Chips from a surgeon's workshop : five consecutive cases of gunshot wounds of the abdominal viscera treated by abdominal section : two deaths, three recoveries / by A.C. Bernays.

  • Bernays, Augustus Charles, 1854-1907.
Date:
1890
Catalogue details

Licence: Public Domain Mark

Credit: Chips from a surgeon's workshop : five consecutive cases of gunshot wounds of the abdominal viscera treated by abdominal section : two deaths, three recoveries / by A.C. Bernays. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    the injury, as long ago as the year 1885. For me this rule of practice has become a principle from which only insurmount- able obstacles could make me deviate at the present time. The decision was made easy for me. I saw a dear friend lose his life on account of non-interference and I had opportuni- ties of seeing three other coroners’ post-mortems where the injuries were such as seemed to me clearly amenable ta the reparative art of the surgeon. I am of the opinion that if the records of all the coroners’ offices in the United States, cover- ing the period of the past ten years, could be compiled, at least one thousand cases of death following non-interference in perforating gunshot wounds of the abdomen could be col- lected2. Only one-half of them might prove to be cases in which our art could have won laurels under favorable circumstances, but even that number wrould open a grand field of usefulness for laparotomy. I am aware that these subjective convictions do not bear as much weight as the statistical records of work done and I must admit the logical correctness of Stimson’s conclusion quoted above. Let the subjoined cases bear wit- ness and perhaps it will then be admitted by all that my con- victions have proven useful in my practice. Case I.—Annie Gorman, between nine and ten years of age, was shot by her brother on July 3d, 1887, while playing with a toy pistol, the mouth of which was almost touching her dress when discharged. The boy had loaded the pistol with three shot, caliber 18 (Turkey shot). There was but a single hole in the skin. It was situated three inches below the umbilicus and about three and one-half inches to the right of the median line, just over the cfecum. The probe could not be passed into the abdominal cavity because of the contractions of the muscles and the changed position of the patient, she having been shot while walking. After she was fully anaesthetized the probe passed through the parietes and considerable blood escaped through the bullet hole. Lapar- otomy was performed by enlarging the wound upwards and downwards. In the fascia of the external oblique two per- forations were found side by side and there were two holes, one oblong the other round in the parietal peritoneum. 2. This opinion is based on a calculation of probabilities, arrived at by keeping a lookout in the criminal items of the daily press for two years.