Chap, xvii] THE SPLEEN. 359 



For instance, a woman ruptured her spleen in an 

 attempt to save herself from falling, and another in 

 springing aside to avoid a blow. The patients in each 

 instance were natives of India, and the latter case 

 gave rise to a charge of homicide. The spleen being 

 extremely vascular, it follows that ruptures of the 

 viscus are usually, but not necessarily, fatal from 

 haemorrhage. It is well to note, in connection with 

 this matter, that the spleen contains most blood 

 during digestion. A case is reported, however, of a 

 boy who met with an accident just after dinner, and 

 who managed to walk some distance, although his 

 spleen, as the autopsy revealed, was separated into 

 three portions. He lived some days. In severe 

 fractures of the ninth, tenth, and eleventh ribs the 

 spleen may be damaged and lacerated. 



The capsule of the spleen contains muscular tissue, 

 and must possess some contractile power. This fact 

 may serve to explain cases of recovery from limited 

 wounds of the organ, such as small gunshot wounds. 

 In such lesions the capsule may contract and greatly 

 narrow the hole in the viscus, while the track of the 

 bullet or knife may become filled with blood-clot, and 

 the bleeding thus be stayed. 



The spleen may be greatly enlarged in certain 

 diseased conditions. The hypertrophied spleen may 

 attain such dimensions as to fill nearly the whole 

 abdomen, and in one case a cystic tumour so com- 

 pletely occupied both iliac fossae that it was mistaken 

 for an ovarian cyst, and the operation for ovariotomy 

 was commenced. It is said that the enlarged spleen, 

 in its earlier stages, encroaches upon the thoracic 

 cavity relatively more in the child than in the adult. 

 This is explained by the statement that the costo-colic 

 fold, upon which the spleen rests, is much more 

 resisting in the young than it is in those of more 

 mature age. 



