Memphis daily appeal. [volume] (Memphis, Tenn.) 1847-1886, 1862-07-19
BY RCLANAHAN g DILL.

Z N
CriIuean War.
4. Waor being of the utmost Importance {,
wounded men, care should be taken, when be
fore the enemy, not only that the barrels at
tached to the cOnveyancs carts ore properly
I filled with g0od Water, or such other means 6s
are commonly used ia the country for carrying
il, should be procured and duly Fl led
4 2 Bsndsges or rollers, applied on the field o
/ battle arc, IN general, so many things wasted
IS they become dirty and stiff and are usually
cut sway and destroyed without having beer
really useful; they are therefore not forth-com
I ing when required, and would be Of no use
\ ?. Simple guushot wounds require nothing
mora, for the first two or three days than the
application OF piece Of wet OF oiled linen
4 fastened on with strip Of sticking plaster or il
/ possible, kept constantly wet snd cold with
l water. W hsn cold diSagrees, warm water should
be substituted.
1 4 Wounds made by swords, sabers or Other
cuttTg 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 10 be treated by raising
the arm to or above right angle with the body,
I in which position it is 10 be retained, however
( iheonyenisnt it may be. Ligatures may be in
/ serted, but through the skin only. II the threat
] be cut across in 'front.' any great vessels should
be tied, and oozing stopped by a sponge After
I e. few hours, when the OOzing is arrested, re-
iroIo the sponge, and the head brought down
/ iowarithe chest, and retsined in that position
I withoU. hga.ures; if this is done too soon, tie
sufferer may possibly be sutfocated by The infl-
tratiol OF bloo3isto the ageolag tissue parts ad-
I jaceut,
.. If tie cavity Of the chest is opened into by
! q swC7d or lance, il is of the utmost Importance
4 that the wound p the skin should be effectively
closed, and this can only be done by sowing Il
! up as q tailor or a lady would sew up seam,
I skin only being iuUllded q compress list should
be applied over tie st cbes, fastened on By silcE-
-ing plaster The patient IS then 10 be placed
! on the wounded s.de that the lang may ial
/ down If i can, upon, or epply itself 70 the
/ woundsd part AMI adhere 10 i, BY which happy
and hoped for incident life may in all pTooaD.iify
1 be preserved. If the lung shoUid be seen pro
/ trUIisg in tbs wound. it should no. be turned
beyuud the level Of the ribs, but b. covered over
/ by thu external parts.
q. l. IS advisable to enCCU-age previously the
discharge Of blood from the cavity Of the cnest,
# aDy have fallen into it; bat if the bleeding
| from within should continue, so as TO place the
life Of tie sufferer in danger tEe ex erEal WeUai
should be closed ard events awaited.
:. When it IS doubtful whether the bleeding
proceeds from the cavity Of lie chest, or from
| the inseIeosial artery "a surgical bugbear,) an
inCis0n through the skin and the external nier-
costal muscle viii expose The artery close TO the
q gs OF the rib having the internal intercOstal
muscle behind it. The vessel thus exposed may
be tied, OF the end Pinched by the fOTceps, until
it ceases to bleed. Tying string round the
NOS Is destructive piece OF cruelty, and tie
plugs, etc, formerly recommended, may be coz
sideTed as surgical ineongruities.
.. A gun-shot wound in the chest caurot close
By adhesion, and must remain open. The pcs
ton IF the sufferer should therefore be that
which Is most comfortable TO him. 4 smsll hole
penetrating tae cavity is more dangerous than 2
large one, and the wound is less dangerous if the
ball goes through the body The wounds
should De examined and enlarged if necessary,
ii c1der to remove all extraneous substances,
even If they should be seen to stick on the sur
face Of the lungs ths opening should be cover
Ell with soft oiled or wet lint-a bsudage when
agreeable The ear Of the surgeon and the
ststh-seopa are invaluable aids, and ought al
ways 70 be used: indeed, no injury Of the chest
can Be scientifically treated without them.
9. Incised and gun-shot wounds Of the abd0-
men are TO be trsat-d in nearly q similar man
ner; tie posiEon 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. fit cannot be passed,
an opening should be made In the peripGum for
as possible.
. H. In gun-shot fractures Of the skull, the
loose, broken pieces Of bone, and all eXtrGneous
substances are to 5e removed as soon as possible,
and depressed fractures of bone &Je to be raised.
A deep cut made by a heavy sword through the
bone, into the brain, generally causes a consid-
cradle depression of the inner table Of bone,
whilst the cu.er may appear to be merely d.
vided
M A. 49,, = -,-,g-- O., l-.,-y,,,-,t,l,l ,-,,r.t
from ths effects of q cannon shot. The head OF
the bole is 10 be sawn off, if necessary. The
eibow-ioint as to be cut OU il destroyed, and the
sufferer in either case, may have a very useful
arm
13. Incass Of gun-shot fracture of the upper
arm, in which the bone is much splintered, incis
ions are to be made, for the removal Of al the
broken pieces which 1t is feasible to take away.
The elbow Is to be supported. The forearm is
to be treated in similar manner the splints
used should be solid
H. Ths hand is never 10 be smpUtated, unless
al or nearly al its parts are destroyed. Differ
ent bones Of It and of the wrist to be removed
when iueeoyerably injured, with or without tho
metsIcarpal bones and fingers OF the thumb
bnt a thumb and one finger should always be
pTeservd when possible
Is. The lead Of the thigh-bone should be sswn
of when broken by a mUskct-b ball Amputa-
ton at the hip joint should only be done when
the fracture extends some distance into the shaft,
or the limb is destroyed by cannon-shot.
l6. The knee Joint should be cut OUt when II
recoversbly injured; but the limb is 40. to be
smputated uAtl 1t cannot be avoided.
II. q gun-shot fracture of the middle Of the
thigh attended by great spintering, is g case
for amputsGOn. In less difficult cases, tie
splinter should be removed by incisions, par
@-r- -l- IL,
ard oUtog side OF the thigh. The limb should
be placed on q stTsight, firm spli1t. A broken
thigh does not admit Of much, and sometimes
Of DO extension without an UnsdYisGble increase
Of suffering. An inch OF Two Of shcEtouiEE the
thigh does not so materially interfere with pro
gression as to mako the sufferer regret having
escaped amPutati0n.
IS. a leg injured below che I1nee should rare
" be anpUtated in the fT5t instance, unless
from the elects Of Gcsanon-sh0t. The sPlinteTs
Of bone are al 70 be Immediately removed, by
saw or forcsps, SITTER due incisicns. The limb
should be placed in iron splints and hung on q
permanent frame as afording the greatest COM
fo-t and probable chance Of ultimate success.
10. An aBkle-joint is 10 be cut out, unless the
tendous around are too much injured, and so
are the tarsal and metataTssl bones and toes.
Incisions have hitherto been too little employed
in the early treatment Of these injuries OF he
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
immediate amputstion necessary In no other
part Of the body is amputaton 10 be done IN the
first instance for such injury. LigstuTes 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 Of
these cases viii be known BY ths change of
color in The skin. L viii rarely occur in the
upper extremity, but viii 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 notified white. Am
putation should be performed Immediately above
the fractured part. The modification is yet
I local