Gun-shot wounds : particularly those caused by newly-invented missiles : an essay which received the Fiske Fund Premium of the Rhode Island Medical Society, for 1864 / by Alexander R. Becker.

  • Becker, Alexander R.
Date:
[1865]
Catalogue details

Licence: Public Domain Mark

Credit: Gun-shot wounds : particularly those caused by newly-invented missiles : an essay which received the Fiske Fund Premium of the Rhode Island Medical Society, for 1864 / by Alexander R. Becker. Source: Wellcome Collection.

Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.

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    in his directions to remove balls so placed, and predicts the most unfortunate results if this be neglected. And Malgaignc, after nar- rating several instances in which balls have remained without caus- ing harm, concludes thus :— It is necessary to mention these fortu- nate cases, as evidence of the resources of nature; but they hardly serve to weaken the force of the prognosis, when a ball cannot be extracted, or the essential indi(iation of this sort of lesion, the ex- traction of a foreign body. This indication is, then, of the first importance. Nerves usually escape injury by a ball. Still, if the ball has been rendered jagged by previous contact with some hard substance, it may cause grave injury even to the largest nerves, especially when they lie in close proximity to a bone. The paralysis which succeeds an injury to a nerve may come on at once, or be for a long time de- layed ; and may or may not be accompanied by pain. For instance, the hand has several times been known to waste, without pain, when some of its nerves have been injured. But making all due allowance for the form, strong coat, and elas- ticity of arteries, it is wonderful how frequently they escape injury from gun-shot wounds. The rarity of primary haemorrhage on the field is well known; and yet we constantly see wounds through the very course of large arteries. When primary hsemorrhage does oc- cur on the field, it is more frequently from the veins, which are more easily cut than arteries. We have fewer instances of the wandering of balls now than for- merly. The conical ball generally takes the shortest route to and through its mark, and sometimes even further; for cases have been related where one ball has been known to pass through the bodies of two men and lodge in a third. But of the round ball many curious stories are told. Dr. Macleod, to whom I have before referred, nar- rates two instances : in one of these, the ball entered above the el- bow and was removed from the opposite maxilla; and in the other it entered the right hip and was removed from the left popliteal space. In examining a gun-shot wound, we must always bear in mind the possibility of some foreign substance, as a piece of the man's cloth- ing or accoutrements, having entered with the ball; and its presence in the wound is often far more troublesome than the ball itself. There has been a great deal of discussion and diversity of opin- ion in regard to the extraction of balls. Begin's precept, as given to the Academy, seems to me to coincide with both science and com- mon sense. '' Selon moi, he says, I'indication de leur extraction est toujours presente; toujours le chirurgeon doit chercher a la rem- plir; mais il doit le faire avec la prudence, et la measure que la rai- son conseille. S'il recussit, il aura beaucoup fait en faveur du blesse. S'il s'arrete devant I'impossibilite absolue, ou devant la crainte de produire les lesions additionelles trop grave, il aura encore satisfait