The sun., 1881-10-02


besides hose Already specified 10 '''A''' '''AN
The right kidney weighed six ounces. the
loft kidney seven. Just beneath the capsule Of
the left kidney. ut about the middle OF its con-
0sN border DER there Tas little shsccss
small serous cyets on the convex border Of the
right kidney. Just beneath its capsule. In other
respects the tissue Of both kidneys was normal
In appearances and in texture.
Tho urinary bladder was empty. Behind the
hre as tss ts as pSet Of a"t pn,
was disescted into. 1t was found that from the
point at which It had fractured the right elev--
the vertebrai spines). the missile hnd gone to
the lett obliouely forward. passing through the
in the adipose connestve ert tissue im9
below the lower border Of the pancreas, about
two inches and half to the LETT of the spinal
bec6me completey encysted.
The track OF tho bullet between the point at
at which 1t entered the first lumbar vertebra
was considerably dilated. and the pus had bur-
FoTHd Is, through The adipcse tissue
its % way between the peritoneum and the right
,iia' iii, vhish iassn = making descending chan, chan
The saipo.e tissus behind the Ridnsy 0G; n
the vicinity Of this descending chan;
By & * tho shsnns ss sSnosRsS sRsS
was found almost FREQ from pus. lay the flexible
catheter introduced into the wound at ths COM
found doubled upon itself Immediately beneath
the perioneum. reposing upon the lilac fascia.
e Ths nnS chsn
mel. now clearly seen to have becn caused hy
the bnrrowine of pus from the wound. was sup
posed during life to have been the track OF tho
bullet. The last dorsal. together with the first
and second lumbar vertebre. and the twelfth rib
were then removed from the body for more
When this e1amination was .msde II was
found that the bullet had penetrated the first
lumbar vertebra In the upper part OF the right
side OF its body. The aperture By which 1t on
tered involved tho interyertobrai cartilage next
to tho intervcrtebral foramen. from which its
upper margin was about one-ouarter OF an inoh
Ss S9sqe e ;hs ss. % S Ss
aperture. tho centre o; which was about half an
which also involved the intorvertebrai cartilage
next above. Tho cancellat.d tissue OF ths body
Comm @ nussd @ AND the rssmsn., fragment @ sOms.1as diH dis,
placed Several deep flssuree extended from
the track OF the bullet into the lover part Of the
the interyertebral cartilage between it and the
sirOy.d By liberation; 4 number Of
VertsbSa had ssen % driven me into the % ADJACENT
soft parts. I, wns further found that the
right twelfth rib also was fractured at a point
ono inch and quarter to the right OF the trans
This injury had not been recognized during
u
tho right OF the median line It was found that
tho spinal canal was not involved BY the track
Of the ball The spinal cord and other contents ate M
abnormal appearances; The rest OF the spinal
Beyond, the first lumbar vertebrn tho bullet
continued to go to the lett. passing behind tho
pancreas to the point where 1t waa found Hero
sheh IL
quantity OF inspissated. somewhat cheesy pus.
which formed ed thin Layer over portion q , the
proved on microscopic examination to be the
from this cyst the track OF the ball behi nd the
pancreas was completely ooli.erated by the
the body Of the first lumbar yerIebrS. ths. track
was, filed with coagulatod blood. which ex..
tended on tho left into an irregular space rent
rltoneum and above the pancreas. The blood
had worked its way to tho left bursting finally
the abdominal cavity. Tho rendinG Of the tis-
sues by tho extravssation ofthis blood was un-
n- S
This mass OF coaCulated blood was Of irregu.
lar form. and nearly as large as mans tist It
could be distinctly seen from in front. through
the peritoneum. after its site behind the greater
curvature OF the stomach had been exposed by
the stomach. and especially after some delicate
adhesions between the stomach and tho part OF
fs as oGs sss hsa
lations Of the mass as thus seen 1t was believed
that the hemorrhage had proceeded from ono
that a minute dissection would be required to
determine the particular branch involved. It
sdIoinine soft mart. shouid bs nrsssrSed fop
subsequent study.
On the examination and dissection made In
accordance with this agreement. II was found
that the fatal hemorrhaee proceeded from a
rent nearly four-tenths OF an inch long in tho
hs 10 q the the Of the sac h:
rent must have occurred at. least several days
before death. since tho everted edges in tho
to the surrounding connective tissue. thus
forming an almost continuous wall bounding
the 9o9n OF ne 'S co
vicinity vas dispoeed IN pretty firm concentric
layers. II was further found that the cyst be-
the bullet was found was situated three inches
and half TO the left OF the eoeliac axis.
described. another. about the size OF walnut
was found in the greater omsntum near the
splenic extremity Of the stomach: The commu.
hemorrhagio mass could not be made out.
Tho examination Of the thoracio viscera re-
ounces. All the cavities were entirely empty
except the right ventricle. in which few shreds
s1 tbs Of
mitral valve there were several spots OF fatty
degeneration with this exception the cardiac
the heart was soft. and tore easily. A few
spots OF fatty degeneration existed in the
lining membrane OI tue aOrtd. JubI dDONr tuo
semilunar valves. and slender clot OF fbrin
wns found in tho aorta where i was divided.
about two inches from these valves. for the re-
moval OF the heart. On the right side slight
pleuritio adhesions ez lsted between the convex
surface OF tho lower lobe OF the
lung and the costal pleura, and firm ad-
htsions between the anterior edge OF the lower
lote the pericardiurn and the diaphragm. The
right lung weighed 32 ounces. The posterior
part OF the nssure between Its upper and lower
lobes was conRenitniy incomplete. The lower
lobe OF the right lung was hypostaticaily con-
Rested aud considerable portions. especially
toward ts base. were the seat Of 6roncho; pnsu-
con siderable quantity of strinRy muco pus;
their mucous surfaes was redeemed by
bronchitis. The lung tissue was
ndematous Ia foot note here says: part. at |
least of this condition WAS doubtless due TO the
extravasation Of tho injecting fluid used by the |
embamerl. but contained no abecesses or in
farctions On the left side the lower lobe OF the
lung was bound. behind TO the costal pleurs. |
above TO the upper lobe. and below TO the dla-
phrsgm by pretty firm pleur:tic adhesions. |
The left lung weighed twsnty-ssven ounces.
The condition Of its bronchial tubes and OF the |
lung tssus was very nearly the same as on the |
righ, side. the chief difference Icing that the |
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