of the pleura, two by four inches,
had been torn away, exposing the pericardium and the left lung, and
showing the former to have been penetrated and the latter torn. The
lung collapsed completely, and for three or four months no air seemed
to enter it, but respiration gradually returned. The lacerated
integument could only be closed approximately by sutures. It is worthy
of remark that, although extremely pale, the patient complained of but
little pain, and exhibited only slight symptoms of shock. The pleural
cavity subsequently filled with a dirty serum, but even this did not
interfere with the healing of the wound and the restoration of the
lung; the patient recovered without lateral curvature.

Bartholf reports a case of rapid recovery after perforating wound of
the lung. The pistol-ball entered the back 1 1/2 inches to the right of
the spinous process of the 6th dorsal vertebra, and passed upward and
very slightly inward toward the median line. Its track could be
followed only 1 1/4 inches. Emphysema appeared fifteen minutes after
the reception of the wound, and soon became pronounced throughout the
front and side of the neck, a little over the edge of the lower jaw,
and on the chest two inches below the sternum and one inch below the
clavicle. In four hours respiration became very frequent, short, and
gasping, the thoracic walls and the abdomen scarcely moving. The man
continued to improve rapidly, the emphysema disappeared on the seventh
day, and eighteen days after the reception of the wound he was
discharged. There was slight hemorrhage from the wound at the time, but
the clot dried and closed the wound, and remained there until it was
removed on the morning of his discharge, leaving a small, dry, white
cicatrix.

Loss of Lung-tissue.--The old Amsterdam authority, Tulpius, has
recorded a case in which a piece of lung of about three fingers'
breadth protruded through a large wound of the lung under the left
nipple. This wound received no medical attention for forty-eight hours,
when the protruding portion of lung was thought to be dead, and was
ligated and cut off; it weighed about three ounces. In about two weeks
the wound healed with the lung adherent to it and this condition was
found six years later at the necropsy of this individual. Tulpius
quoted Celaus and Hippocrates as authorities for the surgical treatment
of this case. In 1787 Bell gave an account of a case in which a large
portion of the lung pr