Memphis daily appeal. [volume] (Memphis, Tenn.) 1847-1886, 1862-07-17
BY MCLANAHAN & DILL.

Directions to Army Surgeons en- she Field
Of Eataie-By g. j. Guthrie, sHrEeoIi-
General 90 the British Forces daring Ile
CFimenH War.
J. Water being Of the utmost Importance to
wounded men, care should be taken, when be-
fore tho enemy, not only that the barrels at
tsched to the conveyance carts are properly
filed with good water, or such other means as
are commonly used In the country for carrying
It, should be procured and duly f led.
.. Bandsges or rollers, applied on the field of
battle are, in general, so many things wasted,
Is they become dirty and stiff, and are usually
cut away and destroyed, without having been
really useful they are therefore not forth
ing when required, aud would be OF no use
. Simple gunshot 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
wster. When cold disagrees, warm water should
he substituted.
4. Wounds made By swords, sabers or other
cutting instruments are TO be trested principally
by position Thus, a cut down to tie 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,
IN which position It is TO be retained, however
inconvenient it may be. Ligstures may be in
a.
be cut across il front, any great vessels should
be tied, and oozng stopped by sponge. After
q few hours, when the oczing is arrested, re-
move the sponge, and the head brought down
toward the chest, and retained in that position
without ligatures if this is done too soon, the
sufferer may possibly be sutfocated by the in6i-
tratiou of booi i8to the aIeolsT tissue parts ad-
jacent
3. If the cavity Of the chest is opened into by
e 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 sowing it
up as a tailor or q lady would sew up seam,
skin only being included; compress list should
be applied 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 iaA
down, If II can, upon, or apply itself 10 the
wounded part, ana adhere to it, by which happy
and hoped for incident life may IN all probability
be preserved. If the lung should be seen Pre-
tudirg in tie wound it should not be returned
beyond Inc level o! the r5Ss but Discovered over
by the external paris.
6. Ii Is advisable 70 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 ex' 'ernal WeUnd
should be closed and events awaited.
:. When It is doubtful whether the bleeding
proceeds from the cavity of the chest, or from
the interccs.sl artery "a surgical bugb5ar,) an
incision through the skin and the external inteT
costal muscle will expose the artery close to the
e5re Of the rib having the internal intercostal
muscle behind II. The vessel thus exposed may
be tied, or the end piuched by the foTceps, until
It ceases TO bleed. Tying string round the
ribs is destructive piece OF cruelty, and the |
pings, etc, formerly recommended, may be COZ /
sideTed as surgical incongTuities
g A gun-shot wound IN the chest cannot close /
by adhesion, and must remain open. The pos'- /
ton Ct the sufferer should therefore be that 4
which is most comfortable to him. a small 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, aud enlarged if necessary, /
in order TO remove all eXtTaGeoUs substances, /
even If they should be seen to stick on the sur
face of The lungs; the opening should be cover
cd with soft oiled or wet lint--a baudage when /
agreeable. The ear Of the surgeon and the
stgthoscope are invaluable aids, and ought al
ways to be used: indeed, no injury Of the chest
can be scientifically treated without them.
9. Iucised and gun-sbOt wounds Of the abdo-
men are to be treat-d in nearly similar man
ner; the position in both being that which is
most agreeable to the patient, the parts being re-
.axel.
10. In wounds of the bladder, an elastic cath
,r is generally necessary. If cannot be passed,
IN opening should be made il the perin8um for
.he evacuation Of the UTine with as little delay
as possible
il. In guu-shot fractures of the skull, the
loose broken pieces Of bone, and all exuaneous
substances are to be removed as soon as possible, 4
and depressed fractures of bone are to be raised.
A deep cut made By a heavy sword through the |
bone, into the brain, generally causes consid- |
erabls depression OF the inner table OF bone, |
whilst the outer may appear to be merely di- |
vided.
p An arm IS rarely to be amputated, except /
from the effects of a cannon shot The head of
the bone is to be sawn eff, if necessary. The |
elbow-ont Is to be cut out, if destroyed, and the
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 splintered, incis
ions are TO be made, for the removal of al the
broken pieces which it is feasible to take away.
The elbow is to be supported The forearm IS
70 be treated in q similar manner the splints
used should be solid.
IA The hand is never TO be amputated, unless |
all OF nearly all its parts are destroyed. Differ
ent bones Of itand Of the wrist to be removed .
when irrecoverably injured, with or without the |
bones ana fingers or the thumb ; /
bnt q thumb and one finger should always be
preseryd when possible.
10. The head Of the thigh-5one should bs sswn /
off when broken by a musket-bal. Amputa-
ton at the hip joint should only be done when 1
the fracture extends some distance into the shaft
or the limb is destroyed by cennon-shot
l6 The knee Joint should be cut out when IL
recoverably injured; but the limb is not to be /
smpUtst5d until it cannot be avoided.
Il. A gun-sbot fracture Of the middle Of the /
thigh, attended by great splntering, is Q case
for smputation. la less difficult cases, the /
splinter should be removed by incisions, PSF
tieulary when they can be made on the uppoZ
and cutter side Of the thigh The limb should f.
be placed on a straight, firm splint. A broken /
thigh does not admit Of much, and sometimes /
Of no extension, without en- Unadvisable increase
Of suffering An inch CT two Of shortening the
thigh does not so materially interfere with pro-
gresson as to make the sufferer regret having
escaped amputstion.
J5. 4 leg injured bolsu the knee should rare
y be smputsted IN the first instance, unless |
from the effects Of q cGunOE-shot. The splinteTs
Of bona are al to be Immediately removed, by |
saw OF forcsps, after due incisions. The limb |
should be placed in iron splints and hung on a
permanent frame as affoTding the greatest com |
fort, and probable chance of ultimate success.
-. An ankle-j0int is 10 be cut out, unless the
tendons around are too much injured, and so
are the tsrsal and metetarsal bones and toes |
IncisiOns have hitherto been too little employed
in the early treatment Of these injuries OF the
foot for the removal Of the ex.raneous sub /
stances.
20. A wound of the principal artery of the
thigh, IN addition to a gun-shOt fracture, renders
oH k4Aar