er
sacrosciatic notch. Camper records the case of a sailor who fell from a
mast and struck upon some fragments of wood, one of which entered the
anus and penetrated the bladder, the result being a rectovesical
fistula. About a year later the man consulted Camper, who
unsuccessfully attempted to extract the piece of wood; but by incising
the fistula it was found that two calculi had formed about the wooden
pieces, and when these were extracted the patient recovered. Perrin
gives the history of a man of forty who, while adjusting curtains, fell
and struck an overturned chair; one of the chair-legs penetrated the
anus. Its extraction was followed by a gush of urine, and for several
days the man suffered from incontinence of urine and feces. By the
tenth day he was passing urine from the urethra, and on the
twenty-fifth day there was a complete cicatrix of the parts; fifteen
days later he suffered from an attack of retention of urine lasting
five days; this was completely relieved after the expulsion of a small
piece of trouser-cloth which had been pushed into the bladder at the
time of the accident. Post reports the case of a young man who, in
jumping over a broomstick, was impaled upon it, the stick entering the
anus without causing any external wound, and penetrating the bladder,
thus allowing the escape of urine through the anus. A peculiar sequela
was that the man suffered from a calculus, the nucleus of which was a
piece of the seat of his pantaloons which the stick had carried in.

Couper reports a fatal case of stab-wound of the buttocks, in which the
knife passed through the lesser sacrosciatic notch and entered the
bladder close to the trigone. The patient was a man of twenty-three, a
seaman, and in a quarrel had been stabbed in the buttocks with a long
sailor's knife, with resultant symptoms of peritonitis which proved
fatal. At the autopsy it was found that the knife had passed through
the gluteal muscles and divided part of the great sacrosciatic
ligament. It then passed through the small sacrosciatic notch,
completely dividing the pudic artery and nerve, and one vein, each end
being closed by a clot. The knife entered the bladder close to the
trigone, making an opening large enough to admit the index finger.
There were well-marked evidences of peritonitis and cellulitis.

Old-time surgeons had considerable difficulty in extracting arrow-heads
from persons who had received their injuries while on horseback. C