Southern standard. (McMinnville, Tenn.) 1879-current, 1881-10-15
onOo Of the bullet, either in that region or

TcUOVGQ ITOnl tuC UOhgN PluSOA Ah pNAtubhO
vessels, and examined seriatim, with the fol
lowing result: f .al
The adhesions between the liver and trans
verse colon proved to bound nh abscess cavity
between the under surface of the liver and
the transverse mese-colon, which involved the
gall-bladder and extended to about the same
distance on each side OF 1t, measuring six
inches transyersely ard four inches from be-
fore, backward This cavity was lined by a
thick pyogenic membrane, which completely
replaced the capsule Of that part of the under
surface of the liver occupied by the abscess.
II contained about two ounces OF greenish-
yellow huid-a mixture of pus and hillary
matter. This abscess did not involve any por-
ton of the substance OF the liver except the
surface with which it was in contact, and no
communication could be detected between 1t
and any part CT the wound. $3.50.
Some recent peritoneal adhesions existed
between the upper surface Of the right lobe
of the liver and the diaphragm. The liver
was larger than normal, weighing eighty
four ounces. Its substance was firm, but of a
pale, yellowish color on its surface and
throughout the interior of the organ, from
fatty degeneration. No evidence that it had
~NSA PShS'AUtSu W thO builCb Cuulu DO lOulus
nor were there there any assesses or infurc-
tons in any part OF the tissue.
The spleen was connected by diaphragm ad-
hesions. There were several rather deep
congenial assures in its margins, giving it d
lobulated appearance. 1t was abnormally
large, weighing eighteen ounces, of very
dark lake red COLOR both on the surface and
on section. Its parenchyma was soft and fab
by, but contained no assesses or infnrctions.
There were some recent peritoneal adhe-
sions betwe the posterior wall of the stom-
ach and the posterior abdominal parietes.
With this exception no abnormalties were dis
covered in the stomach or intestines, nor were
any other evidences of general or local peri
tonitis found besides those already specified.
The right kidney weighed six ounces; the
left kidney seven. Just beneath the capsule
OF the left kidney, at about the middle Of its
convex border there was little abscess one
third of an inch in diameter. There we're three
small serious cysts on the convex border of the
right kidney, 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 the removal
of that organ from the body, the dilated track
of the bullet was dissected into. 1t was found
that from the point a: which it had fractured
the right eleventh rib three inches and half
to the right of the vertebral spine1 the missile
had gone TO the left oblquely forward, pass
ing through the body of the first lumbar YER
zebra and lodging in the adipose connective
tissue Immediately below the lower border Of
the pancreas, about two inches and half to
the left OF the spinal column, and behind the
peritoneum. 1t had become completely en-
cysted. The track of the bullet between the
point at which 1t had fractured the eleventh
rib and that at which it entered the first lum-
bar vertebra was considerably dilated
and the pus had burrowed aownwards
through the adipose tissue behind
tho right kidney, and thence had
| found its way between the perltoneum aud
t-sssS-ssersT 1luNfIA a. ucsccuuluB
channel, which extended almost to the groin.
The adipose tissue behind the kidney, in the
vicinity of this descending channel, was much
thckeIed and condensed by Inflammation. In
the channel which was found almost free
from pus, lay the flexible catheter, introduced
into the wound at the commencement OF the
| autopsy. Its extremity was found doubled
| upon itself, Immediately beneath the perlto-
neum reposing upon the lilac fascia, where
the channel was Diluted into pouch of con-
siderable size. This long-descending channel,
now clearly seen to have been caused by the
| hurrowing of pus from the wound, was sup
| posed during life to have been the track Of the
bullet.
The last dorsal, together with the first and
second lumbar vertebre and the twelfth rib
were then removed from the body for more
thorough examination. When this ex
animation was made it was found
that the bullet had penetrated the first
lumbar vertebra in the upper part Of
the right side of its body. The aperture by
which it entered involved the intervertebral
cartilage next above and was situated just
below and anterior to the lntervertebra
foramen, from which its upper margins were
about one-quarter of an inch distant. Passing
obliquely TO the left and forward through the
upper part Of the body of the first lumbar
vertebra, the bullet emerged by an aperture
the centre of which was about half an incl
to the left of the median line, and which also
involved the intervertebral cartilage mex
above the cancclatcd tissue. The body of thu
first lumbar vertcbra was very much com
minuted, and the fragments somewhat dis
placed. Several deep assures extended from
the track of the bullet into the lower part o.
the body of the twelfth dorsal vertcbra. 9th
ers extended through the first lumbar vcrte
bra into the international cartilage between
1t anf the second lumbar vertebra. Both thi
carthage and that next above were partly dc
strOyed by liberation. A number of miEut,
fragments from the fractured lumbar vcrtC
bro had been driven into the adjacent sof
pats. II was further found that the RICH
twelfth rib also was fractured nj a point on,
inch and quarter 10 the right of the trans
verse process OF the twelfth dorsal vertcbra
This injury had not been recognized durinl
life.
On saving through the vertebra little Il
the right of the median line, it was foun'
that the spinal column was not involved b.
the track of the bullet. The spinal cord an,
other contents OF this portion OF the spina
canal presented no abnormal appearances
The rest of the spinal cord was not examined
Beyond the first lumbar yertebra the bulle
continued to go to the left, passing behind tn
pancreas to the point where it was found
Here it was enveloped in a firm cyst Of cor
nective tissue, which contained, besides tn
ball, q minute quantity Of insplssated, some
what cheesy pus, which formed a thin laye
over portion of the surface of the lead
There was also black shred adhering to
part of the cyst wall. which proved, on micro
scopic examination, TO be the remains Of
blood clot. For about an inch from this cyst
the track of the ball behind tn
pancreas was completely ohliterated b
the healing process. Thence, as far back
ward as the body of the first lumba
vertebra, the track was file with coagulate'
blood. which extended on the left into regu
lar space rent in the adjoining adipos tissue
Behind the pertoneum and above the par
creas the blood had worked its way TO the lef
burrowing finally through the peritoneum be
hind the spleen into the abdominal cavity
The rending ofthe tissues by the extrayast
ton of this blood was undoubtedly the caus