The two following very interesting cases of abdominal injury having been received while these pages were passing through the press, are here inserted:—
A man in the 19th Regiment was wounded through the abdomen, and survived nineteen hours, the ball entering near to the umbilicus, and passing out close to the sacrum. On the post-mortem examination, the small intestines were found to have been wounded no less than sixteen times by the ball in its passage. When wounded, he was stooping in the act of defecation.
T. Alexander, Deputy Inspector-General.
5th August, 1855.
On the evening after the battle of Alma, as my regiment was halting on the brow of a hill, previous to bivouacking, a wounded Russian officer, apparently in great pain, was perceived on the other side of the ravine. Passing over to where he lay, I found that he had been wounded by a musket-ball, that had entered the lumbar region directly over the spine. As he was enabled in his agony to crawl on his hands and knees, it was evident there was no paralysis, and on passing a probe I found the ball had avoided the spine, but as I could not pass in the instrument more than an inch, I was left in uncertainty as to its further course.
He was removed to my hospital tent, when I tried, but with little success, to remove the excessive pain from which he was suffering. In about two hours after he took my finger and placed it on a hard substance imbedded in the walls of the abdomen, and on cutting down on this I perceived a musket-ball. Previous to extracting it, however, I observed a white, glistening substance oozing from the wound, which, on carefully removing with the probe, proved to be a portion of tape-worm, about a yard and a half in length. I then extracted the ball, and again another portion of the worm presented, which measured about two yards and a half in length. It was now complete, though cut in two evidently by the ball, and the two portions, one containing the head and the other the tail, were soon writhing on the table.
The patient experienced immediate relief; the pain had ceased; he slept well, and on the following morning he was free from thirst, with a tolerably quiet pulse. Unfortunately the order arrived for all prisoners and wounded to be sent to the rear, and I lost sight of the case.
What was the cause of this agony of pain? Evidently the writhing of the worm, or why should it so suddenly cease on the worm’s liberation? The abdomen must have been entered by the ball, or how could the worm’s exit have been effected? Nevertheless, but for its presence, the patient was so free from constitutional symptoms on the following morning that a surmise might really have arisen that the ball had passed round the abdomen without injury to the peritoneum.
Rt. De Lisle, Surgeon,
4th K. O. Regiment.