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
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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
_Concussion_.--Temporary loss of function was often observed in the
limbs, corresponding to the distribution of one or more nerve trunks
when wound tracks had passed in their vicinity. Interference with
function sometimes amounted to loss of sensation alone: in others to
loss of both sensation and motor power. Such symptoms were of a
transitory character, lasting for a few days or a week; if both
sensation and motion were impaired, sensation was usually the first to
be regained. In these cases secondary trouble was not uncommon, since
the near proximity of the track to the originally affected nerve offered
every chance for implication of the latter in the resulting cicatrix.
This sequence was often observed, and its symptoms are described under
the heading of secondary implication below. Equally striking were the
instances of concussion in the case of the nerves of special sense and
their end organs, temporary loss of smell, vision, or hearing being not
uncommon, often passing off in the course of a few days with no apparent
ulterior ill-effect.
One of the most interesting illustrations of the occurrence of
concussion was furnished by cases in which complete paralysis of a limb
rapidly cleared up with the exception of that corresponding to a single
individual nerve of the complex apparently originally implicated.
Instances of severe contusion or division of one nerve of the arm, for
instance, accompanied by transient signs of concussion of varying
degrees of severity in all the others, were by no means uncommon.
_Contusion_.--The symptoms of contusion were somewhat less simple,
since, in addition to lowering or loss of function, signs of irritation
were often observed. In the slighter cases irritation was often a marked
feature, as was evidenced by hyperaesthesia and pain combined with loss
of power. In cases in which pain and hyperaesthesia were primary
symptoms, these were often transitory. I will quote an illustrative case
which, though affecting the nerve roots, is characteristic of the
effects of slight contusion in the case of the nerve trunks in any part
of their course:--
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