. Modern surgery, general and operative. d 50 cases operated upon: 56 per cent,recovered and 44 per cent. died. Fevrier- has collected 56 ruptures ofthe spleen. In 46 cases operation was performed and the mortality was 50percent. E. Berger (Archiv. fiir klinische Chirurgie, Bd. 28, Heft 3) col-lected 168 fatal cases of rupture of the spleen: 145 died during the first dayand every one of them died from hemorrhage. After the first day 23 90 per cent, of the entire series hemorrhage caused death; in 10 per cent,infection was responsible for death. Vedova collected 194 cases of splenectomy
. Modern surgery, general and operative. d 50 cases operated upon: 56 per cent,recovered and 44 per cent. died. Fevrier- has collected 56 ruptures ofthe spleen. In 46 cases operation was performed and the mortality was 50percent. E. Berger (Archiv. fiir klinische Chirurgie, Bd. 28, Heft 3) col-lected 168 fatal cases of rupture of the spleen: 145 died during the first dayand every one of them died from hemorrhage. After the first day 23 90 per cent, of the entire series hemorrhage caused death; in 10 per cent,infection was responsible for death. Vedova collected 194 cases of splenectomyfor traumatic rupture, with 65 deaths, a mortality of per cent. (PracticalMedicine Series, vol. ii, 1913). Hemorrhage is the great danger in rupturedspleen—hemorrhage from the parenchyma rather than from the great parenchyma is friable and contains multitudes of capillaries andveins, there is no muscular tissue, divided vessels do not tend to contract, ^ Jour. Am. Med. Assoc., Oct. 25, 1902.^Rev. de Chir., Nov., Fig. 707.—Fauntleroys case of rupturedspleen. External surface. Exploratory incision willrecognize the conditionElders table there are Enlargements and Tumors of the Spleen 1203 and the capsule is thm (the elder Senn, in Jour. Am. Med. Assoc., , 1903). Treatment of Wounds and Rupture.—The treatment is evident from theprevious remarks. It is as follows: Open the abdomen immediately, the patientbeing surrounded with hot bottles and hot salt solution flowing into a the spleen and other viscera. If the spleen is damaged, we may dosplenectomy (total or partial), may use the suture, the cautery, or the tampon,and any other visceral injuries are, of course, attended to. The usual operation has been total splenectomy. In partial splenectomyonly the injured part is excised and the wound margins are sutured. The arrest of hemorrhage by suture is known as splenorrhaphy. Lamarchia,in 1896, was the first to perform this operation. The
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