A Treatise on Gunshot WoundsLongmore, T. (Thomas), Sir
History
A Treatise on Gunshot Wounds
Longmore, T. (Thomas), Sir
Gunshot wounds
=Seat of injury.=—A knowledge of the seat of injury from the passage of
a ball involves diagnosis of its course, the depth of its penetration,
the particular organs or structures injured, and the extent of the
injuries to which they have severally been subjected. The course
pursued by balls in wounds presents many features of interest. The
depth of penetration, in connection with direction, becomes of great
importance when there is question of one of the great visceral cavities
being opened. This part of the subject, however, together with that
of injuries to the viscera themselves, will be more conveniently
considered when treating of gunshot wounds in their special relations
to particular regions. In like manner, the diagnosis of the extent of
injury in wounds complicated with fractures of the long bones will be
best considered under gunshot wounds of the extremities.
=Course of balls.=—Of the circuitous and unexpected directions pursued
by bullets in their course through the human frame, which were formerly
so common, we are not likely to see many instances in future warfare,
when the rifle is the weapon chiefly employed. The conical shape
of the ball and the force with which it is propelled have had the
effect, among others already named, of changing this characteristic
of the ball from the smooth–bored musket. The latter, bearing a
force that scarcely carried it true to a mark at eighty yards, and
usually receiving, as it left the firelock, an impulse which caused it
to revolve on its axis at right angles with the line of flight, was
deflected by the most trifling obliquity of surface, by the resisting
obstacle of a bone, by tendons or the aponeuroses of muscles, or even
by the elastic resilience of muscles themselves in a state of action,
when the relative direction of their fibers was favorably placed to
exert this influence. The Enfield cylindro–conoidal bullet, armed with
a force that will carry it to a given spot distant one thousand yards
or upwards, flies like an arrow, penetrates the softer tissues in a
straight line, and on meeting bone, as before noticed, enters it like
a wedge. When a bullet of this kind strikes an object point–blank, it
is always the apex of the conical part which first meets the object
struck; and, if sufficient resistance be met with, it is this apex
which becomes first compressed and turned back. When it strikes a
solid object lying nearly parallel with its line of flight, the ball
is planed, as it were, from its apex toward its base. In a case before
referred to—page 29—where a conical ball entered the loin of a soldier
of the 19th Regiment, and was subsequently passed per anum, the apex
of the bullet was found to be turned and bent round on itself, and the
ball generally flattened. On examining carefully the convex surface
of the convoluted apex, minute spiculæ of bone were observed to be
impacted in its substance. It became evident, therefore, that the ball
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