CASE.—Corporal James D. M——, Co. D, 108th New
York Volunteers, was wounded at the battle of
Fredericksburg, Virginia, December 13th, 1862, by
a conoidal ball, which lacerated the scalp over
the upper anterior portion of the left parietal
bone. He was admitted into Grace Church Hospital, Alexandria, on the 19th, where the wound was
diagnosticateddiagnosed as as a gunshot wound of the scalp. He
was able to walk about, and stated that he had
been unconscious only a short time. After a few
days he was attacked with convulsions, which
affected only the right side, producing tonic
spasms, only lasting about one hour. He recovered
from these sufficiently to be again able to walk
about. About the 18th or 19th of January, 1863,
the convulsions returned and grew more frequent,
until he sank into a comatose state, with constant
rigidity of the right side. He could be aroused
sufficiently to answer questions by yes and no.
The right pupil was dilated, and the pulse slow
and intermitting. Acting Assistant Surgeon A. W. Tryon, cut down on the skull and removed several
pieces of bone, one of which, triangular in shape,
and about half an inch in length, had been driven
into the brain matter. The operation afforded no
relief, and the symptoms above described gradually
increased, till death supervened on January 30th. At the post-mortem examination an immense abscess
was found, which occupied nearly the whole
anterior lobe of the left hemisphere, and
penetrated into the ventricle of that side. The
septum lucidumseptum pellucidum was broken down, and the right
ventricle filled with pus. The under portions of
the meninges of the brain were inflamed, being
much injected with blood. At a number of places
pus had formed under the arachnoid. There were
congested spots in the brain matter, about the sac
of the abscess, and nearly the whole mass of brain matter was
much softer than natural. The pathological
specimen is No. 1723, Sect. I, A. M. M. The vault
of the cranium is fractured just below the
anterior superior angle of the left parietal bone.
Fragments have been removed from an opening
three-fourths of an inch in diameter. Two fragments
of the outer and inner tables remain attached,
being depressed two lines on the free edge. The
surrounding bone is soft and porous. The specimen
and history were contributed by Acting Assistant Surgeon A. W. Tryon.