Memphis daily appeal. [volume] (Memphis, Tenn.) 1847-1886, 1862-06-28

General TO the British Forces daring iLn
= .CrimeRn War.
) J. Water being of the utmost importance I
|. wounded men, care should be taken, when be
fore the enemy, not only that the barrels Al
tarhed to the conveyance carts are properl
? filled with good water, or such other means a
are commonly used in the country for caTTyiU,
it, should be procured and duly # led.
: ,. BIudages or rollers, applied on the field 0
battle are, in general, so many things wasted
as they become dirty and stiff, and are usual,
cut away and destroyed, without having beer
really useful; they are therefore not forth com
ing when required, and would be of no use.
=. Simple gunshOt wounds require nothing
more, for the first two or three days, than the
application of piece Of wet or oiled linen
fastened on with strip Of sticking plaster, or i
possible, kept constantly wet and cold with
water. When cold dsagrees, warm water should
} be substituted
L. Wounds made by swords, sabers or other
cutting instruments, are TO be treated principally
by position Thus, cut down to the bone,
across the thick part Of the arm, Immediately
below the shoulder, is to be treated by raising
the arm to or above right angle with the body,
Iii which position it is to be retained, however
inconvenient it may be. Ligatures may be in
serted, but through the skin only. II the throat
be cut across In front, any great vessels should
be tied, and Oozing stopped By a sponge After
q few hours, when the oOzing is arrested, re-
move the sponge, and the head brought down
toward the chest. and retained in that position
| without hgatures If this is done too soon, .he
sufferer may possibly be suffocated by the inGl-
tratiou OF blooi into the sreolar tissue parts ad-
jacent
) If the cavity of the chest is opened into by
a sword or lance, it is of the utmost Importance
that the wound in the skin should be effectively
closed, and this can only be done by sewing it
up as a tailor or a lady would sew up e seam
skin only being inCluded a compress list should
be appled over the st ches, fastened on by stick
ing plaster. The patient is then to be placed
on the wounded side, that the lung may fall
down, if it can, upon, or apply itself to the
| wounded part and adhere it, by which happy
and hoped for incident life may in all probability
be preserved. If the lung should be seen pro-
trudiDg in the wound, it should not be returned
beyond the level OF the ribs, but be covered over
| by the external parts.
1t IS advisable to encourage previously the
discharge of blood from the cavity of the chest,
if any have fallen into It but if the bleeding
rom within should continue, 50 as to place the
| life OF the sufferer in danger the ex erna weund
| should be closed and events awaited.
| !. When it is doubtful whether the bleeding
| proceeds from the cavity of the chest, OF from
the intercostal artery "a surgical bug b-ar,) an
| lncision through the SKIN ani the external inter
cOstal muscle viii expose the artery close to the
| edge of the rib having the internal intercostal
muscls behind it. The vessel thus exposed may
be tied, or the end pinched by the forceps until
it ceases to bleed. Tying string round the
| ribs is destructive piece of cruelty, and the
| plugs, etc, formerly recommended, may be con-
| sidered as surgical incOngTuities.
| :. A gun-shot wound in the chest cannot close
| by adhesion, and must remain open. The posi-
ton Of the sufferer should therefore be that.
| which is most comfortable to him. small hole
| penetrating the cavity is more dangerous than
large one, and the wound is less dangerous if the
| bail goes through the body. The wounds
should be examined, and enlarged if necessary,
/ in order to remove all extTaReous substances,
| even if they should be seen to stick on the sur
| face of the lungs; the opening should be cover
/ ed with soft oiled or wet lint-a bandage when
| agreeable. The ear Of the surgeon and the
stethoscOpe are invaluable aids, and ought al
ways to Be used indeed, no injury Of the chest
| can be scientifically treated without them.
| 9. IHcised aud gun shot wounds OF the sbdO-
men are to be treat d in nearly similar
ner; the position in both being that which is
most agreeable to the patient, the parts being re-
| laxed.
| 10 In wounds Of the bladder, an elastic cath
er is generally necessary. Ifit cannot be passed,
an opening should be made in the pernelm for
] the evacuation Of the urine, with little delay
as possible.
| H. In gqR-shOt fractures Of the skull, the
loose, broken pieces of bone, and all extTsneOus
| substances are to be removed soon as possible,
aud depressed fractures Of bone are to be raised.
A deep cut made by heavy sword through the
| bone, into the brain, generally causes a cODsid-
ersble depression of the inner table of bone,
whilst the outer may appear to be merely d.
vided.
70. An arm is rarely to be ampuisted except
| from the effects of a cannon shot. The head of
the bore is to be sawn of, if necessary. The
elbow-join IS to be cut out if destroyed and ths
| sufferer in either case, may have a very useful
arm.
I3. In case Of gun-shot fracture of the upper
arm, in which the bone is much splinte ed incis
ions are to be made, for the removal Of all the
broken pieces which it is feasible to take away.
The elbow is to be supported. The forearm is
| to be treated in q similar manner the splintS
used should be solid.
H. The hand is never to be amputated unless
all or neaSy all its parts are destroyed. Differ
| ent bones of it and of the wrist to be removed
when irrecoverably injured, with or without the
metarcarpal bones and fingers or the thumb
bnt q thumb and one finger should always be
preseTvd when possible.
I5 The head of the thigh-bone should be saWn
off when broken by musket-balL AmPuta-
| ton at the hip joint should only be done when
the fracture ex tends some distance into the shaft
or the limb is destroyed by cannon-shOt.
| IS. The knee joint should be cut out when ir-
recoverably injured; but tho limb is not to be
amputated until it cannot be avoided
| Il. A gun-sbot fracture of the middle Of the
/ thigh, attended by great splintering, is case
/ for smputatOn In less difficult cases, the
! splinter should be removed by incisions, par
! ticularly when they can be made on the upper
and outer side of the thigh. The limb should
be placed on a straight firm splint. A broken
| thigh does not admit of much, and sometimes
of no extension, without an Unadyisable increase
of suffering An inch or two of shortening the
thigh does not so materially interfere with pro-
gression as to make the sufferer regret having
escaped amputstion.
Is. A leg injured below the knee should rare
ly be amputated in the FIRST instance, unless
from the effects Of a csnnon-shot. The splinters
of bone are all to be Immediately removed, by
| saw or foTceps, after due incisions. The limb
should be placed in iron splints and hung on q
permanent frame as affOrding the greatest COM
fort, and probable chance of ultimate success.
| 80. An ankle,jOint is to be cut out, unless the
| teudons around are too much injured, and so
| are the tarsal and metatarsal bones and toes.
Incsions have hitherto been too little employed
in the early treatment of these injuries OF the
foot for the removal Of the extTaneous sub
stances.
90 A wound of the principal artery Of the
thigh, In addition to gun-shot fracture, renders
i immediate amputation necessary. In no other
part of the body is amputstion to be done in the
first instance for such injury. Lgstures are to
be placed on the wounded artery, one above, the
other below the wound, and events awaited.
81. The occurrence OF modification in any Of
these cases will be known by thu change of
color in the skin 1t will rarely occur in the
upper extremity, but will frequently do so in
the lower. When about to take place, the color
of the skin Of the foot changes, from the natural
flesh color. to a tallOwry or mnttled white. Am-
putation should be performed Immediately above
the fractured part. The modification is yet
local
%. When this discoloratiOn has not been OBJ
seryed and the nart shrinks OF eanorana has