The Canton advocate. [volume] (Canton, D.T. [S.D.]) 1877-1897, 1881-10-06

not adherent to the intestines, which
we're moderately distended with gas.
No intestine adhesion was found other
than those between the transverse colon
and the liver already mentioned.
The abdominal cavity being now
washed out as thoroughly as possible
| A fruitless attempt was made to obtain
some indication Of the position of the
bullet before making any further incis-
ions; by pushing the intestines aside,
the extremity Of the catheter which
| had passed into the wound, could be
felt between the peritoneum and right
| lilac fascia, but it had evidently doubled
upon itself, and although Il prolonged
search was made nothing could be
seen or felt to indicate the presence of
the bullet, either in that region or
elsewhere. The abdominal viscera
S.sSG. then carec:, y. remove9 fc 4;
/ the body, placed in suitable vessels,
and examined the seriation with the
following result: The adhesions be-
tween the liver and transverse colon
proved bound to an abcess. The cavi-
| ty between the under surface of the
liver and the transverse meso colon,
which involved the gall and bladder,
and extended to about the same dis
lance on each side of it, measured six
inches transversely and four from be-
fore. Backward this cavity was lined
by thick hyogenic membrane, which
completely replaced the capsule OF
that part of the under surface OF
the liver occupied by the abscess; it
contained about two ounces Of green
ish yellow, and blush fluid, a mixture
of pus and billiany of matter. This
abscess did not involve any portion of
the substance of the liver, except the
surface with which it was in contact,
and no comm unication could be de-
tected between it and any part of the
wound. Some recent peritonial ad-
hesions existed between the upper sur
face Of the right lope of the liver and
diagraphm. The liver was larger than
normal, weighing eigty-four ounces.
Its substance was firm, but Of q pale,
yellowish color on its surface, and
throughout the interior of the organ.
From the fatty generation no evidence
that it had been penetrated by the bull
let could be found, nor was there any
Assesses or inforetion in any part of
its tissue. The spleen was connected
by diaphragm adhesions, and there
were several rather deep concealed tis-
sures in its margins, giving it
a lobulated appearance. 1t was
abnormally large, weighing eighteen
ounces, of very dark red color, both on
the surface and on the section its pa
renchyna was soft and fabby, but con-
tanned no assesses or infections. There
were some recent peritonial adhesions
between the posterior wall of the stom-
ach and the posterior abdominal cavi-
ties. With this exception no abdormal
tiles were discovered in the stomach or
intestines, nor were any other evidence
Of general or local peritonitis found,
besides those already specified.
The right kidney weighed six ounces;
the left seven. Just beneath the cap
sule of the left kidney at about the
middle of its converse border, there
was little abcess, one-third of All inch
in diameter. There were three small
senous cysts on the convex border Of
the right kidney just beneath its cap
sule. In other respects the tissue Of ,
both kidneys were normal in appear
ance and in texture. The urin-
airy was entirely empty. Behind
the right kidney, tafter the removal
of that organ from the body, the di-
lated track of the bullet was dissected
into. It was found that from the point
at which it had fractured the right
eleventh rib, three inches and q half
to the right Of the vertebral spines, the
missile had gone to the right obliquely
forward, passing through the body Of
the first lumber vertebra and lodging
in the adipose connecttoe tissue imme-
diately below the lower border of the
pancreas, about two inches and
half to the left of the spinal
column and behind the peritoneum,
it had become completely incysted.
the track of the bullet between the
point at which it entered and the first
lumbar vertebra, was consider
ably dila.ed, and pus had burrowed
downward through the adipose tissue
and behind the right kidney, and
thence had found its way between the
peritonum and the 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 from puss, lay
the flexible catheter introduced into
the wound at the commencement Of
the autopsy. It's extremity was found
doubled upon itself Immediately be-
meath the peritorium, upon the lilac
facia, where the channel was dilated
into 4 pouch Of considerable size. This
long, descending channel now clearly
seems to bsve'been caused by the bur
roWings of pus from the wound. II was
supposed during life to have been
the track OF the bullet. The last
ldorsaL together with the first and sec
Iond lumbar vertebre, and the twelfth
rib, were then removed from the body
for more thorough examination. When
this examination was made, it was
found the bullet had penetrated the
4 first lumbar vertebre, in the upper
part Of the right side Of the body. The
aperture BY which it entered, involved
Il the intef.veftebre cartioliage, next
above, and was situated just below, and