The sun. [volume] (New York [N.Y.]) 1833-1916, 1898-07-31
WOUNDS OF OUR SOLDIERS.

Lleut,sCOI, Semi N, D,p Ch1ok OF OpeF0Nlng
staff, Writes Of His Surgical Experiences
After SantiaGO-Mauser Bullet Not as
Deadly rs the Old.Fashioned LoRden Ono.
Under the title. Recent Experiences in Mill
tary Surgery After the Battle Of Santiago"
Lieut., Col. n. Sem. NJ, D.. U. 8. ". who Is chief
Of operating staff with the army IN the field.
contributes to the Medical Record these inter-
estihg results OF his experiences in the cam
paign. He writes under the title Of wound
infection:
Our recent experience In Cuba has shown
that the small jacketed bullet seldom carries
with IL into the Tissues clothing or other In
fected substances. Most Of the wounds Of the
soft tissues uncomplicated by visceral LESSONS.
which In themselves would become q source Of
infection. healed by primary intention in . re-
markably short time. II infection followed. IL
usually did so In the superficial portion Of tho
wound in connection with the skin. and. what
Is more than suggestive, the wound Of exit was
moro frequently affected than the wound OF
entrance This can be readily explained from the
larger size Of the wound and moro extensive
laceratlon and tearing OF the Tissues. In many
Of the easeS ideal healing OF the wound did not
occur. owing to a subsequent superficial sup
puration OF the wound. The deep tissues were
seldom implicated in such cases. IhAve reason
70 believe that some Of the compound fractures
which are now suppurating had such o source
Of infection that Ia. the extension Of q super
fetal infection to the seat Of fracture"
o I the value OF the X-ray rs an instrument
OF diagnosis he writes:
Tho value OF the probe as Q ~diagnoBtic in
strument In locating bullets has In modern mil
itary service been almost entirely superseded
by dissection and the employment Of the x-ray.
If from the nature Of the injury and the symp-
toms presented the bullet Is located In q part
| 80 kha hoAu raadiIv md anRaIu oannaoIhIa 30 The
knife. and it is deemed advisable and expe-
dlent to remov 1t. this can often be done moro
expedltiously. and with q greater degree OF
certainty, by enlarginG the track made By
the bullet than by relying on the probe
In finding and on the forceps In extracting
the bullet. II. as is often the case. the
whereabouts Of the bullet Is not known. itS
presence and exact location can by the use OF
the X-ray be determined without any pain or
any additional risks to the patient. AL Of the
bullets removed on board the hospital ship Re-
lief were located in this manner. DR.. Gray, an
expert in skiARraphy, who has charge Of the
scientific work of the floating hospital. has
been of the greatest service to the surgeons in
enabling them to locate bullets and In guiding
them as to the adyisability OF undertaking an
operation for their removal"
OF the effect OF the Mauser bullet. Lieut.. Col.
Benn writes:
I'm cases In which the bullet passed through
the tissues some distance and not far from the
surface OF the skin. tho location and direction
of the wound canal were indicated by o dis
celebration of the skin a few days after the in
jury occurred. In a number OF cases Of aseptio
wounds. in which the bullet had lodged in the
Tissues and was removed a week or ton days
later. / had an opportunity to study the remote
effect 1.-THE injury on the tissues. In all cases the
swelling OF the tissues at this time had nearly
or entirely obliterated the tubular wound, the
location Of which was indicated by a dark dis
coloration, parenchymatous extravasation. re-
mains OF fluid or coaRulated blood. and q linn
tied area OF odema and infltration, These con-
dltions served as a useful guide In following
the course Of the bullet.
THE bullet itself was usually found loose In
small cavity filled with liquid blood or bloody
serum. while a more extensive Zone Of infltra-
ton indicated the early stage OF encapsulation,
/ have no further doubt that the now bullet
will become encapsulated and remain harmless
In the tissues as readily or more 80 than the
o!d-iashioned !eaden bullet. In isolated easel
latO suppuration at the seat OF the bullet 70
suited In the formation Of "A circumscrtbed alb
scess. u complication which aided the surgeon
in Locating, finding, and removing the missile
1t was q surprise TO us all TO find that II
more than 10 pet cent. OF oil the wounded thu
bullet was lodged In the tissues, q vastly
greater number than we had any reason 10 cx
peet, The cause for this became apparenr
when VIC began to study the condition Of thu
bullets recovered.
"Alarge proportion OF the bullets recovered
were found deformed. showing that they wor
detected bullets which had struck a hard OBJ
joet. or had passed through a resisting medium
before they reached the object for which tho.
were Intended, The ground upon which tn,
battle was fought is stony and covered viii
trees and thick underbrush, furnishing tn
most favorable conditions for detection OF tn,
missiles. Some Of the firing was done at
, BALL was found, In tho soft Tissues witlou
| injury 70 the bone, One OF these bullet
: size, the, Jacket rertoct. that was removes
, from the leg about tour inches above. the Rnkl
the popliteal space aPd never touchedt le bone
, have another bullet q thy SANE ktnd, ~
] which was removed Ecom tbs head OF the ubla.