Daily globe. [volume] (St. Paul, Minn.) 1878-1884, 1881-10-02
yellowish color. On it's surface and through
out the interior of the organ was firm, fatty

| yellowish color. On it's surface and through
out the interior of the organ was firm, fatty
degeneration. No evidence that it had beer
penetrated by the bullet could be found. mol
was there any abscess or infractiOns in any part
of its tissue. The spleen was connected with
the diaphragm by adhesions. There were
several rather deep congenital assures in its
margins giving it tabulated
appearance. 1t was abnormally large, weigh
ing IS ozs., and of very dark lake red color
both on the surface and section. Its pareychyma
was soft and fiabby. but contained no assesses
or infractlons. There were some recent perit
onal adhesions between the posterior wall oil
the stomach and the posterior abdominal pare.
ties. With this exception no abnormalitles
were discovered in the stomach or intestines,
nor were any other evidences OF
general or local peritonitis found, besides
those already specified. The right kidney
| weighed six ounces; the left kidney seven.
| Just beneath the capsule of the eft kidney, at
| about the middle of its convex border there
was little abscess, one-third of an inch in
diameter. There were three serous cysts on
the convoid border of the right kid
ney, just beneath its capsule. In
| other respects the tissue of both
kidneys was normal in appearance and in
texture. The urinary bladder was empty.
Behind the right kidney, after removal of
that organ from the body, the dilated track
of the bullet was dissected into. 1t was found
from the point at which it had fractured the
right eleventh rib, three inches and half to
the right of the verterbal spines, the missile
had gone to the left oblquely forward, pass
ing through the body of the
first lumbar vertebra and lodging in
the adipose connective tissue, Immediately be-
low theilower border of the pancreas, about
two inches and one-half to the left of the
spinal column and behind the peritoneum. 1t
had become completely encysted The track
of the bullet between the point at which it en-
tered the first lumbar vertebra was consider
ably dllated and pus had burrowed downward
through the adipose tissue behind the right
kidney, and there had found its way between
the peritoneum and right lilac fascia, making
descending channel which extended almost
to the groin. The adipose tissue behind the
kidney. in the vicinity of this
descending channel was much
thickened and condensed by Inflammation. In
the channel, which was found almost free of
pus, lay the flexible catheter introduced into
the wound at commencement of the autopsy.
Its extremity was found doubled ,upon itself
Immediately beneath the peritoneum, repos-
ing upon the lilac fascia, where the channel
was dilated into pouch of considerable size.
This long descending channel, which clearly
seems to have been caused by the burrowing
of pus from the wound was supposed during
"
The last dorsal together with the first and
second lumbar vertebra and the twelfth rib
were then removed from the body for more
thorough examination. When this examine
ton was made 1t was found the bullet had
penetrated the first lumbar vertebra in the up-
per part of the right side of the body. The ap-
erture by which it entered involved the inter
vetebral cartilage next above and was situated
just below and anterior to the intervertebral
fron MI fc
about one quarter OF an inch distant.
Passing obliquely to the left and
forward through the upper part
of the first lumbar vertebra, the bullet
emerged by an aperture, the centre of which
was about One-half an inch to the left of the
median line, and which also involved the in
tervertebral Cartilage next aboves TIE can
cellated tissue OF the body of the first lumbar
vertebra very much comm ifk,t.el and
the fragments somewhat displaced Several
deep assures extended from the track of the
bullet into the lower part of the body of the
twelfth dorsal vertehra. Others extended
through the first lumbar vertoebra into the
intervertebral cartilage, between it and the
second lumbar yertebra. Both this cartilage
and that next above were partly destroyed
by liberation. A number ef minute frap-
ments from the fractured lumbar vertebra had
been driven into the adjacent soft parts It
was further found that the right twelfth rib
also was fractured at a point an inch and a
quarter to the right of the transverse process
of the twelfth dorsal vertebra. This injury
had not been recognized during kfe On saw
ing through the vertebra little to the right
of the median line it was found that the
spinal column was not involved by the track
of the bullet. The spinal cord and other con-
tents of this portion Of the spinal canal pre-
sented no abnormal appearances. The rest of
the SD nal cord was not examined A
Beyond the first lumbar vertebra the bullet
continued to go to the left passing behind the
pancreas to the point where it whs found.
Here it was enveloped in firm cystsof con-
nective tissue, which contained sbestbs tue
ball a minute quantity of ruspissated soHe-
what cheesy pus, which formed al thin layer
over portion of the surface of lead, there was
also black shred adhering to part of the
cyst wall, which proved on microscopic exam
ination to be the remains of blood clot. For
about an inch from this cyst, the track of tie
ball behind the pancreas was complete
ly obliterated by the healing process,
thence as far backward as the body
of the first lumbar vertebra
the track was filled with coagulated blood,
which extended on the left into an irregular
space rent in and adjoining the adipose tissue
behind the peritoneum and above the parcre-
as. The blood had worked its way to the left,
burrowing finally through the peritoneum
behind the spleen into the abdominal CAVITY
The rending of the tissues by the extravasasion
of this blood was undoubtedly the cause of
the paroxyms of pain which occurred short
time before death. This mass of coagulated
blood was of irregular form and nearly as
large as mans fist. It could be distinctly
seen from in front through
the peritoneum, after its site,
forming an almost continuous wall,
bounding the adjoining portion of the
tlood clot. Moreover the peripheral portion
of the clot in this vicinity was disposed in
pretty 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 coetiac axis.
Besides the mass of coagulated blood Just
described another, about the size of walnut,
was found in the greater omen
tum, near the spIenic extremity of
the stomach. The communication
behind the greater curvature of the stomach
had been exposed by dissection of the greater
omentum from the stomach, and especially
after some of the 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
mass as thus seen, it was believed that the
hemorrhage had proceeded from one of the
mesentric arteries, but as it was clear that a
minute dissection would be required to deter
mine the particular branch involved, it was
elected the ntiltrated tissues and adjoining
-, - L.