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
When admitted at Netley the patient came under the care of Major Dick,
R.A.M.C., who ligatured the popliteal artery on the proximal side by an
incision in the line of the tendon of the adductor magnus. The aneurism
then consolidated.
(7) _Traumatic popliteal aneurism._--Wounded at Magersfontein.
_Entry_ (Mauser), centre of patella. _Exit_, centre of
popliteal space; the knee was bent at the time it was struck.
There was considerable primary external haemorrhage, and so much
blood collected in the knee-joint that it was aspirated. On the
eighth day secondary haemorrhage occurred from the exit wound
and the femoral artery was tied in Hunter's canal. No further
haemorrhage occurred, but at the end of three weeks feeble
pulsation was palpable in the popliteal space, suggesting an
aneurism; the latter decreased and the patient was sent home
apparently well.
(8) _Traumatic axillary aneurism._--Wounded at Karree. The
bullet entered 2-1/2 inches below the acromial end of the right
clavicle and emerged over the 9th rib in the posterior axillary
line. The Mauser bullet was found in the patient's haversack.
Both apertures were of the slit form, and healed per primam.
Three weeks later at Wynberg a large arterial haematoma which
pulsated was noted in the axilla. Signs of injury to the
musculo-spiral nerve were also observed. The tumour altered
little, but a fortnight later Major Burton, R.A.M.C., cut down
upon it through the pectorals. The aneurism was of the third
part of the axillary artery, and a ligature was applied at the
lower margin of the pectoralis minor. The wound healed by
primary union and the aneurism rapidly shrank. The patient left
for England a month later; the musculo-spiral paralysis was
improving. I am indebted to Major Burton for the notes of this
case.
(9) _Traumatic popliteal aneurism._--Wounded in Natal. _Entry_
(Mauser), immediately above head of fibula. _Exit_, immediately
inside semi-tendinosus tendon at level of central popliteal
crease. Fulness but no pulsation was noted at end of three
weeks; seven days later pulsation was evident, and an aneurism
the size of a pigeon's egg, with firm walls, became localised
and palpable. It gave rise to no symptoms, and patient refused
operation during the three weeks he remained in hospital. The
aneurism continued to contract, and the patient was sent home.
The aneurism has since spontaneously consolidated.
Public-domain text, read in full here on John Shaqi.
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