A Treatise on Gunshot WoundsLongmore, T. (Thomas), Sir
History
A Treatise on Gunshot Wounds
Longmore, T. (Thomas), Sir
Gunshot wounds
From the earliest time of the application of gunpowder to implements
of war, down to the present day, the wounds inflicted by its means
have excited the most marked interest among surgeons; nor can this
be wondered at, when the immensely superior energy of this agent
in comparison with all the mechanical powers previously in use for
hostile purposes, and the terrible nature of its effects on the human
frame, are remembered. By its introduction the whole aspect of war
was changed, in a great degree, by the distance at which opposing
forces were enabled to contend with each other; just as, in our
day, the nature of battle seems destined to undergo another change
from the increased range and precision of fire obtained through the
general use of rifled weapons. But though the alterations now being
made in the qualities of fire–arms are of the utmost importance to
those whose business and especial study is the art of war, to the army
surgeon the interest they excite is chiefly limited to the degree of
injury and destruction inflicted by them as compared with weapons of a
less perfect kind; while to the surgeons employed at the time of the
introduction of gunpowder, the wounds were wholly new in their nature
as well as degree. Recollecting the ignorance which then prevailed in
all departments of science and art, it can excite no surprise that
the new engines of war, with the flame and noise accompanying their
discharge, were regarded with superstitious terror; nor that surgeons
for a long time found an explanation of the sloughing severity of the
injuries they inflicted, and of their difficult cure, in the poisonous
nature of gunpowder, or of the projectiles which had been acted upon
by it, or in the burning effects of these latter from heat acquired
in their rapid flight through the air. Unfortunately, these erroneous
views did not end with the theories from which they started, but led to
treatment which only aggravated the evils inflicted by the new weapons,
and interrupted the progress of the healing action, which nature would
otherwise have established. The wound being regarded as a poisoned
wound, it was only by a long and tedious process of suppuration that
the poison could be hoped to be got rid of from the surface, and
prevented from entering the system of the patient. The irritative
fever, the wasting and emaciation, and all the other results of the
protracted cure of the injury were so many evidences of the indirect
effect of the poison working in the frame; just as the constitutional
shock at the time of the wound, the loss of vitality along the surface
in the track of a small projectile, or of the tissues laid bare by the
passage of the cannon–ball were regarded as evidences of its direct
influence. On looking back at the works of successive writers on
this class of injuries, the reader is surprised that the improvement
in their treatment has been so gradual and slow; and cannot fail to
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