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.

  • Augustus Charles Bernays
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.

    27/32 page 23
    Since the history of the above cases was written I have seen a case of gunshot wound of the abdomen which although it did not lead to a laparatomy is so instructive that I desire to record my observations and reflections in this connection. On Dec. 25th, 1889, at 8: 30 p. m., I received the following telegram: Dated, New Florence, Mo., Dec. 25th, 7:00 p.m. Can you come to operate on a strong, healthy patient suffer- ing from gun shot wound in the abdomen? Answer. Dr. T. H. Kallmeyer. Nat. C. Dryden. The latter name is the name of a celebrated criminal law- yer, who as I afterward learned is the attorney for the defend- ant in the criminal cause arising from the shooting. Evi- dently the jurist, who had been told that the chances of re- covery of the patient were very small intended to use the surgeon in his client’s favor, as well as the physician did, in favor of his patient. The Deputy Marshal, Mr. Messenger, about 40 years of age had been shot at very close range with a 38-caliber revolver while attempting to make an arrest. The ball entered the abdomen at a point about midway on a line extending from the umbilicus to the spine of the left ilium. The patient was doing exceedingly well, pulse ranging from 80 to 90, temperature was 991°, never had been above 101°, abdomen somewhat tympanitic but not painful on pressure. Patient had vomited a half dozen times, which one of the at- tending physicians attributed to the morphine that had been administered. About 40 hours had elapsed since the shoot- ing, the bowels had not moved, the patient had been properly and judiciously treated, he had only taken a few doses of mor- phine and quinine and but little liquid nourishment. From a superficial examination any one would have supposed that the ball entered the cavity and must have injured the intes- tines, either the descending colon, the sigmoid flexure or the small intestines or all of these. On account of the long time which had elapsed I did not very urgently press the necessity of performing an explorative laparotomy but after a consulta- tion with Dr. Kallmeyer, Dr. De Vault, Dr. Graves, and Dr. Krebs, we thought an explorative operation should be made, but knowing the bad results following late operations could offer the patient no very encouraging prognosis. The patient
    digitised image 1
    digitised image 2
    digitised image 3