On gunshot wounds of the thorax and the treatment pursued for them in the Crimea, contrasted with that which was followed in former campaigns / by George Lawson.

  • Lawson, George, 1831-1903.
Date:
[1858]
Catalogue details

Licence: Public Domain Mark

Credit: On gunshot wounds of the thorax and the treatment pursued for them in the Crimea, contrasted with that which was followed in former campaigns / by George Lawson. Source: Wellcome Collection.

    9/20 (page 9)
    a gunshot wound of the thorax, the first thing which strikes the surgeon is the state of extreme collapse he is in. His face is blanched, the features pinched, and presenting a peculiarly anxious expression. There is probably some bloody, frothy expectoration, and difficulty of breathing, in proportion to the amount of damage which the lung has received. The pulse is usually small and irregular, the surface of the body cold. On stripping him we examine the nature of the wound, ascertain whether the ball has passed through the thorax or lodged in the lung, and whether there is any haemorrhage going on externally through the wound, or internally into the pleura. Often, when no orifice of egress can be found, a careful examination will detect the ball lying at some point beneath the skin at the opposite side of the chest, perhaps just beneath the angle of the scapula. Emphysema to a greater or less extent will probably exist, the air passing out of the wound during expiration, and escaping partly into the cellular tissue in the neighbourhood. Such are the usual features which at first present them¬ selves on examining a gunshot wound of this region. With regard to the collapse I would say a few words. It is the immediate result of all gunshot injuries, but it is far more marked in those which relate to the thorax and abdomen. This would be partly explained by the serious consequences which occur from wounds to any of the various organs con¬ tained in either of these cavities, but it must also be paitly attributed to the greater degree of apprehension which exists in the mind of the patient as to the severity of the injury he has received. To the unprofessional mind a degree of mystery hangs over the contents of the thorax and abdomen, and as the hidden foe is dreaded more than the open enemy, so wounds of parts which are unseen create much greater