CHAPTER XV.

GUNSHOT WOUNDS, WITH DIRECT INJURY OF THE LARGE NERVES, NOT BEING AT THE SAME TIME CASES OF COMPOUND FRACTURE.

NINE cases were admitted, 3 were sent to duty, 2 to modified duty, and 4 invalided. All were wounds of the brachial plexus. In one there was complete paralysis of the arm, with a partial fracture of the scapula. In two the paralysis was only partial. In one case the arm hung powerless by the patient's side, without the slightest sensation or power of motion, and the temperature much diminished. In the other two cases the impaired condition of their arms, although not to such a great extent, was yet very nearly so. Various treatment was adopted, blisters, galvanism, friction, cold and salt-water baths, &c., without the slightest benefit.

Large nerves, like arteries, generally escape being wounded by musket balls. When they are injured, paralysis of the limb, to a greater or less extent, comes on, along with numbness and wasting of the muscles of the extremity, as occurred in the following case:—

Private Peter Clear, wounded at Cawnpore, November 28th, 1857, by a musket ball, which entered the posterior part of right shoulder, above the spine of the scapula, and caused a partial fracture of this bone, and passed directly forwards, and was cut out immediately above the centre of the right clavicle August 16th, 1858.-Wound healed. He has entirely lost the sense of feeling and of motion in this arm, which hangs quite powerless by his side. Temperature diminished, and the integuments are bedewed with a cold, clammy perspiration. November 23rd.-Invalided.

78th Regiment.-Private John Daniels, wounded at Lucknow by a musket ball, which entered below the right scapula, and

passed out about two inches further forward; re-entered in the axilla, and came out about the middle of the inner edge of the deltoid. He was shot from behind while loading his firelock. July 13th.-Wounds healed. Loss of sensation and motion in arm, which is always covered with perspiration. August 5th.Invalided.

42nd Regiment.-Sergeant Joseph Mumford, æt. 28, on March 11th, 1858, received a wound from a musket ball (round), which entered about an inch and a half from the sternal articulation of the clavicle of right side, and was extracted from the left side of the neck behind, about the centre of the clavicle. The trachea was injured, and he spat blood for seven or eight days, and the air came out through the hole of entrance. The cervical plexus has been injured; the trachea, in the course of the wound, is tender, the opening of exit very much so, and all the fingers appear quite useless; they are fixed, apparently anchylosed in a straight position, but any attempt at bending them causes intense pain in the course of the median nerve. The hand is cold, and affected with nervous tremor; all the fingers are numb, but the motions and sensation of the thumb are good. May, 1859.-Duty. Results of wound probably not to a disqualifying extent.

88th Regiment.-Private C. Walker, æt. 30, was wounded on the 21st October, 1858, at Beurwah, by a musket ball through the back of the right thigh, passing across the popliteal space from without inwards, and apparently wounding the nerve, but not injuring the bone. The wound is healed, but the leg is atrophied and the foot extended; asserts that he cannot put any weight on the foot; is unwilling evidently to do so. On the same date received another bullet wound in left leg, just below the tuberosity of the tibia, which partially fractured the bone, and made its exit over the fibula. Wound soundly healed. Invalided.

CHAPTER XVI.

SWORD, LANCE, AND BAYONET WOUNDS.

SWORD AND LANCE WOUNds.

UNDER this head 47 were admitted, of which 14 were sent to duty, 9 to modified duty, and 24 invalided. In 2 cases the elbow-joint was wounded; in 5 the forearm; in 2 the back of the wrist and in 3 cases the fingers and thumbs were injured. In those invalided the condition of the forearm and fingers was more or less injured. In one of them both bones of the forearm were severed, with nearly total loss of use of the hand resulting. In another the tendons of the ring-finger of the right hand were cut, and the joint became anchylosed; and in the third there was impaired use of the thumb and the index-finger from the extensor tendons having been cut. In one of the cases sent to modified duty the elbow-joint had been opened into, followed by anchylosis. There is also a second case of anchylosis of the elbow-joint that has been invalided.

90th Regiment.-Private Joseph Albison, wounded by sabre cut on the posterior part of the right forearm, about three inches above the wrist, which nearly severed both bones. There is now loss of power of the extensor muscles; there is considerable deposition of new osseous matter around the cut bone. The hand is slightly bent inwards, powerless, and he cannot use his fingers, which are in a straight position. June 15th, 1858.Invalided.

9th Lancers.-Private Joseph Twining, wounded at Delhi by a sabre cut on the posterior and under surface of the left elbowjoint, which appears to have cut the external condyle of the humerus and olecranon. No pieces of bone came away, and

the wound did not heal completely for three months. August 2nd.-Wound healed. Elbow-joint in a bent position, and completely anchylosed. Cannot pronate and supinate the hand. September 3rd, 1588.-Sent to modified duty.

BAYONET WOUNDS.

Only two cases of this description of injury are returned as having arrived from India. One was a wound in the back, close to the spinous processes, and he was sent to duty; and the other was in the forearm; and, from the man's account, the ulnar artery was wounded, and tied at the wound of entrance.

CHAPTER XVII.

MISCELLANEOUS WOUNDS AND INJURIES RECEIVED IN ACTION.

SIXTEEN have been admitted, of which 8 have been sent to duty, 4 to modified duty, and 4 invalided. 3 were caused by explosion of gunpowder, producing severe burns, and 1 by a fall from a ladder at Lucknow when examining a mine belonging to the enemy, injuring his leg. One had lost his ear, and another an eye.

Balls, Missiles, &c.-No. 2952. Specimen of the matchlock ball used by the inhabitants of the Euzuffii country in the Himalayas, extracted from a wound received in action.-Donor, Dr. Jephson, A.S., 9th Lancers.

No. 2953. Rifle ball which was lodged near the hip-joint from a Malay of Ceylon Rifle Regiment. Result, abscess and death. -Donor, Mr. Swettenham, A.S.S.

No. 2957. Grape shot, weight 6 oz., from the thigh of Sergeant Brown, 14th Regiment, invalided for shortening and much impaired use of left leg, after gunshot compound comminuted fracture of the left thigh at the siege of Sebastopol.-Donor, J. R. Taylor, C.B., D.I.G.

No. 2958. Cast of a ball. This grape shot fractured the alveolar process of the superior maxillary bone, and passed downwards, and lodged in the right side of the neck, having fractured the lower jaw, a portion of which was extracted with some of the teeth. The ball weighed one pound three and a half ounces, and was removed by a careful dissection, as it was lying close to the carotid. He still complains of slight pain when pressure is made on the lower jaw, aud he can only make use of liquid diet.-Donor, Dr. Dartnell, D.I.G.

No. 2951. Three pieces of coin removed from the thigh. "A Hanoverian soldier received a severe wound from a grape shot