RECTAL INSUFFLATION OF HYDROGEN GAS AN INFALLIBLE TEST IN THE DIAGNOSIS OF VISCERAL INJURY OF THE GASTRO-INTESTINAL CANAL IN PENETRATING WOUNDS OF THE ABDOMEN.Read in the Section on Surgery, at the Thirty-ninth Annual Meeting of the American Medical Association, May, 9, 1888, and illuistrated by three experiments on dogs.

The operative treatment of penetrating wounds of the abdomen complicated by visceral injury of the gastro-intestinal canal is now sanctioned by the best surgical authorities, and may be considered as a well established procedure, based as it is upon the results of experimentation and clinical experience. A visceral wound of the stomach or any portion of the intestinal canal sufficient in size to give rise to extravasation into the peritoneal cavity must be looked upon as a mortal injury unless promptly treated by abdominal section. A number of well authenticated cases are on record where a wound in the stomach or the large intestine healed and the patients recovered without the intervention of surgery, but these instances are so few that, practically, the force of the preceding statement remains unimpaired. After a careful study of an immense clinical material Otis came to the important conclusion that gunshot injuries of the