CASE.—Private Jacob Smith, Co. D, 48th Pennsylvania Volunteers, aged 33 years, was
wounded in the engagement near Fort Steadman, Virginia, April 2d, 1865, by a conoidal musket
ball, which struck the centre and upper part of
the frontal bone, making a vertical incision of
the scalp two inches in length. The pericranium
was only slightly detached and no fracture was
observable. He was taken to the hospital of the 2d division, Ninth Corps; on April 4th, sent to
Carver Hospital, Washington, and on May 19th,
transferred to Mower Hospital, Philadelphia. Three days later, the right temporal region became
swollen, and erysipelas, attended with high fever,
quick pulse, and delirium, supervened. An abscess
being suspected, an incision was made in the
temple, but none could be found. A brisk cathartic
was given, and the face and head dressed with sol.
sod. sulph. On May 24th, the left side of the head
became involved and head symptoms developed
rapidly. Chloroform being administered, a crucialcruciate
incision was made by Acting Assistant Surgeon W. P. Moon, and the bone exposed, when the slightest
perceptible fissure in the external table was
discovered, from which a thin sanious discharge
was issuing. Upon removing a portion of the two
tables with a trephine, it was ascertained that
the fissure extended through both tables, without
fracturing or depressing either. Quite an amount
of pus escaped from the orifice and considerable
disorganization was evident. Death occurred on May 25th, 1865. At the autopsy, the interior lobes
were found greatly congested, with formation of
pus over a great extent of the longitudinal sinus.
All the vessels of the membranes were much
enlarged and engorged, and at the point of injury
disorganization had taken place. The case is
reported by the operator, Acting Assistant Surgeon W. P. Moon.