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
I only once observed any interference with the sense of taste.
_Remaining cranial nerves._--I have little to say regarding the _third_,
_fourth_, and _sixth_ nerves. In the case of the third nerve, ptosis was
occasionally seen in wounds of the skull involving the roof of the
orbit, but the relative parts taken by injury to nerve and laceration or
fixation of muscle respectively, were usually hard to determine. Again,
the fourth and sixth nerves may have been damaged in some of the more
extensive orbital wounds, especially those in which the globe suffered
injury, but the signs under such circumstances were difficult to
discriminate, and the injury was of slight practical importance, in view
of the major injury to the globe itself.
_Fifth nerve._--Concussion, contusion, or laceration of the different
branches of the three divisions of the fifth nerve were common in wounds
of the head, but most frequent in fractures of the upper or lower jaws.
Localised anaesthesia was common from one or other of these causes, but
for the most part transitory in the cases of contusion or concussion. I
saw no case of entire loss of function in any one division, symptoms
being mostly confined to certain branches, as the supra-orbital, the
temporo-malar, the dental branches of the second division, the
auriculo-temporal nerve, and the lingual, dental, and mental branches of
the third division. I did not observe any cases in which modification of
the special senses accompanied these injuries beyond those mentioned in
the remarks already made on the subject of anosmia, and one case in
which some modification of the sense of taste accompanied an injury to
the floor of the mouth. It was a matter of surprise, considering the
frequency with which subsequent neuritis was met with in the nerves
generally, that trifacial neuralgia in some form was not more often met
with. I never observed any serious case. Perhaps this is one of the
fields in which a longer after-period may increase our knowledge.
Lastly, I never observed motor paralysis in the case of the third
division, although sensory symptoms in some of the branches were common,
evident proof that injuries to the trunk were rare.
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