ed into the hospital
with a strangulated femoral hernia. The sac was opened and its
contents were returned. The woman died in a few days from peritonitis.
The gall-bladder was found close to the femoral ring, and showed a
marked constriction. The liver was misshapen from tight lacing,
elongated and drawn downward toward the ring. There was no evidence
that any portion of intestine or other structure besides the
gall-bladder had passed through the ring.

The fatality of rupture of the spleen is quite high. Out of 83 cases of
injury to this organ collected by Elder, and quoted by MacCormac, only
11 recovered; but the mortality is less in punctured or incised wounds
of this organ, the same authorities mentioning 29 recoveries out of 35
cases. In his "Surgery" Gooch says that at the battle of Dettingen one
of Sir Robert Rich's Dragoons was left all night on the field,
weltering in his blood, his spleen hanging out of his body in a
gangrenous state. The next morning he was carried to the surgeons who
ligated the large vessels, and extirpated the spleen; the man recovered
and was soon able to do duty. In the Philosophical Transactions there
is a report of a man who was wounded in the spleen by a large
hunting-knife. Fergusson found the spleen hanging from the wound and
ligated it. It separated in ten days and the patient recovered.

Williams reports a stab-wound of the spleen in a negro of twenty-one.
The spleen protruded, and the protruding part was ligated by a silver
wire, one-half of the organ sloughing off; the patient recovered. Sir
Astley Cooper mentions a curious case, in which, after vomiting, during
which the spleen was torn from its attachments, this organ produced a
swelling in the groin which was supposed to be a hernia. The vomiting
continued, and at the end of a week the woman died; it was then found
that the spleen had been turned half round on its axis, and detached
from the diaphragm; it had become enlarged; the twist interrupted the
return of the blood. Portal speaks of a rupture of the spleen simply
from engorgement. There was no history of a fall, contusion, or other
injury. Tait describes a case of rupture of the spleen in a woman who,
in attempting to avoid her husband's kick, fell on the edge of the
table. There were no signs of external violence, but she died the third
day afterward. The abdomen was found full of blood, and the spleen and
peritoneal covering was ruptured for three inches.

Splenec