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
The patient was brought off the field in a semi-conscious
condition, the pupils moderately contracted but equal, the
pulse 66, very small and irregular in beat, the respiration
quiet and easy, and with paralysis of the left side of the
body. The faeces had been passed involuntarily.
The wound was cleansed and bone fragments removed. The patient
had to travel in a wagon for the next three days until the
column halted. The progress of the case was unsatisfactory, as
the wound became infected, and the man eventually died on the
14th day of general septicaemia, but with little evidence of
local extension of septic inflammation.
In this instance the head was no doubt struck by a bullet which
had previously made ricochet contact with the ground. I saw
several such cases.
Closely connected with such injuries are those in which large portions
of the skull and scalp were actually blown away. I never witnessed one
of these myself, but I recall two instances described to me by officers
who lay near the wounded men on the field. In one the frontal region was
carried away so extensively that, to repeat the familiar description
given by the officer, 'he could see down into the man's stomach through
his head.' In a second case the greater part of the occipital region was
blown away in a similar manner, and this was of especial interest as the
wounded man was seen to sit up on the buttocks and turn rapidly round
three or four times before falling apparently dead. The observation
offers interesting evidence of the result of an extensive gross lesion
of the cerebellum.
In the absence of exact information, it may well be that such injuries
as the two latter were produced by some special form of bullet, but as
both were produced while the patients were lying on the ground, and
therefore especially liable to blows from ricochet bullets, I am
inclined to attribute both to this cause.
In considering injuries of the above nature, one cannot help speculating
on the possible influence of a head-over-heels ricochet turn on the part
of the bullet while traversing the long sagittal axis of the skull. It
is not uncommon for apical target ricochets to present evidence of
damage to the apex and base of the mantle alone. This must depend on a
rapid turn on impact, which might well be imitated in the case of the
skull, and would then go far to explain the production of some of the
most severe forms of explosive exit wounds met with. See cases 48, 54,
68.
Short of ricochet, the influence of simple wobbling must also be
considered in shots from a long range. The entry wound may be large as a
result of this condition, but as the velocity possessed by the bullet is
low, the injuries would probably not be of a very severe nature.
Public-domain text, read in full here on John Shaqi.
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