SCIENCE. 



499 



extravasation of this blood was undoubtedly the 

 cause of the paroxysms of pain which occurred a 

 short time before death. 



This mass of coagulated blood was of irregular 

 form, and nearly as large as a man's fist. It could be 

 distinctly seen from in front through the peritoneum, 

 after its site behind the greater curvature of the 

 stomach had been exposed by the dissection of the 

 greater omentum from the stomach, and especially 

 after some delicate adhesions between the stomach 

 and the part of the peritoneum covering the blood- 

 mass had been broken down by the fingers. From 

 the relations of the mass as thus seen, it was believed 

 that the hemorrhage had proceeded from one of the 

 mesenteric arteries, but as it was clear that a minute 

 dissection would be required to determine the par- 

 ticular branch involved, it was agreed that the infil- 

 trated tissues and the adjoining soft parts should be 

 preserved for subsequent study. 



On the examination and dissection made in ac- 

 cordance with this agreement, it was found that the 

 fatal hemorrhage proceeded from a rent, nearly four 

 tenths of an inch long, in the main trunk of the 

 splenic artery, two and one-half inches to the left of 

 the cceliac axis. This rent must have occurred at 

 least several days before death, since the everted edges 

 in the slit in the vessel were united by firm adhesions 

 to the surrounding connective tissue, thus forming an 

 almost continuous wall bounding the ad- 

 joining portion of the blood-clot. More- 

 over, the peripheral portion of the clot in 

 this vicinity was disposed in pretty firm 

 concentric layers. It was further found 

 that the cyst below the lower margin of 

 the pancreas, in which the bullet was 

 found, was situated three and one-half 

 inches to the left of the cceliac axis. 



Besides the mass of coagulated blood 

 just described, another, about the size of 

 a walnut, was found in the greater omen- 

 tum, near the splenic extremity of the 

 stomach. The communication, if any, 

 between tnis and the larger hemorrhage 

 mass could not be made out. 



The examination of the thoracic viscera 

 resulted as follows : 



The heart weighed eleven ounces. All 

 the cavities were entirely empty except 

 the right ventricle, in which a few shreds Dl 

 of soft, reddish, coagulated .blood ad- 

 hered to the internal surface. On the surface of 

 the mitral valve there were several spots of fatty 

 degeneration; with this exception the cardiac valves 

 were normal. The muscular tissue of the heart was 

 soft, and tore easily. A few spots of fatty degene- 

 ration existed in the lining membrane of the aorta 

 just above the semilunar valves, and a slender clot of 

 fibrin was found in the aorta, where it was divided, 

 about two inches from these valves, for the removal 

 of the heart. 



On the right side slight pleuritic adhesions ex- 

 isted between the convex surface of the lower lobe of 

 the lung and the costal pleura, and firm adhesions 

 between the anterior edge of the lower lobe, the peri- 

 cardium, and the diaphragm. The right lung weighed 

 thirty-two ounces. The posterior part of the fissure, 



between its upper and lower lobes, was congenitally 

 incomplete. The lower lobe of the right lung was 

 hypostatically congested, and considerable portions, 

 especially toward its base, were the seat of broncho 

 pneumonia. The bronchial tubes contained a consid- 

 erable quantity of stringy muco-pus ; their mucous 

 surface was reddened by catarrhal bronchitis. The 

 lung-tissue was cedematous, but contained no abcesses 

 or infarctions. 



On the left side the lower lobe of the lung was 

 bound behind to the costal pleura, above to the upper 

 lobe, and below to the diaphragm, by pretty firm 

 pleuritic adhesions. The left lung weighed twenty- 

 seven ounces. The condition of the bronchial tubes 

 and of the lung-tissue was very nearly the same as on 

 the right side, the chief difference being that the area 

 of the broncho-pneumonia in the lower lobe was much 

 less extensive in the left lung than in the right. In 

 the lateral part of the lower lobe of the left lung, and 

 about an inch from its pleural surface, there was a 

 group of four minute areas of gray hepatization, each 

 about one-eighth of an inch in diameter. There were 

 no infractions and no abcesses in any part of the 

 lung- tissue. 



The surgeons assisting at the autopsy were unani- 

 mously of the opinion that, on reviewing the history of 

 the case in connection with the autopsy, it is quite 



XY 



)F a Horizontal Section through a Frozen Human Cadaver 

 at the Level of the Pancreas. 



evident that the different suppurating surfaces, and es- 

 pecially the fractured spongy tissue of the vertebra 

 furnish a sufficient explanation of the septic conditions 

 which existed during life. 



The accompanying diagrams (page 503) from the 

 Medical Record illustrate the course of the bullet very 

 aptly. Fig. 6 is, in our opinion, valueless as a diagram, 

 and it is difficult to harmonize the statements about 

 the track of the ball, and the figure reference, "injury 

 to artery'* in the latter illustration. The figure refer- 

 ence, " Point of impact of ball and deflection" may 

 be also taken with some allowance. 



We have added a schematic drawing taken from a 

 plate representing a frozen section through the human 



