The Sun.
London, England, 1862-11-10 00:00:00

purpose of determining what measures should be
adopted for the general's relief, induced the com-
mittee of gentlemen at whose instigation I first went
to Varignano to request me to make another jour-
ney ; and although the visit was undertaken at much
personal inconvenience, I felt it my duty to yield
to their solicitation, and accordingly, having re-
ceived on the 25th Oct. an intimation by telegraph
that the consultation was fixed for the 29th, I left
London on the morning of the 26th. Owing, how-
ever, to tempestuous weather, which prevented the
steamer from leaving harbour, I was unable (though
I travelled without intermission) to reach Spezzia
until after the consultation. I cannot, however, re-
gret my absence, as the large number of medical
men assembled rendered it less satisfactory than it
might otherwise Lave been. I saw the general en
the 30th Gctober, the day of my arrival at Spezzia,
where he occupied a suite of apartments on the first
floor of the Marine Hetel. I was present at the
afternoon clressieg on that *lay, and on the follow-
ing one I made, in conjunction with Dr. Pirogoff,
the chief of the Medical Department of the Rus-
sian Army at Sebastopol, and perhaps the first
authority on gun-shot wounds in Europe, a careful,
quiet, and satisfactory examination into the state of
the general's wound and health. It should be stated
that on the day preceding the consultation M. Nela-
ton, an eminent French surgeon, examined the
wound with a probe, and believed that he detected
a hard substance, which he declared to be the ball,
about an inch within its orifice. His recommenda-
tion was that the wound should be enlarged gra-
dually, by means of tents of increasing size, by
which he anticipated that in the course of five or
six days the ball could be readily removed by a
pair of forceps. On the 29th Oct., at the consulta-
tion, the question of amputation was proposed, dis-
cussed, and happily rejected. At the same time
M. Porta, the experienced and distinguished
surgeon of Pavia, made a searching examination
with his little finger thrust forcibly and deeply
into the wound ; but, though he turned the finger
round in every direction, no bullet could be de-
tected, sho wing that M. Nelaton was mistaken in sup-
posing that he felt the ball within an inch of the
orifice of the wound—in fact, the bullet has never
yet been felt by any one, nor has its presence and
whereabouts been determined by actual demonstra-
tion. M. Pirogoff thought that the ball might be
lodged deeply in the lower joint of the greater and
lesser bones of the leg (the inferior tibio fibular ar-
ticulation), and he based this opinion on the greater
width (three-quarters of an inch, measured by a pair
of callipers) between the ankles of the sound and of
the unsound foot ; but the puffy condition (oedema)
of the parts about the joint, caused probably by
the severe examination of the 29th, accounted to
my mind for the difference, and the most careful
examination and pressure with the fingers in
various situations about the articulation failed to
detect any hard substance, or to indicate the pre-
sence of matter, nor could any matter be extruded
from the wound by pressure at the supposed site of
the projectile. Up to the present time therefore
(though it would be presumptuous of me to declare
the impossibility of the bullet being in the leg), I
see no reason to change my first opinion, agreeing
as it did with the result of M. Porta's examination
on the 4th of September, only six days after the
injury, and confirmed as it was by M. Zanetti, of
Florence, at our consultation on September 10th,
viz., that there is no present evidence of the ball
having lodged in the wound. It must be borne in
mind that the shot was a large, obtusely-conical
rifle bullet, weighing more than an ounce, fired ob-
liquely from below, and in front, at a distance of
only 150 or 200 paces, which penetrated trousers,
boot, and stocking, and broke off by an obliquely
transverse, linear fracture, the internal ankle bone,
but without smashing or comminuting it, though
the fracture laid open, of necessity, the ankle joint.
The bone discharged from the wound from time to
time has been in the form of fine sand-like particles,
and only once a fragment equal in size to that of
half a pea came away. At present the joint is more
swollen their when I saw it at varignano (probably
the result of the examination of the 29th of which
the general vividly complained). The foot, though
otherwise in good position, is turned a little more
inwards, owing, I believe, to the want of support
from the broken off internal ankle. The joint is
free from pain, inflexion, and extension. The Ge-
neral's health is excellent, and his face and expres-
sion unchanged ; his appetite, sleep, S:c., are also
good ; in fact, he has little of the outward
appearance of an invalid. The leg is suspended
in a Salter's swing fracture-cradle, sent to him
by his English friends, and he reposes on an invalid
bed which I was commissioned to select and send out
to him from England, upon which he was removed
from Varignano to Spezzia, and which affords him
the greatest comfort and ease. We found him at
first in a confined room, with the windows fastened
up ; but on the day I left Spezzia his removal was
effected into a large and airy adjoining saloon. The
General has been overwhelmed with visitors, whose
intrusion, of necessity, greatly fatigued him, and I
am sorry to say that our own countrymen and coun-
trywomen have been the most pertinacious intruders.
I ventured, while at Spezzia, to suggest a plan for
the exclusion of these self •indulgent and inconside-
rate pilgrims. lam happy to hear by a letter re-
ceived from Spezzia yesterday, that some such mea-
sures have been adopted ; that visitors have been
rigidly excluded, and that the General already be-
gins to feel the benefit of the greater quiet, and of
the more airy room, and the improved appearance
of the wounded ankle, and in more unbroken arid
tranquil sleep. The General, however, suffers so
much from rheumatic pains, and Spezzia at this
season of the year is so damp and muggy, that his
removal for the winter to a warm and dry climate

is imperative. Dr. Pirogoff and I concurred in
the opinion that amputation is uncalled for, that
the wound should be simply and lightly dressed,
and allowed, if it be so disposed, to heal. That if
the bullut be really lodged in the wound it must be
deeply seated, and that time will indicate its pre-
sence, and facilitate without injury its removal.
Nothing can exceed the tender care and skilful
dressing of his surgeons, who, with the General
himself, received my visit with hearty pleasure and
welcome, and who permitted the examinations of
Dr. Pirogoff and myself with the utmost courtesy
and kindness. In conclusion, I have only to reite-
rate my former opinion, that though the cure must
needs be tedicus, yet that with rest, quiet, good air,
&c., the case will do well, without loss of limb, and
perhaps even without much impairment of the utility
of the injured joint. Some under-clothing peculiarly
adapted to relieve the rheumatic tendencies of the
General, has been, at my suggestion, sent out to
him by an English lady, and I trust has by this
time arrived at Spezzia.
have received information by a letter
from Spezzia this evening (Oct. 8,) that the Gene-
ral feels himself desirous of open-air exercise, and
for that purpose Colonel Vecchi asks me to obtain
for him an invalid couch on wheels, which I trust
his friends will enable me to send him. The tele-
gram of tonight also intimates the General's re-
moval to Pisa, the most favourable climate for him
in Italy.
Nov. 8, 1862.

The Select Committee are now engaged in testing
powder. A very large grain was adopted a short time since,
' but is now said to have damaged some of the Armstrong
guns.—Army and Navy Quote,