SHOT SPLIT KIDNEY.

Auckland Star, Volume LXVI, Issue 269, 13 November 1935, Page 25

SHOT SPLIT KIDNEY.

BUT VETERAN LIVES.

MEDICAL MEN AMAZED. COURAGE MISLED DOCTORS. {By THOMAS R. HENRY.) WASHINGTON, October 8. The strange story of a man who not only miraculously survived a shrapnel wound almost certain to be fatal, but who lived for 13 years without its existence being suspected, while he consulted some of the foremost medical men of three continents, is revealed in the latest issue of the Medical Bulletin of the Veterans' Administration. The case record is appropriately presented in the form of a medical detective story. The subject was' an American officer serving in the A.E.F. Early in October, 1918, he was wounded in action under circumstances that brought him a decoration for bravery. He Was struck in the chest either by a machine-gun bullet or a piece of shrapnel which penetrated his right lung, took a slanting course through the body, and came out in the lower part of the back. His legs were paralysed. He was taken to a field hospital, where the paralysis of liis legs continued for a week and he showed considerable difficulty in breathing. Then he was sent to a base hospital, where, as so often happened, "all the records in the case were lost." In January, 1919, he was back in IJie United States, where he remained in hospital for a year. Then he was discharged, with an allowance of one-tenth disability. His general condition was reported as "good." Apparently he had been treated only for the wound in the lung, and this condition had cleared up satisfactorily. His hospital record in the United States was fairly complete, but what happened to him in the three months between the battle casualty and his return from France is a complete mystery.

Kidney Cut in Two. Actually the piece of shrapnel had cut the man's right kidney completely in two; It must have caused an internal hemorrhage from which not 011 c man in a million could possibly have survived. He had lain for hours on the battlefield without medical attention. The pain must have, been unendurable. Yet none of the army doctors who treated him had any suspicion that anything was wrong with" the kidney. The man resumed his former job. He had been earning more than £4000 a year when he enlisted in 1917. His work took him all over the United States, to Spain and to South America. He was able to carry on his work successfully, the only physical difficulty being weakness and sometimes pain in the legs. From time to time during the .next few years he went to a veterans' bureau clinic for examination. Each time his complaints were essentially the same and each time, apparently, all the attention was paid to the old wound in the lung. At the same time he consalted distinguished private physicians in the various countries he visited. None apparently even suspected the split kidney. The'great difficulty appears to have been the personality of the man himself. Every time he appeared for examination he made light of his real sufferings. "Patient feeling fine" is a frequent note in his American hospital record.

X-ray Reveals Injury. But the pain in his legs was growing worse. It became so severe that he could not sleep. Finally, in 1932 an X-ray examination was made of the kidneys and the evidence was such that an exploratory operation was undertaken. The surgeons could hardly believe their eyes at the condition actually revealed. By all the laws of Nature the man should have been dead 13 years ago. Actually he had led a very active life and since his discharge from the army had never, even been in a. hospital. "It appears incredible that such an injury could have escaped diagnosis," says the report in the Medical Bulletin by Drs. Julius H. Hurst and Fred 11. Clark, of the central office staff. "There is a. possible excuse, however, in the large margin of error which must he allowed for the personal equation. Most physicians know patients so imbued with courage that they will undergo unflinchingly and uncomplainingly pain which is intolerable to the average individual. On the other hand, there are persons in whom the mere application of the blood pressure armlet induces an attack of hysteria. The records afford indisputable evidence as to the category in which this patient belonged. We have his continually reiterated repetition running through his year of hospitalisation of 'feels fine,' 'feels perfectly well,' etc. "Why with such a splitting injury to the kidney did not the patient bleed to death? Lid he lie so long, shocked and unconscious, on the field of battle that primary union took place? In some way the kidney hemorrhage was stopped. How, we do not know, except that we may infer it was not stopped by operative interference, since there is nothing in his army records to suggest that injury to the right kidney was even suspected." In their discussion of the case the two physicians point out that in all the records of the A.E.F. only 129 cases of kidney wounds of any sort were reported, and more than 50 per cent of these proved fatal.— (N.A.N.A.)