The  coins  are  placed  in  the  surgeon's  mouth,  one  on  each  side  of  the  tongue
and  not  touching  each  otlier.  When  the  tips  of  the  wires  come  in  contact
with  the  bullet,  a  pecuhar  metallic  taste  is  appreciated  by  the  operator.  Probes,
however,  will  not  detect  pieces  of  cloth.  The  bullet  may  be  removed  with  the
finger,  or  with  strong  forceps,  such  as  the  setjuestrum  forcejwor  special  forceps
(Fig.  ^3).  The  wound  is  then  disinfected  with  bichlorid  of  mercury  solution
and  drained  with  gauze.  When  a  large  number  of  shot  are  scattered  in  the
tissues,  or  when  the  exact  location  of  a  bullet  is  not  known,  less  risk  will  often
be  taken  in  leaving  the  bullet  than  in  a  long  or  multilating  operation  to  remove


I


GUNSHOT  WOUNDS.
"7


it.    The  tn-atment  of  bullet  wounds  of  the  head,  chest,  and  abdomen  is  con
sidered  in  the  sections  on  regional  surgery.
Blank  cartridge  wounds  should  invariably  be  treated  by  anesthetizing  the
patient,  removing  the  wad  and  devitalized  tissues,  carefully  disinfecting  the
wound,  and  draining  it  with  gauze.  The  administration  of  a  prophylactic
dose  of  antitetanic  scrum  also  is  strongly  recommended  (see  tetanus).
Gutipawder  stains  are  best  removed  by  picking  out  each  grain  with  a  sharp
pointed  tenotome.  Irritating  ointments  followed  by  poulticing  may  be  used
with  the  hope  that  the  grains  will  be  discharged  by  suppuration.  The  appli-
cation of  equal  parts  of  ammonium  biniodid  and  distilled  water  has  been
pcootnmended;  the  spots  gradually  turn  red,  and  the  red  marks  are  faded  by
the  application  of  dilute  hydrochloric  acid.  Electrolysis  and  caustics  cause
permanent  scaring.  When  the  stains  are  quite  superficial,  the  upper  layer
of  the  skin  may  be  shaved  off,  and  the  raw  surface  covered  with  a  Thiersch
gnift.
