Medical Jurisprudence, Volume 2 (of 3)Paris, John Ayrton
Science
Medical Jurisprudence, Volume 2 (of 3)
Paris, John Ayrton
Medical laws and legislation -- Great Britain
communicating with, the hole in the stomach; so that a portion of the
contents of the latter organ had escaped into the cavity of the chest.
This part of the diaphragm was next removed. A careful examination of
the other abdominal and thoracic viscera did not lead to the detection
of the slightest diseased appearance. There was no where the smallest
evidence of previous inflammation, no adhesions or ulcerations of any
part of the viscera. The fluid which had escaped appeared to be nothing
more than the contents of the stomach, of which the wine and water[189]
formed a part, and probably gave it its dark colour. The stomach, on
being examined after its removal from the body, afforded the following
observations. The mucous membrane appeared to be more red and vascular
than usual throughout its whole extent, and, here and there, were small
spots of what seemed to be extravasated blood, lying below the mucous
coat—for these spots were not to be washed off, nor to be removed by the
edge of the scalpel. There were two holes in the stomach, the larger
very near to the cardiac end of the small curvature, and on the
posterior surface: this was more than an inch in length, and about half
that breadth; the other not far from the former, also on the posterior
surface, about the size of a sixpence. The edges of these holes were
smooth, well defined, and slightly elevated. The coats of the stomach
were thin in many other spots, and in one in particular nothing was left
but the peritoneum, the mucous and muscular coats being entirely
destroyed. The hole in the diaphragm was through the muscular portion,
where it is of considerable thickness, and was large enough to admit the
end of the finger. There was no appearance of ulceration or of pus
adhering to the edges of this perforation of the diaphragm.” We have
extracted a full account of this dissection, as the case is in itself
truly interesting. The symptoms of the patient had been carefully
watched, and no pain, or uneasiness was ever heard of, throughout the
whole course of the disease, except in the head.
The powers of the stomach, as it would appear from the report, had
suddenly revived at about twelve hours before his death, for “he asked
for food, and swallowed a few spoonsfull of calves’-foot jelly with
apparent relish.” May we not then conclude by observing, that the facts
above related very satisfactorily corroborate the truth of the corollary
deduced by _Mr. Burns_, “that the digestion of the coats of the stomach
may take place under two very different conditions of the body; that
although such solution is most frequent in those who have been suddenly
deprived of life, when in full health, that it is not confined to those
alone, but does, under certain circumstances, occur in those who have
died from lingering diseases.”
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