anomalies and curiosities of medicine-第177部分

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（10）　Sabre…thrust　between　the　bones　of　the　left　forearm。

（11）　Pistol…shot　through　the　left　pectoralis　major　and　left　deltoid　muscles。

（12）　Deep　cut　dividing　the　commissure　between　the　left　thumb　and　forefinger　down　to　the　carpal　bones。

Somewhat　analogous　to　the　foregoing　is　a　case　reported　in　1834　by　McCosh　from　Calcutta。　The　patient　was　a　native　who　had　been　dreadfully　butchered　in　the　Chooar　campaign。　One　of　his　hands　was　cut　off　above　the　wrist。　The　remaining　stump　was　nearly　amputated　by　a　second　blow。　A　third　blow　penetrated　the　shoulder…joint。　Beside　these　and　several　other　slashes；　he　had　a　cut　across　the　abdomen　extending　from　the　umbilicus　to　the　spine。　This　cut　divided　the　parietes　and　severed　one　of　the　coats　of　the　colon。　The　intestines　escaped　and　lay　by　his　side。　He　was　then　left　on　the　ground　as　dead。　On　arrival　at　the　hospital　his　wounds　were　dressed　and　he　speedily　convalesced；　but　the　injured　colon　ruptured　and　an　artificial　anus　was　formed　and　part　of　the　feces　were　discharged　through　the　wound。　This　man　was　subsequently　seen　at　Midnapore　healthy　and　lusty　although　his　body　was　bent　to　one　side　in　consequence　of　a　large　cicatrix；　a　small　portion　of　the　feces　occasionally　passed　through　the　open　wound。

There　is　an　account　of　a　private　soldier；　aged　twenty…seven；　who　suffered　a　gunshot　wound　of　the　skull；　causing　compound　fracture　of　the　cranium；　and　who　also　received　compound　fractures　of　both　bones　of　the　leg。　He　did　not　present　himself　for　treatment　until　ten　days　later。　At　this　time　the　head…　injury　caused　him　no　inconvenience；　but　it　was　necessary　to　amputate　the　leg　and　remove　the　necrosed　bones　from　the　cranial　wounds；　the　patient　recovered。

Recovery　After　Injuries　by　Machinery；　with　Multiple　Fractures；　etc。Persons　accidentally　caught　in　some　portions　of　powerful　machinery　usually　suffer　several　major　injuries；　any　one　of　which　might　have　been　fatal；　yet　there　are　marvelous　instances　of　recovery　after　wounds　of　this　nature。　Phares　records　the　case　of　a　boy　of　nine　who；　while　playing　in　the　saw…gate　of　a　cotton…press；　was　struck　by　the　lever　in　revolution；　the　blow　fracturing　both　bones　of　the　leg　about　the　middle。　At　the　second　revolution　his　shoulder　was　crushed；　the　third　passed　over　him；　and　the　fourth；　with　maximum　momentum　struck　his　head；　carrying　away　a　large　part　of　the　integument；　including　one　eyebrow；　portions　of　the　skull；　membranes；　and　brain…substance。　A　piece　of　cranial　bone　was　found　sticking　in　the　lever；　and　there　were　stains　of　brain　on　all　the　24　posts　around　the　circumference　of　the　hole。　Possibly　from　1　1/2　to　two　ounces　of　cerebral　substance　were　lost。　A　physician　was　called；　but　thinking　the　case　hopeless　he　declined　to　offer　surgical　interference。　Undaunted；　the　father　of　the　injured　lad　straightened　the　leg；　adjusted　the　various　fractures；　and　administered　calomel　and　salts。　The　boy　progressively　recovered；　and　in　a　few　weeks　his　shoulder　and　legs　were　well。　About　this　time　a　loosened　fragment　of　the　skull　was　removed　almost　the　size　and　shape　of　a　dessert　spoon；　with　the　handle　attached；　leaving　a　circular　opening　directly　over　the　eye　as　large　as　a　Mexican　dollar；　through　which　cerebral　pulsation　was　visible。　A　peculiar　feature　of　this　case　was　that　the　boy　never　lost　consciousness；　and　while　one　of　his　playmates　ran　for　assistance　he　got　out　of　the　hole　himself；　and　moved　to　a　spot　ten　feet　distant　before　any　help　arrived；　and　even　then　he　declined　proffered　aid　from　a　man　he　disliked。　This　boy　stated　that　he　remembered　each　revolution　of　the　lever　and　the　individual　injuries　that　each　inflicted。　Three　years　after　his　injury　he　was　in　every　respect　well。　Fraser　mentions　an　instance　of　a　boy　of　fifteen　who　was　caught　in　the　crank　of　a　balance…wheel　in　a　shingle…mill；　and　was　taken　up　insensible。　His　skull　was　fractured　at　the　parietal　eminence　and　the　pericranium　stripped　off；　leaving　a　bloody　tumor　near　the　base　of　the　fracture　about　two　inches　in　diameter。　The　right　humerus　was　fractured　at　the　external　condyle；　there　was　a　fracture　of　the　coronoid　process　of　the　ulna；　and　a　backward　dislocation　at　the　elbow。　The　annular　ligament　was　ruptured；　and　the　radius　was　separated　from　the　ulna。　On　the　left　side　there　was　a　fracture　of　the　anatomic　neck　of　the　humerus；　and　a　dislocation　downward。　The　boy　was　trephined；　and　the　comminuted　fragments　removed；　in　about　six　weeks　recovery　was　nearly　complete。　Gibson　reports　the　history　of　a　girl　of　eight　who　was　caught　by　her　clothing　in　a　perpendicular　shaft　in　motion；　and　carried　around　at　a　rate　of　150　or　200　times　a　minute　until　the　machinery　could　be　stopped。　Although　she　was　found　in　a　state　of　shock；　she　was　anesthetized；　in　order　that　immediate　attention　could　be　given　to　her　injuries；　which　were　found　to　be　as　follows：

（1）　An　oblique　fracture　of　the　middle　third　of　the　right　femur。

（2）　A　transverse　fracture　of　the　middle　third　of　the　left　femur。

（3）　A　slightly　comminuted　transverse　fracture　of　the　middle　third　of　the　left　tibia　and　fibula。

（4）　A　transverse　fracture　of　the　lower　third　of　the　right　humerus。

（5）　A　fracture　of　the　lower　third　of　the　right　radius。

（6）　A　partial　radiocarpal　dislocation。

（7）　Considerable　injuries　of　the　soft　parts　at　the　seats　of　fracture；　and　contusions　and　abrasions　all　over　the　body。

During　convalescence　the　little　patient　suffered　an　attack　of　measles；　but　after　careful　treatment　it　was　found　by　the　seventy…eighth　day　that　she　had　recovered　without　bony　deformity；　and　that　there　was　bony　union　in　all　the　fractures。　There　was　slight　tilting　upward　in　the　left　femur；　in　which　the　fracture　had　been　transverse；　but　there　was　no　perceptible　shortening。

Hulke　describes　a　silver…polisher　of　thirty…six　who；　while　standing　near　a　machine；　had　his　sleeve　caught　by　a　rapidly…turning　wheel；　which　drew　him　in　and　whirled　him　round　and　round；　his　legs　striking　against　the　ceiling　and　floor　of　the　room。　It　was　thought　the　wheel　had　made　50　revolutions　before　the　machinery　was　stopped。　After　his　removal　it　was　found　that　his　left　humerus　was　fractured　at　its　lower　third；　and　apparently　comminuted。　There　was　no　pulse　in　the　wrist　in　either　the　radial　or　ulnar　arteries；　but　there　was　pulsation　in　the　brachial　as　low　as　the　ecchymosed　swelling。　Those　parts　of　the　hand　and　fingers　supplied　by　the　median　and　radial　nerves　were　insensible。　The　right　humerus　was　broken　at　the　middle；　the　end　of　the　upper　fragment　piercing　the　triceps；　and　almost　protruding　through　the　skin。　One　or　more　of　the　middle　ribs　on　the　right　side　were　broken　near　the　angle；　and　there　was　a　large　transverse　rent　in　the　quadriceps　extensor。　Despite　this　terrible　accident　the　man　made　a　perfect　recovery；　with　the　single　exception　of　limitation　of　flexion　in　the　left　elbow…joint。

Dewey　details　a　description　of　a　girl　of　six　who　was　carried　around　the　upright　shaft　of　a　flour　mill　in　which　her　clothes　became　entangled。　Some　part　of　the　body　struck　the　bags　or　stones　with　each　revolution。　She　sustained　a　fracture　of　the　left　humerus　near　the　insertion　of　the　deltoid；　a　fracture　of　the　middle　third　of　the　left　femur；　a　compound　fracture　of　the　left　femur　in　the　upper　third；　with　protrusion　of　the　upper　fragment　and　considerable　venous　hemorrhage；　and　fracture　of　the　right　tibia　and　fibula　at　the　upper　third。　When　taken　from　the　shafting　the　child　was　in　a　moribund　state；　with　scarcely　perceptible　pulse；　and　all　the　accompanying　symptoms　of　shock。　Her　injuries　were　dressed；　the　fractures　reduced；　and　starch　bandages　applied；　in　about　six　weeks　there　was　perfect　union；　the　right　leg　being　slightly　shortened。　Six　months　later　she　was　playing　about；　with　only　a　slight　halt　in　her　gait。

Miscellaneous　Multiple　Fractures。Westmoreland　speaks　of　a　man　who　was　pressed　between　two　cars；　and　sustained　a　fracture　of　both　collar…bones　and　of　the　sternum；　in　addition；　six　or　eight　ribs　were　fractured；　driven　into　and　lacerating　the　lung。　The　heart　was　displaced。　In　spite　of　these　terrible　injuries；　the　man　was　rational　when　picked　up；　and　lived　nearly　half　a　day。　In　comment　on　this　case　Battey　mentions　an　instance　in　which　a　mill…sawyer　was　run　over　by　20　or　30　logs；　which　produced　innumerable　fractures　of　his　body；　constituting　him　a　surgical　curiosity。　He　afterward　completely　recovered；　and；　as　a　consequence　of　his　miraculous　escape；　became　a　soothsayer　in　his　region。　West　reports　a　remarkable　recovery　after　a　compound　fracture　of　the　femur；　fracture　of　the　jaw；　and　of　the　radius；　and　possibly　injury　to　the　base　of　the　skull；　and　injury　to　the　spine。

There　is　on　record　an　account　of　a　woman　of　forty…three　who；　by　muscular　action　in　lifting　a　stone；　fractured　her　pubes；　external　to　the　spine；　on　the　left　side。　Not　realizing　her　injury　she　continued　hard　work　all　that　day；　but　fell　exhausted　on　the　next。　She　recovered　in　about　a　month；　and　was　able　to　walk　as　well　as　ever。

Vinnedge　reports　recovery　after　concussion　of　the　brain　and　extreme　shock；　associated　with　fracture　of　the　left　femur；　and　comminuted　fractures　of　the　left　tibia　and　fibula。

Tufnell　mentions　recovery　after　compound　comminuted　fracture　of　the　leg；　with　simple　fracture　of　both　collar…bones；　and　dislocation　of　the　thumb。　Nankivell　speaks　of　a　remarkable　recovery　in　an　individual　who　suffered　compound　comminuted　fracture　of　both　legs；　and　fracture　of　the　skull。　It　was　found　necessary　to　amputate　the　right　thigh　and　left　leg。　Erichsen　effected　recovery　by　rest　alone；　in　an　individual　whose　ribs　and　both　clavicles　were　fractured　by　being　squeezed。

Gilman　records　recovery　after　injuries　consisting　of　fracture　of　the　frontal　bone　near　the　junction　with　the　right　parietal；　fracture　of　the　right　radius　and　ulna　at　the　middle　third　and　at　the　wrist；　and　compound　fracture　of　the　left　radius　and　ulna；　1　1/4　inches　above　the　wrist。　Boulting　reports　a　case　of　an　individual　who　suffered　compound　fractures　of　the　skull　and　humerus；　together　with　extensive　laceration　of　the　thigh　and　chest；　and　yet　recovered。

Barwell　mentions　recovery　after　amputation　of　the　shoulder…joint；　in　an　individual　who　had　suffered　fracture　of　the　base　of　the　skull；　fracture　of　the　jaw；　and　compound　fracture　of　the　right　humerus。　There　was　high　delirium　followed　by　imbecility　in　this　case。　Bo