The 3d, 4th, 5th, and 6th ribs
were fractured and torn apart, and about an inch of the substance
of the 4th rib was lost. Several jagged fragments were removed; a
portion of the pleura, two by four inches, had been torn away,
exposing the pericardium and the left lung, and showing the
former to have been penetrated and the latter torn. The lung
collapsed completely, and for three or four months no air seemed
to enter it, but respiration gradually returned. The lacerated
integument could only be closed approximately by sutures. It is
worthy of remark that, although extremely pale, the patient
complained of but little pain, and exhibited only slight symptoms
of shock. The pleural cavity subsequently filled with a dirty
serum, but even this did not interfere with the healing of the
wound and the restoration of the lung; the patient recovered
without lateral curvature.
Bartholf reports a case of rapid recovery after perforating wound
of the lung. The pistol-ball entered the back 1 1/2 inches to the
right of the spinous process of the 6th dorsal vertebra, and
passed upward and very slightly inward toward the median line.
Its track could be followed only 1 1/4 inches. Emphysema appeared
fifteen minutes after the reception of the wound, and soon became
pronounced throughout the front and side of the neck, a little
over the edge of the lower jaw, and on the chest two inches below
the sternum and one inch below the clavicle.
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