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Internal Repairs not Attempted

How many gallant North Carolinians Surgeon Howard killed with his bungling analysis of gunshot wounds is a toll of death no rolls record. But he should perhaps be forgiven his faulty diagnosis of high velocity wounds and their supposedly slight bone damage between those neat holes of entrance and exit, for little exploratory surgery was ever resorted to on the battlefield dressing table. Surgeon Howard preferred in his practice of the inexact science to draw exact inferences and make generalizations good for all cases. That such an approach to medicine is impossible was not revealed to him in his study of gunshot wounds, because he overlooked one branch of preservative surgery to which more modern medicos have, often broken heartedly, devoted their career. This is repairs of gunshots within the body cavity itself.

The doctor brave enough to rip open an abdominal wall and go in and stitch the little holes in a perforated intestine might have existed, but the new work of Pasteur was but a medical journal report, not reduced to practice, and Lister's antiseptics had not yet gained any general acceptance though gallons of rot-gut were poured into festering wounds in a dim-sighted understanding that this was “cleaning” them. Death for sure sat on the shoulder of any doctor who did such drastic surgery under the battlefield conditions of sanitation; death probably claimed its victim in the presence of all the clean towels and “hot water” the students could prepare at the most advanced medical college. Howard’s experience in dealing actively with gunshot wounds, as was the experience of most other physicians, related strictly to the arms and legs; in working with these, was the most success to be found. For success, read: the patient lived, even though a multiple amputee. Howard's appraisal of internal damage from higher-velocity bullets was quite incorrect and must have led to a great deal of suffering. Repairs effected without proper surgery were but a tribute to the tenacity with which the physiognomy of the injured soldier repaired itself.

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