During the greater part of the siege, the means of treating these accidents, whether as regards food, bedding, clothes, or shelter, did not exist in camp; and to transfer them to the rear only made the fatal result the more certain, from the pyoemic poisoning which was sure to be set up by the transport. Thus then, it came to be, that up to the period when things were improved in the camp hospitals and in the transport service, recovery from a compound fracture of the thigh was impossible, or nearly so, and that the best hope lay in an early amputation. The only exception to this I will afterwards allude to.:i'<>rxi> 0V Tin: KXTKLMITIES. Now. while it may with seeming truth saiil. that as most of t; umstanci s w n- peculiar to the Criniran principles dedudble tr<iu them are not of uniapplication; still many of them are inseparably I with warfare.
It al to the successful treatment of compound. that the patient be supplied with suitable food, that his brok'-n limb should be retained for a certain time immovably fixed in a proper apparatus, ami that it be.iilly ami regularly dressed. But how can these things be guaranteed in war? In a siege they ought to be more feasible than in any other kind of campaign; but how was it with Besides the privations which mdergo, there is the inevitable shifting of u, and of the wounded, unless the plan Ksmarch adopted in llolstein be followed, and the into the hands of the enemy in order to obviate the necessity of transport; but I fear tin-re are medical services which could afford to do as he proposes, leave a certain number of their body to be taken prisoners, in order to secure the unremittiim,md careful treatment of the cases, f At the siege of Antwerp, where I. and the men in good health, th-ir waa n> iimn than u-ual.
In the Schlvau war they saved a few, the greatly leas than those which can I r ntlu r I abo, a good many comjmund frac; rl. Imt tlun tli> i tin- tmv. and lia.t murli lesspr;hr IIUIH!M rofcasesmonticiir.l in - matchlock was also a weak weaj Thus we foresee," aayn! an armnnmt of necessity a as of choice, and that limbs whi<h in ha, So much for the health of our men; let me now refer to the second cause, which, I believe, rendered our fractures so unmanageable. There cannot be a doubt that the old round ball, if fired at a certain range, comminuted bone, but it is equally certain that at a longer or shorter distance, it frequently failed to do When fired a few hundred yards off, it had hardly force to enter the body, but might be diverted, as it has been, by the point of the nose.
If it did enter, and impinge upon bone, it might only dent it, as may be seen by an example in the Musee Dupuytren, in Paris; or it might groove it merely, or penetrating the substance of the bone, it might remain at rest without splitting it, as can be verified in any museum of a military hospital. If fired, again, at close range, the round ball might go through a bone, making a bore as clean and sharp as if formed by a punch. Of this fact many illustrations can be seen in surgical museums. Now, so far as my observation goes, none of these results follow the stroke of a heavy conical ball, such as that used by the Kussians, at whatever range it is fired.
It never rests in a bone, preserved, must often, in a flying army or in a dangerous camp, be cut off. It is less dreadful to be dragged along with a neat amputated stump, than with a swollen and fractured limb, where the arteries are in constant danger from the splintered bones; and where, by the least rude touch of a splinter against some great artery, the patient in a very moment loses his life." * I believe that the proportion of cases in which balls have passed through the fleshy parts of an extremity without fracturing the bone, will be found to be much less in the Crimean than in other wars. Thus, in one series of cases mentioned by Deputy-inspector Franklin in his report on the wounded at Meanee, 31 cases of matchlock wounds of the upper arm are given, and in only one was the bone broken.