Cutthroat

“ The situation of the average suicidal or homicidal cut-throat wound is in front, generally across the thyro-hyoid membrane, sometimes dividing the cricoid-thyroid membrane, and not at the side of the neck where the great vessels lie and would be more easily divided. The force is expended, as a rule, before the great vessels are reached. The epiglottis may be cut or detached and the incision may even reach the posterior wall of the pharynx, but the majority of the suicidal cases recover with proper treatment. ”

“ When making the puncture the surgeon grasps the child’s arm in his left hand, puts the skin on the stretch over the insertion of the deltoid with his left forefinger and thumb, pushes the lancet downwards between the cutis and cuticle, about 1-10th of an inch, to raise the latter in a little pocket; he then charges his lancet with lymph and inserts it in the pocket, or if using points, inserts the moistened point for a minute, taking care as he withdraws the point to press the skin down on the point with his left thumb, that the lymph may be well wiped off the point and left in the wound. ”

“ There is little chance of immediate union taking place; and the wound not being approximated when recent and bleeding, does not diminish the chance, but on the contrary augments it. Adhesion is prevented by the insinuation of air and mucus betwixt the edges, by frequent motion of the edges on each other, by the slightest change in the position of the head, either rotatory or nodding, by the action of the muscles of the os hyoides, and by attempting to swallow food or saliva. Every circumstance is opposed to complete approximation and immediate union of transverse wounds of the throat. ”

“ As the action proceeds, the pain and heat often subside—the parts become flaccid—dark-coloured serum is effused beneath the cuticle, forming what are termed Phlyctenæ—the skin becomes dull and livid—dark streaks extend along the limb, perhaps from the colouring matter of the blood transuding, as in commencing putrefaction in the dead body—air is effused into the subcutaneous cellular tissue, causing a sense of crepitation when pressed by the finger—sloughs form, either black or of an ash colour—and the gangrene involves a greater or less extent of the limb. ”

“ This notch is frequently invaded by the knife of the suicide; and there is perhaps no part of the neck on which a gash may be inflicted with less serious injury: the large vessels are far removed, and the larynx lies below the blade, which may, if near to the hyoid bone, enter the pharynx above the epiglottidean fold of mucous membrane, leaving the epiglottis unhurt, or, if more nearly approached to the thyroid border of the space, may partly or entirely sever that cartilage from its inferior attachments. No special surgical operation belongs to the space ”

“ A suture appearing in a wound, when the bone is laid bare, on whatever part of the head the wound may have been inflicted, is the weakest point of the head to resist a blow or a weapon, when the weapon happens to be impinged into the suture itself; but more especially when this occurs in the bregma at the weakest part of the head, and the sutures happen to be situated near the wound, and the weapon has hit the sutures themselves. ”

“ In the thorax, for example, if a rib is struck, the charge and possibly fragments of bone, will penetrate the pleura, and be dispersed throughout the lung; in the head, the skull may be shattered and the brain torn up; and in the abdomen, the hollow viscera may be perforated in many places and the solid organs lacerated.
On covered parts the clothing, by deflecting the shot, influences the size and shape of the wound; the entrance wound is increased in size and more ragged, and portions of the clothes may be driven into the tissues. ”

“ In tracheotomy, the incision of the tracheal rings can be extended with much less injury than can division of the laryngeal cartilages, when the largeness of the foreign body, its being firmly fixed, or other circumstances, require that the wound be of considerable size. The risk or danger in the one operation is not much greater than in the other. Division of the crico-thyroid membrane and skin is effected by one incision; there is nothing important in the way of the knife. ”

“ From Coming Out And How the Cluthe Truss is Held in Position
by Suction—No Belt, Leg-straps or Springs
Around the Body
The Cluthe Truss is the only kind in existence which applies the support at the proper angle—upwards against the rupture opening; thus counteracting the internal downward pressure of the abdominal organs, the natural tendency of the bowels to push out.
And, unlike all others, it is self-adjusting, self-regulating. Automatically adjusts itself with every one of your movements when you in any way exert your strength. ”

“ In the common sore Throat, a local Inflammation is the Disease: All the Symptoms are derived from this Source: An acute throbbing Pain, greatly increased upon swallowing even Liquids, is the principal Grievance. In the other, the whole Habit suffers, as if by a Stimulus of a peculiar Nature and although the Throat is always more or less affected, yet it is sometimes the least Part of the Patient's Complaint; and Instances have occurr'd to me of considerable Sloughs 42being formed, before any Soreness or Pain in the Fauces hath been mention'd. ”

“ Locomotion is impossible. There is intense pain and violent sweating at first. Crepitation may in some cases be discerned by rectal examination, with one hand resting over the coxo-femoral (hip) articulation. Fractures of the tuberosities of the upper end of the bone, the great trochanter, may be identified by the deformity, the swelling, the impossibility of rotation, and the dragging of the leg in walking. Fracture of the body is always accompanied with displacement, and as a consequence a shortening of the leg, which is carried forward. ”

“ At the same time, it is not uncommon, especially in children, for a suture to be sprung by violence applied to the head, or for a fissured fracture to enter a suture and, after running in it for some distance, to leave it again. The edges of a clean cut in the periosteum may be mistaken for a fissure in the bone, especially if reliance is placed on the probe for diagnosis. ”

“ In this dislocation the limb is shortened, moved with difficulty, drawn inwards over the other, and its great toe touches some part of the back of the other foot. The hip itself is altered, the great trochanter being nearer to the crista ilii, and more prominent than on the uninjured side, and the head is often plainly felt in its new position. Resistance to extension of the limb, limited movement of the hip, with rotation inwards, are the distinguishing points between this dislocation and fracture at the neck of the femur. ”

“ Nothing is more annoying, and even distressing, than the suffering itself, besides which there are abnormal sensations in the throat which almost irresistibly compel the patient to believe that there are severe inflammation and ulceration, and that the throat is in danger of being closed up. Although the pain is usually one-sided, it sometimes affects both sides, and is felt also at the back of the pharynx. ”

“ But the vital economy seems not to possess the power of reproducing the muscles and true skin, and therefore, when these parts are wounded, the rupture is repaired by a gelatinous substance, which gradually becomes hard, and sometimes assumes something of a fibrous appearance. It so perfectly unites the divided muscle, however, as to restore its functional power. When the cuticle is removed, it is reproduced and no scar remains; but, when the true skin is destroyed, a scar is formed. ”

“ In speaking of these mechanical arrangements of dress I have as yet made no mention of the throat and the head as parts requiring to be clothed. In suggesting that girls should be clothed as fully as boys, I have incidentally conveyed that the chest of the girl should be covered, and I would add that in both sexes the throat should be covered also during the period extending from October to April. The throat is one of the most important parts to protect, and it is, as is well known, one of the most common parts of the body to become affected during cold weather. ”

“ Cut throat wounds, when suicidal and inflicted by the right hand, are generally oblique from left to right, beginning higher up than they end. They generally cross the thyroid cartilage, and the larger vessels may escape; if made below the thyroid cartilage they are generally smaller and horizontal. ”

“ Between the jaws passes the very narrow throat, which can be opened and closed at will by means of a transverse muscle. The animal derives its importance to man from the close aggregation of the movable lips, the narrow throat, and the toothed jaws, for it is enabled by this peculiarity to break through the skin and suck the blood from it. ”

“ Fractures of the great trochanter are the effect either of falls on that protuberance, or of the action of bodies striking against it. Oblique or transverse, situated sometimes at its summit, and sometimes at its base, these fractures may be either simple or complicated. They are rendered complicated sometimes by splinters and a swelling, as happens when a ball produces the division, and at other times by a fracture of the neck of the bone, an example of which we find in the Journal of Surgery, in the case of a man seventy years of age, who had been long subject to the itch. ”

“ Again, a small cut on the head is more often followed by dangerous symptoms than a much larger one on the legs.—Treatment. If the cut is not a very large one, and no artery or vein is wounded, this is very simple. If there are any foreign substances left in the wound, they must be taken out, and the bleeding must be quite stopped before the wound is strapped up. If the bleeding is not very great, it may easily be stopped by raising the cut part, and applying rags dipped in cold water to it. ”

“ To cut some one's throat is the shortest way out of heaps of holes into which one gets. It is only what some call conscience, and others blue funk, which stays one's hand. It wasn't the cutting of the throat which he objected to, but what came after. ”

“ In inflammation of the throat, as in pharyngolaryngitis, the head is extended upon the neck and the angle between the jaw and the lower border of the neck is opened as far as possible to relieve the pressure that otherwise would fall upon the throat. In dumminess, or immobility, the hanging position of the head and the stupid expression are rather characteristic. ”

“ On the forehead, about an inch above the nasal process of the frontal bone, was a cut an inch and a half in length, extending obliquely downwards from the right side; through this a triangular fracture was felt, the base of which was in the direction of the external wound, and the apex pointing downwards; the fractured portion of the bone was slightly depressed; the bones of the nose were also fractured, and there was great discharge of blood from the nostrils. One third, or nearly, of the upper lip was cut off, and a good deal of blood had been lost from the labial artery ”

“ When the superficial veins are emptied, the blood flowing by those deep-seated is to be directed to the wound by muscular action; with this view the patient is made to grasp the lancet-case, or any other solid body, in his hand, and turn it round. If the opening in the integument is too small, the flow gradually diminishes, and at length stops, in consequence of blood being insinuated into the cellular tissue, coagulating, and so forming what is termed a405 thrombus, which plugs the wound. ”

“ The muscles of the neck should not be compressed. If the muscles of the neck and larynx are compressed by a high cravat, or other close dressing, not only will the free and energetic movements of these parts be impeded, but the tones will be feeble and ineffective. Therefore the dress of the neck, particularly of public speakers and singers, should be loose and thin. For a warm dress upon the neck, when the vocal organs are in action, will induce too great a flow of blood to these parts, which will be attended by subsequent debility. ”

“ Croup exceeds by contracting the trachea enough to impede the passing of air to the lungs; diphtheria has more swelling of the tonsils, throat and glands of the neck, but all depend upon the same blood and nerve supply, or a general law of blood beginning with arteries to and from veins, lymphatics, glands and ducts to supply and take away all fluids that are of no farther use to the vital and material support. As all authors have agreed that the brain furnishes the propelling forces to the nerves, it would be proper to inquire how the brain is nourished. ”

“ Hundreds of mules are in a measure ruined by allowing the throat-latch to be worked too tight. A tight throat-latch invariably makes his head sore. Besides, it interferes with a part which, if it were not for, you would not have the mule--his wind. I have frequently known mules' heads so injured by the throat-latch that they would not allow you to bridle them, or indeed touch their heads. ”

“ Wounds of the lower part of the thorax may involve at the same time the thoracic cavity proper and its contained viscera, the diaphragm and the abdomen and its viscera. This is the order in which the different parts would be met with in a wound from behind forward; the order might be the reverse of this in a wound from before backward. Penetrating wounds of the thorax may involve the lungs, heart, or great blood-vessels. Of these, the lungs are most often injured, which is easily accounted for by the greater size of the lungs. In wounds of the lungs the immediate danger is from hemorrhage. ”