagic effusion, may be capillary, arterial, or venous; when the former, coagulation occurs early, the swelling is firm, and the color dark. The same is true of arterial haemorrhage, but when