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Resolved, That the Medical Profession has lost an upright and faithful member, and our Society an esteemed and honored brother.
Resolved, That we extend our heart-felt sympathy to his family for this their irreparable loss.
Resolved, That a copy of these resolutions be presented to his family and also to the "New York Medical Record" for publication.
REPORT OF A CASE OF PISTOL-SHOT WOUND
OF THE SECOND AND THIRD CERVICAL VERTEBRÆ, CONSIDERED IN ITS MEDICO-LEGAL ASPECTS.-ATTEMPTED
From the Bulletin of the Medico-Legal Society of New York, Vol. IV., No. 5, March, 1881.
Gentlemen: I have the honor to report for your consideration this evening a case of pistol-shot wound of the vertebræ of the neck, caused by an attempt at suicide, which is interesting not only per se, but which presents some important MedicoLegal bearings, and upon which I would be pleased to have the expressed opinion of the Society.
A few months ago I was requested, in the early part of the evening to visit Mrs. -, age 48, the statement made by the messenger being that she was suffering from a severe attack of sore throat. Being professionally engaged at the time, and not able to respond promptly, I made some hasty inquiries, and was told that she had been well in the morning; that her husband had left her so, and on returning in the evening found her suffering from sore throat; hence the urgent call for a physician. I said I could not respond at the time, and that if the symptoms were of a very urgent nature, another physician had better be called; but the family desired my services, and I was retained to attend her.
Shortly afterwards I proceeded to her house, and at twelve o'clock in the evening found her sitting on the sofa, with apparently nothing in her appearance to indicate any grave state of affairs. On interrogating her as to her condition, she stated simply that she had "sore throat." Her pulse was normal, or but little above, countenance calm, and there was a general
*Meeting of Feb. 2, 1881.
absence of external symptoms of a serious nature. On examing her mouth and depressing the tongue, I found the latter organ very black, thickened and congested. It filled the mouth, and made it difficult to open it. I asked her several questions, which she failed to answer in a satisfactory manner, because of her inability to articulate freely. I asked her to write the answers, but she refused to answer any questions by writing. In short the whole affair had the appearance of mystery.
Upon a further examination of the fauces, the first thing to suggest itself was gangrene; but when I considered that she had been well in the morning, and that there was absence of the usual collateral symptoms of gangrene, that conclusion was laid aside.
The next idea to suggest itself was that there had been an attempt at suicide from corrosive acid. But there was absence of pallor or any indication of the loss of blood. I felt, therefore, that she knew more about the case than I did, and treated it upon the expectant plan.
Having procured the necessary syringes, I applied warm water douches, and continued the same at intervals through the night. At six o'clock I allowed myself a few hours' rest. On reflection, I concluded that I would question her more particularly as to the cause of her condition, aud during the absence of other members of the family. She seemed anxious, and wanted to know the probabilities of her recovery. I also considered that, whatever her knowledge of the case might be, we had better have counsel. She then told me that she had attempted her life with her husband's pistol, by firing two shots in her mouth. On inquiring for the pistol, she told me it was in the bureau drawer. On examining the mouth, with this information, I found that one of the projectiles had penctrated the tongue, entering about an inch from the apex, passed through the tongue lengthwise, coming out at the base and imbedding itself in the cervical vertebræ.* Its location was confirmed by the aid of Nelaton's probe. I then went to my office to procure proper instruments for the extraction
*With reference to the velocity of the ball, experiments subsequently made with the same pistol, held in close proximity, proved the penetrating power sufficient to perforate an inch board and become deeply imbedded in another board of the same thickness.
of the bullets, together with the oral speculum of Dr. Whitehead.
I fortunately secured the assistance of my friend Dr. C. A. Leale. We endeavored, by our conjoined efforts and the aid of reflected light, to extract the bullets. We had three sittings. On the first day we did not succeed; neither did we on the second, although we got hold of a bullet: but on the third day I succeeded in extracting one. It had passed through the soft palate; but the opening was so small that we were obliged to enlarge the original orifice with a scalpel. I failed to extract the second ball.
She seemed very anxious that no one should be informed of what had happened, as none of the family were at all suspicious of the true state of affairs. But I told her that it would be very essential that she should give me in writing a statement of her case, the circumstances connected with it, and the reasons which induced her to make this attempt at suicide. I assured her that I would not use the statement unless I was compelled to, but that I must have it for my own protection. It is as follows, names being omitted for obvious reason:
"Dr. Ed. C. Harwood: I have not been feeling well in a long time. Am naturally very nervous, and I imagine all sorts of things that no one would ever think of. I feel at times as though I should go right through the window. Would go and close my blinds every night. Could not see into my rooms. My family all being away from day to day, it left me alone to my gloomy, sad feeling, and I got so excited, and my brain was so crazed, it seemed all on fire, that last Saturday, at two o'clock P. M., I took a pistol from -'s* drawer and fired two shots into my mouth, with the intention of taking my life. I was on my son's bed when I fired them. I lay awhile, then got up, took off the sheets and pillow-slips, put them away in the clothes-basket, and when he came home I sent him out after you; and when you came that night, I could not tell you; but after working over me all night, as you did, not knowing what I had done, I knew I must tell you."
The case was treated according to the most approved
* Naming her husband.