Commentaries on the Surgery of the War in Portugal, Spain, France, and the Netherlands: from the battle of Roliça, in 1808, to that of Waterloo, in 1815; with additions relating to those in the Crimea in 1854-55, showing the improvements made during and since that period in the great art and science of surgery on all the subjects to which they relate.Guthrie, G. J. (George James)
History
Commentaries on the Surgery of the War in Portugal, Spain, France, and the Netherlands: from the battle of Roliça, in 1808, to that of Waterloo, in 1815; with additions relating to those in the Crimea in 1854-55, showing the improvements made during and since that period in the great art and science of surgery on all the subjects to which they relate.
Guthrie, G. J. (George James)
Crimean War, 1853-1856 -- Medical care; Napoleonic Wars, 1800-1815 -- Medical care; Surgery, Military -- Europe -- History; War wounds -- Europe -- History
If there be two openings, the exit of the ball, or the counter-opening,
is in general much the cleaner, being often in a fair granulating
state before the entrance of the ball is free from slough. If the
inflammation have been smart, the limb is at this time a little swollen
and discolored for some distance around; fibrin and serum are thrown
out into the cellular membrane, or areolar tissue, as it is now termed;
the redness diminishes; the sloughs are discharged, together with any
little extraneous substances which may be in the wound; and there is
frequently a slight bleeding, if the irritable granulations are roughly
treated. The limb on the twelfth, and even fifteenth day, retains the
appearance of yellowness and discoloration which ensues from a bruise,
and which continues a few days longer. The sloughs do not, sometimes,
separate until this period, and, in persons slow to action, not even
until a later one. The wound now contracts; the middle portion of the
track first closes, and is no longer pervious; the lower opening soon
heals, while the upper, or that usually made by the entrance of the
ball, continues to discharge for some time, and toward the end of six
weeks, or sometimes two months, finally heals with a depression and
cicatrix, marking distinctly the nature of the injury that has been
received.
16. The state of constitution, the difficulties and distresses of
military warfare, exposure to the inclemency of the weather, the season
of the year, or the imprudence of individuals, will sometimes bring on
a train of serious symptoms, in wounds apparently of the same nature as
others in which no such evils occur. After the first two or three days,
the symptoms gradually increase, the swelling is much augmented, the
redness extends, and the pain is more severe and constant. The wound
becomes dry, stiff, with glistening edges, the general sensibility is
increased, the system sympathizes, the skin becomes hot and dry, the
tongue loaded, the head aches, the patient is restless and uneasy,
the pulse full and quick; there is fever of the inflammatory kind.
The swelling of the part increases from deposition in the areolar
tissue to a considerable extent above and below the wound, and the
inflammation, instead of being entirely superficial or confined to
the immediate track of the ball, spreads widely. The wound itself the
sufferer can hardly bear to be touched; it discharges but little,
and the sloughs separate slowly. Pus soon begins to be secreted more
copiously, not only in the track of the wound, but in the surrounding
parts; sinuses may form in the course of the muscles, or under the
fascia, and considerable surgical treatment be necessary, while the
cure is protracted from three to four, and even to six months; and is
often attended for a longer period with lameness, from contraction of
the muscles or adhesions of the areolar tissue. The parts, from having
been so long in a state of inflammation, are much weaker, and if the
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