Text-book of forensic medicine and toxicologyBuchanan, R. J. M. (Robert James McLean)
Science
Text-book of forensic medicine and toxicology
Buchanan, R. J. M. (Robert James McLean)
Medical jurisprudence; Poisons
Wounds of the _chest_ are dangerous, on account of the amount of the
hæmorrhage which may take place, and the importance of the organs
which may be injured. Death may result more from the mechanical action
of the blood effused than from the depressing effect of the quantity
evacuated. Penetrating wounds of the thorax injuring the lungs cause
emphysema, pneumo-, pyo-, or hæmothorax, any of which may prove fatal;
pleurisy and pneumonia may occur. A fracture of the ribs may give rise
to injury of the lung substance or to inflammation of its coverings.
Laceration of the lungs may take place without fracture of the ribs.
The ventricles of the heart may be pierced, and yet life may be
prolonged for one or two months, permitting of considerable locomotion
during that period (Briand et Chaudé, _Med. Leg._, vol. i. p. 511).
Wounds of the heart, however, are, as a rule, rapidly fatal. Rupture
of valves may follow blows on the chest, and rupture of the heart may
occur from crushes or violent blows. Rupture of the heart has taken
place during violent exertion, and this is more likely to occur when
the muscle is diseased. It is often difficult to make out the direction
of the wound, as the lungs change their position during respiration.
Injuries of the Abdomen
Wounds of the _abdomen_, penetrating the intestines, although not
necessarily fatal, may cause death from peritonitis, due to the escape
of the intestinal fluids. Rupture of the intestine may follow blows or
crushing; it is generally fatal from peritonitis unless early surgical
treatment is carried out. Hernia may also follow wounds of the abdomen.
Rupture of the liver is not of infrequent occurrence, and may occur
without any external signs of the injury. The rupture is, as a rule,
longitudinal, transverse lacerations being rare. It is often followed
by pneumonia if not rapidly fatal. The cœliac plexus may be much
damaged by a blow or kick on the stomach, especially if this organ be
distended with food, and death may result without leaving any trace of
the injury externally or internally. The bladder may be ruptured and
death result from extravasated urine. Rupture of the bladder may occur
from fracture of the pelvis without sign of external injury. Rupture of
the _kidney_ may be recovered from if slight, but when severe is fatal.
Rupture of the spleen is usually fatal, and is more likely to occur
when enlarged from any cause. Coagulable lymph, the effect of a wound
of a serous membrane, may be thrown out in twelve hours or less.
Injuries to the abdomen may cause death by--
1. Shock; without lesion of the internal organs,
inflammation, or external signs of injury.
2. Hæmorrhage.
3. Lesion of the internal organs, but without inflammation.
Death in these cases seems to be due to depression of the
nervous system due to the intense pain following these
injuries.
4. By inflammation without lesion of internal organs.
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