6 pounds; there is another
record of one weighing 15 pounds. Elliot mentions a spleen weighing 11
pounds; Burrows one, 11 pounds; Blasius, four pounds; Osiander, nine
pounds; Blanchard, 31 pounds; Richardson, 3 1/2 pounds; and Hare, 93
ounces.

The thoracic duct, although so much protected by its anatomical
position, under exceptional circumstances has been ruptured or wounded.
Kirchner has collected 17 cases of this nature, two of which were due
to contusions of the chest, one each to a puncture, a cut, and a
shot-wound, and three to erosion from suppuration. In the remaining
cases the account fails to assign a definite cause. Chylothorax, or
chylous ascites, is generally a result of this injury. Krabbel mentions
a patient who was run over by an empty coal car, and who died on the
fifth day from suffocation due to an effusion into the right pleural
cavity. On postmortem examination it was found that the effusion was
chyle, the thoracic duct being torn just opposite the 9th dorsal
vertebra, which had been transversely fractured. In one of Kirchner's
cases a girl of nine had been violently pushed against a window-sill,
striking the front of her chest in front of the 3d rib. She suffered
from pleural effusion, which, on aspiration, proved to be chyle. She
ultimately recovered her health. In 1891 Eyer reported a case of
rupture of the thoracic duct, causing death on the thirty-eighth day.
The young man had been caught between a railroad car and an engine, and
no bones were broken.

Manley reports a case of rupture of the thoracic duct in a man of
thirty-five, who was struck by the pole of a brewery wagon; he was
knocked down on his back, the wheel passing squarely over his abdomen.
There was subsequent bulging low down in the right iliac fossa, caused
by the presence of a fluid, which chemic and microscopic examination
proved was chyle. From five to eight ounces a day of this fluid were
discharged, until the tenth day, when the bulging was opened and
drained. On the fifteenth day the wound was healed and the man left the
hospital quite restored to health.

Keen has reported four instances of accidental injury to the thoracic
duct, near its termination at the base of the left side of the neck;
the wounding was in the course of removals for deep-seated growths in
this region. Three of the cases recovered, having sustained no
detriment from the injury to the thoracic duct. One died; but the fatal
influence was not special