CASE.—Private Philip R——, Co. I, 10th New York
Volunteers, was wounded at the battle of
Fredericksburg, Virginia, December 13th, 1862, by
a gunshot missile, which fractured and depressed
the left parietal bone, just below the tuberosity.
He was admitted into the Ascension Church Hospital, Washington, on the 17th, partially
insensible, but answering when spoken to sharply. The pupils were nearly normal, pulse 72, and
gradually becoming slower and more suggestive of
approaching coma. On the 19th, the patient was
placed under the influence of chloroform, and
Surgeon J. H. Brinton, U. S. V., assisted by
Surgeon J. C. Dorr, U. S. V., and Dr. Brodie of
Edinborough, performed the operation of
trephining. The depressed fragments were elevated
and removed, causing considerable hæmorrhage,
which gradually ceased after the operation. At
seven o'clock P. M., the pulse was 66, thready end
sharp; patient semi-conscious and complaining of
cold. The next morning the pupils were nearly
normal; pulse 78; breathing natural, but bowels
not open. There was considerable hæmorrhage at
noon, which was readily checked. Afterward, coma
gradually supervened, the pupils became dilated
and insensible to light, and involuntary
urinations occurred. He continued to sink rapidly,
and died on the morning of December 22d, 1862, in
a state of complete coma. The pathological
specimens are Nos. 528, 965, and 966. The former
shows a section of the vault of cranium, with one
disk and seven fragments from the left parietal
bone. The two latter are wet preparations of the
dura mater and the left cerebral hemisphere
containing an abscess. The specimens were
contributed by Surgeon J. C. Dorr, U. S. V.