Shell explosion (1 meter distant) kills a soldier by bursting both lungs within the intact thoracic cage.
Case 201. (Sencert, January, 1915.)
A man of the 26th Regiment of Infantry was brought October 26, 1914, to Ambulance No. 6 of the Twentieth Army Corps at the Chateau d’Henu. Weakly and jerkily the man was able to tell how, as he was going forward, a large calibre shell fell less than a meter in front of him and exploded. He fell back and lost consciousness, was picked up in the evening and carried to the relief post and then to the ambulance, where he arrived ten hours after the fall. There were signs of a considerable shakeup, with pale and anxious face, nose pinched, hollow eyes, rapid superficial respiration, small pulse, 120, and a feeble voice. There were small skin wounds of the right arm, a finger, and ear, but there was otherwise no wound. The thorax and abdomen were somewhat painful all over, but there was no especial point of pain. The chest showed a slight dulness at the bases. Examination of the abdomen produced defensive movements and the man vomited blood during examination. He was put on his back, kept warm, given artificial serum, hypodermic injections of camphorated oil and caffeine, and carefully watched. In the night he had another bloody vomiting, his pulse became smaller and smaller, dyspnea became more and more intense, and he died late in the night.
The autopsy showed that the abdomen was free of lesions and that all the organs were of a normal appearance and color. There was no sign of perforation or of peritonitis. The stomach itself was filled with blood and there was a generalized ecchymotic appearance of the mucosa, with small, submucous hematomata and a number of tears in the pyloric portion.
The pleurae were found filled with blood, almost a quart in each cavity. The right lung showed a large tear at the level of the middle lobe, 15 cm. long. An orange-size, black bit of lung protruded through the tear. There was no sign of rib fracture opposite this tear, and no subpleural, intercostal or subcutaneous contusion. The thorax wall was perfectly normal.
The left lung showed, in the middle portion of the upper lobe, a somewhat analogous pleural tear, almost as big as that on the right, with another large hernia of black lung. Bits of the herniated lung sank in water. The thorax wall was intact. The pericardium was free from blood. There was nothing else abnormal about the body.
Re effects of an explosion upon structures with intervening objects left intact, Fauntleroy notes that a shell bursting three yards from an aneroid barometer may force its levers into an abnormal position. A further fact will indicate how permanent is the physical state into which the levers are forced; for when the barometer with its levers placed right was placed under a bell-jar and the pressure therein was reduced to 410 mm., the levers resumed the position into which the explosion of the big shell had thrown them.
Re windage and internal effects in the human body, Ravaut recalls the fact that the internal and intraneural hemorrhages of Caisson disease (“bends”) are well known. The external hemorrhages of aeronauts and mountain climbers belong in the same physical class. Dynamite exploded in a pond kills fish. Dynamite may break pillars inside a building without damaging its front. Cases like Chavigny’s ([198]), Roussy and Boisseau’s ([199]), Claude and Lhermitte’s ([200]), as well as Ravaut’s own case ([202]) are in point.