K——, B——a machine readable transcriptionSusan C. LawrenceKenneth M. PriceKenneth J. Winkle2011med.d1e16676Civil War WashingtonUniversity of Nebraska–LincolnCenter for Digital Research in the Humanities319 Love LibraryUniversity of Nebraska–LincolnLincoln, NE 68588-4100cdrh@unlnotes.unl.edu2011
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Kenneth M. PriceAJ HowellMatthew BosleyElizabeth LorangStacey BerryElisabeth TraceyThe Medical and Surgical History of the War of the Rebellion.
(1861–65.)Surgeon General Joseph K. Barnes, United States ArmyWashington, D.C.Government Printing OfficePart 1Volume 21870264Medical and Surgical History of the War of the Rebellionon special wounds and injuries of the headwounds and injuries of the headgunshot woundsgunshot fractures of the cranial bonestrephining after gunshot fractures of the skulltrephining practiced, fatal terminationcarbine ball fractured right parietal bone near junction of coronal and sagittal
sutures, bone depressedportion of ball and spiculæ of bone removed on battlefieldleft leg and arm paralyzedcoma profound, left pupil dilated and unresponsive to light, right pupil closely
contracteddura mater lacerated, brain tissue escapedlongitudinal sinus bleeding from small veins into sinusbleeding checked, right pupil expanded, left pupil diminished and responded to
lightconvulsive twitching of right face and right side of bodycoagulated blood in arachnoid cavity, spread over convexity of right cerebral
hemisphere, largest quantity at base of middle and posterior lobesautopsyblessedadded figure encodingadditional proofing of transcription and encoding, edited
and added keyword termsadditional proofing of transcription and encodingcase text extracted and transformed from larger
fileenriched encodingvalidated fileencodedinitial checking of OCR text against PDF; encoded
CASE.—Private B——
K——, Co. G, 6th Ohio Cavalry, aged 21
years, was wounded in a cavalry skirmish near Middleburg,
Virginia, June 21st, 1863, by a
carbine ball, which fractured the right parietal bone near the junction of the coronal and
sagittal sutures. The bone was depressed one-sixth of an inch. A portion of the ball and
several spiculæ of bone were removed on the field. The patient was conveyed to Washington, D. C., and admitted into Stanton Hospital on the 24th, being perfectly conscious, but complaining of headache. The pupils were
normal, deglutition good, pulse accelerated and rather feeble, and the left lower extremity
paralyzed. An ice bag was applied to the head, an enema administered, and quiet enjoined. He
passed a very restless night and on the following morning became delirious, with a pulse at
120. On the 26th, coma was profound,
respiration sterterous, and slower than natural, the skin hot and dry, and the pulse ranging
from 65 to 80. The pupil of left eye was dilated and not responsive to the stimulus of
light, that of the right eye was closely contracted, and the conjunctiva injected with
blood; the left leg and arm were paralyzed, the micturition involuntary. Surgeon John A. Lidell, U. S.
V., made an incision two inches in length, applied the trephine on the right edge
of the fracture and cut out a disc of bone, and removed, with an elevator, two fragments of
depressed bone; one, about one and a half inches in length by three-fourths of an inch in
breadth, embracing both tables of the skull, the other being a small fragment of the inner
table. The dura mater at the posterior and external part of the opening was found to be
lacerated to the extent of half an inch, and a small quantity of brain tissue escaped. The
longitudinal sinus having been uncovered, a copious stream of dark-colored blood came away,
apparently flowing from the open mouths of the small veins which run from the cranium into
the sinus. The bleeding was checked by a pledget of lint, saturated with a solution of
persulphate of iron. The pupil of the right eye expanded to the natural size and that of the
left diminished and responded to the light. The engorgement of the conjunctiva of the right
eye perceptibly decreased, the stertor disappeared and the breathing became more natural;
the pulse rose to 110, but consciousness did not return. Ice was again applied to the head
and an enema was ordered. The next morning respiration was 60 per minute, and bronchial
rattles were audible throughout the chest; pulse 130, and weak; the left side of the body
was rigid, while the right side was moved quite freely. There were convulsive twitchings of
right side of face, which, in two hours, extended over the entire right side of the body,
while the left side lost its rigidity, but was not affected by convulsive movements. In the
meantime the breathing became more frequent and feeble, and the patient died at five o'clock
P. M., June 27th, 1863. At the autopsy, an
elongated opening in the calvaria was exposed, half an inch long and three-fourths of an
inch in width, commencing one-fourth of an inch behind the coronal suture and extending
backward and a little to the right of the median line. The dura mater was lacerated to the
extent of half an inch at the posterior end of the chasm in the skull. On raising that
portion of the dura mater which covers the convex surface of the right hemisphere of the
cerebrum, a quantity of coagulated blood was found in the cavity of the arachnoid, spread
out over the convexity of the right hemisphere; the largest quantity of effused blood was
found at the base of the middle and posterior lobes of the right hemisphere. The effused
blood, which was very dark, amounted, in all, to three ounces, and came from the
longitudinal sinus. The whole brain showed very great venous congestion. There was softening
of the brain tissue at the seat of injury, near the summit of each cerebral hemisphere, but
it was more marked on the right than on the left side. The pathological specimen is No.
1333, and was contributed, with the history, by Surgeon John A.
Lidell, U. S. V. This case is
erroneously reported as a sabre cut, in bound MSS. Div. Surg. Rec. S. G. O. No. 63, p.
22.