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
(109) _Peroneal nerve branches._--Wounded at Colenso. _Entry_,
at the anterior margin of the fibula 5 inches above the
external malleolus; the track crossed the anterior aspect of
the leg obliquely, to its _exit_ 1 inch above the centre of the
ankle joint. Incomplete paralysis of the peronei muscles
followed, combined with progressive wasting of the whole limb,
which at the end of a month was marked, and then commenced to
improve.
(110) In a second case the wound took a similar course in the
centre of the leg, crossing the line of the branches of the
musculo-cutaneous nerve. Motor paralysis of the peronei
followed, together with general lowering of tactile sensation
in the musculo-cutaneous area.
_Traumatic neurosis._--In connection with the cases just quoted, mention
must be made of the fact that the functional element was often somewhat
prominent. The influence of this factor was not to be neglected in case
108; again, its presence was a feature in cases 132 and 134, of injury
to the sciatic nerve and of peripheral injury to the seventh nerve (p.
355). A remark has been made as to the occurrence of functional
paraplegia on p. 337. Again, in the case of the organs of special sense.
Case 66, of injury to the occipital lobes, showed that a mixture of
organic and functional phenomena might be a source of error, even in the
determination of the visual field in the subject of an undoubted
destructive lesion. On more than one occasion an injury was accompanied
by loss of the power of speech; thus a patient who received a slight
wound of the neck did not speak again until the application of a battery
by my colleague, Mr. H. B. Robinson. A patient was also for a short time
an inmate of No. 1 General Hospital, Wynberg, who had become deaf and
dumb as a result of the explosion of a shrapnel shell over his head.
This patient also did not recover his powers until he returned to the
mother-country.
In many other cases of nerve concussion or contusion, the recovery of
power and sensation, or the disappearance of neuralgia or contractures,
was so sudden and rapid after prolonged continuance of the symptoms, as
to suggest a very strong functional element in their origin. The
influence of the general shock to the nervous system received by the
patients had an important bearing on these phenomena, and their interest
from a prognostic point of view was very great.
INJURIES TO SPECIAL NERVES
_Cranial nerves._--It will be convenient first to make a few remarks
concerning the nerves of special sense.
Public-domain text, read in full here on John Shaqi.
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