Trench "frost-bite" : some observations on cases admitted to the Duchess of Westminster's War Hospital / by C. Gordon Watson and Charles S. Myers.

  • Watson, C. Gordon.
Date:
1915
Catalogue details

Licence: In copyright

Credit: Trench "frost-bite" : some observations on cases admitted to the Duchess of Westminster's War Hospital / by C. Gordon Watson and Charles S. Myers. Source: Wellcome Collection.

    8/16 (page 6)
    f) was slight pain, but no swelling. On both feet (which were of normal appearance and temperature) anaesthesia was present over the first three toes and the ball of the hallux, and hyper- aesthesia over the fourth and fifth toes and instep. Case v. Private F. W. was admitted to clearing hospital on November 30th, and to this hospital on December 4th. On December 7th, in addition to extensive anaesthesia of both feet, the two terminal phalanges of the middle, ring, and little fingers were found to be “ numbed.” Case vi. Private J. E., on November 25th (nine days before admission here), while in the trenches found his feet were swollen. He remained three more days in the trenches and when he came out he was unable to walk. He first noticed that his fingers were tingling on his journey in the train to this hospital. On admission he complained of his fingers “ feeling twice as large as usual ”; no anaesthesia, swelling or other abnormal appearance could be detected. The difficulty of movement of the toes and occasionally at the ankle-joints in many cases has been already men¬ tioned. In the following two patients, admitted at the same time, difficulty of movement without “frost-bite” was also present. Case vii. Private E. W., fourteen days after admission here began to have pains in his ankles, later in his knees and back. On admission his heart and temperature were found normal. The movements of the legs were carried out with great caution and with great rigidity. He complained two days later of shooting pains in the legs. Case viii. Private A. G., nine days before admission here began to complain of cramping pains in the back and legs. On admission his heart and temperature were found normal. There was much stiffness of the back and lower limbs, the pains being vague, widely spread, and apparently muscular. The cultivation of Staphylococcus albus from a bleb at the margin of the area of necrosis in a case of the “ third degree ” has been already mentioned. Beside this case may be placed the following : Case ix. Private J. N. In the trenches between November 12th and 19th, 22nd and 25th, and November 28th to December 1st. Boots not removed between November 22nd and December 1st. Feet continually wet. No swelling of the feet. Since Novem¬ ber 26tb numbness and coldness of both feet. On November 29th, when “ stamping ” feet in order to get warm, his legs gave wa}^ at the knees, and he fell to the ground. On December 1st he walked to hospital, a distance of 1,000 yards, in one hour and three-quarters. He had never warmed his feet. On admission here, December 4th, his feet were found to be cool and of normal colour. He complained of a “ numbish ache” over the metatarso-phalangeal joints of both feet. Voluntary movement of the toes was much diminished. Sensibility to light touch was lost on the dorsal and plantar surfaces of both halluces and on the two next toes of the left foot. Sensibility to prick was lost on both surfaces of the left hallux. The loss extended in each case to the metatarso-phalangeal joint. The remaining toes showed diminished sensibility to light touch