A Treatise on Gunshot WoundsLongmore, T. (Thomas), Sir
History
A Treatise on Gunshot Wounds
Longmore, T. (Thomas), Sir
Gunshot wounds
In one, where a ball entered at the junction of the malar
bone and os frontis on the left side, and descended and escaped at
the posterior border of the sterno–mastoid muscle, the sight of the
left eye was destroyed, and that of the right weakened; and constant
headache, dullness of intellect, and incapacity for mental application
remained. The injury had originally been followed by symptoms of
cerebral concussion. In another case, the man came home with an
iron shot firmly wedged and lodged in the center of the vomer. When
extracted, at Chatham, by Staff–Surgeon Parry, it was found to weigh
nearly four ounces. The returns of the Crimean campaign, from the 1st
of April, 1855, to the end of the war, show 533 wounds of the face,
of which number 445 returned to duty, 74 were invalided, and 14 died.
Bones were penetrated in 107 of these cases, one eye was injured in
42, and both eyes in 2 cases. Mr. Guthrie has recorded that he several
times saw both eyes destroyed by one ball, without much other mischief,
and one, and even both, rendered amaurotic by balls which had passed
behind the eyes. Of 21 cases of wounds of the face, with injuries to
bones, returned to England from the late Indian mutiny, and recorded by
Dr. Williamson, 11 had lost the sight of one eye, and 1 of both eyes;
6 cases were complicated with fracture of the lower jaw, and in 3 of
these the fracture remained ununited.
GUNSHOT WOUNDS OF THE CHEST.
These always form a large proportion of the injuries from warfare,
both in the open field and more especially in sieges, where the upper
part of the body is chiefly exposed. Dr. Scrive’s returns show that
the proportion of chest to other wounds was 1 in 12 in the trenches,
and 1 in 20 in ordinary engagements. In the British forces they are
returned as 1 in 10 among the officers during the whole war, and nearly
1 in 17 among the men, from 1st April, 1855, to the end of the war.
The ample space of this region, and the exposed surface it offers as a
target toward the enemy, would lead to an anticipation of such results.
The serious complications which ensue when the cavity of the chest is
penetrated, and the dangerous consequences of wounds of its viscera,
cause the proportionate mortality to be very great. The British returns
show that among the officers treated for these wounds 31–1/2 per cent.
and among the men 28–1/10 per cent. died. Out of 603 wounded men who
returned to England from the late Indian mutiny, the number who had
received wounds of the chest was only 19. In many instances men thus
wounded do not live long enough to come under treatment, but die on the
field of action from penetration of the heart, hemorrhage, suffocation,
or shock; and the proportion of chest wounds returned as “killed in
action,” or as “died under treatment,” will constantly vary according
to circumstances connected with the nature of the military operations,
and the opportunities of early removal from the field to hospital.
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