English Translation

25a IV. Bacteriological findings. l.) Encapsulated space under the left diaphragm cup. In direct swab Gram positive cokes for two and Gram positive rods. Cultural: non-hemolding staphylococci, enterococken (direct sowing). Gram hegative rods not grown. 2.) Left pleural cavity. In swab red blood cells, leukocytes and Gram Positive cokes in pairs. Cultial nest: no growth in direct seed. After enrichment, non-hemolating streptococci, bacterium coli and non-hemolytic white staphylococci. Cultures of proteus overgrown. 3.) Heart sac. In swab red blood cells, fibrin threads, leukocytes, no microorganisms. Culturally: in direct sowing no growth, after enrichment Bacterium coli and do not hemilüsieren de white staphylococcal. V. Pathologically anatomical diagnosis. Bacterial general infection (intoxication) with tremor swelling of liver, kidneys and heart muscle. Surgically supplied gunshot by explosive: shot opening at the back at the height of the ll. Rib; condition after Kxcision of the skin wound edges and seam, as well as removal of parts of the ll. rib Mäeb Drainage. Fibrinous purulent left-side pleuritis due to mixed infection with opacified haemorrhagic exsudat (650 and 50 cem) drainage of the left pleural cavity in the sinus phrenico costalis; sewed through wound in the muscular part of the Left Zwörhfell halves, phlegmons of the diaphragm in the urination. Surprising defect of the spleen. By fresh fibrinous bonding against the free abdominal height covered and drained under the rib bogem mixed infected wound cavity under the left diaphragm half. Described phlegmons of the chest muscles in the vicinity of the Drainoids. Blande, partially thrombosis of the arteria and vena lienalis. Low right-wing hydrothorax, compression telectase of the lower back sections of the right lung. Lung oedema. Very low fat loss in the intima of the aorta and the cramping veins. VI. Epicrisis, 7 days before death, the shot injury caused by øSprengstück had opened the thoracic cavity and, as a result of the throttle of the diaphragm, also opened the abdominal cavity, and led to a tearing of the spleen. The surgical care of all of these injuries had to be expected that these wounds were contaminated by germs that were also penetrated and were concerned to derive the expected inflammatory exudate formation to the outside. Accordingly, the thoracic cavity and the abdominal cavity were drained completely and in a purpose-oriented manner after the spleen had been removed. The predicted inflammation caused by introduced germs actually occurred and spread during the days following the injury in the area of the diaphragm wound; furthermore, an inflammatory et-guss also developed in the left thoracic cavity, which contained numerous bacteria (streptococcal, baeterium coli, etc.). In the last time before death, this inflammation was spread to the pericardial sac. The fact that bacteria must have entered the blood together with their toxins arises from the typical damage of vital parenchymatous eaxf organs, such as liver, kidneys and heart muscle.