MASTER L. H . , age 6, was knocked down and run over by a motor-car on July 9, 1915. He was seen at 6 p.m., three and a half hours after the accident, in consultation with Dr. Eustace Harwood. The front wheel of the car had passed obliquely across the abdomen and thorax from the right iliac spine to the left axillary region. He had not been rendered unconscious, but, as he explained himself, he had been badly 'winded,' and was still suffering from slight 'stitch' on the right side whenever he took a deep breath. There were some surface abrasions on the body, but no bones were broken. The general condition of the patient was good, and considering the nature of the accident and the age of the patient, the amount of shock was comparatively slight.
There was no evidence of head injury, and from the condition of the patient at such an interval from the time of the accident, grave internal hemorrhage could be excluded. The problem of injury to an internal viscus remained for consideration. He passed eight ounces of normal urine three hours after the accident. The abdomen was tender from the bruising of the muscles, but otherwise it moved freely, was not rigid or distended, and the liver dullness was present and apparently normal in extent. A gross injury t o any part of the alimentary tract seemed unlikely in the presence of these signs, and it was therefore determined to regard him as potentially a case of bruising of some part of the abdominal contents, capable of recovery if complete rest to the affected part could be achieved. He was placed in the Fowler position, continuou6 administration of 20 per cent solution of glucose in saline per rectum was begun, a total abstinence from anything by mouth-including