OCR Text |
Show OF THE EXTRACTION OF THE BALL. In all his difficulties, the surgeon has still to hold in his re» taid aside, and the common dressing forceps in most cases pre- ferred. If we have to unfix a ball from its place, the lever is certainly the instrument best adapted for the purpose; and, afterwards, the extraction ought not to be an operation rcquiring strength. If it cannot be done with a long pair of common dressing forceps, one of the old crane-bill form will be useful*. Nothing is more apt to deceive than the feeling of bones shattered by gun-shot. We touch a splinter with the point of the finger, or feel it loose to the probe; but if we attempt to draw it away with strong forceps, we find, in all probabili- ty, that there has been a splitting up of the bone, and that we have got hold of a very principal part. Even when loose, these pieces are found to require extensive incisions to extract them, or the parts are torn as the pieces of bone are drawn forth. I question very much the propriety of tearing away even lesser pie es, when they adhere to the soft parts. The second stage is that in which the. first inflammation ris‘ When the wound is first received, the inflammation and .4. .. with/mil. . L r an :37 collection the stages and progress of a gun-shot wound, as they relate to operation. 'Jbuvy‘ mum-l or run INCISION or GUN-SHOT wovxns. pain has not yet arisen. If the ball is to be felt distinctly, it is to be extracted. But we have to remember the diiiiculty of ascertaining the place of the ball, especially if it be flatten- ed and irregular, as when it has touched a bone. If we can touch it with the finger, there can remain no doubt of the propriety of its being extracted. If it can be felt in the part of the limb opposite to the wound, there can be no doubt of the propriety of making a counter opening for the purpose of extracting it. This opening will quickly heal, and it ought to be allowed to bleed freely. In the operation of extracting the ball, forceps should, if possible, be laid aside, and the spoon or lever used, fg. 2. The forceps, which are generally made 5. .- ib. t hum es to its height. All things considered, I can see no occasion iMIL‘Cl‘ for incisions, except when the pain is extreme, with strong binding of the inflamed limb by the fascia ; or where abscess- Axum." w-v- A : - .....,-- u 3‘52." r‘l'ikfin‘ 91!." : I es are forming in the tract of a raking shot, which has taken a course under the fascia. This extreme pain and binding of the fascia may change the nature of the inflammation, and gangrene may follow; or, what is more common, the violence Fig. 1. Crane-bill Foraps. Fig. 2. Tim Lever. for the extraction of balls, (those, for example, which Mr. Chevalier has engraved in his book, and which he says are now QCllt‘rally sent out with the field apparatus) seem to me very useless. of the inflammation will lay the foundation for extensive abscesses amongst the muscles and bones, which in the end may destroy the patient. When suppuration has followed a due degree of inflammation, but the inflammation has again arisen in censequrince of Indeed, I know from experience, and from the corn renewed irritation; or where a profuse discharoe seems to lit curring testimony of army surgeons, that they must be often kept up, this makes a second stage in which the examination mu" ‘ tions i -SL.., the combina ' ‘ particu ' lar 'instances of‘ the effect to be apprfi‘ in of the wound will be necessary: and now, in all probability, the dead bones will be found loosened, and the pieces of the - . . LCt‘delli) attended with a renew oi Cu» "hole unntomy ofthe body in the most interesting and useful form -, and even to tzn- Silult‘l'i'. in his closet, it w ill be, found ofthc most essential service: to prosecute his inquiries, in this "'3?- " The ball forceps should have a groove towards the point which may at» low the surgeon to slip them along the probe as :1 dii‘cct'fi‘?‘ |