Title: L——, Philander D.

Source text: Surgeon General Joseph K. Barnes, United States Army, The Medical and Surgical History of the War of the Rebellion. (1861–65.), Part 1, Volume 2 (Washington, D.C.: Government Printing Office, 1870), 272.

Keywords:wounds and injuries of the headtrephining after gunshot fractures of the skullgeneral anesthesia, etherpyæmiaclot formed between inner table and dura materball inflicted lacerated wound of scalp over superior anterior angle of parietal bone

Civil War Washington ID: med.d1e16841

TEI/XML: med.d1e16841.xml

CASE.—Corporal Philander D. L——, Co. H, 1st Maine Heavy Artillery, aged 28 years, was wounded at the battle of Spottsylvania​ Court-house, Virginia, May 19th, 1864, by a conoidal ball, which inflicted apparently only a lacerated wound of the scalp, over the superior anterior angle of the left parietal bone.⃰ He was conveyed to Washington, and on the 23d, admitted to the Armory Square Hospital. On examination the external table was found to be fissured and denuded of periosteum. Up to May 30th the patient did not show any symptoms of compression of the brain, but on that day he had a chill. On the 31st, he was placed under the influence of ether. Surgeon D. W. Bliss, U. S. V., then applied the trephine over the seat of injury, and excised a disk one inch in diameter, including only the outer table and diploë. The inner table of the skull was found to be intact, but friable and easily broken. Several pieces of this were removed, as was also a clot which had formed between the inner table and the dura mater. Simple dressings were applied and tonics administered, but pyæmia set in, and death ensued on June 8th, 1864. The specimen is represented in the wood-cut, and consists of a disk and five fragments of bone. The largest fragment is from the inner table, and measures three-fourths by one and one-fourth inches. The disk is one inch in diameter, and includes the outer table and diploë only. The specimen and history were contributed by Surgeon D. W. Bliss, U. S. V.

⃰Another report from the Armory Square Hospital states that the inner table was depressed at the anterior superior angle.

FIG. 138.— Disk and five fragments from left parietal, removed by trephining after gunshot fracture by a musket ball. Spec. 2383, Sect. I, A. M. M. [Nat. size.]