Temperature Chart 6.—Wound of Lung. Secondary development of Hæmothorax, with rise of temperature. Spontaneous recovery. Case No 157
(157) Moderate hæmothorax. Secondary effusion at the end of twenty days. Spontaneous recovery.—Wounded at Paardeberg; range from 700 to 1,000 yards. Entry, in the centre of the second right intercostal space, anteriorly; exit, at the level of the sixth rib posteriorly, through the scapula, close to its vertebral margin.
The patient arrived at the Base on the sixth day; he said he expectorated some blood at the end of about ten minutes after being shot, and experienced a 'half-choking sensation.' A small quantity of phlegm and occasional clots had been expectorated since. He had walked about a good deal; movement occasioned cough, and he became 'blown' very rapidly.
On admission there were signs of fluid in the lower third of the pleural cavity, but no general symptoms beyond an evening rise of temperature to an average of 99°. About the twentieth day the temperature commenced to rise, and on the twenty-third and four following evenings reached 102°. The fever was accompanied by some distress, and a well-marked increase in the physical signs of the presence of fluid in the chest. The pulse rose to 96, and the respirations considerably above the average of 24, which was at first noted. A strictly expectant attitude was maintained, and the temperature steadily fell in a curve corresponding to the rise, gradually reaching the normal at the end of a week. The physical signs at the base steadily cleared up, and at the end of six weeks the patient returned to England convalescent.
CHAPTER XI
INJURIES TO THE ABDOMEN
Perhaps no chapter of military surgery was looked forward to with more eager interest than that dealing with wounds of the abdomen. In none was greater expectation indulged in with regard to probable advance in active surgical treatment, and in none did greater disappointment lie in store for us.
Wounds of the solid viscera, it is true, proved to be of minor importance when produced by bullets of small calibre; but wounds of the intestinal tract, although they showed themselves capable of spontaneous recovery in a certain proportion of the cases observed, afforded but slight opportunity for surgical skill, and results generally deviated but slightly from those of past experience. Such success as was met with depended rather on the mechanical genesis and nature of the wounds than upon the efforts of the surgeon, and operative surgery scored but few successes.