The Virginia enterprise. [volume] (Virginia, St. Louis County, Minn.) 1893-19??, 1896-07-24
WOUNDS IN THE ABDOMEN.
There Is Strange Uncertainty About
Intestinal Injuries.

Intestinai Injuries.
That startling shooting of a. bank,
president last week, with the suicide Of
his nssailant later, suggests the uncer-
wounds of the abdomen. 1t seems to be
impossible at first to tell now extensively
the patients injury is.
In II recent shooting case in New Or
leans the man who was injured had four
teen perforutions i'll his intestines. Yet
he had a good: full pulse and did not
seem to be suffering from any special
shock when he was brought into the
hospital to be operated on. Again. some
patients are so shocked by the occur
renee i'll which they receive their injury
that they seem to be extremely de-
pressed by the result of simple ACCT
dent. man was brought into the Char
ity hospital in New Orleans with an ex-
ternal wound in the abdomen. He was
lifted into bed absolutely helpless. and
the physicians thought that they had u
serious gunshOt wound of the abdomen
The man himself feared that death was
imminent.
On examining his clothes the bullet
was found i'll the leg of his drawers
him to get up and go home, but he was
unable to get out of bed for hours.
Sometimes bullets 80 into the perito-
neal cavity and do not injure any vital
organ. In the American journal Of Medi-
cal Sciences for May several similar
cases are described. One, strong man
about 80 years old, was shot, but had no
bad symptoms, and an exploratory cper-
alton revealed five bullet wounds in the
small intestine. which were properly
sewed up. During the night the patient
got drunk, got out of bed and tore off all
the dressings He subsequently died,
and 1t was shown that the wounds III the
intestine had all healed nicely, but
he had infected the outside of his wound
and that killed him. Another man is
mentioned who was shot a little above
the navel. An operation showed eight
wounds of the intestine, which were re-
paired and the patient recovered prompt
ly. Another case was shot in the spleen
and kidney and recovered after opera
ton.
Another case was found to have been
shot through the liver, stomach and into
the intestine. One wound was not
found, but the man recovered, and was
discharged from the hospital curad in
two months. In the Civil war there
were innumerable such cases. but nearly
all died. because the advancement of an
tiseptic surgery had not reached Il yuint
which made it safe to cut freely into the
patient and hunt up all the places the
bullet had injured.
When the use of antiseptics and steriI-
lied instruments and dressings came in a
great advance was made. President Gar,
field was shot before this era, and prob
ably lost his life as Il consequence
The rule at present is for surgery al
ways promptly to enlarge the wound and
examine the entire abdominal cavity. to
see if there are not bleeding points in
side, and to see plainly just what the bull
let has and has not penetrated The OBJ
ject of doing this at once is to try to pre-
vent peritonitis developing from the in
fection of the wound If the intestine
has been penetrated. some of it's contents
will have probably escaped The way to
prevent this accident causing peritonitis
is to flush out the cavity with many gal
Ions OF boiled water, with a little salt
dissolved in it. This is done with hot
water for the sake of the tonic influence
to the heart.
If all the wounds have been sutured
and the washing completed satisfactorily.
the external wound can be entirely closed.
or left open for few days with drain
age tubes
These cases indicate that if a great
surgeon can see the patient in time a
bullet wound in the abdomen is not the
worst ACCIDENT that can happen to a man.
New York Press