Abstract
The following unusual case occurred recently in my practice: Patient. —A boy, aged 16, was shot in the left breast. Examination. —I found the patient with a rapid pulse of fairly good quality, showing moderate signs of shock, with a bullet wound over the fifth rib, on the left side, 1½ inches inside the mammary line. An hour previously a friend, in handing to him a 22-caliber rifle, had accidentally discharged it when the muzzle was almost touching his breast, and directed slightly outward and upward. It seemed that the heart could not have escaped. No apex beat was visible, and to my surprise none could be felt, nor could any sound be heard in the usual locality. Percussion gave moderately dull note at the fifth rib, passing into dulness lower down and continuing the costal margin. Examination of the right side cleared up the anomaly, as there was no
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