493 



SCIENCE. 



about two ounces of greenish yellow fluid — a .mixture 

 of pus and biliary matter. This abscess did not in- 

 volve any portion of the substance of the liver except 

 the surface with which it was in contact, and no 

 communication could be detected between it and any 

 part of the wound. 



Some recent peritoneal adhesions existed between 

 the upper surface of the right lobe of the liver and the 

 diaphragm. The liver was larger than normal, weigh- 

 ing eighty-four ounces ; its substance was firm, but of 

 a pale yellowish color on its surface and throughout 

 the interior of the organ, from fatty degeneration. 

 No evidence that it had been penetrated by the 

 bullet could be found, nor were there any abscesses 

 or infarctions in any part of its tissue. 



The spleen was connected to the diaphragm by 

 firm, probably old, peritoneal adhesions. There were 

 several rather deep congenital fissures in its margins, 

 giving it alobulated appearance. It was abnormally 

 large, weighing eighteen ounces \ of a very dark lake- 

 red color both on the surface and on section. Its 

 parenchyma was soft and flabby, but contained no ab- 

 scesses or infarctions. 



There were some recent peritoneal adhesions be- 

 tween the posterior wall of the stomach and the pos- 

 terior abdominal parietes. With this exception no 

 abnormities were discovered in the stomach or in- 

 testines, nor were any other evidences of general or 

 local peritonitis found besides those already specified. 



The right kidney weighed six ounces, the left kidney 

 seven. Just beneath the capsule of the left kidney, at 

 about the middle of its convex border, there was a 

 little abscess one-third of an inch in diameter, and 

 there were three small serous cysts on the convex bor- 

 der of the right kidney, just beneath the capsule ; in 

 other respects the tissue of both kidneys was normal 

 in appearance and texture. 



The urinary bladder was empty. 



Behind the right kidney, after the removal of that 

 organ from the body, the dilated track of the bullet 

 was dissected into. It was found that from the 

 point at which it had fractured the right eleventh rib 

 (three and one-half inches to the right of the vertebral 

 spines) that missile had gone to the left, obliquely 

 forward, passing through the body of the first lumbar 

 vertebra and lodging in the adipose connective tissue 

 immediately below the lower border of the pancreas, 

 about two and one-half inches to the left of the spinal 

 column, and behind the peritoneum. It had become 

 completely encysted. 



The track of the bullet between the point at which 

 it had fractured the eleventh rib and that at which it 

 entered the first lumbar vertebra was considerably di- 

 lated, and the pus had burrowed downward through 

 the adipose tissue behind the right kidney, and thence 

 had found its way between the peritoneum and the 

 right iliac fascia, making a descending channel which 

 extended almost to the groin. The adipose tissue be- 

 hind the right kidney, and thence had found its way 

 between the peritoneum and the right iliac, fascia, 

 making a descending channel which extended almost 

 to the groin. The adipose tissue behind the kidney 

 in the vicinity of this descending channel was much 

 thickened and condensed by inflammation. In the 

 channel, which was almost free from pus, lay the flex- 

 ible catheter introduced into the wound at the com- 



mencement of the autopsy ; its extremity was found 

 doubled upon itself, immediately beneath the perito- 

 neum, reposing upon the iliac fascia, where the chan- 

 nel was dilated into a pouch of considerable size. 

 This long descending channel, now clearly seen to be 

 caused by the burrowing of pus from the wound, was 

 supposed, during life, to have been the track of the 

 bullet. 



The last dorsal, together with the first and second 

 lumbar vertebra and the twelfth rib, were then re- 

 moved from the body for more thorough examination. 



When this examination was made, it was found 

 that the bullet had penetrated the first lumbar verte- 

 bra in the upper part of the right side of its body. 

 The aperture by which it entered involved the inter- 

 vertebral cartilage next above, and was situated just 

 below and anterior to the intervertebral foramen, from 

 which its upper -margin was about" one-fourth of an 

 inch distant. Passing obliquely to the left, and for- 

 i ward through the upper part of the body of the first 

 ! lumbar vertebra, the bullet emerged by an aperture, 

 the centre of which was about one-half inch to the 

 left of the median line, and which also involved the 

 intervertebral cartilage next above. The cancellated 

 tissue of the body of the first lumbar vertebra was 

 very much comminuted and the fragments somewhat 

 displaced. Several deep fissures extended from the 

 track of the. bullet into the lower part of the body of 

 the twelfth dorsal vertebra. Others extended through 

 the first lumbar vertebra into the intervertebral carti- 

 lage between it and the second lumbar vertebra. 

 Both this cartilage and that next above were partly 

 destroyed by ulceration. A number of minute frag- 

 ments from the fractured lumbar vertebra had been 

 driven into the adjacent soft parts. 



It was further found that the right twelfth rib also 

 was fractured at a point one and one-fourth inch to 

 the right of the traverse process of the twelfth dorsal 

 vertebra; this injury had not been recognized during 

 life. 



On sawing through the vertebra, a little to the right 

 of the median line, it was found that the spinal canal 

 was not involved by the track of the ball. The spinal 

 cord, and other contents of this portion of the spinal 

 canal, presented no abnormal appearances. The rest 

 of the spinal cord was not examined. 



Beyond the first lumbar vertebra, the bullet con- 

 tinued to go to the left, passing behind the pancreas 

 to the point where it was found. Here it was en- 

 veloped in a firm cyst of connective tissue, which 

 contained, besides the ball, a minute quantity of in- 

 spissated, somewhat cheesy pus, which formed a thin 

 layer over a portion of the surface of the lead. 

 There was also a black shred adherent to a part of 

 the cyst-wall, which pioved, on microscopical exam- 

 ination, to be the remains of a blood-clot. For about 

 an inch from this cyst the track of the ball behind 

 the pancreas was completely obliterated by the healing 

 process. Thence, as far backward as the body of 

 the first lumber vertebra, the track was filled with 

 coagulated blood, which extended on the left into an 

 irregular space rent in the adjoining adipose tissue 

 behind the peritoneum and above the pancreas. The 

 blood had worked its way to the left, bursting finally 

 through the peritoneum behind the spleen into the 

 abdominal cavity. The rending of the tissues by the 



