New-York daily tribune. [volume] (New-York [N.Y.]) 1842-1866, 1861-09-28
LECTuHE ON GUMSHoT WOUNDS.

l &foi- aAPHAHL u TIC NcW-ICfk k1eclc3f college
IN Thirteenth street delivered interesting lecture on
the above subject, on Tuesday m rning. Aftsr re-
captivating previous lecture on the same subject
Dr. Raphael proceeded to describe the differences be-
tween apeures Of entrance and apertures of exit A
general rule spertures 90 entrance presented tire
lohowing appearance: the " oand was circular with
ragged edges, slishily eyerte,i and generally die.
coorea and OF hvld aspect. from the retention Of
particles of POWDER which are VIII ed off when the bali
enters but sometimes owing to We condition caused
by the passage OF the ball Tie are vnFe. the Doctor
continued ID seemingly smaller tina the bullet; but
the fact Is not remarkable, as the same q true
with regard to any green tree on which
the experiment may be tried, or oil YER Substance
possessed OF contraetHty. The exit woul ia rather
larger, on the other hand than the wound entrance
and instead of being cireuar, appears s OF cut
with knife. This is whom the wound con. v from q
round ball. When a conicsl ball iaficis the wound,
and the missile enters with great momentum the dir
ference between eotrance and exit is 20 skeds
If, however, the ball is partially spent, YES In
contact with resisting structure, such lore,
which will impede the velocity, then the exit W, Hpd
is very larger than the wound Of entrance. tn
often four or five times larger. These Appearances ~
must be observed, occur only when the wounds V
examined after the injury, for IN very shoa
time Inflammation will set 10, ard after two or threet
days lapse both wounds viii have changed In e6arac
ter. 4hs sloughng, which takes place mainly from
the wound OF entrance renders that much the arger
Ahhonghn Is not Of great practical importance 70
know which has been the aperture Of entrance and
that OF exit, yet In medco-legsl point OF view it's
exceedingly important. A Gaze of murder was cited
in which Sir Ashley Cooper testified that from post
norton examination, the wound must have been in
fitted by left-handed person--on the strength Of
which q man arrested and convicted. The symp-
toms of gunshOt wounds present the following charsc-
teriscs: In regard pain general rule there is
very little. 1t has frequently been observed that per-
who have had limb entirely carried away BY q
ball were yet unconscious Of any injury until
attempting to Tie same holds true with regard
TO wounds made by. musket bali. Whea pain 10
felt is not aeose IN lite character bat the feeling
o. if the part had been struck with cane, or ~
sometimes expressed, Like red bot iron passing
through it. II has also been observed that the wound
ed frequently refer the psia to different locality from
the wound. soldier In tue Crimosn war, having
experienced pain in his forearm supposed that be
Injured in that part and left the battlefield carefully
supporting his arm with the other. Ga arriving at the
hospital he asked for some water but N attempting
to drink he found his mouth Tiled with blood. Upon
examination it was found that the arm uninured,
but the ball had passed through the jaw, iajaIins
probably of the nerves which pass TO the arm-
| Similar instances are by no means rare.
In reference tohemorrhags from gun-shot wounds, IL
is not generally copi0us except where large artery
has been severed, and then the wounded man viii In
all probability die In few minutes. Doubles many
hundreds Of the soldiers found dead upon the bat
tie might generally be saved did the officer in command
or some know the ofthe large arteries,
and thus be enabled to stop hemorrhsgs Immediately.
Before they can reach surgical assistance the ef
will bleed TO DEATH may be put into hand.
kerehief and twisted, by means OF stick or ramroo,
press the stone against the artery In the man
ner Of tourniquet. HemOrrhage upon the field Of
battle is usually from OF the veins. as they are
more liable be wounded than the arteries; the AT
teres being very elastic glide out Of the way when the
ball passes in the neighborhood Ia all cases OF severe
wounds secondary hemorrhage IL 10 be apprehended.
| Secondary hemOrrhage usually comes on between
about the fifth and fifteenth dGys In no case should
the surgeon allow his patient to DO left where seoond
airy heTorThage might come on beyond the res;n 81
closed should he feel Pecure from secondary bemorr-
hage.
Ia regard to what il termed the shock attending an
injury, much depends upon the stare OF mind OF the
person at the time. A slight wound might under the
influence of the effect upon tirnid person,
cause him 10 perish, when veteran might hive under
very serious injury, and call 1t comparatively mag:
nifcant. In Kentucky the lecturer saw captain OF
| the United States Army who had fought dael With
balletoaded shot-guns ana received q wound Ia the
hip, SCATTERING tne TENOR Al hough but few ounces
OF blood lost, the officer died two hours after.
Toe effect of the shock that be did not rally, his
face remained pald his appearance feeble presenting
all the symptoms of 3 man 10 state Of collapse
A severe wound lie more likely to produce death Ia
person addicted 10 intemperance than In one OF or
poeile habits Moral circumstances also seem TO have
| an effect in the progress OF man belonging
to a victorious party would be more likely 10 re-
cover than If he had suffered defeat
la the treatment Of gunshot wounds the first thing
to be done il TO bring about reaction. This effected
by means OF stimulating applications to the extremi-
ties, and, If the patient is able 70 swallow giving
| eluuldOl5 dr OIhuay dhu NatoiI
mOnia or something of that description. The benor-
rhape then should be arrested. This may be done
either Dy hgature, by compression, by the use III
some styptlc application. II il is an artery Of any
size il eau be seen and the hgature preferable TO
| ANYTHING else. In some cases, however, where the
bleeding is slight, compression will answer, in con-
junction with cold application, such as pounded Ice
wrapped in handkerchief. There are many Different
kinds of stypics in use, such as strong solution OF
alum and sulphate of "copper" but perhaps the best y
per suphate Of iron. Alter the hemorhae Is arrested,
then search should be made for the ball, If IL has
been retained. great diversity Of opinion has ex-
listed among military surgeons IN regard TO the exnc-
ton OF balls While there many instances Of bais
remaining for wears unexracted, yet even IN these
cases the Inconvenience suffered by the patient should
warrant the surgeons attempting in all caees IN ex.
traction provided the injury be nic Ia searching foF
h is not greater than what might 6e produced b. the
retention OF the ball itself Mons. HUM chief physi.
clan of the Hotel des IRraies, says on this point,
thar out of 1900 cases he found only IL who bad ex
perenced no Inconvenience from the retention OF the
bail while 200 had suffered or less, until relieved
by an operation In searching for the oa the finger
| IL the best instrument that can be used In cases
where the ball has penetrated very deeply. and the
finger is not long enough, probe OF some flexible ma
| terial must be procured.
After showing variety Of buletforceps, Dr. Raphael
here concluded and announced that the subject would
| be resumed next Tuesday at ~ o'clock.