, 65 were
caused by cutting or sharp-pointed instruments. Of this group, 23
recovered and 42 died. The chief causes of death were hemorrhage and
peritonitis. The principal symptoms of wounds of the liver, such as
traumatic shock, collapse, local and radiating pains, nausea, vomiting,
and respiratory disturbances were all present in the case of President
Carnot. From an experience gained in the case of the President, Romme
strongly recommends exploratory celiotomy in all penetrating wounds of
the liver. Zeidler reports three cases of wound of the liver in which
recovery ensued. The hemorrhage in one case was arrested by the tampon,
and in the other by the Pacquelin cautery.

McMillan describes a man of twenty who was kicked by a horse over the
liver and rupturing that organ. A large quantity of offensive fluid was
drawn off from the liver, and the man recovered. Frazer reports a case
of rupture of liver and kidney in a boy of thirteen who was squeezed
between the tire and driving chain of a mill, but who recovered despite
his serious symptoms. Allen mentions recovery after an extensive
incised wound of the abdomen, liver, and lung. Massie cites an instance
of gunshot wound of the right hypochondrium, with penetration and
protrusion of the liver. The patient, a boy of seven, recovered after
excision of a small part of the protruding liver. Lawson Tait has
incised the liver to the extent of three inches, evacuated two gallons
of hydatids, and obtained successful recovery in ten weeks.

There are several cases of wound of the liver followed by recovery
reported by surgeons of the United States Army. Whitehead mentions a
man of twenty-two who on June 3, 1867, was shot in the liver by a slug
from a pistol. At the time of the injury he bled freely from the wound
of entrance continuing to lose blood and bile until daylight the next
morning, when the hemorrhage ceased, but the flow of bile kept on. By
June 10th there was considerable improvement, but the wound discharged
blood-clots, bile, and serum. When the patient left the hospital on
July 15th the wound was healthy, discharging less than 1 1/2 ounces
during the twenty-four hours, of a mixture of free bile, and bile mixed
with thick material. When last heard from--July 27, 1867--the patient
was improving finely in flesh and strength. McKee mentions a
commissary-sergeant stationed at Santa Fe, New Mexico, who recovered
after a gunshot wound of the liver. Hassig reports the