No blood appeared by stool. The wound suppurated healthily. He was, kept on very mild and diet. On the eighth day, severe pain suddenly set up in the left iliac region. This pain was by pressure, but was very limited in its extent.!y, and his pulse rose to 110 per minute. His bowels had acted freely the day be; His tongue was dry and furred. lie had a dozen leeches and. fomentations applied to the abdo's powder, in doses of g. i ordered hour.? the pain had quite left, was stopped. II: L not act without the use of a clyster. He got plenty of mild >hinent, anil. time, cod-liver oil. Though without; -a or symptom of ailment, he be. but olti v.liied, and made a good the ball never depth of the wound wthat it had pene! the I saw a in one of the French hospitals at (' stautinople whose abdomen had Md from P THE CRIMEAN WAR. behind, forwards, by a ball at Inkerman.
The bulk't had entered near the spine of the last dorsal vertebra, and had escaped near to, but slightly to the left of the umbilicus. The gut protruded for some days at the anterior wound, but did not appear to be injured, at least no intestinal secretion showed itself at either orifice. Hardly any bad symptom seemed to have followed. The gut was returned, the man kept low, and opium freely administered. He made a most excellent recovery. In another patient in the same hospital, a wound of exactly the same description had been inflicted. The same symptoms and result followed, except that the gut did not protrude, and that recovery was slower. The following was a very remarkable case, which, though not strictly a wound of the abdomen, I mention here as I do not intend to refer to gun-shot wounds of the rectum.
I saw the patient at Scutari, towards the end of 1854, under the immediate charge of Mr. Price, now assistant-surgeon of the 14th regiment. A ball entered the front of a soldier's left thigh, three inches above the patella, as he was mounting the heights at Alma, and passed upwards deep among the muscles of the thigh. It then turned round the limb, traversed the muscles of the left hip, crossed the perineum deeply, and escaped on the right hip, having passed through the rectum some way above the anus. The wound of exit closed, and for several days before death fasces passed by the wound above the knee. Sloughing arid irritative fever set in, and he sank rapidly. To prevent the infiltration of feecal matter in these cases, Larrey has recommended the use of a tube in the rectum. MF bladder has been wounded by pin-shot several.ring tlu- past war, bur the returns fail to tell us how oft.
Balls at timrs pass through the pelvis, and yet sj Thus, in one inch I have notes, ssed in by one sacro-ischiatic notch, and out by the ithout doing more mischief than contusing the iiu. Vv'hen the bones of the pelvis are broken, the injury is very serious, from their deep position, ne I to important vessels, and thick covering. meyer has called attention to the great liability there is to pya-mia after such injuries. If the ball p; through the peritoneum, then the risk of violent inilamis so great us to render the wound generally The bladder may be wounded in many di. hut the passage of the ball in an obli<:ue line from above downwards, and to either side, seems the most course for it to take.
Occasionally its superior In. is opened by a ball passing across the abdomen from. close ab syniphysis puhis. Tinwill depend mainly mi whether has been injured or not. If it lias not been opened, then the prognosis will, in some measure, n tlie empty or full condition of the viseus at the moment of penetration. If the direction of the u of urine into I -ill not be long These are the cases whose hopeless nature p llippoeratie axiom, "em caae of a man wounded at Cliillianv.:illah, thmt. t he unrvivod four days. SUKGEKY OF THE CRIMEAN WAR. persecta vcsica lethale; " as gun-shot wounds, at any rate, implicating those parts of the viscus which are uncovered by serous membrane, are by no means so mortal as they were so long supposed.
Dr. John Thomson saw in Belgium alone, fourteen cases in a fair way of recovery. A ball may lodge either in the neighbourhood of the bladder, or entering its cavity, remain there. This latter result will be most apt to occur when the bladder is full of urine, or the ball much spent at the moment of contact. In rare cases a ball, when very small, has been passed with the urine, and it has been known to escape by the formation and opening of an abscess in the perineum. The urine may escape by the wound at once, or at a later period when the eschar separates from the wound; or it may not escape at all. It is seldom, however, that it fails to pass in some quantity at the time of injury.