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
Figs. 24 and 25 illustrate wounds of this nature. In the case figured in
fig. 24 the bullet entered over the third rib in a vertical line above
the right nipple; it then coursed obliquely down, crossing the seventh
costal cartilage, and finally emerged 3 inches above the umbilicus.
Where the track crossed the prominence of the thoracic margin the skin
was so thinned as to undergo subsequent discoloration, while a distinct
groove was evident there on palpation. In some similar cases I have seen
the central part of the track secondarily laid open as a result of the
thinning of the skin and consequent sloughing due to the interference
with its vitality.
Short of sloughing, the skin may show signs of alteration of vitality
for a long period after the injury; thus fig. 25 depicts the condition
seen in a superficial wound of the thigh five weeks after the injury.
The line of passage of the bullet between the two openings was still
clearly visible as a dark red coloured streak. Grooves in such cases are
generally readily palpable in the early stages, while later the want of
resistance is replaced by the readily felt firm cord representing the
cicatrix. These points are of much importance in discriminating between
perforating and non-perforating wounds of the abdomen, and are again
referred to in that connection.
The direction of the tracks obviously depends on the attitude assumed by
the patient at the moment of impact of the bullet and the direction
whence the firing has proceeded. The frequent assumption of the prone
position during the campaign led to the occurrence of a large proportion
of longitudinal tracks in the trunk, or trunk and head, which will be
referred to later. Certain battles were in fact strongly characterised
by the nature of the wounds sustained by the men. Thus at Belmont and
Graspan, where some rapid advances were made in the erect attitude,
fractured thighs were proportionately numerous, while at Modder River,
where many of the men lay for a great part of the day in the prone
position, glancing wounds of the uplifted head, of the occipital region,
or longitudinal tracks in the trunk and limbs were particularly
frequent. I very much regret that the material at my disposal does not
allow me to add some remarks as to variation in the nature of the
wounds according to whether they were received from an enemy firing from
a height or from below, but it is possible that some information on this
subject may be forthcoming when the returns of the Service are made up,
since it is naturally of great importance as to the effect of trajectory
in the proportionate occurrence of hits.
Public-domain text, read in full here on John Shaqi.
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