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[Illustration: FRONTISPIECE.
Photo, H. KISCH Ladysmith. Engraved and Printed by Bale and Danielsson,
Ltd.]
SURGICAL EXPERIENCES
IN
SOUTH AFRICA
1899-1900
BEING MAINLY A CLINICAL STUDY OF THE NATURE AND EFFECTS OF INJURIES
PRODUCED BY BULLETS OF SMALL CALIBRE
BY
GEORGE HENRY MAKINS, F.R.C.S.
SURGEON TO ST. THOMAS'S HOSPITAL, LONDON
JOINT LECTURER ON SURGERY IN THE MEDICAL SCHOOL OF ST. THOMAS'S HOSPITAL
MEMBER OF THE COURT OF EXAMINERS OF THE ROYAL COLLEGE OF
SURGEONS OF ENGLAND, AND LATE ONE OF THE CONSULTING SURGEONS
TO THE SOUTH AFRICAN FIELD FORCE
LONDON
SMITH, ELDER, & CO., 15 WATERLOO PLACE
1901
TO
SURGEON-GENERAL W. D. WILSON
PRINCIPAL MEDICAL OFFICER TO THE SOUTH AFRICAN FIELD FORCE
THE MEMBERS OF THE ROYAL ARMY MEDICAL CORPS
EMPLOYED IN SOUTH AFRICA
AND TO THE
CIVIL SURGEONS TEMPORARILY ATTACHED TO THAT CORPS
These Experiences are Dedicated
AS AN EXPRESSION OF APPRECIATION
OF THE INVARIABLE KINDNESS AND SYMPATHY EXTENDED
TO THE AUTHOR
WITHOUT WHICH THE BOOK COULD NOT
HAVE BEEN WRITTEN
PREFACE
A word of explanation is perhaps necessary as to the form in which these
experiences have been put together. The matter was originally collected
with the object of sending a series of articles to the _British Medical
Journal_. Various circumstances, however, of which the chief was the
feeling that extending experience altered in many cases the views
adopted at first sight, prevented the original intention from being
carried into execution, and the articles, considerably expanded, are now
published together.
As to the illustrative cases introduced in support of various statements
made in the text, only those have been chosen from my notes which were
under my own observation for a considerable time, and many of these have
been brought up to date since my return to England. I have, as a rule,
avoided the inclusion of cases seen cursorily, and few simple ones have
been quoted since their character is sufficiently indicated in the text.
These remarks seem necessary since the mode of selection has resulted in
the inclusion of a number of cases of exceptional severity, and any
attempt to draw statistical conclusions from them would be most
misleading.
The first two chapters have been added with a view to affording some
information, first, as to the conditions under which a great part of the
surgical work was done, and, secondly, as to the mechanism and causation
of the injuries, which would not readily be at hand in the case of the
general surgical reader. For much of the information contained in
Chapter II. I must express my indebtedness to the work of MM. Nimier and
Laval, so frequently quoted.
The only other object of this Preface is to express my thanks to the
many who have aided me in the task of amplifying the observations on
which the articles are founded, and I think no writer ever received more
sympathetic and kindly help in such particulars than the author.
My first thanks, those due to the Members of the Royal Army Medical
Corps, I endeavour to express by the dedication of this volume. Any
attempt to make individual acknowledgment to either the Members of the
Service, or to the Civil Surgeons temporarily attached, would be
impossible. I have, however, tried to associate the names of many of
those in charge of cases in the recital of histories and treatment
throughout.
My thanks are not less due to the Military Heads of Departments at the
War Office, who have helped me in the collection of details as to the
subsequent course of many of the cases described, and in the acquisition
of information regarding the weapons and ammunition treated of. I should
particularly express my gratitude to Colonel Robb, of the
Adjutant-General's Department, and Colonel Montgomery, of the Ordnance
Department.
I am greatly indebted to my former colleague Mr. Cheatle for two of the
illustrations of wounds, and for permission to quote some of his other
experience, and to Mr. Henry Catling, to whose skill I owe the majority
of the skiagrams of the fractures under my observation at Wynberg and
elsewhere.
I must also express my thanks to Mr. Danielsson and his artist, Mr.
Ford, for the trouble they have taken in converting my rough sketches
into the illustrations contained in the volume.
Lastly, my warmest gratitude is due to my friends, Mr. Cuthbert Wallace,
who has read some of my chapters, and to Mr. F. C. Abbott, who has read
the whole book for the press and suggested many improvements and
modifications.
47 CHARLES STREET, BERKELEY SQUARE, W.
_February_ 1901.
CONTENTS
PAGE
CHAPTER I
INTRODUCTORY
Itinerary--Surgical outfit--Personal transport--General health of the
troops--Climate--Consideration of the number of men killed and
wounded--Transport of the wounded--Vehicles--Trains--Ships--Hospitals 1