Gunshot injuries : how they are inflicted : their complications and treatment . tion producedis allied to one of contusion in whicha localized portion of the spinal cordsustains a destructive process suffi-cient to interrupt the normalchannels of communication withthe higher centers. In a numberof cases cited the symptoms arethose of complete transverse lesion. (3) Contusion.—Mr. Makinsdistinguishes this condition frompure concussion though the twoare closely allied. In cases ofcontusion the post-mortem condi-tions showed adhesion between thecord and enveloping dura at pointswhere the ball had
Gunshot injuries : how they are inflicted : their complications and treatment . tion producedis allied to one of contusion in whicha localized portion of the spinal cordsustains a destructive process suffi-cient to interrupt the normalchannels of communication withthe higher centers. In a numberof cases cited the symptoms arethose of complete transverse lesion. (3) Contusion.—Mr. Makinsdistinguishes this condition frompure concussion though the twoare closely allied. In cases ofcontusion the post-mortem condi-tions showed adhesion between thecord and enveloping dura at pointswhere the ball had struck the neural arch without fracture. Thelesion of the cord which was most marked suggested injury bycontre-coup. The duration of life was about five weeks. Oneor two segments of the cord were completely disorganized, thecord substance was represented by a semi-diffluent yellowish ma-terial of soft consistency. When held up the membranes wereprone to collapse opposite the affected portion as shown in The case to which the figure refers is described as follows:. Fig. IIS.—Appearance of spinal cordenclosed in membranes in case 103 after re-moval from the canal. When the mem-branes were opened a white custard-likesubstance took place of the cord. Slightevidence of extradural hemorrhage existed.(Makins.) 218 GUNSHOT WOUNDS total transverse lesion; slight intra-dural hemorrhage. Wound ofentry (Mauser), below spine of scapula, close to right axilla; exit,2 1/2 inches to left of tenth dorsal spinous process. Complete motorand sensory paralysis below ensiform cartilage, with well-markedhyperesthetic zone around trunk. All reflexes absent. Retention ofurine. Incontinence of feces. Bed-sores in sacral region developed dur-ing the first two days, and seventeen days later well-developed serpigi-nous trophic sores developed on the outer side of each leg and con-tinued to increase slowly until death. The paralysis remained of theabsolutely flaccid variety. Great emaciation o
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