Report on gun-shot and sabre wounds of invalids sent to Fort Pitt during the years 1860-61 / by Thomas Longmore.

  • Longmore, Sir Thomas, 1816-1895.
Date:
[1863]
Catalogue details

Licence: Public Domain Mark

Credit: Report on gun-shot and sabre wounds of invalids sent to Fort Pitt during the years 1860-61 / by Thomas Longmore. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    for India, and dunntj the passage exposed himself considerably to the sun wliile helping to work tlie sliip. Pain in the head recurred, with tenderness and tunietaction at the site of the wound ; symptoms of abscess followed ; and eventually the old cicatrix became re-opened, and a large portion of necrosed bone was exposed and removed. He was invalided from India, where he was greatly affected l)y tlie sun, on account of frequent attacks of ce])lialalgia, and fits of an epileptoid character. Very moderate quantities of alcoholic liquors excited him violently. The wound was again healed on liis arrival at Chatham, but the cicatrix was so tender that he could not bear any ])rebsure on the part. The cerebral symptoms continued, but in a modified degi-ee. There was no return of the fits while he was at Fort Pitt. While in India he had lost all the hair from his head. Class 2.—Wounds of the Face. Three wounds of the face occurred. In one instance the wound was on the left side of the face, and caused by a pistol ball at Lucknow. The alveolar process of the jaw was fractured, end the ball lodged beneath the zygoma, whence it was extracted three months afterwards. INecrosis of a portion of tlie alveolar process, with loss of two molar teeth, and a bicusjiid followed. There was also partial loss of hearing on the same side. This patient was discliarged, having completed twenty-one years' service. The next case was similai-; the left upper maxillary bone was fi-actured by a fragment of shell. Union took place without loss of bone, but all the teeth on that side became carious. Hear- ing and vision on the same side were both impaired. On opthalmoscopic examination of the affected eye, small deposits of pigment were observed over- lying the retina, probably tlie consequences of ecchymosis,and there was general haziness of this structure. The dioptric apparatus of the eye was normal. The third case was remarkable—perhaps unique, as I cannot find that any similar one lias been recorded. The injury was followed liy total dumbness, without any direct lesion of the tongue, larynx, or those structures which are chiefly concerned in vocalization. Thepatient, Private James Davis, 1st Dragoon Guards, a stout, healthy soldier, was struck just below the centre of the lower lip, during a charge of his regiment, on the 21st of September, I860, at the general action of Pal-i-chou, near Pekin, by a small matchlock ball, weighing 7 drachms. The ball penetrated, cairied away part of the alveolar process, 4 teeth, viz., 2 incisors, 1 canine, and 1 bicuspid, on tlie left side, travelled down- wards behind the symphysis, clearing away the origins of the genio-hyo-i;lossi muscles in its passage, and lodged in the soft tissues of the floor of the mouth, below the frjenum-linguse. According to the history of the case, loss of the power of articulation immediately followed the wound, and never returned in the slightest degree, either in China, or during the voyage home to England. The ball was not removed till the twenty-third day after the injury ; it was then extracted fi-om within the mouth.* When this patient was examined in Fort Pitt, the inferior maxillary bone was found to be a little thickened at the seat of injury, viz., at the symphysis, and for about an inch and a half of the left side of the body of the bone. The power of opening the mouth was slightly more limited than natural. The gum was sunk at the i)lace from which the alveolar process had been reiiioved by the projectile. The tongue appeared to be somewhat wasted, and its move- ments, upwards towards'the palate, and forwards towards the lips, rather more limited than natural. There was no evidence of muscular paralysis. The sense of taste was unimpaired, nor was there any loss of ordinary sensation. The larynx seemed unaffected. The usual laryngeal sounds could be uttered, but none of their modifications necessary for speech could be effected. Ihe power of whistling was gone. It did not seem clear to what special cause this total deprivation of the power of articulation was due. Neither injury to the hypo-glossal nerve, if such had occurred, nor the separation of the genio-liyo- * The man had the ball in his possession at tbo time ho was in Fort Pitt. He would not part with it, and a cast was, therefore, taken of it and placed in tlto museum. It shows ot-curatcly euoiigb the alterations of form and lurrougha ot surface caused by collision with the bone (Specunen No. 3698.
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