ition was better, but the
abdomen was very rigid and tender. (Subsequently died.)
CASE VIII.--The point of entrance of the bullet was about 2
inches from the anterior end of the seventh left intercostal
space, and of exit rather lower down and further back on the
right side. The patient said that he had vomited brown fluid
after the injury. There was much abdominal pain, but his
general condition was fair. On April 1 there was still much
pain, but his general condition was good.
CASE IX.--The bullet had entered about 1-1/2 inch in front of
the anterior inferior spine on the right side, had gone
directly backwards, and had come out in the buttock. The
patient, however, suffered very little. On March 31 there was
slight tympanites and tenderness in the right iliac fossa. The
bowels acted well, and no blood was passed. On April 1 he was
very well, and it was considered very doubtful if any viscus
was wounded.
CASE X.--The point of entrance was in the middle of the right
buttock, a little above the level of the trochanter; the exit
was through the anterior abdominal wall in the right semilunar
line at the level of the umbilicus. The patient was decidedly
ill; the abdomen was a good deal distended, and pressure on it
caused an escape of gas through the anterior opening. There was
a good deal of abdominal tenderness and rigidity. I opened the
abdomen outside the right linea semilunaris, and found a
perforation in the anterior wall of the _ascending colon_,
without any adhesions around, which was easily stitched up. The
posterior opening was found about 2 inches lower down, with a
piece of omentum firmly adherent to it and completely closing
it. As the patient was in a bad state, I thought it better,
instead of excising the piece of intestine beyond the holes or
tearing off the omentum, to leave the wounds alone, merely
cleaning out the peritoneal cavity as well as I could and
arranging for free drainage. He rallied from the operation very
well, and for twenty-four hours it looked as if he might get
better; but he gradually got worse and died on April 2.'
The above statistics are particularly valuable, as they give the
incidence of abdominal injuries compared with those in general in one
definite battle. This amounted to the high number of 15 in
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