Surgical Experiences in South Africa, 1899-1900: Being Mainly a Clinical Study of the Nature and Effects of Injuries Produced by Bullets of Small CalibreMakins, George Henry
History
Surgical Experiences in South Africa, 1899-1900: Being Mainly a Clinical Study of the Nature and Effects of Injuries Produced by Bullets of Small Calibre
Makins, George Henry
Gunshot wounds; South African War, 1899-1902; Surgery, Military
(2) A patient received a wound at Doornkop which traversed the
calf in an obliquely antero-posterior longitudinal direction.
Three weeks later a soft fluctuating swelling developed at the
inner margin of the tendo Achillis occupying the lower third of
the leg. Neither pulsation nor murmur was detected. There was
anaesthesia in the area of distribution of the posterior tibial
nerve. No tendency to further increase was observed, and
operation was postponed. The temperature was normal.
(3) An Imperial Yeoman was struck at Zwartskopfontein at a
range of one hundred yards. The man rode four miles on his
horse after being hit, but the horse then fell and rolled over
him twice. The man was treated successively in the Van Alen,
Boshof, and Kimberley Hospitals, and from the last he was sent
to Wynberg which place he reached on the twenty-third day. When
admitted into No. 2 General Hospital the wounds of type form
and size (_entry_, in posterior fold of axilla; _exit_, 1-1/2
inch below junction of anterior fold with arm) were healed. The
whole upper arm was swollen and discoloured, while an indurated
mass extended along the line of the vessels into the axilla.
This was considered a blood effusion; it was not obviously
distensile, and pulsation was very slight. The brachial radial
and ulnar pulses were absent. A fluctuating swelling was
present along the anterior border of the deltoid. There were
some signs of nerve contusion, but no paralysis, beyond tactile
anaesthesia in the area of distribution of the median nerve.
Four days later little alteration had been noticed beyond a
tendency to variation in firmness of the different parts of the
swelling. On the thirty-first day considerable enlargement was
observed. This enlargement, together with continued rise of
temperature, aroused the suspicion of suppuration, and an
exploratory puncture with a von Graefe's knife was made by
Major Lougheed, R.A.M.C., after consultation with Professor
Chiene. Blood clot first escaped, followed by free arterial
haemorrhage. The incision was enlarged while compression of the
third part of the subclavian was maintained; a large quantity
of clot was turned out, and an obliquely oval wound half an
inch in long diameter was found in the axillary artery.
Ligatures were applied above and below the opening between the
converging heads of the median nerve. The veins were not
damaged. The wound healed by first intention. On the twelfth
day a feeble radial pulse was perceptible, and shortly
afterwards the man left for England, diminished median tactile
sensation being the only remnant of the original symptoms.
Public-domain text, read in full here on John Shaqi.
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