On gunshot wounds of the thorax and the treatment pursued for them in the Crimea, contrasted with that which was followed in former campaigns / by George Lawson.

  • George Lawson
Date:
[1858]
Catalogue details

Licence: Public Domain Mark

Credit: On gunshot wounds of the thorax and the treatment pursued for them in the Crimea, contrasted with that which was followed in former campaigns / by George Lawson. Source: Wellcome Collection.

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    suppuration must take place along this line. It is necessary for the casting off the dead tissue, by it, foreign particles which have been carried before the ball in its progress are washed out, and through its means healthy granulations may spring up and obliterate the canal, leaving only an almost linear cicatrix to mark the bullet’s former course. It is the surgeon’s care to keep this inflammatory action within the bounds necessary for the reparative process, and at the same time to maintain it sufficient for the required purpose. He desires that this action which is going on in the track of the bullet should be limited, that the whole lung should not par¬ ticipate in the inflammatory process which the wound has kindled. This limitation of inflammation and suppuration is effected by means of an effusion of coagulable lymph external to, and along the site of, the injury, cutting it off, as it were, from the healthy tissue and isolating it until nature has completed her work of repair, thus preventing anything beyond a local patch of pneumonia or a spot of pleurisy. This, indeed, is greatly to be desired in cases where the ball has lodged. In such instances it has been invested in an adventitious cyst, and thus coated has remained for years in its new situation, with¬ out producing much distress to the patient. Mr. Paget, in his lectures on pathology, states that he has found in the so-called serum, raised by the blister of can- tharides, that the amount of fibrinous or coagulable lymph in each case varied according to the strength and vigour of the patient. Thus, he observes, “in cases of purely local disease in patients otherwise sound, the lymph thus obtained formed an almost unmixed coagulunr in which, when the fluid was pressed out, the fibrine was firm, elastic, and apparently filamentous. In cases at the opposite end of the
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