Lancaster daily intelligencer. [volume] (Lancaster, Pa.) 1864-1928, 1881-10-03
LANCASTER DAILY INTELLIGENCER MONDAY, OCTOBER

body of the first lumbar vertebra the bull
let emerged by an aperture, the centre of
which was about half an inch to th e left
of the median line, and which also in
volved the intervertebral cartilage next
above. The cancellated tissue of the body
of the first lumbar vertebra was very
much comminuted 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 vertebra. Others extended through
the first lumbar vertebra into the interver
tebral cartilage between it and the second
lumbar vertebra. Both this cartilage and
the one above were partly destroyed by
liberation. A number of minute frag-
ments from the fractured humber vertebra
have been driven into the adjacent soft
parts. 1t was further found that the right
twelfth rib also was fractured at point
one inch and quarter to the tight of the
transverse process of the twelfth dorsal
vertebra !; this injury had not been recog-
nized during life.
Tho Fatal HemorrhaGc.
Beyond the first lumbar vertcbra the
bullet continued to 60 to the left, passing
behind the pancreas to the point where it
was found. Hero it was enveloped in a
firm cyst of connective tissue, which con-
tanned besides the ball a minute quantity
of inspissated, somewhat cheesy pus,
which formed thin layer over a portion
of tue surface of the lead. There was also
black shred adherent to part of the cyst
wall, which proved on micrOscopical ex
animation to be the remains Of blood
clot. For about an inch from this cyst the
track of the ball behind the pancreas was
completely obliterated by the healing pro-
cess. Thence, as far backward rs 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 tho adjoining adipose tissue behind
the peritoneum and above the pancreas.
The blood had worked its way to the left,
bursting finally through the peritoneum
behind the spleen into the abdominal cav
ity. The rcnding of the tissues by the
extravasatiOn of this blood was undoubt-
edly the cause Of the paroXysms of pain
which occurred 4 short time before death.
On subsequent examination and dissection
it was found that the fatal hemOrrhagc
proceeded from \ rent, nearly fOur-tenths
of all inch long, in the main trunk of the
splenic artery, two inches and half to the
left of the cDliac axis. The rent must
have occurred at least several days before
death, since the evcrted edges in tho slit
in the vessel were united by firm adhcsiOns
to the surrounding connective tissue, thus
forming an almost continuous wall bound
ing the adjoining portion Of the blood
clOt.
The ThoracIc Viscera.
The report next describes the condition
of the heart and lungs. The former was
empty and presented no special features
except some marks of fatty degeneration.
There were slight plcuritic adhcsions on
the right side.
The lower lobe Of the right lung was hy.
postatically congesJcd, and considerable
portions, especially towards its base, were
the scat of brOncho- pneumonia. The
bronchial tubes contained considerable
quantity Of stringy muco- -pus :; their mu-
cous surface was Redeemed by catarrhal
bronchitis. The lung tissue was Gdema-
tous, but contained no assesses or infarc
tions On the left side the lower lobe Of
the lung was bound, behind to the costal
pleura, 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 its brOn-
chial tubes and of the lung tissue was very
nearly tho same rs on the right side, the
chief difference being that the area Of
broncha-pncumonia in the lower lobe was
much less extensive in tho left lung than
in the right. In the lateral part of the
lower lobe of the left lung, and about an
inch from it's plcural surface there was a
group of four minute areas of gray hcpati-
zation, each about one. eighth of an inch
in diameter. There were no infarctions
and no abScaSSoS in any plrt Of the lung
tissue.
The surgeons assisting ut the autopsy
were unanimously of the opinion that on
reviewing the history Of the case in connec-
tion with the autopsy it is quite evident
that the different suppurating surfaces,
and especially the fractured spongy tissue
OF the vertebra, furnish a sufficient expla.
nation of the septic condition which existed
during life.
The record is accompanied by engravings
from photographs of the injured vertebr1
and of the rupturcd artery with the parts
adjacent.