Gunshot injuries, their history, characteristic features, complications, and general treatment : with statistics concerning them as they have been met with in warfare / by Sir T. Longmore.

Date:
1895
Catalogue details

Licence: Public Domain Mark

Credit: Gunshot injuries, their history, characteristic features, complications, and general treatment : with statistics concerning them as they have been met with in warfare / by Sir T. Longmore. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    or wound sufficiently for ascertaining its nature, and for applying a primary dressing, but at the same time to leave the coverings in such a state that they may still be made use of until fresh clothing can be obtained. In field surgical practice such matters are by no means trifling, for they often have an important influ- ence on the patient’s comfort and subsequent welfare. Objects of the preliminary examination.—One of the prin- cipal objects of the preliminary examination of a shot wound is to determine whether haemorrhage is going on, or is likely to occur during the further removal of the patient, so that it may be at once stopped in the former case, and steps be taken to prevent its occurrence in the latter. The next object, should there be no haemorrhage demanding attention, is rapidly to ascertain whe- ther any and what provisional treatment will improve the general state of the patient, diminish the dangers and discomforts of his wound, according to its particular features, and more especially to apply such dressings or supports as will best protect the wound from septic influences, and at the same time obviate the risk of additional injury during his transport further to the rear, or during the interval which may elapse before he will again come under surgical observation and care. The provisional treatment of wounded men.—All provisional treatment, when there is no active bleeding to demand the sur- geon’s interference, should be of the simplest kind, and such as can be carried out with great celerity. Elaborate appliances, dressings that require a considerable time for arranging them, are quite out of place. As a general rule, there are too many wounded and too few surgeons, the risks from sudden movements of troops and the enemy’s missiles are too great, and the means altogether insuffi- cient, for such attention to be given to individual cases. The principle must always be kept in mind that it is the duty of surgeons in the front, whether near to the fighting line or at the dressing-stations, to pass on, as quickly as possible, every wounded man that can be sent to the field hospitals in the rear with safety and propriety. Cases in which the wounds are found to be so trifling that the subjects of them can be retained for helping in attendance upon their more severely wounded comrades, or sent back to rejoin their corps, and others of a nature so manifestly fatal that the patients cannot long survive, and again a third class of men among whom there is imminent risk of loss of life unless some professional operation be immediately resorted to, are the only exceptions to this rule. The cases last named, in which there is an extremely urgent need for some surgical proceeding as a means of saving life, should not be sent away in transport vehicles to the field hospitals; but to such, even at the field dressing- stations, surgeons should devote all possible attention. Even this precept, however, must be followed with a certain reserve, for no