Notes on the medical history and statistics of the British Legion of Spain; comprising the results of gun-shot wounds, in relation to important questions in surgery / [Sir Rutherford Alcock].

  • Rutherford Alcock
Date:
1838
Catalogue details

Licence: Public Domain Mark

Credit: Notes on the medical history and statistics of the British Legion of Spain; comprising the results of gun-shot wounds, in relation to important questions in surgery / [Sir Rutherford Alcock]. Source: Wellcome Collection.

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    Unfortunately, a rare combination of favourable circum- stances is required to render the observations and registry of a sufficiently large number of facts, thus accurately and fully defined, possible. Military surgeons who have the greatest opportunities are, too generally, pressed with duties.more im- mediately involving the lives and interests of the mass of their wounded, to be able to devote the time and concentrated at- tention necessary. Tor it is precisely when opportunities of observation most abound, that the labours of their station ac- cumulate upon them. Surgeons are not agreed in the particular cases, even those who are the most decided advocates for primary amputation, which may advantageously be left for the chance of cure, or the alternative of delayed aniputation. For instance, in eun-shot fracture of the lower third of the femur, if not much shattered, it is admitted or recommended by Mr. Guthrie and other writers, that they may be left for trial. His opinion has doubtless great weight, and naturally no one can feel disposed to respect it more than myself; nevertheless it is opposed to the conclusions drawn from my own experience, more limited, it is true, and the expediency on service of ever delaying the removal of the limb with a complete fracture of the femur from gun-shot seems to me more than doubtful. This refers to soldiers—with officers the result may be some- what less unfavourable, as indeed has been shown, although it may be observed, with respect to all such cases by gun- shot, that the injury to the periosteum seems to irritate and excite the whole of the membrane to such a degree, as rarely to permit a good and healthy union. ‘The proportion of such wounds, indeed, is exceedingly small ; out of upwards of 3,000 wounded, I have observed only five or six, and in more than one of those the fracture extended up to the middle third, and the attempt to produce union was unsuccessful. These trans- verse or slightly comminuted fractures of the femur from gun-shot are so exceedingly rare—the bone generally splin-
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