Excerpt from Wounds in War: The Mechanism of Their, Production and Their Treatment
Probably no branch of surgery has undergone more important changes, in consequence of the teachings of Lister and of Pasteur, than that of gunshot wounds. As antiseptic methods have, in certain cases, rendered possible the performance of operations on regions of the body hitherto untouched by the civil surgeon, and as they have, in others, enabled him to avoid interference, and warranted him in substituting conservative treatment for the more radical measures of earlier times, so they have, in the treatment of the wounded in war, enabled the military surgeon to save lives and limbs, the latter of which, at all events, would, in the days of Larrey and Guthrie, have been sacrificed without hesitation.
At the end of the last century, during the Peninsular War, and even in the Crimea, a gunshot wound of a long bone, and more especially one implicating a large joint, was held to demand immediate amputation. But of late years the employment of antiseptics has so revolutionised the surgery of war that no general rule of this kind is admissible for a moment, and amputations for gunshots are only taken into consideration when the disorganisation of a limb is so extreme that but little of it remains to be preserved by conservative treatment, and when that little is more likely to prove an encumbrance than a help to its possessor if retained by the successful issue of the system applied.
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