Contusion

“ The other injuries were of little consequence—the lesion on the forehead did not go beyond the skin; the contusion on the left leg was no more than a bruise of little importance. In short, it was nothing. All she required was rest.
To carry out the physician’s orders, then took place that revolution in the habits of the household, and that transformation in the aspect of the house itself, which sickness always brings with it. ”

“ If the contusion has been so great, as to splinter the bones, such splints as are loose, and seem to prick through the flesh, should by all means be removed. Violence must however be avoided; for by a little patience, nature will of her own accord separate and discharge them. ”

“ Have the child bend backward over the arm of a sofa, for example, or put him in bed with the body hanging out of the bed face upward. If none of these effect relief you must depend upon the skill of the physician.
A Bruise or Contusion.—A bruise or contusion is an injury to the tissues underneath the skin, but this does not imply that the skin itself is opened or damaged. In every bruise the small blood vessels are ruptured, and the blood collects in the tissues causing distention, swelling and pain. ”

“ It may be pointed out, however, that hæmatemesis, the main feature in the symptoms pointing to wound, is by no means direct proof of more than contusion.
2. That perforating wounds of the small intestine are very fatal injuries; every patient in whom the condition was certainly diagnosed died. ”

“ I have known very unfavourable symptoms in the morning change to favourable ones at noon, and return to unfavourable again at night. Of wounds, indeed, it is rightly and truly said, Nemo repente fuit turpissimus.* I was once, I remember, called to a patient who had received a violent contusion in his tibia, by which the exterior cutis was lacerated, so that there was a profuse sanguinary discharge; and the interior membranes were so divellicated, that the os or bone very plainly appeared through the aperture of the vulnus or wound. ”

“ A young healthy man, at 20 years old, received a contusion by a fall, was instantly carried to a neighbouring surgeon, and, at my request, bled in the following manner.
I inserted a glass funnel into the neck of a large clear phial about ℥x. contents, and bled him into it to about ℥viii. By these means the blood was exposed to the air as little a time as possible, as it flowed into the bottle as it came from the orifice. ”

“ Contusions or Bruises.—In slight bruises, and those not likely to be followed by much inflammation, nothing more is usually necessary than to bathe the part in cold water, or with spirit, as eau de Cologne, brandy, &c., mixed with an equal proportion of vinegar and water. In more severe cases, however, and where the accident is near an important part, as the [116] eye, or any of the joints, it becomes a desirable object to prevent the approach of inflammation. ”

“ The medical gentlemen who examined the body have not reported, so far as we have heard, that death was occasioned by violence. There are several contusions on the body, particularly one on the upper lip, which was swollen and cut, a severe one on the back, one on the scapula, and one or two on the limbs ”

“ BRUISES, or contusions, being frequently neglected at first, may produce consequences more alarming than those of wounds. Blows received on the head, pit of the stomach, hip, or the knee, are the most dangerous. A violent inflammation, in consequence of injured nerves, or the destruction of blood vessels, often occasions the mortification of those parts, which the most skilful treatment cannot retrieve, if the accident be neglected for many hours or days. ”

“ Face pale; right eye open and prominent, left closed; mouth closed, contained food apparently from [769] the stomach; tongue retracted; slight mark on neck under which the tissue was normal: atlas dislocated on axis, but tissues around were normal; no lesion in spinal canal; penis not erect; moisture having the odor of urine on the shirt; large ecchymosis and infiltration of left cheek; extensive contusions on scrotum, with hemorrhagic infiltration, especially around right testicle. Veins of head engorged with black fluid blood. Brain normal. ”

“ Hence arise indigestion, constipation, headaches, weariness, depression of spirits, palpitation, and a feeling of oppression at the heart, pain in the side, eruptions on the skin, which either feels chilly all over its surface or sometimes burns, and, what will probably seem of much more importance to those whom vanity has induced to lace tightly, pallor and thickness of complexion, with a yellowish or greyish tinge to the cheeks, and owing to impaired circulation, swelling and redness of the hands and feet, and, worst of all to the would-be beauty, redness of the nose. ”

“ There comes a white swelling or scab, with a change of the color of the hair on the part from its natural hue to yellow; then the appearance of a taint going deeper than the skin, or raw flesh appearing in the swelling. Then it spreads and attacks the cartilaginous portions of the body. The nails loosen and drop off, the gums are absorbed, and the teeth decay and fall out; the breath is a stench, the nose decays; fingers, hands, feet, may be lost, or the eyes eaten out. ”

“ Contused Wounds Definition.—Wounds are said to be “contused” when the skin, although bruised, is not cut through or broken; they are followed by the usual symptoms of inflammation, namely, redness, swelling, heat and pain.
Causes.—These can be best understood by one or two illustrative examples. A horse gets the collar chain around his heels at night when he becomes fast, and, in struggling to free himself, he bruises and excoriates the hollow of the pastern. Next morning he is found very lame, with swelling and great tenderness of the parts, but there is no rent in the skin. ”

“ The discoloration of the skin increases, until the body is of a dusky brown, livid or mahogany color, and there are frequent hæmorrhages from the mouth, nose, eyes, or even under the skin, forming livid spots and blotches. The body now exhales a cadaverous odor, the tendons of the wrist twitch convulsively, hiccough is constant, the features are pinched and ghastly, cold sweats come on, and the patient passes away in convulsions or coma, though occasionally he retains his intellectual faculties unimpaired to the last. ”

“ As the result, then, of lowered vitality, a certain area becomes congested and effusion takes place into the tissues. This effusion coagulates and a hard, brawny mass is formed which softens towards the centre. If nothing is done the softened area increases in size, the skin over it becomes thinned, loses its vitality (mortifies) and a small ``slough'' is formed. When the slough gives way the pus escapes and, tension being relieved, pain ceases. A local necrosis or death of tissue takes place at that part of the inflammatory swelling farthest from the healthy circulation. ”

“ Shorn of its natural protective covering, the muco-cutaneous covering of the glans soon becomes true dermoid tissue. Mr. J. Hutchinson (loc. cit.) speaks of 'every one who is acquainted with the effects of circumcision in rendering the delicate [Pg 39] mucous membrane of the glans hard and skin-like.' Contact with the clothing, &c., necessarily induces a chronic inflammatory condition of the part, followed commonly by contraction and condensation. We cannot with impunity rashly interfere with any of Nature's dispositions, however seemingly insignificant. ”

“ Those, that are seated in the eyes, or in the gums, the nostrils or the exterior angle of the eye, or in the cavity of the ears, abdomen or the umbilicus, or about any suture of the body, hips, ribs, arm-pits, chest, breasts, sides, or the joints, as well as those, that secrete frothy blood or pus with a gurgling sound, or contain any foreign matter embedded in their inside, are healed only with the greatest difficulty. ”

“ The softening of the swelling is not a mere change of solid substance into a fluid, as if by decay, but it is the result of an active process, which we call suppuration. When this process is properly performed, good pus is made, or as the old writers in medicine rather quaintly expressed it, laudable pus. ”

“ The most satisfactory course which it can take is through the wall of the abdomen and out above the right groin. As it is making its way in this direction the skin over that part becomes red, swollen, hot and tender, and the tissues between it and the skin become swollen and brawny. Rarely is fluctuation to be made out until the pus has worked its way close to the surface. ”

“ But if the humors are hard and dry, they are confined within the interior of the organs, such as bones, nerves and membranes: and these, being hard in themselves, do not receive the moisture, nor suffer extension or dilatation, and thus no swelling results. Since, therefore, the material of this variety of arthetica, in which no swelling is present, is formed of grosser and harder substance and is found in the vicinity of hard and cold localities, it is dissolved slowly and the disease is not cured until this solution takes place. ”

“ Because a pale, uncertain-yeared woman had had nose-bleed, he had been overcome by a horrible nausea, an intolerable, hitherto unknown feeling in the pit of his stomach. Why, he had seen blood, felt blood, smelt blood, worked swiftly, calmly in blood against time and death—and now a pale woman with a nose-bleed.... ”

“ The loss of the entire nose may be due to traumatism, actual amputation, the bites of man or beast, duels, the removal of neoplasms, gangrene after freezing or disease, rhinosclerosis, syphilis, the application of caustics, tubercular disease, lupus, cancer, and rarely congenital absence of the organ. ”

“ It is believed that wind of every kind may not only be expelled from the body by way of the esophagus and rectum, but also by the pores of the skin, and all the secreting organs of the body. It may hence be drawn off by suction; as cupping, poultices, bleeding, and scarification. They also attempt to drive the surplus wind from one part of the body to another part where it may be wanting. ”

“ The face turns pale, the smooth muscles of the skin contract, the skin is covered with a cold perspiration, the heart stops beating: in a word there is a general organic disturbance following the stimulation of the medulla oblongata, and this disturbance is the supreme expression of disgust. ”

“ Intense [93] burning is often felt along the cord and base of the brain, which is not influenced by pressure; hyperæsthesia of the skin of one or both legs and feet, and the scrotum; testes and penis are often too sensitive to touch; at times, neuralgic pains in the genitals, with herpes præputialis, periodically appearing; great tenderness of the anus, with herpetic eruptions ab margine ani. Again, anæsthesia may take the place of exalted sensibility, with formication—or tingling, or sensation of “pins and needles”—of the feet and legs. ”

“ Symptoms.—A fullness or a swelling is first noticed in the groin, which is made worse in standing, coughing and lifting. This disappears on lying down and reappears on rising in many cases, even at first; coughing makes the lump or swelling harder. It may come on both sides, when it is called double rupture or hernia.
MOTHERS' REMEDIES.—Rupture, Poultice for.—"Take equal parts of lobelia and stramonium leaves; make a poultice and apply to the parts. Renew as often as necessary. This combination makes a very effective poultice and is sure to give relief." ”

“ Affections of the external skin consequent upon complaints of the genital organs being thus no less common in Ancient times than they are to-day, it follows that in inverse proportion forms of ulceration of the palate and nose, as well as complaints affecting the bones, must have fallen into the background and have been of more rare occurrence, just as is observed to be the case in the present day189. ”

“ Syphilis usually begins with a sore which may look like a cold sore or any other kind of sore or pimple around your sex organ. Soon the sore disappears, even without treatment, and is often followed by an inflammation of the mouth and throat, and rashes on the body. ”

“ Deformities as of the skin are generally the consequences of a distempered blood thrown upon it. Promoting the ordinary discharges, and rectifying the skin by proper washes, is the only way to get rid of such disorders. ”

“ The body is bloated and appears greatly increased in size from the development of gases within the abdomen, thorax, and scrotum, and also in the cellular tissue of the body generally. The swollen condition of the eyelids, lips, nose, and cheeks is usually of such extent as to obliterate the features and to destroy the identity of the body. ”

“ The inflammation experienced by sensitive persons seems to result chiefly from the puncture of the skin by the sharp piercing setæ which constitute the puncturing element of the mouth parts, as there seems to be no secretion of poison other than the natural fluids of the mouth. ”

“ It is probable that the accumulation is the result of excited action in the part, for its origin is most frequently attributable to external injury—blows or bruises, followed by rapid swelling, which, after a time, subsides, leaving perhaps some enlargement of the testicle, or of the more superficial tissues, and succeeded by the gradual appearance of the disease in question. ”