This is, as can be easily understood, a most dangerous accident, (o.) If the force of propulsion be a little greater, then the bone may be split longitudinally, without fractured across, as in a case related by Leveille, and quoted by Malgaigne, in which an Austrian soldier at Marengo was struck by a ball in the lower third of the leg. He walked several miles to the rear, where he was seen, and the wound thought to be very slight. A superj -SHUT ' TH: LTMENT, I ficial exfoliation of the bout- was alone expected; howi 'iis that the le. rely, into their shafts, a ball may be driven to a plank <>t' wle, <>t'; which oeeiirren will afterwards relate cases j but the eonieal Itall n iu these ways, SO lar as I have seen.
It is in -j'lit but invariably splinters the bone vhieh it strikes to a greater <>r less and that in the dir etinn of! splitting in i much more in a dt' balls rnu-rally fra<ture and split the i of a bone if they Mrike it about its middle. whi'<;i but little comminution results tilround b.ill. the conical ballrsjieeially that which has a bm cup in its base splits and v. that narrow f; manv inrhein portions are thrown iii all directions, cronwise at the seal oi I driven into tli" nei.dibourin-soft parls.
It Mients. as Ifurt! or TIII: WAK. the now ball so I had many most interesting opportunities of seeing the extraordinary manner in which the conical hall destroys hone in the way I refer to. I have never met with an instance in which sueli a ball, fired at whatever range, and striking at all perpendicularly on a long bone, has failed to traverse it and comminute it extensively. From the comparatively little employment of the round ball during the late war, there were fewer illustrations of the splitting of balls on the edge of bone, as, for instance, on the edge of the tibia, or on the bridge of the nose, or on the humerus, than usually occur in a campaign.
I do not believe that the conical ball, with its immense force of propulsion, could be so split. Thereis a case borrowed from Mr. Wall of the 38th, given later under wounds of the head, in which "a round rifle ball " was thus split on the parietal bone, onehalf entering and the other half going off externally, in a soldier of the 38th, wounded on the 8th September. As instances of how great a difference it makes in the prognosis of cases whether a round or a conical ball has been the wounding agent, I may relate two cases, from a host of others. In the first instance, the ball entered on the external side of the ankle, near the tendo-achillis, and passing forwards and inwards, lodged, as if in a piece of wood, in the lower end of the tibia, close over the ankle joint.
When the ball was removed, the bone was found.not to have been split in any direction. A conical ball would have, to a certainty, opened the joint, and, in all probability, so split tintibia as to have necessitated amputation in the upper part of the leg. In another case, a round ball made a clean hole through one of the condylt-s of the femur, and did not split the bone; while, if a conical ball had struck the same part, it would have so cleft the bone that amputation in the middle of the femur would have been called for; whereas, the removal of the limb at the knee joint a much less serious operation sufficed in tincase referred to. WOUNDS AND THKIK TREATMENT, her somewhat similar case occurred in the 19th lent li.is by no meani uncommon that a ball should be thus split on thi' lie of it occur in works un military sundry.
No case clearly OD <>t' splitting came under my own notice; but in one instance, a ball so. changed, in shape as to appear the section of one, was extracted from within iliac fossa. Instances are on record in which balls have been split into three parts by the bones of the face, and the trochanter major. Although it cannot be for a moment doubted that bulls may remain for a lifetime imbedded in bone, if any annoya; <. i Dually certain that the most grievous results much more frequently arise from their presence in such situations. Of this, innumerable examples readily occur to any one who has seen many " " or who has read much on the sul I.
When speaking of wounds if the shoulder-joint, I will detail some cases which illustrate is action of balls h-t't impacted in hone. (iut: racy emphatic in his directions to remove balls so placed, and predicts the most disastrous conse, tinne-leet ot' this several cases in which balls have remained without causing harm, concludes thus: "It is necessary to mention these fortunate cases as evidence of the resources of nature, l.nt they hardly serve to weaken the force of I when a hall cannot I.e. extra ortfa ition of this.-the b)dy. This indication is. then.: import. The nerves most My escape injury from a TV All. If the missile has been rendered in shape by previous contact with some hard substance, then it may do much damage to even the larger nerve trunks.
Numbness, succeeded by pain in the extremity of a limb traversed by a ball, is not uncommon, and probably arises from the contusion or laceration of SOUKchief nerve the swelling and the pressure it occasions assisting to give rise to the subsequent uneasiness. The paralysis which succeeds the injury of a nerve may come on at once, or after an interval, and may, or may not, be accompanied with pain in the part itself, or in other regions connected with it by nervous communication. I have seen the hand several times waste when some of its nerves had been injured by a ball. In one case in particular, in which the ball had coursed up under the muscles on the external surface of the upper arm, this symptom was very marked.