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
Operations in the Field hospitals were proportionately not numerous, and
they should be kept down in number, as far as possible. At the same time
such operations as are necessary are mostly of capital importance, such
as the treatment of fractures of the skull, abdominal section, the
ligature of arteries, and amputations. Of these only the first and last
classes occur with any degree of frequency. In order to be prepared for
these a stock of filtered water which has been boiled, and some special
sterilised sponges, should be at hand if possible, also some small
towels which can be wrung out in antiseptic lotion. If sterilised
sponges are not to be had, wool pads wrung out in carbolic lotion must
be substituted.
Primary amputations bore transport badly. I saw few sent down from the
front within a few days of their performance in which the flaps did not
slough, or worse consequences ensue. On the other hand, if the first
fortnight could be tided over at the front, they did well enough. The
head cases on the other hand bore movement fairly well, provided only
that asepsis was ensured.
Retained bullets are rarely suitable for removal in the rush of the
first work of a Field hospital after an engagement. A short delay is of
no importance, and ensures their being removed safely if necessary. With
regard to the broad question of the advisability of removing them at
all, it may be laid down that they should not be interfered with unless
some obvious reason exists. Those most commonly calling for removal are
as follows: 1. Bullets lying immediately beneath the skin or quite
superficially in any region, or those which, although they have produced
an exit opening, yet lie within the body. 2. Those which lie at the
bottom of an infected track, or cause secondary suppuration. 3. Those
causing pressure on important structures, particularly nerves. 4. Those
which interfere with the movements of joints when lodged in the bones or
soft tissues in close proximity, or those which lie within the articular
cavity itself. Bullets sunk in the great body cavities or in positions
difficult of access should never be interfered with. Retained bullets
sometimes give rise to unexpected surprises; thus in a man with a
retained bullet in the pelvis no steps for its removal were taken.
During the man's voyage home on a transport he had an attack of
retention of urine. As a catheter would not pass, he was placed in a
warm bath, and shortly after passed a Mauser bullet per urethram, and
thus saved himself a cystotomy.
Public-domain text, read in full here on John Shaqi.
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