The
postmortem examination showed that the ball had pierced the
sternum just above the xiphoid cartilage, and had entered the
pericardium to the right and at the lower part. The sac was
filled with blood, both fresh and clotted. There was a ragged
wound in the anterior wall 1/2 inch in diameter. The wound of
exit was 5/8 inch in diameter. After traversing the heart the
ball had penetrated the diaphragm, wounded the omentum in several
places, and become lodged under the skin posteriorly between the
9th and 10th ribs. Church adds that the "Index Catalogue of the
Surgeon-General's Library" at Washington contains 22 cases of
direct injury to the heart, all of which lived longer than his
case: 17 lived over three days; eight lived over ten days; two
lived over twenty-five days; one died on the fifty-fifth day, and
there were three well-authenticated recoveries. Purple tabulates
a list of 42 cases of heart-injury which survived from thirty
minutes to seventy days.
Fourteen instances of gunshot wounds of the heart have been
collected from U.S. Army reports, in all of which death followed
very promptly, except in one instance in which the patient
survived fifty hours. In another case the patient lived
twenty-six hours after reception of the injury, the conical
pistol-ball passing through the anterior margin of the right lobe
of the lung into the pericardium, through the right auricle, and
again entered the right pleural cavity, passing through the
posterior margin of the lower lobe of the right lung; at the
autopsy it was found in the right pleural cavity.
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