REPORTS OF CASES. 
377 
scess almost continuous. Intestines healthy. Ruptured 
stomach. Rest of cadaver seemed healthy. 
Two young M. D-s were present and loudly proclaimed 
her death was caused by ruptured stomach. So it stands. 
How I missed the correct diagnosis I cannot understand. 
So I say, be careful. 
PUNCTURE OF ABDOMINAL WALL. 
By The Same. 
Aug. io. Mare frightened and jumped on picket fence. 
Remained there until fence was razed. One pale entered ab¬ 
domen about three inches. I was called three hours after. 
Local talent had been at work. 
Pulse rapid, weak and about 70; head pendulous; surface 
of body and extremities cold; bowels out a foot and a half at 
least, black and cold; had laid down on gut several times. 
Told them “ It’s a very, very doubtful case indeed. Do what 
you can.” Ordered water heated, and started a man for 
tracheotomy tube. Gave stimulant, and prepared solution 
bichloride mercury, needles, etc. Laid her carefully on her 
back and secured her. 
Protrusion proved to be coecum with some gastro-colic 
omentum. Puncture about three inches in extent and situ¬ 
ated half-way between umbilicus and xyphoid cartilage and 
almost in mesian line. Bathed bowel with warm, weak an¬ 
tiseptic until it was warm. 
I endeavored for at least half an hour to return it; could 
not; too much straining ; could not wait for tube. I enlarged 
opening an inch or two; no hemorrhage externally from cut. 
I now returned bowel easily; opening now about five inches 
in length. Took six stitches, four strands each, needle in 
handle. Started them at least an inch back, and carried them 
entirely through abdominal wall. Think I drew them too 
tight. 
Released her; remained down an hour; gave stimulant, 
dried and blanketed her; very much distressed and weak; 
got up and walked to cowshed; crowd soon dispersed ; re¬ 
mained alone with her all night; towards morning ate and 
