British medical journal . , and arrived at the hospital on October 6th. He was then found to a woitnd caused by a pro-jectile which, entering in the left hypochondriac region,had passed upwards and backwards and emerged througha hole 3 in. wide close to the left scapula. The inter-vening track was sloughy aud the svurouuding superficialand other tissues in the sanic condition, with muchscchymosis further afield. Under a general anaesthetic aumbar injection of 20 antitetanic serum was firstgiven and the track then opened uji. It was found thatthere were comminuted fractures of the s
British medical journal . , and arrived at the hospital on October 6th. He was then found to a woitnd caused by a pro-jectile which, entering in the left hypochondriac region,had passed upwards and backwards and emerged througha hole 3 in. wide close to the left scapula. The inter-vening track was sloughy aud the svurouuding superficialand other tissues in the sanic condition, with muchscchymosis further afield. Under a general anaesthetic aumbar injection of 20 antitetanic serum was firstgiven and the track then opened uji. It was found thatthere were comminuted fractures of the seventh andeighth ribs in the mid-axillary line aud that some piecesof leather and clothing were embedded. These havingbeen removed and ttie sloughing surfaces scraped awaythe wound was irrigated and packed with gauze. On the following days the dressings were removed, the wound bemg syringed with hydrogen peroxide solution,and by October 12ih the patient was doing well, theworoid being clean and his temperature normal. ir^. Fig. 1.—Shrapnel wound of side of chest, with fracture of seveiithand eighth ribs. Case ii. The patient in ihis case died on the filth day after howas wounded, aud the picture (Fig. 2) shows only one ofhis many lesions. All were due to the impact of shrapnelbullets or shrapnel shell casing, but he was so ill when horeached hospital on October 6th that nothing could boascertained as to the circumstances except the fact thathe had been wounded on October 3rd. Ou the right sidethere was a compound fracture of both leg bones, severeexcoriation of the skin over the thigh, two flesh woundsover the shoulder, and a compound fracture of the lowerthird of the radius. Ou the left side there was a com-pound frswture just above the ankle, a compound fractuiwof two metacarpal bones, a lesion which resembled alarge burn on the back of the hand, aud a lacerated fleshwound on the outer side of the upper arm. All the lesionswere markedly septic. The right leg was the seat of
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Keywords: ., bookcentury1800, bookdecade1850, booksubjectmedicine, bookyear185
