Memphis daily appeal. [volume] (Memphis, Tenn.) 1847-1886, 1862-07-04

tacbed 70 the conveyance carts arc properly
filed with good water, or such other means a.
are commonly used in the country for carrying
It, should be procured and duly f led
?. Bandages OF rollers, applied on the field o
battle are, IN general, so many things wasted
as they become dirty and stiff and are usually
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 gunsh6t wounds require nothing
more, for the first two or three days, than the
application of a piece of wet or oiled linen
fastened on with strip of sticking plaster or il
possible, kept constantly wet and cold with
water. When cold disagrees, warm water should
be substituted.
A. Wounds made by swords, sabeTs or other
cutting instruments, are 10 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 bouy,
/ in which position it is to be retained, however
inconyenient it may be. LgatUes may be in
serted, but through the skin only. 1t the throat
be cut across IN 'front.' any great vessels should
be tied, and o0zing stopped by a sponge. After
/ 3 few honrs- when tke=aazins Is Ef-eSt95' re-
+ iaoYe The sponge, and the head brought down
4 toward the chest, and retained in that position
without ligatures; if this is done too soon, the
sufferer may possibly be sUffOcated by the infl-
tration OF blood into the areolaT tissue parts ad-
jaeent.
5. If the cavity of the chest is opened into by
q sword OF 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 1t
/ up as q tailor or q lady would sew up seam,
/ skin only being ineluded compress list should
| be applied over tho stches, fastened or by stick
/ ing plaster The patient is then to be placed
on the wounded side, that the lung may tall
down, If It can, upon, or apply itself to the
wounded part. and adhere 1t, by which happy
and hoped for incident life may in al probability
] be preserved. IF the lung should Be seen pro
1 truding in the wound, it should not be returned
beyond the level of the ribs, but bscoyered over
I by the external parts.
6. 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
! from within should continue so as to place the
/ life Of the sufferer in danger the external wound
should be closed and events awaited.
! Z When it is doubtful whether the bleeding
! proceeds fTom the cavity Of the chest, or from
! the iGtercostal artery (s surgical bugbear,) an
incision through the skin and the external inter
costal muscle viii expose the artery close to the
/ edge of the rib having the internal intercostal
muscle behind it. The vessel thus exposed may
be tied, OF the end pinched by the forceps, until
it ceases to bleed. Tying 8 string round the
ribs is q destructive piece of cruelty, and the
plugs, etc, formerly recommended, may be con-
sidered as surgical incongruities.
s 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. AsmAll hole
penetrating the cavity is more dangerous than
large one, and the wound is less dangerous If the
ball goes through the body. The wounds
should be examined, and enlarged if necessary,
In order TO remove all extrsneous substances,
even if they should be seen 20 stick on the sur
face Of the lungs; the opening should be cover
ed with soft oiled or wet lint-a baudage when
agreeable. The ear OF the surgeon and the
stethoSeope are invaluable sids, and ought al
ways 70 Be used indeed, no injury of She chest
can be scientifically treated without them.
3. Incised and gunsEot wounds Of the abdo-
men are to be treated in nearly q similar msn-
ner; the position in both being that which IS
most agreeable to the patient, the parts being re-
la1ed
10 In wounds Of the bladder, an elastic cath
er is generally necessary. If cannot be passed,
an opening should be made in the periDaeum Tor
the evacuation of the urine, with as little delay
as possible.
II. In gun-shot fractures Of the skull, the
loose, broken pieces Of bone, and all extTaneous
substances are to be removed as 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, CENTRALLY causes consid-
eGabla depression of the inner table OF bone,
whilst the outer may appear to be merely di-
Tided.
u An arm is rarely ID be amputated, except
from the effects Of a cannon shot. The head Of
the bone IS to BE- sawn eff, if necessary. The
elbowjo IS to be cut out, if destroyed and the
sufferer in either case, may have a very useful
arm.
I3. Incase Of gun-shot fracture Of the upper
arm, in which the bone is much gpintered incis
ions are to be made for the removal Of ali the
broken pieces which II is feasible to take away.
The elbow is to be supported. The forearm is
to be treated in a similar manner; the splints
used should be solid.
il. The hand is never 10 be amputated, unless
al or nearly all its parts are destroyed. Differ
ent bones of il and Of the wrist to be removed
when nTecoverably injured, with or without the
metsrcarpsl bones and fingers OF the thumb
bnt q thumb and one finger should always be
preseTvd when possible.
-. The head Of the fhigli-bone should be sswn
of when broken by q mnsketbalL Amputa-
ton at the hip Joint should only be done when
the fracture extends some distance into the shaft,
/ OF the limb is destroyed BY caEnon-shOt.
! 16. The knee joint should be cut out when ir-
1 reeOversbly injured; but The limb is not to be
amputated until it cannot be avoided.
IL. A gun-shot fracture Of the middle OF the
! thigh, attended By great spGhteTing, is q case
( for amputatiOn In less difficult cases, the
4 splinter should be removed BY incisions, par
i ticulaIly 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 unadyissble increase
/ of suffering. An inch OF two Of shortening the
thigh does not so materially interfere with pro-
/ gTesson as to make the sufferer regret having
! escaped amputation.
I8. A leg injured below the knee should rare
4 y be amputated in the first instance, unless
I from the effects of cannoE-shot. The spEnGers
I Of bone are al to be Immediately removed, by
saw or forceps, after due incisions. The limb
should be placed in iron spliuts and hung on a
/ permanent frame as affording the greatest com
i fort, and probable chance Of ultimate success.
49, An ankle-joint is to be cut cut, unless the
tendons around are too much injured, and so
are the tsrssl and metGtarssl 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 extraneous sub
stances.
90 A wound Of the principal artery Of the
thigh, in addition to q gun-shOt fracture, renders
immediate amputation necessary. In no other
part of the body Is amputation to be done in the
first instance for such injury. LigatuIes are to
be placed On the wounded artery, one above, the
other below the wound, and events awaited.
q. The occurrence of modification IN any oi
these cases viii be known by the change Of
color in the skin. It viii rarely occurs the
upper extremity, but will frequently do SO in
the lower When about to take place, the color
Of the skin Of the foot ch9nges, from the natural
aesb color. 70 a tallowry or mOttled white. Am
iuutation should be performed immediately above
the fractured part. The modification IS yet
local
%. When this discoloraton has net been OBJ
served, and the part shriilks, or gangrene has
set in with more marked appearances, but ye
seems to have stopped al the ankle, delay IS
perhaps, admissible, but if It should agaI
-. :.