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
[Illustration: FIG. 43.--Four Soft-nosed Bullets of small calibre shown
in fig. 37. Twenty large-calibre leaden carbine and rifle bullets from
cartridges found in Boer arsenals. These were not very extensively used,
but specimens of most varieties were at times removed from our wounded
men. It will be noted that some are of great weight, and a large
proportion either cupped or flattened at the apex to increase area of
impact and consequent resistance. The 'express' bullet with a copper
core is included in this series. It is worth remarking that all the
bullets of this nature in the Pretoria Arsenal were waxed, and that the
wax retained its white colour on the lead.]
I still, however, incline to the opinion that the bullet in these cases
had come into contact with some bone, or was one of the larger varieties
of projectile. A few cases of wound of the calf did, however, come under
my observation which presented fairly typical 'explosive' characters
without evidence of solution of continuity of the bones. I will shortly
recount two of them. In the first the exit opening was very large and on
the outer aspect of the limb in the upper third. The bullet had
apparently passed between the bones. Secondary haemorrhage from the
anterior tibial artery necessitated exploration of the wound and
ligature of the vessel (Mr. Carre). When the wound was thus laid open no
injury to the bones could be detected, but I do not consider that it
could be actually excluded. In the second case a wound traversed the
calf transversely, just above the centre; the exit aperture was large
and ragged. Deep suppuration occurred, and the wound had to be laid
open, when a fracture of the tibia without solution of continuity was
discovered. I also saw one or two wounds of the buttock in which very
large exit apertures were present with small entry openings; in these
again it was impossible to exclude passing contact of the bullet with a
part of the pelvic wall. Unfortunately in all these cases it is
impossible to obtain the bullet responsible for the injury. In this
relation I append a diagrammatic illustration of a peculiar wound shown
to me by Mr. Hanwell. In this case a typical small entry wound was
situated at the outer margin of the left erector spinae muscle in the
loin. The bullet had taken a subcutaneous course of not more than
three-quarters of an inch, while the exit opening was a long shallow
wound measuring 4-1/2 in. in length by 1-1/2 in. width. (Fig. 44.)
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