PECULIAR CASES OF TRAUMATISM OF INTERNAL ORGANS, 



SOME DUE TO TROPICAL CONDITIONS 



AND PRACTICES. 



By Maximilian Heezog. 

 {From the Biological Laboratory, Bureau of Science, Manila, P. I.) 



During the years 1904 and 1905, I encountered among my autopsy 

 material five cases of fatal traumatism of internal organs without ex- 

 ternal injuries. However, in two of these five instances fractured ribs 

 were responsible for the internal damage, which was followed by fatal 

 haemorrhage. Each one of the five presents quite peculiar and note- 

 worthy features, two are probably unique in kind; two were of rupture 

 of the spleen occurring in splenomegaly, two of rupure of the heart, one 

 a fatty heart which, in the absence of any other injury, was pierced by 

 a rib in consequence of a slight fall, and one case, rupture of fatty liver, 

 occurred during parturition because of native obstetrical practice. 



TWO CASES OF SPLEEN EUPTUEE . IN SPLENOMEGALY. 



Eupture of the spleen in the tropics is probably not at all rare, although 

 heretofore, it appears to have been the general impression that it is so. 



Glogner 1 has quite recently called attention to its occurrence in Java, where, 

 during the years 1893 to 1898 he saw ten cases of rupture of the spleen. A sum- 

 mary of Glogner's observations will be of interest. In all ten cases, the spleen 

 was enlarged, in several instances very much so; in all, the cause of the rup- 

 ture, followed by fatal haemorrhage, was comparatively slight; in four cases 

 malarial parasites were found in the spleen upon post-mortem examination. 

 Glogner, from his observations, draws the practical conclusion that a person 

 during or after a malarial infection, as long as an enlarged spleen is present, 

 should be guarded carefully against any danger which might lead to a rupture 

 of the spleen. 



Our own two cases of rupture of the spleen are the following : 



Case I. — J. R., a 15-year old, male, Filipino boy, on July 15, 1904, was brought 

 to the San Juan de Dios Hospital. It appears that the boy had received a slight 

 kick or had suffered a fall. No diagnosis was made and he died syncope on July 

 16, in the afternoon. 



1 Glogner : Ueber Milzrupturen in den Tropen. Arch. f. Schiffs u. Trop. Syg. 

 (1906), 10, 17. 



