A Treatise on Gunshot WoundsLongmore, T. (Thomas), Sir
History
A Treatise on Gunshot Wounds
Longmore, T. (Thomas), Sir
Gunshot wounds
Beyond the extraction of any foreign bodies which may have lodged,
as in this last case, it is not known that there are any indications
for special treatment of tetanus as occurring after gunshot injuries.
The employment of woorali has again been brought into notice by its
successful administration by M. Vella, of Turin, in the case of a
French sergeant wounded in the metatarsus of the right foot, on the 4th
of June, 1859, at the battle of Magenta, by a musket–ball which lodged.
The projectile was extracted three days after his admission into
hospital at Turin, on the 10th of June, and tetanus set in three days
afterward. But the woorali failed in two other cases; and it has yet to
be determined, should it be found to possess any peculiar power over
tetanic spasm, to what class of cases its properties are applicable.
=Hospital gangrene=, a common disease of wounded soldiers when
circumstances of war lead to overcrowding in ill–ventilated buildings,
and to deficiency in the proper number of attendants for securing
personal cleanliness and purity of atmosphere, with inferior diet;
and =Pyemia=, a frequent cause of fatal termination after gunshot
fractures, injuries of joints, and other suppurating wounds, especially
under the influence of circumstances like those above named, are
treated separately under their respective heads.
ANESTHESIA IN GUNSHOT WOUNDS.
The complete applicability of chloroform on the field to injuries
caused by gunshot, as to all others in civil practice, is established
among Continental surgeons, and among a majority of British army
surgeons. The first opportunity of testing chloroform largely as an
anesthetic agent in British military surgery occurred in the Crimean
war, and a long report on the subject will be found in the published
Surgical History of the Campaign. The general tenor of this report is
to limit considerably the use of chloroform—in minor operations, on
the ground of occasional bad results, even when the drug is of good
quality and properly administered; or, in cases where the shock is very
severe, on the ground that such do not rally, owing to the depressing
effect of the drug, after the anesthesia has gone off; or in secondary
operations, from the systems of the patients having been much reduced
by purulent discharges. But from the report it appears that only one
patient died from the effects of chloroform; and in this instance,
Professor Maclagan, of Edinburgh, to whom a portion was forwarded
for examination, reported the drug to be “acrid and nauseous when
inhaled,” and “totally unfit for use.” On the other hand, Dr. Scrive,
chief of the French Medical Department in the East, has written, in
his Relation Médico–Chirurgicale de la Campagne d’Orient, p. 465: “De
tous les moyens thérapeutiques employés par l’art chirurgicale, aucun
n’a été aussi efficace et n’a réussi avec un succès aussi complet que
le chloroforme; jamais, dans aucune circonstance, son maniement sur
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