Surgical Experiences in South Africa, 1899-1900 | Page 4

481
95. FRAGMENTS OF BOER SEGMENT SHELLS 483
96. NORMAL AND DEFORMED LEADEN SHRAPNEL BULLETS
485
TEMPERATURE CHARTS
1. CASE OF AXILLARY HÆMATOMA, BLOOD TEMPERATURE
119
2. CASE OF HÆMOTHORAX WITH RECURRENT
HÆMORRHAGES 395
3. PRIMARY AND SECONDARY RISES OF TEMPERATURE IN
HÆMOTHORAX, RECOVERING SPONTANEOUSLY 402

4. SECONDARY RISE OF TEMPERATURE IN HÆMOTHORAX
403
5. FALLS OF TEMPERATURE IN HÆMOTHORAX FOLLOWING
PARACENTESIS 404
6. SECONDARY HÆMOTHORAX, SPONTANEOUS FALL OF
TEMPERATURE 405

SURGICAL EXPERIENCES
IN
SOUTH AFRICA
CHAPTER I
INTRODUCTORY
The following pages are intended to give an account of personal
experience of the gunshot wounds observed during the South African
campaign in 1899 and 1900. For this reason few cases are quoted
beyond those coming under my own immediate observation, and in the
few instances where others are made use of the source of quotation is
indicated. It will be noted that my experience was almost entirely
confined to bullet wounds, and in this respect it no doubt differs from
that of surgeons employed in Natal, where shell injuries were more
numerous. This is, however, of the less moment for my purpose as
there is probably little to add regarding shell injuries to what is already
known, while, on the other hand, the opportunity of observing large
numbers of injuries from rifle bullets of small calibre has not
previously been afforded to British surgeons.
I think the general trend of the observations goes to show that the
employment of bullets of small calibre is all to the advantage of the
men wounded, except in so far as the increased possibilities of the
range of fire may augment the number of individuals hit; also that such

variations as exist between wounds inflicted by bullets of the
Martini-Henry and Mauser types respectively, depend rather on the
form and bulk of the projectile than on any inherent difference in the
nature of the injuries. Thus in the chapter devoted to the general
characters of the wounds, it will be seen that most of the older types of
entry and exit aperture are produced in miniature by the small modern
bullet, and that the main peculiarity of the deeper injuries is the
frequent strict localisation of the direct damage to an area of no greater
width than that crossed by narrow structures of importance such as
arteries or nerves.
It is to be regretted that I am unable to furnish any important statistical
details, but incomplete numbers, such as are at my disposal, would be
of little value. In view, however, of the considerable interval which
must elapse before the Royal Army Medical Corps is able to arrange
and publish the large material which will have accumulated, it has
seemed unwise to defer publication until the completion of a report
which will deal with such matters thoroughly.
It may be of interest to premise the opportunities which I enjoyed of
gaining experience during the campaign. I arrived in South Africa on
November 19, 1899; two days later I proceeded to Orange River with
Surgeon-General Wilson, and on the day three weeks after leaving
home performed some operations in the field hospitals on patients from
the battle of Belmont. I remained at Orange River during the three next
engagements, Graspan, Enslin, and Modder River, and on the day of
Magersfontein I went forward to the Field hospitals at Modder River,
arriving during the bringing in of the patients from the field of battle. I
returned to Orange River with the patients and remained there a further
period of three weeks, during which time the patients were gradually
transferred to the Base hospitals at Wynberg. At Christmas I followed
the patients down to the base, and thus was able to observe the course
of the cases from their commencement to convalescence. I remained at
Wynberg six weeks, during which time a number of cases from the
neighbourhood of Rensburg and some from Natal were received. On
February 7, I left Wynberg, following Lord Roberts up to my old
quarters at Modder River, where I saw a few wounded men brought in

from the engagements at Koodoosberg Drift. On Lord Roberts's
departure for Bloemfontein he requested me to return to Wynberg to
await the wounded who might be sent down from the fighting which
might occur during his advance. I therefore had the disappointment of
seeing the start of the army, and then returning to Wynberg, where I
remained for another six weeks in attendance at Nos. 1 and 2 General
Hospitals.
During this period a very large number of the wounded from
Paardeberg Drift and other battles were sent down and treated, after
which surgical work began to flag.
On April 14, I was recalled to the front and journeyed to Bloemfontein,
where I stayed three weeks, making one journey out to the Bearer
Company of the IX.