The Abdomen 163 



one, three perished immediately from hemorrhage, and another died 

 very soon from perforation of the bladder. Of the twenty-seven, 

 eighteen succumbed in less than twenty hours. Of this number 

 four died from peritoneal infection after severe hemorrhage, and 

 the other fourteen from peritonitis without hemorrhage. Of the 

 remainder, six died on the second or third day and three on the 

 fourth. In most of the animals the perforations were numerous, 

 there being in none of them fewer than six, and in one twenty-six. 

 Chaput advocates immediate surgical intervention. When he 

 operated within three-quarters of an hour after receipt of the in- 

 juries he saved one hundred per cent. Seven cases operated upon 

 later than this terminated in four deaths and three recoveries. 



McGraw shot four dogs through the abdomen with balls of 

 22 caliber and one drachm weight. All lived, and had apparently 

 recovered on the twelfth day after the shooting, when they were 

 killed. In one animal there was no trace whatever of the ball, 

 either in the abdominal cavity or the skin and muscles. In another 

 the ball had penetrated the spleen and cut four holes in the small 

 and one in the large intestines. The omentum, which was wounded 

 and injured, and intestines were bound together by adhesions. On 

 separating the coils of the intestines, the wounds were found to 

 have united, but a pouting projecting portion of the mucosa showed 

 where the ball had passed through. The third animal had suffered 

 perforation of the spleen and the small gut in several places. Many 

 of the places had healed, as in the second animal, but in one part 

 there remained two orifices lined by everted mucosa, which pre- 

 vented discharge of the contents by adhesion to neighboring coils 

 of intestine. In the fourth animal the spleen alone was injured. 

 In all the spleen wounds had healed without suppuration. These ex- 

 periments would indicate that bullet wounds of 22 caliber may 

 be left to natural processes of repair with safety. 



With regard to wounds produced by implements, it may be 

 said that they are usually dangerous. Anything of the nature 

 of a bayonet stab is certainly so, but Stockfleth has recorded a case 

 of a dog being pierced transversely through the abdomen by a 

 hay-fork, the animal recovering fully without any sign of suppura- 

 tion having taken place. 



Symptoms and Diagnosis. In perforating wounds of the 

 abdomen it is very difificult to decide whether the intestine or any 



