Daily globe. [volume] (St. Paul, Minn.) 1878-1884, 1881-10-03

|
Behind the right kidney, after removal Of
that organ from the body, the dilated track
Of the bullet was dissscted 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 spnes, the missile
had gone to the left obliquely forward, pass
ing through the body Of the
| the adipoee connective tissue, Immediately be-
| low the1lower border of the panereas, about
two inches and one-half to the left of the
| spinal column and behind the peritoneum. 1t
had become completely epcysted. 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 10 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 1t 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 burlOwing
Of pus from the wound was supposed during
life to have been the track of the bullet.
The Last dOrssl together with the fret and
second lumbar vertebra and the twelfth rib
were then removed from the body for more
thorough examination When thus examine
ton was made 1t was found the bullet had
penetrated the first lumbar vertebra in the up
per part ofthe right side of the body. The ap-
erture by which 1t entered involved the inter-
| vetebral cartilage next above and was situated
| just below and anterior to the intervertebral
forsmen, from which its upper margin was
about one quarter of an inch distant.
Passing obiiqsely 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 liue, and which also involved the in
| teryertebral cartilage next above. The can
cellated tissue of the body of the first lumbar
vertebra 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 vertoebra into the
intervertebral cartilage, between it and the
second lumbar vertebra. Both this cartilage
and that next above were partly destroyed
by liberation. A number of minute frag-
menus from Tue 1r8cIuIeQ lutODaI VerLeOra Eau
been driven into the adjacent soft parts. 1t
was further found that the right twelfth rib
also was fractured at point an inch and
quarter to the right of the transverse process
of the twelfth dorsal vertebra. This injury
had not been recognized during life. 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-
10 - - - 0f h. ,1s~ Il
sented no abnormal appearances. The rest of
the spinal cord was not examined.
Beyond the first lumbar vertebra the bullet
continued to 20 to the left passing behind the
pancreas to the point where it was found.
Here it was enveloped in firm cyst of con-
nective tissue, which contained besides the
ball minute quantity of ruspissated some
what cheesy pus, which formed 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
nation to be the remains of blood clot. For
about an inch from this cyst, the track of the
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 filed with coagulated blood,
which extended on the left into sn irregular
space rent in and adjoining the adipose tissue
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 a short
time before death. This mass of coagulated
blood was of irregular form and nearly as
large as mans fist. 1t could be distinctly
seen from in front through
noYitnNql1n- 70
forming an almost continuous wall,
bounding the adjoining portion of the
blood clot. Moreover the psripheral 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 a half to the left of
the coetiac axis.
Besides the mass Of coagulated blood just
described another, about the size of a walnut,
was found in the greater omen
tum, near the splenic 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, 1t was believed that the
hemorrhsge had proceeded from one of the
mesentric arteries, but as it was clear that
minute dissection would be required to deter
mine the particular branch involved, it was
elected the infltrsted tissues and adjoining
soft parts should be preserved.
if any, between this and the larger hemmor
rhaeic mass could not be male cut.
The examination of the thoracic viscera re-
suited as follows: The heart weighed eleven
ounces. All the cavities except the right
ventricle, on which few shreds of soft, red
dish coagualated blood adhered to the internal
surface. On the surface of the mitral valve
there were several spots of fatty de-
generation. With this exception car
diac valves were - normal. The
muscular tissue of the cart was soft and tore
easily. A few spots Of fatty degeneration ex-
listed in the lining membranes of the aorta
just above the semi-lunar valves, and slender
clot of fbrine was found In the aorta, which
was divided about two inches from these
valves for the removal of the heart.
The adipose tissue divided by the missions
was little more than one-eighth OF an inch
thick over the thorax, but was thicker over
the abdomen, being about one-quarter Of an
inch thick along the linear alba and as much
q one-half an inch thicker towards the outer
extremity of the transverse Incision.
On inspection of the abdominal viscera stu,
the transverse colon was observed to Lie at q
little above the line Of the ambilicus. 1t was
firmly adherAnt IN tia interior efpe of the