The Iola register. [volume] (Iola, Allen County, Kansas) 1875-1902, 1881-10-14
ve.,e,, ana e,.mined seriatim. with the fol-

vessels. and examined seriatim, with the 1of-
owing result: ,
The adhesions between the liver and trans
yerse colon proved to bound an abscess Cavity
,etveen the under surface Of the liver ana
the transverse meso-colon, which involved the
,ali-bladder and extended to about the same
distance on each side Of 1t. measuring SIX
inches transverseiy and four inches from De-
fore, backward. This cavity was lined oy
thick pyOgenic membrane, which comPietev
replaced the capsule of that part OF the unoer
surface of the liver occupied by the abscess.
It contained about two ounces OF greenlsn-
yellow fiuid-a mixture Of pus and hillary
matter. This abscess did not involve any por'
ton of the substance Of the liver except the
surface with which it was in contact, ana no
could be detected between II
and any part CT the wound.
Some recent peritOneal adhesiOns existed
between the upper surface OF the rtgnt iooe
of the liver and the diaphragm. The liver
was larger than normal, weighing elSnCy
four ounces. Its substance was hrm. OUT Oh
pale, yellowish color on Its surface anu
throughout the interior OF the organ Iiom
fatty degeneration. No evidence that II naa
been penetrated by the bullet could be FOUND
nor were there there any assesses OF iniufc-
tons in any part OF the tissue.
The spleen was connected by diaphragm 40
hesions. There were several rather deep
congepial assures in its margins, giving it
lobulated appearance. 1t was abnormaiiy
large, weighing eighteen ounces, of very
dark lake red color, both on the surface ana
ON section Its parenchyma was soft ana nab
bv but contained no Assesses or 1nfurctions.
There were some recent peritoneal aone-
sions betwe the posterior wall OF the stom-
ach and the pOsterior abdominal parletles.
With this exception no abnormalties were as
covered in the stomach or intestines, nor were
any other evidences of general or Local per-
tonitis found besides those already specineo'
The right kidney weighed six ounces; tne
| left kidney seven. Just beneatn the capsule
| of the left kidney, at about the middie VI i's
convex border, there was little aoscess one
third of an inch in diameter. There were tnIee
small Serious cysts on the convex Dofoer VI INC
right kidney, just beneath Its capsule III
other respects the tissue of both kidneys was
normal in appearance and in texture
The urinary bladder was empty.
Behind the right kidney. after the removal
of that organ from the body, the dilated track
of the bullet was dissected into. 1t was founo
that from the point at which it had fractured
the right eleventh rib three inches and hai1
to the right of the vertebral spine, the missile
had gone to the left obliquely forward, pass
ing through the body of the first LUMBAR YER
zebra and lodging in the adipOse connective
tissue Immediately below the lower border OF
the nancreas, about two inches and hal1 10
the left of the spinal column, and oenlno inc
peritoneum. 1t had become completely en-
cysted. The track of the bullet between the
point at which it had fractured the eleventh
rib and that at which it entered the nrst iunl-
bar yertebra was considerably oliateo
and the pus had burrowed downward:
} through the adipose tissue behind
} the right kidney, and thence had
found its way between the peritoneum and
the right lilac fascia, making descending
} channel. which extended almost to the groin
! The adipose tissue behind the kidney, in tht
) vicinity of this descending channel, was mucf
thickeued and condensed by inflammation. Ii
, the channel, which was found almost fre'
: from pus, lay the flexible catheter, introduced
. into the wound at the commencement OF I'M
autopsy, Its extremity was found douoiee
: upon itself, Immediately. beneath the perito
: neum, reposing upon the lilac fascia, wher
f the channel was dilated into pouch OF con
: siderable size. This long-descending channel
|, now clearly seen to have been caused by In
q burrowing of pus from the wound. was sup
G posed during life to have been the track Oh In
= bullet.
y second lumbar vertebrR and the tweirtn III
9 were then removed from the body for NOR
b thorough examination. When this e.
o animation was made it was foun
r that the bullet had penetrated the frs
y lumbar vertebra in the upper part Q
+ the right side of its body. The aperture o
70 which it entered involved the intervertebrs
l. cartilage next above, and was situated jus
e below and anterior to the intervertepr'
e foramen, from which its upper margins wer
( about one-ouarter of an inch distant. Passln
., obliouely to the left and forward through tn
u upper part of the body of the hrst iumpa
r yertebra, the bullet emerged by an aperture
IS the centre of which was about hall an Inc
r. to the left of the median line. and which ais
q involved the intervertebral cartilage ne1
1t above the cancellated tissue The BODY OF u
b. first lumbar vertebra was very much COT
rs minuted. and the fragments somewhat d.
I'd placed. Several deep assures extended fro
the track of the bullet into the lower part
,i- the body of the twelfth dorsal vertebra. Ut
OF ers extended through the first lumbar vert
IS bra into the intervertebral cartilage betwe'
re- it and the second lumbar vertebra- Both In
cd cartilage and that next above were partly q
ra stroyed by liberation. A number of minu
Ne FRAGMENTS from the fractured lumbar vert
an bra had been driven into the adjacent SO
x, IN, t. It was further found that the rig
ng twelfth rib also was fractured at point OF
ga inch and q quarter to the right of the trar
I'D verse process of the twelfth dorsal vertebi
IN. This injury had not been recognized duri
'la life.
lie On saving through the vertebra little
1t the right of the median line, it was foul
OF that the spinal column was not involved
he the track of the bullet The spinal cord
MS other contents Of this portion of the spill
till canal presented no abnormal appearance
JUS The rest of the spinal cord was not examine
ms Beyond the first lumbar vertebra the bul
es, continued to go to the left, passing behind
The paucreas to the point where it was foul
m, Here it was enveloped in firm cyst OF G
nectiye tissue, which contained. besides
,ns ball, minute quantity of inspissated, son
as what cheesy pus, which formed thin la,
an over a portion of the surface OF the le
the There was also a black shred adhering t
the ,art of the cyst wall. which proved. on mic
lew scopic examination, to be the remains OF
ore blood clot For about an inch from this cy
the track of the ball behind
red pancreas was completely ohliterated
rin the healing process. Thence. as far ba
tnis ward as the body of the first lum
ass vertebra, the track was illei with coaSula