. Virginia medical semi-monthly . re-flex to be tested, when it was found noraial. Drainage was employed throughout, the woundhealing by first intention. On the fifteenth day,the patients condition being so satisfactory, hewas removed to his home, where the woundswere dressed several times subsequently. Oneday, while he was straining at stool, owing toincreased intracranial pressure, the wounds,which had not entirely healed, opened and per-mitted the escape of serous fluid. I was calledand dressed them, with the assurance that allwould be well, explaining that the loss of boneat the entrance a
. Virginia medical semi-monthly . re-flex to be tested, when it was found noraial. Drainage was employed throughout, the woundhealing by first intention. On the fifteenth day,the patients condition being so satisfactory, hewas removed to his home, where the woundswere dressed several times subsequently. Oneday, while he was straining at stool, owing toincreased intracranial pressure, the wounds,which had not entirely healed, opened and per-mitted the escape of serous fluid. I was calledand dressed them, with the assurance that allwould be well, explaining that the loss of boneat the entrance and exit wounds made thesepoints weak—that the normal resistance wasgone. After the patient was dismissed as a surgi-cal case, he presented himself, at my request,at intervals for inspection for about threemonths. During this time he complained ofa constant pain in the occipital region, partialdeafness and loss of sensation in the finger tips,all of which have entirely disappeared. In cases of this character, especially the one. I present, the best treatment to employ, in myopinion, is conservatism, only interfering whenwe have a specific purpose in view, and thenunder the most aseptic conditions. 1909.] THE VIRGINIA MEDICAL SEMI-MONTHLY. 61 Despite my persuasion, the patient returnedto his former place of business; but he hasmoved to the country to live, coming in to thecity in the mornings to business. I feel that it is not out of place to mentionthe ballistics and volistics incident to this character of wounds produced by the mis-siles from fire-arms are dependent upon theirweight, size, velocity and shape. The kind oftissue destroyed in each case depends upon acombination of these factors; and the particu-lar tissue or structure of the body upon whichtheir influence is exerted. A projectile canonly produce a traumatism when it is in mo-tion. A .32-calibre revolver fires a missilewhose velocity is low (700 feet per second) ;hence, it is readily arrested and lodged,
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectmedicine, bookyear191
