A Treatise on Gunshot WoundsLongmore, T. (Thomas), Sir
History
A Treatise on Gunshot Wounds
Longmore, T. (Thomas), Sir
Gunshot wounds
imbedded in the pubes, the urethra being stretched around the convex
surface; and this explained the cause of a distressing distention of
the penis and dribbling of urine which had existed without intermission
from the time of the injury, but ceased at once on the removal of the
bullet.
GUNSHOT WOUNDS OF THE EXTREMITIES.
These injuries, always very numerous in warfare, offer many subjects
of consideration for the military surgeon. No class of wounds includes
so many cases that fall under his prolonged care as this. A large
proportion of wounds of the head and trunk are immediately fatal, or
from the commencement contain the elements of fatal results; while
wounds of the extremities, if those of the thigh be excepted, are free
from this extremely serious character. The treatment to be pursued,
including questions of conservation, resection, amputation, and the
proper time for the adoption of these latter if determined upon, often
demands the closest attention of the surgeon. These subjects will
be considered in their general bearing in other parts of this work,
and only those points especially connected with the circumstances of
warfare will be here referred to.
Gunshot wounds of the extremities divide themselves into flesh wounds
and contusions, and those complicated with fracture of one or more
bones. Flesh wounds may be simple, and these offer few peculiarities,
whatever their site; or they may be accompanied with lesion to nerves,
or blood–vessels, or both, and these usually increase in gravity in
proportion as they approach the trunk.
When complicated with fracture, the lesion is usually rendered compound
by the direct contact of the projectile with the bone injured; but the
fracture is sometimes simple, when caused by indirect projectiles,
such as stones or splinters, or by spent balls. These injuries are
liable to become further aggravated by the fracture extending into or
being complicated with an opening of one of the joints. Joints may
be contused or opened by projectiles, without apparent lesion of any
portion of the bones entering into their composition; but these are
exceptions to the usual order of such cases from gunshot.
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