Evening star. [volume] (Washington, D.C.) 1854-1972, 1881-07-12
Eare Similar Cases.
WHAT DIR. psArEe SAYS.

Eare Similar Cases.
WHAT DIR. DENrE:p SAYS
Dr. Dexter. OF this city. he's compiled the fol-
lowing eases of gunsliot wouadc and ether inju-
ries sustained by the liver which are of interest
at this time:
10 nse Essttor Of De Start forward to you
Two or three cases of gunahot wounds and other
Injuries sustained by the liver which may be of
interest 70 the general public at this time.
The following case which had the privilege
OF observing in New York hospital while stu
dent. was published I'm New York Neyiic1, Times.
io3i, oy ". Leroy. resident surgeon, under the
title OF "Punctured Wound Of the Liver Fol-
lowed by Recovery
VIM. Craddock aged q. New York, seaman,
admitted into New York hospital July 4th. 1851.
or Post in attendance with penetrating
wound OF the abdomen, caused by the premature
discharSe OF hoiSe-p pistol. from which he was
endeavOring to withdraw the ramrod The rod
passed between his hands and struck the abtio-
men a little to the right of the mejian line
ABOUT an inch below the common cartilage Of
the false ribs on that side Upon Introducing
the fnger and tracing the course Of the wound
t4e ilVer could be distinctly felt. and on passing
IT'S extremity over the surface of the organ
laceratlon of it was detected that correspondent
Win the external opening. From the nature Of
tie injury. its precise depth could not be ascer-
taihed. Pat4ent had on at the time of the acct
dent common cOored shirt with red one be-
meath it. The fragment of red flannel was
removed by the physician who attended him
previous to his admission into the hospital. The
portions OF the colored garment were supposed
TO nave been carried in with the rsmred. Has
present suffers no pain: some difficulty in respi-
raCioh; shght venOus hemorrlage from the
wounds: pulse natural. This was condition of
patent when admitted into hospital. July 5th-
latlent passed comfortable night. July eth
Slight tympanites had made its appearance
y nf an, clara <.tnr
presented themselves The edges of the wound
show signs of healthy granuatioR. Removed
several pieces of cotton. which proved to
De the missing portions of the colOred shirt.
July 2Oth-Has had several paroXysms of pain
over the region Of the liver and in the right
shoulder; most intense in the evening. Respira-
tlon lab0red "a per minute. Pulse alternating
between q and 50. No undue excitement. July
2lst-To-day had his first chill being the seven
teenth day after the accident July 22d-Another
chill, followed by great prostration. July ed
General condition very unfavOrable. countenance
haggard hot surface - inspiration labored
cough. with pain in the side. Pulse 80. Pros
tration continues. July Atlf-The graver symp-
toms controlled under the adopted treatment.
yet complains of pain in the side and difficult in
splratlon. July 30th-Has had four distinct chills
during the last "A hours. patient greatly pros
trated. Wound entirely healed. August 4th-
No chilfs for the past four days. The whole sur
face OF the trunk covered with suppurating boils
their subsding, marked improvement occurred
and patient commenced gaining in flesh. August
l6til-Slnce last date an abSceSS has formed aud
pointed In the original wound, opened spOnta-
neously. gave exit to a greenish discharge. pus
apparently tinged with bile; upon its ceasing the
wound again closed, and he was discharged
cured
Another case reported by j. c. Masse. NJ D..
Houston. Texas-New Orleans Med. and Surg
Journal. 1S52-''Wound of the Liver; EXcison
o<lf<l Ds<rl,<
Was summoned the fourth day after the ecci-
dent, to youth seven years of age the whole
load OF large shot from gun having passed into
the right hypochondrium. and mostly out about
the region of the SpigaStrium. Found him in
very deplorable situations: the anterior margin
OF the right lobe OF the liver was protruding
through the cavity on the right and few
lines above the umbilicus; it was in gan
grenous condition, with portion of the omen
tum attached: the substance of both was so
much altered it was really difficult to tell what
the protruding portion was; the abdomen very
tense and hard. the least pressure giving severe
pain; great arteria! excitement. high iniianl-
matory fever. My friend DR.. Black, as well
as myself. regarded the case in hope
less condition. informed his friends after
the operation, that l would remove the
gangrenOus portion of the liver, and give him all
the possible chance there could be left for his
me- Inc external character and appearance Of
TIC WOuuu Indicated tiidt SanTrene might have
extended within the abdominal walls Having
enlarged the wound or external opening found
two shot had passed at least two and quarter
inches from the inferior border of the liver pen
etratlng through it; the substance of the liver
which was in juxtaposition to the wounds had
thick. grumOus appearance. with gangrenous
portions. Under the circumstances. l determined
to excise every portion of the liver which had
the appearance here described. The operation
resulting in the removal of one-half of the right
lobe OF the liver. yet the patient made speedy
and positive recovery.
A case which came under the observation of
pr. Eve, while in India is of interest. Hin
doc. aged between 70 and 20, was brought
distance of six miles to Howrah. with a spear
wound in the abdomen about three inches
above the umbilicus and two inches to its right.
through which a triangular portion of the liver
protruded, of about the size and shape of the
four fingers of the hand, lying side by side. The
wound itself did not exceed an inch in length.
and was completely chOked up by the liver. The
man stated that he had been stabbed in the
dark about twelve hours previously, ard that
the liver came through the wound as the spear
was drawn out. 1t was added that there had
Deen very cOpiOus hemOrrhaye, but the liver
itself was not wounded. though the patient
was in considerable pain, the pulse was very
little depressed. My friend. DR.. c. NJ. Hender-
son, who was present. agreeing that it would be
impossible to return the prOtrusiOn without en-
larglng the wound to the extent of several
inches, it was resolved, rather than wait for the
tedious process of sloughing, to remove it by
the knife. To prevent hemorrtage lgature
was applied tightly round the base of the pro-
trusion, which was then cut Off
NO attempt was made to return the portion of
the liver which still filed up the wound. as it
was desirable to prevent all risk of blood or of
bile being eXtravasated into the cavity of the
abdomen. In nine days the ligatures came
away with a small slough of liver; the wound
granulated and healed. and the man returned to
his home in three weeks. No bilious discharge
occurred from the graduating surface of the
liver. The portion of liver removed. after
having lost its blood, and being in spirits for
some weeks, weighed ~ ounces. DIR. Eve
to allude to the wounds of the abdomen gem
orally. OF of the liver in particular or to the ex-
traOrdinarY recoVeries from almost every variety