1897 The Lancet  
145 CLINICAL NOTES. md examination we concluded that the boy had in all probability sustained a rupture of the intestine, and that in immediate laparotomy lay his sole chance of life. Accordingly I asked Dr. Balfour, of Chard, to administer chloroform. Before Dr. Balfour's arrival the boy rapidly got worse ; the ,pulse at the wrist became imperceptible, and the temperature -fell to 97°. The lad was evidently dying, and under the -circumstances it seemed useless to risk the accusation of baving
more » ... cusation of baving killed him. He died abut an hour afterwards. Dr. Crosby told me that before death the abdomen became much more distended, with tympanitic percussion note all over, and loss of liver dulness. By the coroner's order I made a post-mortem examination fourteen hours after death. The peritoneum contained about two pints of cloudy fluid, mixed with partially digested food. 'There were flakes of recent lymph adherent to the intestines, which were much reddened. On turning back the omentum and coils of small intestine a rent in the second part of the duodenum was revealed, from which the chyme was escaping. ilt was large enough to admit four fingers, and was distant four and a half inches from the pyloric orifice. The case seems to me to be of interest from the fact that,
doi:10.1016/s0140-6736(00)32036-0 fatcat:u34zbke3n5dbzbyom66v2in5uu