Note 4 — GUNSHOT WOUNDS.

In the Medical and Surgical History of the War against Russia in the Years 1854-55-56, published by authority, vol. ii. p. 265, the physical effects of concussion in producing “shock” are strongly dwelt upon. It is remarked: “The shock of the accidents frequently witnessed by the military surgeon differs, often in a very material degree, and possibly in kind also, from that witnessed in civil life. When a cannon-shot strikes a limb and carries it away, the immense velocity and momentum of the impinging force can scarcely be supposed to have no physical effect upon the neighboring or even distant parts independent of, and in addition to, the ‘shock,’ in the ordinary acceptation of the term, which would result from the removal of the same part by the knife of the surgeon, or the crushing of it by a heavy stone or the wheel of a railway wagon. * * In the great majority of cases, the whole frame is likewise violently shaken and contused, and, probably, independent of these physical effects, a further vital influence is exerted, which exists in a very minor degree, if at all, in the last-named injuries, and may possibly depend upon the ganglionic nervous system.”