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JAMA 100 Years Ago
August 6, 2003

Bullet Wounds.Bullet Wounds.

JAMA. 2003;290(5):678. doi:10.1001/jama.290.5.678-a

CURRENT MEDICAL LITERATURE.—From a study of modern high velocity military bullets, Law advises to refrain from meddlesome treatment of the wounds. Dressings should be less frequently changed on the field for fear of infection. He also notices the peculiar lack of susceptibility of the blood vessels to wounds, and the rarity of external primary hemorrhage. Lodgment of the projectile is relatively frequent, on account of the range of fire, but attempts at removal should be abstained from unless it causes trouble. Primary amputations are rarely necessary except with shell wounds or great infection. Fracture cases do as well as those in civil practice. Infection from the undeformed bullet is rare. Head wounds are among the most fatal class of cases and require most frequently operative interference. Joint wounds are among the most favorable class, and generally leave perfect function. Thoracic wounds, unless immediately fatal, recover with few complications. Tetanus and gangrene are exceptional. Abdominal perforating wounds constitute the most serious class and should not be operated on. He considers the high velocity steel-jacketed projectile as a step towards the end of all wars. It disables the enemy with the minimum of death, suffering and maiming, and impairs the subject less for future life after his return home. (1903;41:633)