194 Miscellanies. i 



a rare one ; and we congratulate the public, and especially the med- 

 ical profession, that it fell into the hands of one who appreciated its 

 value, and who possessed the requisite intelligence, perseverance, and 

 candor, to make the investigation which it afforded, and to state the 

 results of such investigation, in a plain, simple, intelligible manner, 

 without bias from preconceived opinions, or fanciful hypotheses. 



The case which gave rise to these experiments will be understood, 

 from a brief summary of a particular account given of it, in the in- 

 troduction to the book. 



In the year 1822, Alexis St. Martin, then in the employment of the 

 American Fur Company, while at Michillimackinac, where Dr. B. 

 was stationed, was wounded in the side by the accidental discharge 

 of a musket loaded with buck shot. The contents of the gun struck 

 him upon the left side, and passed in an oblique direction forward 

 and inward, literally blowing off integuments and muscles of the size 

 of a man's hand, fracturing and carrying away the anterior half of 

 the sixth rib, fracturing the fifth, lacerating the lower portion of the 

 left lung, and the diaphragm, and perforating the stomach. The pro- 

 gress of the case, after so extensive a wound, involving parts of so 

 much importance, was, of course, slow. The soft parts in the vicinity 

 sloughed away : the ribs and their cartilages were successively at- 

 tacked and destroyed by inflammation, and removed by the sur- 

 geon ; and it was not until June, 1823, a year from the time of the 

 accident, that recovery, so far as it took place, was completed. At 

 that time, the parts were in the following state : the injured parts 

 were all sound, and firmly cicatrized, with the exception of the aper- 

 ture in the side and stomach. The perforation was about two and a 

 half inches in circumference ; and the food and drinks constantly 

 exuded, unless prevented by a tent, compress and bandage. At the 

 point where the lacerated edges of the muscular coat of the stomach 

 and the intercostal muscles met and united with the cutis vera, the 

 cuticle and the mucous membrane of the stomach approached each 

 other very nearly. They did not unite, like those of the lips, nose, 

 &c, but left an intermediate marginal space, of appreciable breadth, 

 between them, completely surrounding the aperture. This space is 

 about a line wide ; and the cutis and nervous papillae being unprotect- 

 ed, are as sensible and irritable as a blistered surface abraded of the 

 cuticle. The only change which has since taken place, is the gradual 

 falling down from the upper margin of the orifice, of a fold of the 



coats of the stomach, fitting itself to the aperture, and forming a valve, 



