Profuse ha-moptysis, fain; d dyspnoea, oozing of blood from the wound, and the escape of air followed, lie was largely bled, and his symptoms thereby relieved. Ten hours afterwards, a return of the difh'ciilty of breathing f.r further depletion, and the use of antimony. imonia followed, which implicated the lower half of the wounded lung. The treatment was that for -em-rally. The wound suppurated, and ultimately closed. AYhen the patient lelt tluhospital iii December, the IIUIL: acted well throughout, except for a shori round the wound, whenit was dull on percussion, and seemingly inn air. The resonance was notably in. Teased ontt the upper part of the w-f the thorax. i by tinball, and its position as found after death, give interest to the following case: At the Alma a soldier was struck by a musket ball, on tlic outer side of the left shoulder.
His arm was l>y his sidr at the moment he was wounded. It was observed that tlu-. ball had passed through the head of the humerus, but its ultimate position could not be ascertained. Nothing was done for the arm. The ball was supposed to have made a clean hole through the bone. A severe attack of pleurisy followed, and on the subsidence of this, pus was found to point both below the clavicle, and in the axilla of the wounded side. Much bone came away. Pus flowed copiously by the openings which were made in the axilla, and below the clavicle. The patient became hectic and died. It was then found that the ball, having passed through the head of the humerus and the glenoid cavity, had entered the chest between two of the ribs, and having run forwards within the cavity, and between the walls and the pleura, had lodged in the anterior mediastinum, where it was found coated with lymph.
The chest symptoms, the surgeon in charge informed me, had been very slight, and the presence of the ball had given rise to no uneasiness. If the joint, which was the main source of irritation and hectic, had been excised early, a more favourable result might have followed. The four following cases are further illustrations of most severe gun-shot wounds implicating the lung: At the Alma a soldier was struck by a ball near the centre of the left axilla. The bullet escaped on the same level as that at which it had entered, and within an inch and a half of the spine. Profuse haemorrhage by the wound and by the mouth followed immediately, and caused the patient to faint.
He was bled at night, as OF TIIF. C1T well. to relieve tin- dyspnoea, which wa0 &t A severe attack of pneumonia followed, which, though subdued, recurred <>u two subsequent occasions. By December tin- lunir h:i red, except at its base, where it was impervious t< air. 'Flu- respiration at the summit v. ted. There was in the hospital, at tin- same tiiin', another man. whose wound and its results icily similar, only that the ball had entered!.y the riirht axilla in place of the h-ft, and had escaped a very little lower than in the. In this case the liver escaped injury. A serp-ant was struck at the Alma by a musket ball, Hi th' ri -lit side, between the sixth and seventh ribs. close to.-Jes.
The ball traversed the hum', and;>ed close above the inner angle of the clavicle of the same side. Tin- man said that, on the receipt of the wound, his mouth filled with blood, and that he fell down and thought he was killed. Profuse ha-moptysis 'lined for some days after his admission into hospital.!y lli-d a few hours after wounded, and also on the two succeed in; days, when the dillicultv from which he suffered, became severe. irivni him, and he was kepi in.irly low for sevt of the injury. lie c(mplaine(l of sr jured IUII.L: during the whole period he continued in hospital.
Thr< l.ein.ir wound. -d, in the r'-spirat"ry murmurall over Inch delicie! l.y an increase on the left. Bronchophony was marked at the upper part of the right side. There was dullness now on percussion all over the right lung, but chiefly at its upper part. The expectoration was profuse and purulent. Cough severe and painful. Pulse high and irritable. His gums were sore with mercury, and blisters had been repeatedly applied to the surface of his chest. He gradually recovered, under the influence of a generous diet; and when he went to England, about four months after -being wounded, both wounds were closed, the anterior having cicatrized first. At that period the right side of his chest was somewhat contracted and flattened.