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
_Aperture of exit._--The wound of exit in normal cases offers far more
variation in appearance than that of entry, this variation depending on
several circumstances: first, the want of support to the skin from
without, and such other factors as the degree of velocity retained by
the travelling bullet, the locality of the opening, and the density,
tension, and resistance offered by the particular area of skin
implicated.
When the range has been short and the velocity high, it is often
difficult to discriminate between the two apertures. Both may be
circular and of approximately the same size, and the only distinguishing
characteristic, the slight depression of the margin of the wound of
entrance, may be absent if any time has elapsed between the infliction
of the injury and examination by the surgeon. One very strong
characteristic if present is the general tendency of the margins, and
even the area surrounding the exit wound itself, to be somewhat
prominent. Fig. 16 shows this point, although the wound from which it
was drawn had been produced thirty-six hours before death. The specimen
was then hardened in formalin and still preserves its original aspect.
This character is, however, more frequently displayed in wounds received
at mean, or longer, ranges. In wounds produced by bullets travelling at
the highest degrees of velocity it is often absent.
[Illustration: FIG. 20.--Circular Entry back of arm; exit (bird-like) in
anterior elbow crease]
[Illustration: FIG. 21.--Circular Entry over patella. Starred exit of
elongated form in popliteal crease]
When the range of fire has been greater and the velocity retained by the
bullet lower, slit wounds are common, or some of the slighter degrees of
starring. Actual starring I never saw, but reference to figs. 20 and 21
will show a tendency in this direction, also a close resemblance to the
starred wounds resulting from perforations by large leaden bullets.
Such wounds, I believe, are usually the result of a somewhat low degree
of velocity.
Slit exit wounds may be vertical or transverse (fig. 20) in direction,
and the production of these is dependent on the locality in which they
are situated, the thickness, density, and tension of the skin, and the
nature of the connection of the latter with the subcutaneous fascia in
the locality. Thus in wounds of different parts of the hairy scalp, so
little variation exists in the relative density and structure of the
skin, that, in spite of the want of external support at the aperture of
exit, it is often difficult to discriminate offhand the two apertures,
if neither bone nor brain debris occupies that of exit.
Public-domain text, read in full here on John Shaqi.
Reviews
Reviews
No reviews yet
Be the first to share your thoughts on this work.
Elsewhere in the archive
Join the Discussion
Join the discussion
Sign in to leave a comment or review.
Sign InorCreate an account