CASES OF ABDOMINAL WOUND.

By Sub-Assistant Surgeon Harrynarain Banerjee.

CASE I.?WOUND OF TtlE ABDOMEN; RUPTURE OP THE PERI- TONEUM; PROTRUSION OF THE INTESTINE; PERFECT RECOVERY.

A small strong bull inflicted a severe wound on the right iliac region of a poor female, named Doorgee, aged about 45, at 1 p.m. of the 26th August, 1871. The woman fell down

instantly, and the peritoneum being ruptured, a large portion of the small intestine, about two feet long, protruded. She was

brought to me almost insensible at 5 p. m. of tliat dav, when, with careful manipulation, I replaced the protruded gut, which was cedematous and distended with gas, but not much dis- colored. The wound, which was circular, rather constricted, and measured about an inch in diameter, was sutured and

dressed with carbolic oil. The bleeding was copious, and the shock was severe. On the second day, that is, after the expiration of 24 hours,

although there was very little extravasation of blood into the

peritoneal cavity, she complained of smarting pain and extreme tenderness overthe abdomen surrounding the injured portion. The fever was high ; skin hot; pulse rapid and full; and there was loss of appetite, with restlessness and extreme thirst. Ordered?Morphia every four hours, anodyne fomentation, and

light food. These were sufficient to check the further progress of peritonitis; but on the subsidence of the inflammation, diarrhoea, of a serious nature, occurred, and there was consi- derable vomiting. Astringents, opium, port, and light nutri- tious food were administered with care, and the diarrhoea got over. She then began to rally her strength, and the localized

inflammation, which poured forth healthy plastic lymph that bound up the inflamed peritoneum with the abdominal wall, subsided completely, and she was discharged, cured, on the 26th October, 1871.

CASE II.?GUNSHOT "WOUND OF THE ABDOMEN; PERI- TONITIS; RECOVERY.

Mkhir Sheik, a stout Mnhomedan, aged about 30, was shot in the abdomen on the night of the 26th May, 1872. At about 5 p.m. of the day following he was brought to me quite pros- trated from loss of blood and severe shock. I extracted three more pellets from the different parts of the body ; a shot also entered the chest, and penetrated the whole depth of the left lung. This shot, in all probability, made its exit through the back.

On tlie 28tli, a greater portion of the abdominal wall became very tender, so much so that even a coarse cloth could not be placed upon it. The tongue was furred, and the breath foul; there was considerable thirst ; the pulse tvus rapid and full 5 and the heat of skin greater than before. With all these

bad symptoms, low muttering delirium supervened, and I

feared loosing the patient very soon ; but, contrary to every expectation, and to my great joy, the patient began to rally from the 31st May. Still, there was considerable swelling of the abdomen, which was also painful. By care and atten- tion the patient improved daily, till on the 14th June, when he was thought out of danger. The portion of the lung through which a shot entered, also inflamed ; but the inflam-

mation was not very severe. On the 16th June he was seized

with diarrhoea, which was almost uncontrollable. With great difficulty the patient was saved from this unexpected compli- cation. lie was discharged on the 26th June, 1872. Remarks.?The peculiar feature in these two cases is the

occurrence of diarrhoea at the time when the inflammatory lymph was absorbing. Is it the irritating property of the lymph which, as it was absorbed, produced serious diarrhoea ; or is it an undue excitement of the contiguous parts during the process of absorption, so that a copious secretion from the

glandular apparatus of the intestine was effected ? The former mode of explanation cannot be true, and the latter is the most probable. These two cases also show that after a severe injury of vital organs, life may be saved, especially in the laboring classes of the natives; so t.liat, however dangerous the injury may be, we ought never to be hopeless.