A Treatise on Gunshot WoundsLongmore, T. (Thomas), Sir
History
A Treatise on Gunshot Wounds
Longmore, T. (Thomas), Sir
Gunshot wounds
Gunshot wounds of the abdomen, like those of the chest, are, for the
sake of convenience, divided into _non–penetrating_ and _penetrating_.
The NON–PENETRATING may be either simple flesh wounds, or may be
accompanied with fracture of some of the pelvic bones, or with injury
to some of the contained viscera. In PENETRATING wounds, the peritoneum
only, or, together with it, one or more of the abdominal viscera, may
be wounded; or, in comparatively rare cases, a viscus may be penetrated
without the peritoneum being involved. It is in the regional cavity
of the abdomen that the proportion of penetrating wounds is the
greatest. The cranium, from its form, structure, and coverings, serves
as a strong defense even against gunshot; the osseous yet elastic and
movable ribs, the sternum, and muscular parietes greatly protect the
contents of the cavity which they inclose; but the extensively exposed
surface of the abdomen, anteriorly and laterally, has no power of
resistance to offer against a projectile directly impinging it; and
when this important cavity is once penetrated by these means, death
is the almost inevitable result. Even the chances of a favorable
termination which may exist in wounds from other causes are generally
wanting; and much of their treatment, such as the use of sutures, and
other means to insure the apposition of cut edges, is inapplicable,
from the parts to a certain distance being almost necessarily deprived
of their vitality, to injuries from gunshot.
=Non–penetrating= wounds require but few remarks in this place. The
fatal injuries which occasionally occur from masses of shell or round
shot, in which the liver, spleen, or other viscera are ruptured without
penetration of parietes, and where death ensues from shock, hemorrhage,
or peritonitis, have already been alluded to. If, although the viscera
have been contused, the injury does not amount to being mortal, the
patient should be subjected to perfect quiet, extreme abstinence,
and, only when inflammation arises, to the necessary treatment for
its control. If the parietes have been much contused, abscess or
sloughing may be expected; and a tendency to visceral protrusion must
be afterward guarded against.
Public-domain text, read in full here on John Shaqi.
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