书城公版Anomalies and Curiosities of Medicine
33139200000329

第329章

(6) An exploded shell passed through the hamstring muscles of the right thigh and embedded itself in the ligamentous tissues of the internal condyle of the femur.

(7) Shot by a ball between the 6th and 7th ribs of the left side.

(8) Bayonetted through the body, the steel passing through the left lobe of the liver and penetrating the posterior border of the diaphragm.

(9) Pistol-ball shot through the sternocleido muscle of one side of the neck, emerging through the corresponding muscle of the other side of the neck.

(10) Sabre-thrust between the bones of the left forearm.

(11) Pistol-shot through the left pectoralis major and left deltoid muscles.

(12) Deep cut dividing the commissure between the left thumb and forefinger down to the carpal bones.

Somewhat analogous to the foregoing is a case reported in 1834 by McCosh from Calcutta. The patient was a native who had been dreadfully butchered in the Chooar campaign. One of his hands was cut off above the wrist. The remaining stump was nearly amputated by a second blow. A third blow penetrated the shoulder-joint.

Beside these and several other slashes, he had a cut across the abdomen extending from the umbilicus to the spine. This cut divided the parietes and severed one of the coats of the colon.

The intestines escaped and lay by his side. He was then left on the ground as dead. On arrival at the hospital his wounds were dressed and he speedily convalesced, but the injured colon ruptured and an artificial anus was formed and part of the feces were discharged through the wound. This man was subsequently seen at Midnapore healthy and lusty although his body was bent to one side in consequence of a large cicatrix; a small portion of the feces occasionally passed through the open wound.

There is an account of a private soldier, aged twenty-seven, who suffered a gunshot wound of the skull, causing compound fracture of the cranium, and who also received compound fractures of both bones of the leg. He did not present himself for treatment until ten days later. At this time the head- injury caused him no inconvenience, but it was necessary to amputate the leg and remove the necrosed bones from the cranial wounds; the patient recovered.

Recovery After Injuries by Machinery, with Multiple Fractures, etc.--Persons accidentally caught in some portions of powerful machinery usually suffer several major injuries, any one of which might have been fatal, yet there are marvelous instances of recovery after wounds of this nature. Phares records the case of a boy of nine who, while playing in the saw-gate of a cotton-press, was struck by the lever in revolution, the blow fracturing both bones of the leg about the middle. At the second revolution his shoulder was crushed; the third passed over him, and the fourth, with maximum momentum struck his head, carrying away a large part of the integument, including one eyebrow, portions of the skull, membranes, and brain-substance. A piece of cranial bone was found sticking in the lever, and there were stains of brain on all the 24 posts around the circumference of the hole. Possibly from 1 1/2 to two ounces of cerebral substance were lost. A physician was called, but thinking the case hopeless he declined to offer surgical interference. Undaunted, the father of the injured lad straightened the leg, adjusted the various fractures, and administered calomel and salts. The boy progressively recovered, and in a few weeks his shoulder and legs were well. About this time a loosened fragment of the skull was removed almost the size and shape of a dessert spoon, with the handle attached, leaving a circular opening directly over the eye as large as a Mexican dollar, through which cerebral pulsation was visible. A peculiar feature of this case was that the boy never lost consciousness, and while one of his playmates ran for assistance he got out of the hole himself, and moved to a spot ten feet distant before any help arrived, and even then he declined proffered aid from a man he disliked. This boy stated that he remembered each revolution of the lever and the individual injuries that each inflicted. Three years after his injury he was in every respect well. Fraser mentions an instance of a boy of fifteen who was caught in the crank of a balance-wheel in a shingle-mill, and was taken up insensible. His skull was fractured at the parietal eminence and the pericranium stripped off, leaving a bloody tumor near the base of the fracture about two inches in diameter. The right humerus was fractured at the external condyle; there was a fracture of the coronoid process of the ulna, and a backward dislocation at the elbow. The annular ligament was ruptured, and the radius was separated from the ulna. On the left side there was a fracture of the anatomic neck of the humerus, and a dislocation downward. The boy was trephined, and the comminuted fragments removed; in about six weeks recovery was nearly complete. Gibson reports the history of a girl of eight who was caught by her clothing in a perpendicular shaft in motion, and carried around at a rate of 150 or 200 times a minute until the machinery could be stopped.

Although she was found in a state of shock, she was anesthetized, in order that immediate attention could be given to her injuries, which were found to be as follows:--(1) An oblique fracture of the middle third of the right femur.

(2) A transverse fracture of the middle third of the left femur.

(3) A slightly comminuted transverse fracture of the middle third of the left tibia and fibula.

(4) A transverse fracture of the lower third of the right humerus.

(5) A fracture of the lower third of the right radius.

(6) A partial radiocarpal dislocation.

(7) Considerable injuries of the soft parts at the seats of fracture, and contusions and abrasions all over the body.