Surgical Experiences in South Africa, 1899-1900. George Henry Makins

rel="nofollow" href="#ulink_5a94ced4-a0c7-564f-b928-43af666ba473">56 17. Gutter Wound of Shoulder56 18. Oblique Gutter Exit Wound 57 19. Oval Entry, Starred Exit Wounds58 20. Circular Entry, Slit Exit Wounds59 21. Circular Entry, Starred Exit Wounds59 22. Entry and Exit Wounds in Six Successive Spots made by same Bullet61 23. Four Successive Entry and Exit Wounds of same Bullet62 24. Superficial Abdomino-thoracic Track64 25. Superficial Linear Ecchymosis of Thigh65 25a. Sections of Mauser Entry and Exit Wounds74 25b. Prolapsed Omentum77 26. Sections of Four Bullets82 27. Normal Mauser Bullet83 28. Four Mauser Ricochets 84 29. Mauser Ricochet, Disc Form 85 30. Fissured Mauser Mantle 86 31. Mausers Deformed by Impact on Femur 86 32. Apical Mauser Ricochet 87 33. Spiral Ricochet88 34. Normal Lee-Metford Bullet89 35. Apical Lee-Metford Ricochets90 36. " " " 91 37. Four Types of Soft-nosed Bullets92 38. 'Set-up' Soft-nosed Lee-Metford Bullets92 39. Flattened, Solid-based Mantle From Ricochet93 40. Mauser Bullet, Jeffreys-Tweedie Modification94 41. Section of Mark IV. and Soft-nosed Mauser94 42. Tampered Bullets95 43. Large Leaden Sporting Bullets98 44. Explosive Wound of Back100 45. Dead Men on Field of Battle102 46. Flattened Leaden Cores from Mantled Bullets105 47. Explosive Exit Wound over Fractured Ulna156 48. Explosive Exit Wound over Fractured Humerus158 49. Explosive Exit and Entry Wounds of Legs159 50. Types of Gunshot Fracture161 51. Lower End of Fractured Femur164 52. Oblique Perforation of Femur, Separation of Fragment at Exit Aperture in Bone169 53. Gutter Fracture of Head of Humerus178 53a. Diagram of 'Butterfly' Type180 54. Wire Gauze Splint 187 55. Gutter Fracture of Pelvis 191 55a. Diagram of 'Butterfly' Type 200 56. Cane Field Splint for Lower Extremity 209 57. Tunnel Fracture at Surface of Tibia 219 58. Cane Field Splint for Leg 222 59. Skiagram of Injury to Interphalangeal Joint 237 60. Skiagram of Bullet in Nasal Fossa 244 61. Diagram of Aperture of Entry into Cranium 245 62. Aperture of Entry into Frontal Bone 252 63. Fragment of Inner Table Displaced from Opening seen in Fig. 62 253 64. Gutter Fracture of First Degree in Parietal Bone 255 65. Diagram of Gutter Fractures 256 66. Gutter Fracture of Second Degree in Parietal Bone 257 67. Diagrams of Gutter Fractures 258 68. Superficial Perforating Fracture of Parietal Region 259 69. Diagram of Superficial Perforating Fracture 260 70. Fragment Forming Floor of Temporal Gutter Fracture 260 71. Scale of External Table in Low Velocity Injury of Frontal Bone 261 72. Frontal Perforation, Aperture of Exit 261 73. Visual Field in Occipital Injury 279 74. " " " 279 75. " " " 281 76. " " " 281 77. " " " 283 78. " " " 283 79. Contused Spinal Cord 333 80. Divided Spinal Cord 334 81. Superficial Track in Anterior Body-wall 377 82. Spirally Grooved Bullet 381 83. Ecchymosis in Fractured Ribs with Hæmothorax392 84. Subcutaneous Division of Abdominal Muscles409 85. Lateral Incomplete Wound of Small Intestine. Slit Form416 86. Lateral Perforation of Small Intestine. Gutter Form417 87. Entry and Exit Wounds in a Transverse Perforation of Intestine418 88. Inner Aspect of Piece of Intestine Shown in Fig. 87419 89. Impaction of Omentum in Exit Wound of Abdominal Wall421 90. Fragments of Large Shells 475 91. Fragments of Percussion and Time Fuses 477 92. Complete 1-lb. Pom-pom Shell 479 93. Fragments of Exploded Pom-pom Shells 480 94. Percussion Fuse From 1-lb. Pom-pom Shell481 95. Fragments of Boer Segment Shells 483 96. Normal and Deformed Leaden Shrapnel Bullets 485

TEMPERATURE CHARTS

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      1. Case of Axillary Hæmatoma, Blood Temperature 119 2. Case of Hæmothorax with Recurrent Hæmorrhages 395 3. Primary and Secondary Rises of Temperature in Hæmothorax, Recovering Spontaneously 402 4. Secondary Rise of Temperature in Hæmothorax 403 5. Falls of Temperature in Hæmothorax following Paracentesis 404 6. Secondary Hæmothorax, Spontaneous Fall of Temperature 405

SURGICAL EXPERIENCES

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      IN

      SOUTH AFRICA

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CHAPTER I

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INTRODUCTORY

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      The following pages are intended to give an account of personal experience of the gunshot wounds observed during the South African campaign in 1899 and 1900. For this reason few cases are quoted beyond those coming under my own immediate observation, and in the few instances where others are made use of the source of quotation is indicated. It will be noted that my experience was almost entirely confined to bullet wounds, and in this respect it no doubt differs from that of surgeons employed in Natal, where shell injuries were more numerous. This is, however, of the less moment for my purpose as there is probably little to add regarding shell injuries to what is already known, while, on the other hand, the opportunity of observing large numbers of injuries from rifle bullets of small calibre has not previously been afforded to British surgeons.

      I think the general