A Treatise on Gunshot WoundsLongmore, T. (Thomas), Sir
History
A Treatise on Gunshot Wounds
Longmore, T. (Thomas), Sir
Gunshot wounds
observe that the chief impediment to a more rapid amelioration of
the system pursued has been the prevailing idea of the necessity of
delaying the tendency of nature to close the wound, in order that the
supposed poison might be eliminated from the constitution. The openings
of entrance and exit and track of the ball were incised; the wound
dilated by tents or other means, and terebinthinates, or even boiling
oil, poured into it; irritating compounds and ointments applied where
superficial dressings were practicable; and it was only after the wound
was considered to be fully purged of its venom and foul humors by the
extensive suppurative action thus kept up, that cicatrization was
permitted to be established.
It required long years of observation in many conflicts, and the
exercise of much industry, not to mention moral courage in opposing
authorized custom and prejudice, before a simpler and more rational
mode of practice was followed. It is satisfactory to know that though
Continental surgeons have written more voluminously on the subject of
gunshot wounds, the older English military surgeons and writers stand
forth conspicuously in leading the way to a more practical knowledge of
their nature and proper treatment.
Although, however, much that was erroneous was removed by the earlier
surgeons, the light of science can hardly be said to have penetrated
this important province of military surgery until the great and last
work of John Hunter, on the Blood, Inflammation, and Gunshot Wounds,
was published in 1794. This distinguished philosopher filled some of
the highest positions in the British service, having been appointed in
1776 Surgeon Extraordinary to the Army, in 1786 Deputy Surgeon–General,
and subsequently Surgeon–General; but he only served abroad about three
years, and then only had the opportunity of seeing active service as
staff–surgeon in the expedition to Belleisle. Had the field of his
practical observation been more extensive, there can be no doubt that
his zealous and scientific mind would have turned the advantage to
the most valuable results for humanity. The physiological principles
which he enunciated, based on extensive study and observation in civil
life, cannot be controverted; but their practical application, so far
as regards the treatment of gunshot wounds, has been greatly modified
since his treatise on the subject was published. There cannot be a
better illustration of the special position in which this department
of military surgery is placed, from the peculiar circumstances under
which it is practiced, than the fact that, though men of the highest
mental attainments have discussed the subject of gunshot wounds, we are
nevertheless indebted to practical experience in military campaigns for
every improvement, some few of recent date excepted, that has occurred
in their treatment. Thus John Hunter was led to advocate very strongly
the delay of amputation, after severe gunshot wounds, for weeks, that
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