104 



THE MODERN SYSTEM 



ened, they are late in inflaming. But when 

 a ball has fractured a bone, which fracture 

 has occasioned great injury of the soft parts, 

 independently of that caused immediately by 

 the ball itself, the inflammation will come on as 

 quickly as may be wished ; because the dead- 

 ened part bears no proportion to the laceration, 

 or wound in general. 



When the ball moves with little velocity, 

 the mischief is generally less ; tlie bones are 

 not so likely to be fractured, and the parts are 

 less deadened. However, when the velocity 

 is just enough to splinter a bone which is 

 touched, the splintering is generally more ex- 

 tensive, than if the impetus of the ball had 

 been much greater ; in which case it would 

 rather have taken a piece out. When the 

 ball moves slowly, it is more likely to be 

 turned by any resistance it may encounter in 

 its passage through parts ; and hence, the 

 wound is more likely to take a winding course. 

 When a ball enters a part with great velocity, 

 but is almost spent when it comes out again, 

 in consequence of the resistance it has met 

 with, there may be a good deal of sloughing 

 about the entrance, and little or none about 

 the exit, owing to the difl'erent degrees of ce- 

 lerity with which the ball traversed the parts. 



As the ends of the torn vessels are contused 

 and compressed, gun-shot wounds have little 

 jropensity to bleed much, and unless very 

 considerable vessels are lacerated, they do not 

 bleed at all : sometimes not in this case. The 

 greatest danger of bleeding is always when 

 the dead parts are detached eight or ten days 

 after the injury. Angular uneven bodies, such 

 as pieces of iron, cut lead, &c., always occa- 

 sion far more dangerous wounds than round 

 even bodies, like leaden bullets. Wounds 

 •iccasioned by a small shot are frequently 



more pesilous than others produced by larger 

 balls, because their track is so narrow, that it 

 cannot be traced, nor consequently the ex- 

 traneous body itself extracted. Such a shot 

 oftentimes injures a viscera, when there is not 

 the smallest external symptom of such an oc- 

 currence. Sometimes a great part of the 

 danger also arises from the number of shots 

 which have entered. 



TREATMENT OF GUN-SHOT WOUNDS. 



The first thing to be done is to ascertain, if 

 possible, the extent of the wound ; which is at 

 all times best done with the finger, in pre- 

 ference to a probe. Besides, in extracting the 

 ball, or any pieces of harness, &c., the finger 

 will act as a director ; these, if possible 

 should be at once extracted. If extraneous 

 substances remaining in the wound, either 

 loosen gradually, and come into view, so as to 

 be easily removable ; or they continue con- 

 cealed, prevent the cure, and frequently give 

 birth to a fistulous ulcer. In some instances 

 the foreign bodies remain in during life with- 

 out inconvenience ; and in other cases, aflter a 

 time, they bring on a renewal of inflammation 

 and suppuration. Sometimes a foreign body 

 varies its situation, sinking down, and after- 

 wards making its appearance at a different 

 part, where it may excite inflammation and 

 suppuration. 



When the ball lodges in the wound, it is 

 difficult to trace it, as the parts collapse after 

 its passage. The ball does not regularly take 

 a straight directi n through the injured part, 

 but oftentimes a very tortuous one. The latter 

 circumstance is more apt to occur as the ball 

 is more spent In every case in which it is 

 not easily discoverable, all painful examina- 

 tions should be abandoned, and the foreign 



