Savannah morning news. [volume] (Savannah) 1868-1887, 1881-10-03

entered the trst lumbar VerteOra was con-
siderably dilated and the pus had burrowed
down through the sdipose tissue behind
the right kidney, and thence had found its
way between the peritontum and the right
lilac fascis, making descending channel,
which extended almost to the groin adj
pose tissue behind the kidney in
the vicinity. This descending chan
mel was much thickened and
condensed by the Inflammation. In
the channel, which was found almost free
from pus, lay flexible catheter introduced
into the wound at the commencement of
the autopsy. It's extremity was found
doubled upon itself Immediately beneath
the peritonium, reposing upon the
lilac fascia, where the channel
was dilated into pouch of
considerable size. This long descending
channel. now clearly seen to have been
caused by the burrowing of pus from the
wound, was supposed, during life, to have
been the track Of the bullet. The last dor
sal, together with first and second lum-
bar vertebra and the twelfth rib were then
removed from the body for more thorough
examination
''When this examination was made 1t 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 entered involved the interverte-
bral cartilage next above, and was situated
just below and anterior to the
iDtervertebral foraman, from
which its upper margin was about one-quar-
ter of an inch distant. Passing obliquely
to the left and forward through the upper
part of the body of the lumbar Vertebra, the
bullet emerged by an aperture, the centre
of which was about half an inch to the left
of the median line. and which also involved
the intervertebr cartilage next above The
cancellated tissue of the body of the first
lumbar vertebra was very much communi-
ted, and the fragments were somewhat dis
placed. Several deep assures extended from
the track of the bullet into the lower part of
the body of the twelfth dorsal vertebra. 9th
ers extended through the first lumbar
vertebra into the intervertebral cartilage,
between It aud the second lumbar vertebra.
Both this cartilage and that next above
we're partly destroyed by liberation. A
number of minute fragments from the
fractured lumbar vertebra had been driven
into the adjacent soft parts. 1t was further
found that the right twelfth rib also
was fractured at a point one inch and
quarter to the right of the transverse pro-
cess of the twelfth dorssl vertebra. This
injury had not been recognized during life.
On saving through the vertebra little to the
right Of the median line it was found that
the spinal canal was not involved by the
track of the ball
"The spinal cord and dthe'other,contentso of
this portion of the spinal canal, presented
no abnormal appearance. The rest of the
spinal cord was not examined. Beyond the
first lumbar Vertebra the bullet continued to
the left, passing behind the pancreas to the
point where it was found. Here It was en-
veloped in firm cyst of connective tissue,
which contained besides the ball a minute
quantity of inspissated, somewhat cheesV
pus, which formed thin layer over a por-
ton Of the surface of the lead. There was
also black shred adherent to part OF the
cyst wall, which proved on microscopical
examination to be remains of blood cot.
For about an inch from this cyst the track
OF the ball behind the pancreas was COM
pletely obliterated by the healing process.
Thence as far backward as the body of the
first lumbar veTtebra the track filed with
coagulated blood. which extended on the
left into an irregular space rent IN the ad-
joining adipOse tissue behind the perito-
neum and above the pancreas.
"BlOOd had worked its way to the left,
bursting finally through the peritoneum be-
hind the spleen into the abdominal cavity
Rending OF the tissue by the extravasation
of this blood was undoubtedly the cause of
the paroXysm of pain which occurred short
time before death. This mass Of cosgulated
blood was of irregular form and nearly as
large as a mans fist. 1t 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
dissection of the greater omentum from the
stomach, and especially after some delicate
adhesions between the stomach and the part
of the peritoneum covering the blood
mass had been broken down by the fingers.
From the relations OF the macs as thus seen
it was believed that the hemorrhage had
proceeded from one OF the mesenteric ar
teries, but as it was clear that minute dissec-
ton would be required to determine the
particular branch involved, It was
agreed that the enfiltrated tissues and the
adjoining soft spot parts should be pre-
served for subsequent study. On examination
and dissection, made in accordance with
this agreement, 1t was found that the fatal
hemorrhsge proceeded from a rent nearly
trunk Of the splenic artery, two
inches and a half to the left
Of the celiac axis. This rent must have
occurred at least several days before death,
since the eveTted edges in the vessel were
united by firm adhesion to the surrounding
connective tissue, thus forming an almost
continuous wall bounding the adjoining por-
tion of the blood clot. Moreover, the peri
phiral portion of the clot in this vicinity was
disposed in pretty firm concentric layers 1t
was further found that the cyst below the
lower margin Of the pancreas, in which the
bullet was found, was situated three inches
and half to the left Of the celiSc axis.
Besides the mass of cosgulated blood Just
described, another about the size of a wal
nut was found In the great omentum, near
the splenic extremity of the stomach. The
communication, If any, between this and
the larger hemorrhagic mass could not be
made outn
"The examination of the thoroaic viscera
resulted as follows: The heart weighed
eleven ounces. All the cavities were en-
tirely empty except the right ventricle, In
which few shreds of soft, reddish coagu-
lated blood adhered to the internal surface.
On the surface of the metral valve there
were several spots of fatty degenera-
tion. With this exception the cardioc
valves were normal. The muscular tissue
Of the heart was soft and tore easily. A
few spots of fatty degeneration existed in
the lining membrane of the arata just
above the semi-lunar valve, and a slender
clOt of fbrin was found in the aorta,
where it was divided about two inches
from these valves, for the removal of the
hesrt.
"On the right side slight pleuritic adhe-
sion existed between the convex surface of
the lower lobe Of the lung and the costal
pleura, and firm adhesions between the an
terror edge of the lower lobe, the pericar-
dium and the diaphragm. The right lurg
part of the fssure between its upper and
lower lobes was congenitally incomplete.
The lower lobe of the right lung was hy-
postaiicallY congested and considerable
portions, especially towards It's base, were
the seat OF broncho pneumonia. The bron-
chial tubes contained q considerable
quantity OF stringY muco pus. Their
mucous surface was Redeemed by
catarrhal broncbita. The lung tissue was
demateous "a foot note here saws part at
least of this condition was, doubtless, due
to the extravssation of the injecting fluid
used by the embalmer), but contained no
assesses or infections On the left side,
the lower lobe of the lung was bound be-
hind to the costal pleurs, above to the upper
lobe, and below to the diaphragm by
pretty firm pleuritic adhesions.
The left lung weighed twenty-seven
ounces. The condition of itslbronchial tubes
and lung tissue was very nearly the same as
on the right side, the chief difference being
that the area of broncho pneumonia in the
lower lobe was much less extensive in the
left lung than in the right. In the lateral
part of the lower lobe of the left lung and
about an inch from its pleural surface there
was group Of four minute areas Of gray
repatriation, each about one-eighth OF an
inch In diameter. There were no infrac-
tions and Assesses In any part OF the lung
tissue.n
The surgeons assisting at the autopsy
were unanimously of the opinion that on
reviewing the history of the case in
connection with the autopsy 1t was
quite evident that different suppurating
surfaces, and especially the fracture
In the spopgy tissue of the Vertebra furnish