A Treatise on Gunshot WoundsLongmore, T. (Thomas), Sir
History
A Treatise on Gunshot Wounds
Longmore, T. (Thomas), Sir
Gunshot wounds
[6] Perchlorure de fer, 30 drops, two or three times daily as a tonic,
and diluted with six parts of water as an injection.
[7] Dict. des Sciences Méd., Paris, 1813, p. 217.
[8] See Edin. Med. and Surg. Journal, vol. xiv.—Case of gunshot wound
of the heart, by J. Fuge, Esq.
[9] For 1855, vol. i. p. 606, and vol. ii. p. 437.
[10] Bulletin de l’Académie Impériale de Médecine, 24th April, 1860.
See also Des Amputations consécutives à l’Ostéomyélite dans les
Fractures des Membres par armes à feu, par M. H. Baron Larrey, Paris,
1860.
[11] Dupuytren made a division of the splinters of bone broken by
gunshot into three classes, viz.: primary sequestra, those directly
and completely separated by the force of the projectile; secondary
sequestra, those retaining partial connections by periosteal, muscular,
or other attachments, but afterward thrown off during the suppurative
process; and tertiary sequestra, or necrosed portions, produced by the
effects of the contusion and prolonged inflammatory action in parts
adjoining the seat of fracture. In accordance with this arrangement,
the removal by the surgeon of the primary and secondary splinters
has been regarded as simply anticipating nature in her work; but Dr.
Esmarch states, as one result of the experience of the surgeons of the
Sleswick–Holstein army, that, in the majority of comminuted fractures,
the removal of splinters retaining any connection with periosteum is
unnecessary and often injurious, as is also the practice of sawing
off the broken ends of the bone projecting from the comminuted part.
By proper treatment and under favorable circumstances, he asserts,
such splinters become impacted in callus, and in time unite with the
other fragments of the bone, and in this manner a cure is completed
without operative interference. It is a matter, however, of frequent
observation that splinters which have thus become impacted in callus
lead to mischief in various ways, or are subsequently discharged as
if they were so many foreign bodies, while the removal of the jagged
ends of the broken bone seems to be a valuable means of preventing
irritation, and thus of favoring union between them; and English
surgeons, therefore, generally pursue the practice above recommended.
[12] The officer referred to must have greatly improved in condition
since Dr. Macleod wrote, as he has been of late on active service in
India.
[13] Notes on the Surgery of the Crimean War, p. 264.
[14] In the surgical history of this war, this statement, which was
quoted by the late Mr. Guthrie, in the Addenda to his Commentaries, is
said to be a mistake, on account of the absence (not to be wondered at,
amid the confusion of that period) of official records on the subject.
Special reports on these cases were obtained at the time from Scutari,
and were shown to the writer by the late Director–General shortly
before his decease.
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