Aids to Forensic Medicine and Toxicology

by W. G. Aitchison Robertson

8. Of the Heart.—Penetrating wounds are fatal from hæmorrhage, of the base more speedily than of the apex; but life may be prolonged for some time even after a severe wound to the heart. Injury to the right ventricle is the most fatal injury and the most frequent. Rupture from disease usually occurs in the left ventricle; rupture from a crush is usually towards the base and on the right side.

9. Of the Aorta and Pulmonary Artery.—Fatal.

10. Of the Diaphragm.—Generally fatal, owing to the severe injury of the other abdominal organs. If the diaphragm be ruptured, hernia of the organs may result.

11. Of the Abdomen.—Of the walls, may be dangerous from division of the epigastric artery; ventral hernia may follow, internal hæmorrhage, etc. Blows on the abdomen are prone to cause death from cardiac inhibition.

12. Of the Liver.—May divide the large vessels. Venous blood flows profusely from a punctured wound of the liver. Wounds of the gall-bladder cause effusion of bile and peritoneal inflammation. Laceration of the liver may result from external violence without leaving any outward sign of the injury; it is commonly fatal. There is rapid and acute anæmia from the pouring out of blood into the abdominal cavity. This may also occur with injuries of other organs in the abdomen.

13. Of the Spleen.—Fatal hæmorrhage may result from penetrating wounds or from rupture due to kicks, blows, crushes, especially if the spleen be enlarged.

14. Of the Stomach.—May be fatal from shock, from hæmorrhage, from extravasation of contents, or from inflammation. The danger is materially lessened by prompt surgical intervention.

15. Of the Intestines.—May be fatal in the same way as those of the stomach. More dangerous in the small than in the large intestines.

16. Of the Kidneys.—May prove fatal from hæmorrhage, extravasation of urine, or inflammation.

17. Of the Bladder.—Dangerous from extravasation of urine. In fracture of the pelvis the bladder is often injured, and extraperitoneal infiltration of urine occurs, with frequently a fatal issue.